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Παρασκευή 14 Ιουλίου 2017
Scholar : These new articles for Voice and Speech Review are available online
Scholar : These new articles for Archives and Records are available online
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Papillary Thyroid Carcinoma: Ectopic Malignancy versus Metastatic Disease.
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Papillary Thyroid Carcinoma: Ectopic Malignancy versus Metastatic Disease.
Case Rep Endocrinol. 2017;2017:9707031
Authors: Agosto-Vargas Y, Gutiérrez M, Martínez JH, Mangual-Garcia M, Palermo C, Vélez-Maymi S, Hernández-Vázquez L, Miranda-Rodríguez S, González-Bossolo A, Solá-Sánchez E, Hernández-Negrón M
Abstract
Papillary thyroid carcinoma frequently metastasizes to regional lymph nodes. However, cervical lymph node metastasis as a sole manifestation of occult papillary thyroid carcinoma is rarely observed. Ectopic thyroid is an uncommon condition defined as the presence of thyroid tissue at a site other than pretracheal area. Approximately 1-3% of all ectopic thyroid tissue is located in the lateral neck. This entity may represent the only functional thyroid tissue in the body. Malignant transformation of ectopic thyroid is uncommon; but even rarer is the development of papillary carcinoma on it. We present a case of a 33-year-old man with an incidental lateral neck mass diagnosed after a motor vehicle accident. Total thyroidectomy and lymph node resection were completed without evidence of papillary thyroid carcinoma. Malignant transformation of heterotopic thyroid tissue was the final diagnosis. The possibility of an ectopic thyroid cancer should be considered in the differential diagnosis of a pathological mass in the neck. The uniqueness of this case strives in the rarity that the thyroid gland was free of malignancy, despite ectopic tissue being positive for thyroid carcinoma. Management strategies, including performance of total thyroidectomy, neck dissection, and treatment with radioiodine, should be based on individualized risk assessment.
PMID: 28702266 [PubMed]
http://ift.tt/2tTj7jN
Scholar : The American Journal of Drug and Alcohol Abuse, Volume 43, Issue 5, September 2017 is now available online on Taylor & Francis Online
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The pan-Bcl2 Inhibitor AT101 Activates the Intrinsic Apoptotic Pathway and Causes DNA Damage in Acute Myeloid Leukemia Stem-Like Cells
Abstract
Background
Leukemia stem cells (LSCs) are considered to be the cause of treatment failure and relapse in acute myeloid leukemia (AML). Overexpression of the Bcl-2 family of anti-apoptotic proteins such as Bcl-2, Bcl-xl, and Mcl-1 accounts for survival and self-renewal of LSCs. AT101 binds to the BH3 motif of all Bcl-2 family anti-apoptotic proteins and demonstrates anti-tumor activity in multiple types of tumor. Thus, we hypothesized that this agent might have the potential to deplete LSCs.
Objective
The present study aims to investigate if and by what mechanism AT101 is able to target AML stem-like cells.
Methods
As LSCs and hematopoietic stem cells (HSCs) are enriched in CD34+CD38− populations, CD34+CD38− cells from KG1α and Kasumi-1 cell lines as well as CD34+ blasts from AML patients were used as LSC models, while CD34+ cells from healthy donors were used as normal hematopoietic cells. Cell proliferation and apoptosis were assessed by a cell counting kit-8 (CCK8) assay and an Annexin V/PI assay using flow cytometry, respectively. Colony-forming units experiments were performed to monitor the stemness features of AML cells. Western blot and quantitative real-time polymerase chain reaction (qPCR) analysis were performed to examine the levels of proteins and mRNAs related to either the intrinsic apoptotic pathway or DNA damage response.
Results
AT101 inhibited proliferation and induced apoptosis in CD34+CD38− KG1α and Kasumi-1 cells in a dose- and time-dependent manner. Exposure to AT101 for 24 h resulted in apoptosis in primary CD34+ AML blasts (EC50 [concentration needed for a 50% maximal effect] = 2.45–76.00 μmol/L), while it only had a modest effect on normal CD34+ hematopoietic cells. Mechanistically, AT101 activated the intrinsic apoptotic pathway by inhibition of Bcl-2 anti-apoptotic proteins, reflected by a decrease in mitochondrial membrane potential. Moreover, AT101 caused DNA damage (e.g., increased γH2AX phosphorylation), which might also contribute to its anti-leukemic effects. Interestingly, the ex vivo efficacy of AT101 in primary AML samples significantly correlated to hyperleukocytosis and FLT3-ITD mutations. AT101 was also effective against CD34+ blasts isolated from elderly patients and patients who did not achieve complete remission after induction therapy.
