Optimizing real time fMRI neurofeedback for therapeutic discovery and development

While reducing the burden of brain disorders remains a top priority of organizations like the World Health Organization and National Institutes of Health, the development of novel, safe and effective treatments for brain disorders has been slow. In this paper, we describe the state of the science for an emerging technology, real time functional magnetic resonance imaging (rtfMRI) neurofeedback, in clinical neurotherapeutics. We review the scientific potential of rtfMRI and outline research strategies to optimize the development and application of rtfMRI neurofeedback as a next generation therapeutic tool. We propose that rtfMRI can be used to address a broad range of clinical problems by improving our understanding of brain–behavior relationships in order to develop more specific and effective interventions for individuals with brain disorders. We focus on the use of rtfMRI neurofeedback as a clinical neurotherapeutic tool to drive plasticity in brain function, cognition, and behavior. Our overall goal is for rtfMRI to advance personalized assessment and intervention approaches to enhance resilience and reduce morbidity by correcting maladaptive patterns of brain function in those with brain disorders

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Computational Methods for Pigmented Skin Lesion Classification in Images: Review and Future Trends

Skin cancer is considered as one of the most common types of cancer in several countries, and its incidence rate has increased in recent years. Melanoma cases have caused an increasing number of deaths worldwide, since this type of skin cancer is the most aggressive compared to other types. Computational methods have been developed to assist dermatologists in early diagnosis of skin cancer. An overview of the main and current computational methods that have been proposed for pattern analysis and pigmented skin lesion classification is addressed in this review. In addition, a discussion about the application of such methods, as well as future trends, is also provided. Several methods for feature extraction from both macroscopic and dermoscopic images and models for feature selection are introduced and discussed. Furthermore, classification algorithms and evaluation procedures are described, and performance results for lesion classification and pattern analysis are given

Tracking movement and temperature selection of larvae of two forensically important blow fly species within a maggot mass

The current study responds to the lack of understanding about the temperatures experienced by individual blow fly larvae within maggot masses. The temperature selection of both aggregating (in a mass) and nonaggregating larvae was compared and their pattern of movement assessed. Infrared imaging determined the temperatures within a mass and in the vicinity of the constituent individual larvae, whose movements were tracked by dyeing their tissues red. Individual Chrysomya rufifacies larvae selected temperatures above 27°C, significantly higher than the temperature selected by Calliphora vicina larvae (24.5°C). However, this same difference was not seen within a mass, with both species selecting temperatures around 28°C. Larval movement in a mass was nonrandom, indicating that larvae actively select their position in a mass. Furthermore, larvae have a strong tendency to select the hottest part of a mass; therefore, maximum mass temperatures might provide a reliable proxy for the actual temperatures experienced by larvae

Oriented Pattern Analysis for Streak Detection in Dermoscopy Images

Abstract. There is an increasing demand for automated detection and analysis of dermoscopy structures and malignancy clues such as streaks in dermoscopy images, for computer-aided early diagnosis of deadly melanoma. This paper presents a novel approach for streak detection and visualization on dermoscopic images. We tackle the detection of streaks by means of ridge and valley estimation. Orientation estimation and correction is applied to detect low contrast and fuzzy streaks lines, and candidate streaks are used to classify dermoscopy images into streaks Absent or Present with the AUC of 90.5 % on 300 dermoscopy images. Our approach can also detect starburst pattern of regular streaks using detected linear structures with accuracy of 81.5 % and AUC of 87.7%.

Intrinsic Melanin and Hemoglobin Colour Components for Skin Lesion Malignancy Detection

Abstract. In this paper we propose a new log-chromaticity 2-D colour space, an extension of previous approaches, which succeeds in removing confounding factors from dermoscopic images: (i) the effects of the particular camera characteristics for the camera system used in forming RGB images; (ii) the colour of the light used in the dermoscope; (iii) shading induced by imaging non-flat skin surfaces; (iv) and light intensity, removing the effect of light-intensity falloff toward the edges of the dermoscopic image. In the context of a blind source separation of the underlying colour, we arrive at intrinsic melanin and hemoglobin images, whose properties are then used in supervised learning to achieve excellent malignant vs. benign skin lesion classification. In addition, we propose using the geometric-mean of colour for skin lesion segmentation based on simple greylevel thresholding, with results outperforming the state of the art.

Automated detection and reacquisition of motion‐degraded images in fetal HASTE imaging at 3 T

PURPOSE: Fetal brain Magnetic Resonance Imaging suffers from unpredictable and unconstrained fetal motion that causes severe image artifacts even with half-Fourier single-shot fast spin echo (HASTE) readouts. This work presents the implementation of a closed-loop pipeline that automatically detects and reacquires HASTE images that were degraded by fetal motion without any human interaction. METHODS: A convolutional neural network that performs automatic image quality assessment (IQA) was run on an external GPU-equipped computer that was connected to the internal network of the MRI scanner. The modified HASTE pulse sequence sent each image to the external computer, where the IQA convolutional neural network evaluated it, and then the IQA score was sent back to the sequence. At the end of the HASTE stack, the IQA scores from all the slices were sorted, and only slices with the lowest scores (corresponding to the slices with worst image quality) were reacquired. RESULTS: The closed-loop HASTE acquisition framework was tested on 10 pregnant mothers, for a total of 73 acquisitions of our modified HASTE sequence. The IQA convolutional neural network, which was successfully employed by our modified sequence in real time, achieved an accuracy of 85.2% and area under the receiver operator characteristic of 0.899. CONCLUSION: The proposed acquisition/reconstruction pipeline was shown to successfully identify and automatically reacquire only the motion degraded fetal brain HASTE slices in the prescribed stack. This minimizes the overall time spent on HASTE acquisitions by avoiding the need to repeat the entire stack if only few slices in the stack are motion-degraded