Tag: nevin manimala

Med Image Anal. 2022 Apr 12;79:102457. doi: 10.1016/j.media.2022.102457. Online ahead of print.

ABSTRACT

Unsupervised domain adaptation (UDA) aims to exploit the knowledge learned from a labeled source dataset to solve similar tasks in a new unlabeled target domain. Existing UDA techniques typically assume that samples from source and target domains are freely accessible during the training. However, it may be impractical to access source images due to privacy concerns, especially in medical imaging scenarios with the patient information. To tackle this issue, we devise a novel source free domain adaptation framework with fourier style mining, where only a well-trained source segmentation model is available for the adaptation to the target domain. Our framework is composed of two stages: a generation stage and an adaptation stage. In the generation stage, we design a Fourier Style Mining (FSM) generator to inverse source-like images through statistic information of the pretrained source model and mutual Fourier Transform. These generated source-like images can provide source data distribution and benefit the domain alignment. In the adaptation stage, we design a Contrastive Domain Distillation (CDD) module to achieve feature-level adaptation, including a domain distillation loss to transfer relation knowledge and a domain contrastive loss to narrow down the domain gap by a self-supervised paradigm. Besides, a Compact-Aware Domain Consistency (CADC) module is proposed to enhance consistency learning by filtering out noisy pseudo labels with shape compactness metric, thus achieving output-level adaptation. Extensive experiments on cross-device and cross-centre datasets are conducted for polyp and prostate segmentation, and our method delivers impressive performance compared with state-of-the-art domain adaptation methods. The source code is available at https://github.com/CityU-AIM-Group/SFDA-FSM.

PMID:35461016 | DOI:10.1016/j.media.2022.102457

ESMO Open. 2022 Apr 20;7(3):100470. doi: 10.1016/j.esmoop.2022.100470. Online ahead of print.

ABSTRACT

BACKGROUND: Resection of liver metastases from colorectal cancer (CRC) in the oligometastatic stage improves survival and is a potentially curative treatment. Thus, predictive scores that reliably identify those patients who especially benefit from surgery are essential.

PATIENTS AND METHODS: In this multicenter analysis, 512 patients had undergone surgery for liver metastases from CRC. We investigated distinct cancer-specific risk factors that are routinely available in clinical practice and developed a predictive preoperative score using a training cohort (TC), which was thereafter tested in a validation cohort (VC).

RESULTS: Inflammatory response to the tumor, a right-sided primary tumor, multiple liver metastases, and node-positive primary tumor were significant adverse variables for overall survival (OS). Patients were stratified in five groups according to the cumulative score given by the presence of these risk factors. Median OS for patients without risk factors was 133.8 months [95% confidence interval (CI) 81.2-not reached (nr)] in the TC and was not reached in the VC. OS decreased significantly for each subsequent group with increasing number of risk factors. Median OS was significantly shorter (P < 0.0001) for patients presenting all four risk factors: 14.3 months (95% CI 10.5 months-nr) in the TC and 16.6 months (95% CI 14.6 months-nr) in the VC.

CONCLUSIONS: Including easily obtainable variables, this preoperative score identifies oligometastatic CRC patients with prolonged survival rates that may be cured, and harbors potential to be implemented in daily clinical practice.

PMID:35461024 | DOI:10.1016/j.esmoop.2022.100470

J Surg Res. 2022 Apr 20;276:394-403. doi: 10.1016/j.jss.2022.02.050. Online ahead of print.

ABSTRACT

INTRODUCTION: The Braden Scale is widely used to assess the risk of pressure injury. However, the vague literal description of the items creates difficulties for bedside nurses and limits its sensitivity. To solve this problem, we developed a cartoon version of the Braden scale (CVBS) to improve the pressure injury risk assessment ability of bedside nurses.

METHODS: The CVBS was constructed by two nurses, and the final version was determined through a two-round Delphi consultation. The scale’s content validity was calculated based on expert ratings. A total of 265 patients were evaluated simultaneously with the CVBS by 119 bedside nurses and 46 wound care specialists; and 114 bedside nurses and the same 46 wound care specialists evaluated 239 patients with the original Braden scale (OBS). The interrater reliability between the two groups was calculated as Kappa value, and then the Kappa values of the two versions were compared.