Conclusions
AT101 effectively eliminates LSCs in vitro through the induction of DNA damage and activation of the intrinsic apoptotic pathway. AT101 is effective towards leukemic cells from patients with adverse prognostic factors, suggesting that AT101 could have the potential as an alternative salvage therapy for the treatment of relapsed and refractory AML.
http://ift.tt/2ugLVFJ
An “on-matrix” digestion procedure for AP-MS experiments dissects the interplay between complex-conserved and serotype-specific reactivities in Dengue virus-human plasma interactome
Publication date: Available online 13 July 2017
Source:Journal of Proteomics
Author(s): Yassel Ramos, Vivian Huerta, Dayron Martín, Sucel Palomares, Alexis Yero, Dianne Pupo, Sebastien Gallien, Alejandro M. Martín, Yasset Pérez-Riverol, Mónica Sarría, Osmany Guirola, Glay Chinea, Bruno Domon, Luis Javier González
The interactions between the four Dengue virus (DENV) serotypes and plasma proteins are crucial in the initial steps of viral infection to humans. Affinity purification combined with quantitative mass spectrometry analysis, has become one of the most powerful tools for the investigation on novel protein-protein interactions. Using this approach, we report here that a significant number of bait-interacting proteins do not dissociate under standard elution conditions, i.e. acid pH and chaotropic agents, and that this problem can be circumvented by using the "on-matrix" digestion procedure described here. This procedure enabled the identification of 16 human plasma proteins interacting with domain III from the envelope protein of DENV serotypes 1, 3 and 4 that would have not been detected otherwise and increased the known DIIIE interactors in human plasma to 59 proteins. Selected Reaction Monitoring analysis evidenced DENV interactome in human plasma is rather conserved although significant differences on the reactivity of viral serotypes with specific proteins do exist. A comparison between the serotype-dependent profile of reactivity and the conservation pattern of amino acid residues suggests an evolutionary selection of highly conserved interactions with the host and other interactions mediated for surface regions of higher variability.SignificanceFalse negative results on the identification of interacting proteins in pull-down experiments compromise the subsequent interpretation of results and the formulation of a working hypothesis for the derived future work. In this study we demonstrate the presence of bait-interacting proteins reluctant to dissociate under elution conditions of acid pH and presence of chaotropics. We propose the direct proteolytic digestion of proteins while still bound to the affinity matrix ("in-matrix" digestion) and evaluate the impact of this methodology in the comparative study of the interactome of the four serotypes of Dengue virus mediated by the domain III of the viral envelope glycoprotein. Fifty nine proteins were identified as putative interaction partners of Dengue virus (IPs) either due to direct binding or by co-isolation with interacting proteins. Collectively the IPs identified from the pull-down with the recombinant domain III proteins representing the four viral serotypes, 29% were identified only after "in-matrix" digestion which demonstrate the usefulness of this method of recovering bait-bound proteins. Results highlight a particular importance of "in-matrix" digestion procedure for comparative studies where a stronger interaction with one of the interest baits could prevent a bound protein to elute under standard conditions thus leading to misinterpretation as absent in the interactome of this particular bait. The analysis of the Interaction Network indicates that Dengue virus interactome mediated by the domain III of the envelope protein is rather conserved in the viral complex suggesting a key role of these interactions for viral infection thus making candidates to explore for potential biomarkers of clinical outcome in DENV-caused disease. Interestingly, some particular IPs exhibit significant differences in the strength of the interaction with the viral serotypes representing interactions that involve more variable regions in the surface of the domain III. Since such variable regions are the consequence of the interaction with antibodies generated by human immune response; this result relates the interaction with proteins from human plasma with the interplay of the virus and the human immune system.
