Vancerouse8421

Applications of neural networks (NNs) in medicine have increased dramatically in recent years. In order to train a NN that performs ECG segmentation, it can be very time consuming, or even completely prohibitive, to manually annotate fiducial points on enough QRST complexes to reach a high level of performance. Existing methods for time series data augmentation risk creating non-physiological ECG signals that may hamper NN training, and are unable to provide accurate fiducial point locations in the augmented data. We therefore developed ECGAug, a new method which generates an augmented training set of QRST signals (single beats or rhythm strips) with accurate fiducial point annotations. Our algorithm recombines a library of existing, annotated QRS complexes and T waves in physiologic ways, and then performs additional physiological transformations to generate a set of new annotated QRST complexes or rhythm strips to be used for NN training or validation of ECG annotation algorithms. In experiments where we trained NNs to annotate QRST complexes with a limited training dataset, QRST complexes added to the training dataset by ECGAug significantly improved NN performance. We present the ECGAug process, demonstrate its efficacy, and provide links for downloading the open source ECGAug software.The human respiratory network is a vital system that provides oxygen supply and nourishment to the whole body. Pulmonary diseases can cause severe respiratory problems, leading to sudden death if not treated timely. Many researchers have utilized deep learning systems (in both transfer learning and fine-tuning modes) to diagnose pulmonary disorders using chest X-rays (CXRs). However, such systems require exhaustive training efforts on large-scale (and well-annotated) data to effectively diagnose chest abnormalities (at the inference stage). Furthermore, procuring such large-scale data (in a clinical setting) is often infeasible and impractical, especially for rare diseases. With the recent advances in incremental learning, researchers have periodically tuned deep neural networks to learn different classification tasks with few training examples. Although, such systems can resist catastrophic forgetting, they treat the knowledge representations (which the network learns periodically) independently of each otheance compared to the conventional fine-tuning (transfer learning) approaches while significantly reducing the training and computational requirements.The purpose of this study is to develop a practical stripe artifacts correction framework on three-dimensional (3-D) time-of-flight magnetic resonance angiography (TOF-MRA) obtained by multiple overlapping thin slab acquisitions (MOTSA) technology. In this work, the stripe artifacts in TOF-MRA were considered as a part of image texture. To separate the image structure and the texture, the relative total variation (RTV) was firstly employed to smooth the TOF-MRA for generating the template image with fewer image textures. Then a residual image was generated, which was the difference between the template image and the raw TOF-MRA. The residual image was served as the image texture, which contained the image details and stripe artifacts. Then, we obtained the artifact image from the residual image via a filter in a specific direction since the image artifacts appeared as stripes. The image details were then produced from the difference between the artifact image and the image texture. To produce the corrected images, we finally compensated the image details to the RTV smoothing image. The proposed method was continued until the stripe artifacts during the iteration vary as little as possible. The digital phantom and the real patients' TOF-MRA were used to test the approach. The spatial uniformity was increased from 74% to 82% and the structural similarity was improved from 86% to 98% in the digital phantom test by using the proposed algorithm. Our approach proved to be highly successful in eliminating stripe artifacts in real patient data tests while retaining image details. The proposed iterative framework on TOF-MRA stripe artifact correction is effective and appealing for enhancing the imaging performance of multi-slab 3-D acquisitions.Globally, 10-20% of horticultural wastes are disposed in landfills leading to environmental pollution. Recycling these wastes as animal feedstuff will lessen food-feed competition and minimize environmental hazards. The present study was undertaken to determine the nutritional quality of fresh fruit and vegetable waste (F&VW) and their dietary inclusion on nutrient utilization, antioxidant status, greenhouse gases (GHG) emissions and potable water sparing efficacy in sheep. Three dietary combinations were formulated i.e. control (C)70% Cenchrus ciliaris hay +30% concentrate mixture (CM), diet with fruit waste (FWD)70% Cenchrus ciliaris hay +20% CM +10% FW and diet with vegetable waste (VWD)70% Cenchrus ciliaris hay +20% CM +10% VW for in vitro and in vivo evaluation of these wastes as potential livestock feed. Twenty-one adult ewes were allocated into 3 groups C, FWD and VWD and fed on the above three diets. Dry matter and crude protein digestibility were significantly enhanced by 5.5 and 7.2%; 7.3 and 7.6% in F&VW supplemented groups, respectively, without affecting feed intake. Plasma total antioxidant capacity (TAC) was improved by 32.2 and 26.3% in F&VW supplemented groups. Inclusion of F&VW biomass reduced annual methane (CH4) and nitrous oxide (N2O) emissions (kg CO2eq/sheep) by 3.12 and 4.55%; 15.18 and 14.92% and thus contributed to lowering of global warming potential by 4.00 and 5.27%, respectively. Furthermore, there was a net reduction of potable water consumption by 21.78 and 13.92% in F&VW supplemented groups, respectively. Therefore, it can be concluded that F&VW can be a potential feedstuff for ruminants and its efficient reuse would minimize environmental impacts associated with disposal of such waste in the landfills.

Adding ovarian function suppression (OFS) after chemotherapy improves survival in young women with moderate- and high-risk breast cancer. Assessment of ovarian function restoration after chemotherapy becomes critical for subsequent endocrine treatment and addressing fertility issues.