RESULTS: The content validity for the draft scale was not good enough. After modification, the indices of all the items in the final CVBS reached 1.00. The Kappa value of the OBS was 0.69 (95% CI 0.61-0.76); for each item, it ranged from 0.60 to 0.80. The interrater reliabilities of the CVBS were higher than those of the OBS, with an overall kappa value of 0.87 (95% CI 0.81-0.92) and a range of 0.77 to 0.93 for each item. The differences between the Kappa values of the CVBS and those of the OBS were all statistically significant.

CONCLUSIONS: The CVBS had good validity and showed higher interrater reliability than the OBS, indicating that it may improve bedside nurses’ ability to assess pressure injury risk.

PMID:35461011 | DOI:10.1016/j.jss.2022.02.050

EBioMedicine. 2022 Apr 20;79:104008. doi: 10.1016/j.ebiom.2022.104008. Online ahead of print.

ABSTRACT

BACKGROUND: The increase in SARS-CoV-2 infections in December 2021 was driven primarily by the Omicron variant, which largely displaced the Delta over a three-week span. Outcomes from infection with Omicron remain uncertain. We evaluated whether clinical outcomes and viral loads differed between Delta and Omicron infections during the period when both variants were co-circulating.

METHODS: In this retrospective observational cohort study, remnant clinical specimens, positive for SARS-CoV-2 after standard of care testing at the Johns Hopkins Microbiology Laboratory, between the last week of November and the end of December 2021, were used for whole viral genome sequencing. Cycle threshold values (Ct) for viral RNA, the presence of infectious virus, and levels of respiratory IgG were measured, and clinical outcomes were obtained. Differences in each measure were compared between variants stratified by vaccination status.

FINDINGS: The Omicron variant displaced Delta during the study period and constituted 95% of the circulating lineages by the end of December 2021. Patients with Omicron infections (N = 1,119) were more likely to be vaccinated compared to patients with Delta (N = 908), but were less likely to be admitted (0.33 CI 0.21-0.52), require ICU level care (0.38 CI 0.17-0.87), or succumb to infection (0.26 CI 0.06-1.02) regardless of vaccination status. There was no statistically significant difference in Ct values based on the lineage regardless of the vaccination status. Recovery of infectious virus in cell culture was reduced in boosted patients compared to fully vaccinated without a booster and unvaccinated when infected with the Delta lineage. However, in patients with Omicron infections, recovery of infectious virus was not affected by vaccination.

INTERPRETATION: Compared to Delta, Omicron was more likely to cause breakthrough infections of vaccinated individuals, yet admissions were less frequent. Admitted patients might develop severe disease comparable to Delta. Efforts for reducing Omicron transmission are required as, though the admission risk might be lower, the increased numbers of infections cause large numbers of hospitalizations.

FUNDING: NIH/NIAID Center of Excellence in Influenza Research and Surveillance contract HHS N2772201400007C, Johns Hopkins University, Maryland department of health, Centers for Disease Control and Prevention contract 75D30121C11061, and The Modeling Infectious Diseases in Healthcare Network (MInD) under awards U01CK000589.

PMID:35460989 | DOI:10.1016/j.ebiom.2022.104008

J Environ Manage. 2022 Apr 20;314:115081. doi: 10.1016/j.jenvman.2022.115081. Online ahead of print.

ABSTRACT

Starting in 2013, China’s key polluting firms have been required to install continuous emissions monitoring systems (CEMS) and to publish the data for real-time oversight and public scrutiny. However, the CEMS data has rarely been used in local environmental law enforcement because its quality is still of great concern. A lack of criteria to evaluate data quality is one of the causes. In this paper, we design a comprehensive analytical framework for evaluating the quality of CEMS data, which includes completeness, accuracy, and authenticity. To demonstrate the applicability of the framework, we build a CEMS dataset for key polluting firms in Henan province from 2017 to 2019 by scraping the CEMS data from a public platform. We then conduct a comprehensive evaluation using our proposed framework. Some data quality issues are identified. About one-third of the firms did not meet official guidelines for data completeness. When comparing the CEMS data with onsite measurement results, we observe statistically significant inconsistencies in about one-fifth of the firms. In addition, we find evidence that some firms might manipulate CEMS data by strategically turning down the CEMS when a pollutant’s concentration is expected to exceed the limit. Our framework can be expanded by incorporating more evaluation methods and data. We suggest that government agencies should implement a comprehensive framework to enhance the quality of CEMS data, thereby facilitating its application in law enforcement.