Graphical abstract
http://ift.tt/2tmCyQ1
The effect of Fusarium culmorum infection and deoxynivalenol (DON) application on proteome response in barley cultivars Chevron and Pedant
Publication date: Available online 13 July 2017
Source:Journal of Proteomics
Author(s): Klára Kosová, Jana Chrpová, Jiří Šantrůček, Radovan Hynek, Lenka Štěrbová, Pavel Vítámvás, Jana Bradová, Ilja Tom Prášil
Fusarium head blight (FHB) disease adversely affects grain quality and final yield in small-grain cereals including barley. In the present study, the effect of an artificial infection with Fusarium culmorum and an application of deoxynivalenol (DON) on barley spikes of cultivars Chevron and Pedant during flowering was investigated at grain mid-dough stage (BBCH 73) 10days after pathogen inoculation (10 dai). Proteomic analysis using a two-dimensional differential gel electrophoresis (2D-DIGE) technique coupled with LC-MS/MS investigated 98 protein spots revealing quantitative or qualitative differences between the experimental variants. Protein functional annotation of 93 identified protein spots revealed that most affected functional groups represent storage proteins (globulins, hordeins), followed by proteins involved in carbohydrate metabolism (α-amylase inhibitor, β-amylase, glycolytic enzymes), amino acid metabolism (aminotransferases), defence response (chitinase, xylanase inhibitor, serpins, SGT1, universal stress protein USP), protein folding (chaperones, chaperonins), redox metabolism (ascorbate-glutathione cycle), and proteasome-dependent protein degradation. The obtained results indicate adverse effects of infection on plant proteome as well as an active plant response to pathogen as shown by enhanced levels of several inhibitors of pathogen-produced degradation enzymes (α-amylase inhibitor, xylanase inhibitor, serpins), chaperones, and other stress-related proteins (SGT1, USP). Genotypic differences were found in hordein abundance between Chevron and Pedant.
http://ift.tt/2tm778P
Nivolumab and Pembrolizumab: Monoclonal Antibodies Against Programmed Cell Death-1 (PD-1) that are Interchangeable
Publication date: Available online 13 July 2017
Source:Seminars in Oncology
Author(s): Vinay Prasad, Victoria Kaestner
Nivolumab (Opdivo®, Bristol Meyer Squibb) and pembrolizumab (Keytruda®, Merck) are the first two FDA approved monoclonal antibodies targeting programmed death-1 (PD-1). Nivolumab and pembrolizumab work by interfering with the interaction between (PD-1) and programmed death-ligand-1 (PD-L1), whose unimpeded interaction downregulates T-cells allowing cancer cells to evade immune surveillance.1-3 [Figure 1] These drugs have earned a series of US Food and Drug Administration US FDA) approvals for melanoma, non-small cell lung cancer (NSCLC), head and neck squamous cell cancer (HNSCC), urothelial cancer, classical Hodgkin's lymphoma, and renal cell cancer. In this review we will summarize the data for efficacy and toxicity for these two agents. We will conclude they represent two valuable but interchangeable alternatives to target their approved indications. We will discuss how this can help global payers seeking to contain the cost of cancer therapeutics that continues to spiral out of control.
http://ift.tt/2tQ3RG0
Invited Commentary: Agent-Based Models—Bias in the Face of Discovery
Abstract
Agent-based models (ABMs) have grown in popularity in epidemiologic applications, but the assumptions necessary for valid inference have only partially been articulated. In this issue, Murray et al. (Am J Epidemiol. 2017;186(2):131–142) provided a much-needed analysis of the consequence of some of these assumptions, comparing analysis using an ABM to a similar analysis using the parametric g-formula. In particular, their work focused on the biases that can arise in ABMs that use parameters drawn from distinct populations whose causal structures and baseline outcome risks differ. This demonstration of the quantitative issues that arise in transporting effects between populations has implications not only for ABMs but for all epidemiologic applications, because making use of epidemiologic results requires application beyond a study sample. Broadly, because health arises within complex, dynamic, and hierarchical systems, many research questions cannot be answered statistically without strong assumptions. It will require every tool in our store of methods to properly understand population dynamics if we wish to build an evidence base that is adequate for action. Murray et al.'s results provide insight into these assumptions that epidemiologists can use when selecting a modeling approach.http://ift.tt/2uZuNSb
A Comparison of Agent-Based Models and the Parametric G-Formula for Causal Inference
Abstract
Decision-making requires choosing from treatments on the basis of correctly estimated outcome distributions under each treatment. In the absence of randomized trials, 2 possible approaches are the parametric g-formula and agent-based models (ABMs). The g-formula has been used exclusively to estimate effects in the population from which data were collected, whereas ABMs are commonly used to estimate effects in multiple populations, necessitating stronger assumptions. Here, we describe potential biases that arise when ABM assumptions do not hold. To do so, we estimated 12-month mortality risk in simulated populations differing in prevalence of an unknown common cause of mortality and a time-varying confounder. The ABM and g-formula correctly estimated mortality and causal effects when all inputs were from the target population. However, whenever any inputs came from another population, the ABM gave biased estimates of mortality—and often of causal effects even when the true effect was null. In the absence of unmeasured confounding and model misspecification, both methods produce valid causal inferences for a given population when all inputs are from that population. However, ABMs may result in bias when extrapolated to populations that differ on the distribution of unmeasured outcome determinants, even when the causal network linking variables is identical.http://ift.tt/2uqdLzI
Invited Commentary: Causal Inference Across Space and Time—Quixotic Quest, Worthy Goal, or Both?