In the adding OFS after chemotherapy trial, patients who resumed ovarian function up to 2 years after chemotherapy were randomised to receive either 5 years of tamoxifen or adding 2 years of OFS with tamoxifen. Ovarian function was evaluated from enrolment to randomisation, and patients who did not randomise because of amenorrhoea for 2 years received tamoxifen and were followed up for 5 years. Prospectively collected consecutive hormone levels (proportion of patients with premenopausal follicle-stimulating hormone [FSH] levels<30 mIU/mLand oestradiol [E2] levels≥40pg/mL) and history of menstruation were available for 1067 patients with breast cancer.

Over 5 years of tamoxifen treatment, 69% of patients resumed menstruation and 98% and 74% of patients satisfied predefined ovarian function restoration as per serum FSH and E2 levels, respectively. Menstruation was restored in 91% of patients younger than 35 years at baseline, but in only 33% of 45-year-old patients over 5 years. Among these patients, 41% experienced menstruation restoration within 2 years after chemotherapy and 28% slowly restored menstruation after 2-5 years. Younger age (<35 years) at baseline, anthracycline without taxanes and ≤90 days of chemotherapy were predictors of menstruation restoration.

During 5 years of tamoxifen treatment after chemotherapy, two-thirds of the patients experienced menstruation restoration, especially patients younger than 35 years. Young age, Adriamycin without taxanes and short duration of chemotherapy appeared to have a positive effect on ovarian reserves in the long term.

ClinicalTrials.gov identifier NCT00912548.

ClinicalTrials.gov identifier NCT00912548.

Outcomes of children with high-risk (HR) relapsed acute lymphoblastic leukaemia (ALL) (N=393), recruited to ALLR3 and ALL-REZ BFM 2002 trials, were analysed. Minimal residual disease (MRD) was assessed after induction and at predetermined time points untilhaematopoietic stem cell transplantation (SCT).

Genetic analyses included karyotype, copy-number alterations and mutation analyses. Ten-year survivals were analysed using Kaplan-Meierand Cox models for multivariable analyses.

Outcomes of patients were comparable in ALLR3 and ALL-REZ BFM 2002. The event-free survival of B-cell precursor (BCP) and T-cell ALL (T-ALL) was 22.6% and 26.2% (P=0.94), respectively, and the overall survival (OS) was 32.6% and 28.2% (P=0.11), respectively. Induction failures (38%) were associated with deletions of NR3C1 (P=0.002) and BTG1 (P=0.03) in BCP-ALL. The disease-free survival (DFS) and OS in patients with good vs poor MRD responses were 57.4% vs 22.6% (P<0.0001) and 57.8% vs 32.0% (P=0.0004), respectively. For BCP- and T-ALL, the post-SCT DFS and OS were 42.1% and 56.8% (P=0.26) and 51.6% and 55.4% (P=0.67), respectively. The cumulative incidences of post-SCT relapse for BCP- and T-ALL were 36.9% and 17.8% (P=0.012) and of death were 10.7% and 25.5% (P=0.013), respectively.Determinants of outcomes after SCT were acute graft versus host disease, pre-SCT MRD (≥10

), HR cytogenetics and TP53 alterations in BCP-ALL.

Improvements in outcomes for HR ALL relapses require novel compounds in induction therapy to improve remission ratesand immune targeted therapy after induction to maintain remission after SCT.

ALLR3 NCT00967057; ALL REZ-BFM 2002 NCT00114348.

ALLR3 NCT00967057; ALL REZ-BFM 2002 NCT00114348.

People around the world are increasingly affected by multimorbidity, where conditions in different medical specialties can correlate in complex ways. This increases the relevance of multidisciplinary integrated care pathways. Modern software solutions provide vast opportunities to enhance information exchange between patients and various healthcare professionals, thereby improving patient-centered and inter-professional care. This paper describes the development and validation of a mobile patient application which exploits Patient Reported Outcomes to enhance patient-centered medical-dental integration with a focus on integrated management of periodontitis and diabetes.

This study was part of a multidisciplinary project for enhancement of medical-dental integration. The Intervention Mapping Protocol was supplemented by the RAND/UCLA Appropriateness Method, including literature reviews, focus group discussions and a Delphi panel in cooperation with various stakeholders. A mobile application was developed ithcare software.

The systematically developed mobile application offers the potential to provide physicians and dentists with treatment-relevant information to enhance medical-dental integration, thereby reducing the workload of medical staff, improving the quality of routinely collected data, and enabling automated data processing. This unique, novel, and validated approach can serve as an open framework for the development and evaluation of interdisciplinary healthcare software.

The global incidence of traumatic brain injuries is rising, with at least 80% being classified as mild. These mild injuries are not visible on routine clinical imaging. The potential clinical role of a specific imaging biomarker be it diagnostic, prognostic or directing and monitoring progress of personalised treatment and rehabilitation has driven the exploration of several new neuroimaging modalities. This systematic review examined the evidence for magnetoencephalography (MEG) to provide an imaging biomarker in mild traumatic brain injury (mTBI).

Our review was prospectively registered on PROSPERO CRD42019151387. We searched EMBASE, MEDLINE, trial registers, PsycINFO, Cochrane Library and conference abstracts and identified 37 papers describing MEG changes in mTBI eligible for inclusion. Since meta-analysis was not possible, based on the heterogeneity of reported outcomes, we provide a narrative synthesis of results.

The two most promising MEG biomarkers are excess resting state low frequency power, and widespread connectivity changes in all frequency bands.