PMID:35460987 | DOI:10.1016/j.jenvman.2022.115081

Angew Chem Int Ed Engl. 2022 Apr 23. doi: 10.1002/anie.202201925. Online ahead of print.

ABSTRACT

The most pristine material of the Solar System is assumed to be preserved in comets in the form of dust and ice as refractory matter. ESA’s mission Rosetta and its lander Philae had been developed to investigate the nucleus of comet 67P/Churyumov-Gerasimenko in situ. Twenty-five minutes after the initial touchdown of Philae on the surface of comet 67P in November 2014, a mass spectrum was recorded by the time-of-flight mass spectrometer COSAC onboard Philae. The new characterization of this mass spectrum through non-negative least squares fitting and Monte Carlo simulations reveals the chemical composition of comet 67P. A suite of 12 organic molecules, 9 of which also found in the original analysis of this data, exhibit high statistical probability to be present in the grains sampled from the cometary nucleus. These volatile molecules are among the most abundant in the comet’s chemical composition and represent an inventory of the first raw materials present in the early Solar System.

PMID:35460531 | DOI:10.1002/anie.202201925

J Genet Couns. 2022 Apr 23. doi: 10.1002/jgc4.1581. Online ahead of print.

ABSTRACT

Transgender and/or gender non-binary (TGNB) individuals face significant health care disparities, including deficiencies in provider knowledge. To address this knowledge gap for genetic counselors, we developed, implemented, and analyzed an educational intervention on gender-affirming genetic counseling (GC) and care for TGNB patients. In partnership with the TGNB community, we designed a 5-module (length = 146 min ± 94 min) genetic counseling-targeted online learning program focused on gender-affirming care (Amplify). Content included elements of gender-affirming care, core components of gender-inclusive GC sessions, and cancer risk assessment/management. Video testimonials featuring TGNB individuals complemented learning within each module. Educational outcomes measured included comfort working with TGNB patients (n = 2 multiple choice questions (MCQs)), impact of education on knowledge (n = 25 MCQs), and clinical self-efficacy based on the Accreditation Council for Genetic Counseling competencies (n = 35 skills). Participants (n = 40), recruited through state and national GC organizations, completed all modules, and pre- and post-education/self-efficacy assessments. Pre-Amplify, 65% (n = 26/40) of participants endorsed feeling ‘somewhat comfortable’ working with TGNB patients. The average knowledge score was 77.6% (SD = 11.2%) with the lowest scores related to the gender affirmation process. After Amplify, overall knowledge improvement was statistically significant with an average 16.9% (p < 0.001) increase in score. Pre-Amplify, the average self-efficacy score was 78.4% (SD = 15.8%) with lowest scores seen in statements surrounding information gathering of family and medical histories. Post-Amplify, overall self-efficacy improvement was statistically significant with an average 13.8% (p < 0.001) increase in score. Linear regression did not identify an impact of practice specialty on participants’ knowledge gains or self-efficacy. This study shows online modules are an effective form of gender-affirming care education for GCs. This intervention can positively improve the care practicing genetic counselors provide to patients and inform future decision-making about the development of gender-affirming care education for genetic counselors.

PMID:35460542 | DOI:10.1002/jgc4.1581

J Cancer Educ. 2022 Apr 23. doi: 10.1007/s13187-022-02169-5. Online ahead of print.