Abstract
The g-formula and agent-based models (ABMs) are 2 approaches used to estimate causal effects. In the current issue of the Journal, Murray et al. (Am J Epidemiol. 2017;186(2):131–142) compare the performance of the g-formula and ABMs to estimate causal effects in 3 target populations. In their thoughtful paper, the authors outline several reasons that a causal effect estimated using an ABM may be biased when parameterized from at least 1 source external to the target population. The authors have addressed an important issue in epidemiology: Often causal effect estimates are needed to inform public health decisions in settings without complete data. Because public health decisions are urgent, epidemiologists are frequently called upon to estimate a causal effect from existing data in a separate population rather than perform new data collection activities. The assumptions needed to transport causal effects to a specific target population must be carefully stated and assessed, just as one would explicitly state and analyze the assumptions required to draw internally valid causal inference in a specific study sample. Considering external validity in important target populations increases the impact of epidemiologic studies.http://ift.tt/2uYYnaJ
Body Mass Index Development and Asthma Throughout Childhood
Abstract
Several studies have found an association between overweight and asthma, yet the temporal relationship between their onsets remains unclear. We investigated the development of body mass index (BMI) from birth to adolescence among 2,818 children with and without asthma from a Swedish birth cohort study, the BAMSE (a Swedish acronym for "children, allergy, milieu, Stockholm, epidemiology") Project, during 1994–2013. Measured weight and height were available at 13 time points throughout childhood. Asthma phenotypes (transient, persistent, and late-onset) were defined by timing of onset and remission. Quantile regression was used to analyze percentiles of BMI, and generalized estimating equations were used to analyze the association between asthma phenotypes and the risk of high BMI. Among females, BMI development differed between children with and without asthma, with the highest BMI being seen among females with persistent asthma. The difference existed throughout childhood but increased with age. For example, females with persistent asthma had 2.33 times' (95% confidence interval: 1.21, 4.49) greater odds of having a BMI above the 85th percentile at age ≥15 years than females without asthma. Among males, no clear associations between asthma and BMI were observed. In this study, persistent asthma was associated with high BMI throughout childhood among females, whereas no consistent association was observed among males.http://ift.tt/2uqDBn7
Human Leukocyte Antigen Shared Epitope and Inflammation, Cardiovascular Disease, Cancer, and Mortality Among Postmenopausal Women in the Women's Health Initiative Rheumatoid Arthritis Study
Abstract
Specific alleles of the human leukocyte antigen (HLA)-DRB1 gene (HLA-DRB1) encode a "shared epitope" (SE) associated with rheumatoid arthritis (RA), especially more severe cyclic-citrullinated peptide antibody-positive (anti-CCP+) RA. We evaluated associations of number of SE alleles (0, 1, or 2) with total and cardiovascular disease (CVD) mortality and incident coronary heart disease (CHD), CVD, and cancer over a mean 8.9 (standard deviation, 3.5) years of follow-up, stratifying by baseline anti-CCP status (positive (+) vs. negative (−)). A longitudinal study, the Women's Health Initiative RA Study (1993–2010), sampled postmenopausal women who reported RA at baseline (1993–1998) or follow-up in the Women's Health Initiative, classified as anti-CCP+ RA (n = 556) or anti-CCP− non-RA (n = 1,070). Among anti-CCP+ RA women, SE alleles were not related to age-adjusted risks of CHD, CVD, or cancer or to total or CVD mortality. Among anti-CCP− non-RA women, age-adjusted hazard ratios for 1 and 2 SE alleles versus 0 SE alleles were 0.41 (95% confidence interval (CI): 0.34, 0.50) and 0.44 (95% CI: 0.27, 0.72), respectively, for CVD; 0.43 (95% CI: 0.37, 0.53) and 0.30 (95% CI: 0.16, 0.64), respectively, for CHD; and 0.62 (95% CI: 0.53, 0.73) and 0.52 (95% CI: 0.33, 0.83), respectively, for cancer. Associations persisted after adjustment for CVD risk factors, joint pain, rheumatoid factor positivity, and inflammatory markers (white blood cell count or cytokine level). In future studies, investigators should evaluate SE associations among anti-CCP− adults without RA and potential mechanisms.http://ift.tt/2uYYjrr
Cow's Milk Allergy in Infancy and Later Development of Juvenile Idiopathic Arthritis: A Register-Based Case-Control Study
Abstract
We examined the association between cow's milk allergy (CMA) and juvenile idiopathic arthritis (JIA). The material for this case-control study was collected from national registers of all children born in Finland between 2000 and 2010 and diagnosed with JIA (n = 1,298) and age-, sex-, and place-matched controls (n = 5,179). We identified 235 children with CMA; 66 of these children also had JIA. A conditional logistic regression analysis was performed to evaluate the association between CMA and JIA and to test whether exposure to antibiotics would be a covariate for this association. In boys (but not in girls), a diagnosis of CMA and the use of hypoallergenic formula in infancy were associated with the later development of JIA (odds ratio = 2.4, 95% confidence interval: 1.6, 3.6). The association was most evident in boys who were diagnosed with JIA before age 3 years or diagnosed with CMA with predominantly gastrointestinal symptoms. There was no statistically significant additive interaction between CMA and antibiotic exposure in the later development of JIA. These associations may reflect impaired maturation of intestinal immunity and integrity in boys with a risk of JIA. Predisposing factors related to JIA pathogenesis seem to display a sex-linked disparity.http://ift.tt/2uqojPm
Tools for the Precision Medicine Era: How to Develop Highly Personalized Treatment Recommendations From Cohort and Registry Data Using Q-Learning
Abstract
Q-learning is a method of reinforcement learning that employs backwards stagewise estimation to identify sequences of actions that maximize some long-term reward. The method can be applied to sequential multiple-assignment randomized trials to develop personalized adaptive treatment strategies (ATSs)—longitudinal practice guidelines highly tailored to time-varying attributes of individual patients. Sometimes, the basis for choosing which ATSs to include in a sequential multiple-assignment randomized trial (or randomized controlled trial) may be inadequate. Nonrandomized data sources may inform the initial design of ATSs, which could later be prospectively validated. In this paper, we illustrate challenges involved in using nonrandomized data for this purpose with a case study from the Center for International Blood and Marrow Transplant Research registry (1995–2007) aimed at 1) determining whether the sequence of therapeutic classes used in graft-versus-host disease prophylaxis and in refractory graft-versus-host disease is associated with improved survival and 2) identifying donor and patient factors with which to guide individualized immunosuppressant selections over time. We discuss how to communicate the potential benefit derived from following an ATS at the population and subgroup levels and how to evaluate its robustness to modeling assumptions. This worked example may serve as a model for developing ATSs from registries and cohorts in oncology and other fields requiring sequential treatment decisions.http://ift.tt/2uYYxi4
Flexible Mediation Analysis With Multiple Mediators
Abstract
The advent of counterfactual-based mediation analysis has triggered enormous progress on how, and under what assumptions, one may disentangle path-specific effects upon combining arbitrary (possibly nonlinear) models for mediator and outcome. However, current developments have largely focused on single mediators because required identification assumptions prohibit simple extensions to settings with multiple mediators that may depend on one another. In this article, we propose a procedure for obtaining fine-grained decompositions that may still be recovered from observed data in such complex settings. We first show that existing analytical approaches target specific instances of a more general set of decompositions and may therefore fail to provide a comprehensive assessment of the processes that underpin cause-effect relationships between exposure and outcome. We then outline conditions for obtaining the remaining set of decompositions. Because the number of targeted decompositions increases rapidly with the number of mediators, we introduce natural effects models along with estimation methods that allow for flexible and parsimonious modeling. Our procedure can easily be implemented using off-the-shelf software and is illustrated using a reanalysis of the World Health Organization's Large Analysis and Review of European Housing and Health Status (WHO-LARES) study on the effect of mold exposure on mental health (2002–2003).http://ift.tt/2uqppdK
The Validity of Predictive Equations to Estimate 24-Hour Sodium Excretion The MESA and CARDIA Urinary Sodium Study
Abstract