ABSTRACT

HPV vaccination series completion rates have increased steadily in the USA, yet specific areas continue to be burdened by HPV-related cancers, including rural areas of Virginia. The primary purpose of this study is to compare the impact of an community driven educational film about HPV on intention to vaccinate and knowledge gained in urban and rural areas of Virginia. From October 2016 to September 2019, the CDC-approved documentary “Someone You Love: The HPV Epidemic” was screened and followed by a Q&A session. Intention to vaccinate and knowledge gained after seeing the DVD intervention were measured through a pre-post-survey and analyzed data using chi-squared tests. The sample included males and females of all races and ages 18+ that identified as either student, parent/guardian, and/or healthcare provider from rural and urban geographical areas. Changes in knowledge about HPV were statistically significant in two out of seven questions (p < 0.05). Changes in attitude were statistically significant in every attitude-based question about HPV (p < 0.05). There were significant differences in knowledge gained and attitudes towards the HPV vaccine when comparing urban and rural locations as well. More research is needed to explore the efficacy of community-based interventions to increase uptake and series completion of HPV vaccination, particularly in rural areas most impacted by HPV-associated cancers.

PMID:35460507 | DOI:10.1007/s13187-022-02169-5

J Ultrasound. 2022 Apr 23. doi: 10.1007/s40477-022-00683-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) and computed tomography (CT) within Bosniak IIF/III categories.

METHODS: After cystic renal mass diagnosis by contrast-enhanced CT, all patients with Bosniak score ≥ II also underwent CEUS between March 2017 and March 2019. Their exams were retrospectively analyzed. One experienced uro-radiologist performed every CEUS and reviewed the exams according to the EFSUMB 2020 Position Statement, while blinded to clinical data. CT Bosniak scores were retrospectively given blindly by two uro-radiologists (CT 1 and CT 2). We compared CEUS, CT 1 and CT 2 scores to clinical findings and histological tests. Clinical performance characteristics and area under the receiver operating characteristic (ROC) curves (AUCs) were determined separately for CEUS and CT, and then compared.

RESULTS: 101 cystic masses were analyzed. In Bosniak categories IIF and III, the AUCs were 0.854 for CT 1, 0.779 for CT 2, and 0.746 for CEUS.

CONCLUSION: Despite some statistical limitations, this study confirms that among cystic renal masses, those classified as Bosniak IIF and III are the most difficult to assess. The diagnostic performances of CEUS and CT are similar within this group. However, in experienced hands, CEUS could be valuable in further evaluation of ambiguous cystic masses, and in more ductile, safer, and cost-effective surveillance of those classified as Bosniak IIF and III. When challenging cystic renal masses occur, CEUS is a useful tool for clinical management and for the follow-up of non-surgical lesions.

PMID:35460506 | DOI:10.1007/s40477-022-00683-2

J Assist Reprod Genet. 2022 Apr 23. doi: 10.1007/s10815-022-02487-z. Online ahead of print.

ABSTRACT

PURPOSE: Does re-biopsy of blastocysts classified as abnormal (ABN) due to segmental aneuploidy (SA) have clinical utility?

METHODS: The live birth (LB) outcomes of mosaic SAs, compared to other categories, were determined after transfer of 3084 PGT-A tested blastocysts. An initial 12-month trial thawed 111 blastocysts classified as ABN due to a SA for clinical re-biopsy, with an additional 58 from a subsequent 16-month revised protocol. Where re-biopsy failed to corroborate the original classification, blastocysts were reported as mosaic and suitable for clinical use.

RESULTS: Segmental mosaics had a LB rate (54.1%) which was indistinguishable from that of euploid (53.7%). Numeric mosaics had statistically significant (P < 0.05) reduced LB rates compared to euploid, with high-level numerics (19.2%) also exhibiting a significant reduction compared to low level (42.3%). Of the initial 111 blastocysts with SAs, 85 could be re-biopsied. Segmental gains became suitable for re-biopsy at a high rate (90.9%), with 84.2% (16/19) of these reclassified as mosaic. Only 73.0% of deletions and complex changes were suitable for re-biopsy, of which 73.0% (46/63) were confirmed ABN. The subsequent 16-month period primarily focused on gains, confirming the high rate at which they can be reclassified as clinically useable.

CONCLUSIONS: Blastocysts harboring mosaic segmental duplications, rather than SAs in general, are the primary source of false-positive PGT-A results and represent a category with a LB rate similar to that of euploid. A high degree of confidence in the reliability of PGT-A results can be maintained by performing confirmatory clinical TE biopsies.

PMID:35460491 | DOI:10.1007/s10815-022-02487-z