We examined the population distribution of urinary sodium concentrations and the validity of existing equations predicting 24-hour sodium excretion from a single spot urine sample among older adults with and without hypertension. In 2013, 24-hour urine collections were obtained from 554 participants in the Multi-Ethnic Study of Atherosclerosis and the Coronary Artery Risk Development in Young Adults study, who were aged 45–79 years and of whom 56% were female, 58% were African American, and 54% had hypertension, in Chicago, Illinois. One-third provided a second 24-hour collection. Four timed (overnight, morning, afternoon, and evening) spot urine specimens and the 24-hour collection were analyzed for sodium and creatinine concentrations. Mean 24-hour sodium excretion was 3,926 (standard deviation (SD), 1,623) mg for white men, 2,480 (SD, 1,079) mg for white women, 3,454 (SD, 1,651) mg for African-American men, and 3,397 (SD, 1,641) mg for African-American women, and did not differ significantly by hypertensive status. Mean bias (difference) in predicting 24-hour sodium excretion from the timed spot urine specimens ranged from −182 (95% confidence interval: −285, −79) to 1,090 (95% confidence interval: 966, 1,213) mg/day overall. Although the Tanaka equation using the evening specimen produced the least bias overall, no single equation worked well across subgroups of sex and race/ethnicity. A single spot urine sample is not a valid indicator of individual sodium intake. New equations are needed to accurately estimate 24-hour sodium excretion for older adults.http://ift.tt/2uYIVuV
The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes
Abstract
Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986–2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35–51 hours per week for the same duration. This study provides the first health risk–based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed.http://ift.tt/2uqoCK4
Impact of Glycemic Control on Risk of Infections in Patients With Type 2 Diabetes: A Population-Based Cohort Study
Abstract
Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying hemoglobin A1c (HbA1c) values and development of community antiinfective-agent-treated and hospital-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an HbA1c level of ≥10.50%, as compared with 5.50%–<6.49%, were 0.97 (95% confidence interval (CI): 0.94, 1.00) for HbA1c measured at early baseline, 1.09 (95% CI: 1.03, 1.14) for updated mean HbA1c, 1.13 (95% CI: 1.08, 1.19) for updated time-weighted mean HbA1c, and 1.19 (95% CI: 1.14, 1.26) for the latest updated HbA1c. Corresponding estimates for hospital-treated infections were 1.08 (95% CI: 1.02, 1.14) for early baseline HbA1c, 1.55 (95% CI: 1.42, 1.71) for updated mean HbA1c, 1.58 (95% CI: 1.44, 1.72) for updated time-weighted mean HbA1c, and 1.64 (95% CI: 1.51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association between current hyperglycemia and infection risk in type 2 diabetes patients.http://ift.tt/2uYZVkT
Association of Recent Bacterial Vaginosis With Acquisition of Mycoplasma genitalium
Abstract
We assessed the association between recent bacterial vaginosis (BV) and incident Mycoplasma genitalium, a sexually transmitted bacterium associated with adverse female reproductive health outcomes. Female sex workers in Mombasa, Kenya, completed a monthly sexual behavior interview and clinical examination. During February 2005–February 2006, vaginal fluid specimens collected from women every other month were tested for M. genitalium by nucleic acid amplification testing. Vaginal microbiota were assessed monthly and categorized by Nugent score (0–3 = normal microbiota, 4–6 = intermediate microbiota disruption, and 7–10 = BV). A discrete failure time analysis for multiple events using logistic regression was employed to estimate the odds of incident M. genitalium infection at follow-up visits among women with BV (vs. normal microbiota) at the preceding visit. Among the 280 women, 54.3% were positive for human immunodeficiency virus. At baseline, 16.1% had prevalent M. genitalium infection and 40.4% had prevalent BV. There were 59 incident M. genitalium infections among 50 women, for an incidence rate of 34.6 cases per 100 person-years. Following adjustment for age, human immunodeficiency virus status, and time, prior BV was associated with a 3.5-fold increase in odds of incident M. genitalium (adjusted odds ratio = 3.49, 95% confidence interval: 1.86, 6.56). This strong association suggests that BV may enhance susceptibility to M. genitalium infection.http://ift.tt/2uqhhKC
Traumatic Brain Injury and Attempted Suicide Among Veterans of the Wars in Iraq and Afghanistan
Abstract
Studies of the association between traumatic brain injury (TBI) and suicide attempt have yielded conflicting results. Furthermore, no studies have examined the possible mediating role of common comorbid psychiatric conditions in this association. This study used Veterans Affairs registry data to evaluate the associations between deployment-related TBI, psychiatric diagnoses, and attempted suicide among 273,591 veterans deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, and who received care from the Department of Veterans Affairs during 2007–2012. We performed Cox proportional hazards regression analyses, adjusting for demographic characteristics. Mediation analyses were conducted to quantify the impact of psychiatric conditions (posttraumatic stress disorder, depression, anxiety, and substance abuse) on this association. The sample was predominantly male (84%); mean age = 28.7 years. Veterans with TBI (16%) were more likely to attempt suicide than those without (0.54% vs. 0.14%): adjusted hazards ratio = 3.76, 95% confidence interval: 3.15, 4.49. This association was attenuated in mediation analyses (adjusted hazards ratio = 1.25, 95% confidence interval: 1.07, 1.46), with 83% of the association of TBI with attempted suicide mediated by co-occurring psychiatric conditions and with posttraumatic stress disorder having the largest impact. These results suggest that veterans with these conditions should be closely monitored for suicidal behavior.http://ift.tt/2uYPpKv
Modeled and Perceived Exposure to Radiofrequency Electromagnetic Fields From Mobile-Phone Base Stations and the Development of Symptoms Over Time in a General Population Cohort
Abstract
We assessed associations between modeled and perceived exposure to radiofrequency electromagnetic fields (RF-EMF) from mobile-phone base stations and the development of nonspecific symptoms and sleep disturbances over time. A population-based Dutch cohort study, the Occupational and Environmental Health Cohort Study (AMIGO) (n = 14,829; ages 31–65 years), was established in 2011/2012 (T0), with follow-up of a subgroup (n = 3,992 invited) in 2013 (T1; n = 2,228) and 2014 (T2; n = 1,740). We modeled far-field RF-EMF exposure from mobile-phone base stations at the home addresses of the participants using a 3-dimensional geospatial model (NISMap). Perceived exposure (0 = not at all; 6 = very much), nonspecific symptoms, and sleep disturbances were assessed by questionnaire. We performed cross-sectional and longitudinal analyses, including fixed-effects regression. We found small correlations between modeled and perceived exposure in AMIGO participants at baseline (n = 14,309; rSpearman = 0.10). For 222 follow-up participants, modeled exposure increased substantially (>0.030 mW/m2) between T0 and T1. This increase in modeled exposure was associated with an increase in perceived exposure during the same time period. In contrast to modeled RF-EMF exposure from mobile-phone base stations, perceived exposure was associated with higher symptom reporting scores in both cross-sectional and longitudinal analyses, as well as with sleep disturbances in cross-sectional analyses.http://ift.tt/2uqdEUO
Influenza-Associated Hospitalizations for Cardiovascular Diseases in the Tropics
Abstract
Influenza is a major cause of mortality and morbidity. We aimed to examine the influenza-associated hospitalization rates and proportions for cardiovascular disease (CVD) in tropical Singapore. Hospital admissions for ischemic heart disease (IHD), congestive heart failure (CHF), and overall CVD were obtained from the national inpatient database for the period of 2010–2014. We used, as the key indicator of influenza virus activity, the overall proportion of specimens from outpatients with influenza-like illness in the community that tested positive for influenza as part of the national influenza surveillance program. The annual influenza-associated hospitalization rates per 100,000 person-years ranged from 9.5 to 12.2 for IHD, 7.7 to 9.1 for CHF, and 15.8 to 19.2 for overall CVD. The influenza-associated hospitalization rates increased with increasing age. Influenza was significantly associated with excess hospitalizations in elderly persons aged ≥80 years, with an excess hospitalization rate per 100,000 person-years of 242.7 for IHD (P = 0.02), 271.8 for CHF (P = 0.01), and 497.2 for overall CVD (P < 0.001). In the tropics, influenza accounts for excess cardiovascular-related hospitalizations, especially in the elderly.http://ift.tt/2uZo0rU
Cover Image, Volume 87, Issue 2
The cover image, by J. Schaefers et al., is based on the Original Article Clinical presentation and outcome of children with central diabetes insipidus associated with a self-limited or transient pituitary stalk thickening, diagnosed as infundibuloneurohypophysitis, DOI: 10.1111/cen.13362.
http://ift.tt/2ulA3So
Scholar : These new articles for Aging, Neuropsychology, and Cognition are available online
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Scholar : AIDS Care, Volume 29, Issue 9, September 2017 is now available online on Taylor & Francis Online
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Gene by Cognition interaction on stress-induced attention bias for food: effects of 5-HTTLPR and Ruminative Thinking
Source:Biological Psychology
Author(s): Robbie Schepers, C. Rob Markus
IntroductionStress is often found to increase the preference and intake of high caloric foods. This effect is known as emotional eating and is influenced by cognitive as well as biological stress vulnerabilities. An S-allele of the 5-HTTLPR gene has been linked to decreased (brain) serotonin efficiency, leading to decreased stress resilience and increased risks for negative affect and eating related disturbances. Recently it has been proposed that a cognitive ruminative thinking style can further exacerbate the effect of this gene by prolonging the already increased stress response, thereby potentially increasing the risk of compensating by overeating high palatable foods.ObjectiveThis study was aimed at investigating whether there is an increased risk for emotional eating in high ruminative S/S-allele carriers reflected by an increased attention bias for high caloric foods during stress.MethodsFrom a large (N=827) DNA database, participants (N=100) were selected based on genotype (S/S or L/L) and ruminative thinking style and performed an eye-tracking visual food-picture probe task before and after acute stress exposure. A significant Genotype x Rumination x Stress-interaction was found on attention bias for savory food; indicating that a stress-induced attention bias for specifically high-caloric foods is moderated by a gene x cognitive risk factor.ConclusionBoth a genetic (5-HTTLPR) and cognitive (ruminative thinking) stress vulnerability may mutually increase the risk for stress-related abnormal eating patterns.
http://ift.tt/2uYUuTd
Social Processing in Early Adolescence: Associations between Neurophysiological, Self-Report, and Behavioral Measures
Source:Biological Psychology
Author(s): Autumn Kujawa, Ellen M. Kessel, Ashley Carroll, Kodi B. Arfer, Daniel N. Klein
Peer relationships play a major role in adolescent development, but few methods exist for measuring social processing at the neurophysiological level. This study extends our pilot study of Island Getaway, a task for eliciting event-related potentials (ERPs) to peer feedback. We differentiated ERPs using principal components analysis (PCA) and examined associations with behavioral and self-report measures in young adolescents (N=412). PCA revealed an early negativity in the ERP enhanced for rejection feedback, followed by a series of positivities (consistent with reward positivity [RewP], P300, and late positive potential) that were enhanced for acceptance feedback. Greater self-reported task engagement correlated with a larger RewP to acceptance and lower rates of rejecting peers. Youth higher in depressive symptoms exhibited a blunted RewP to social acceptance and reported lower engagement. Results highlight ERP components sensitive to peer feedback that may inform understanding of social processes relevant to typical and atypical development.
http://ift.tt/2uqcE38
CME Accreditation Page
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
http://ift.tt/2sWTn4O
Forthcoming Issues
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
http://ift.tt/2ugEkqD
Contributors
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
http://ift.tt/2sXfCrb
Contents
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
http://ift.tt/2ugzQQH
Dual Energy CT: Applications in Head and Neck and Neurologic Imaging
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
Author(s): Reza Forghani, Hillary R. Kelly
http://ift.tt/2sWUGAH
Dual-Energy Computed Tomography
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
Author(s): Reza Forghani, Bruno De Man, Rajiv Gupta
Teaser
There are increasing applications of dual-energy computed tomography (CT), a type of spectral CT, in neuroradiology and head and neck imaging. In this 2-part review, the fundamental principles underlying spectral CT scanning and the major considerations in implementing this type of scanning in clinical practice are reviewed. In the first part of this 2-part review, the physical principles underlying spectral CT scanning are reviewed, followed by an overview of the different approaches for spectral CT scanning, including a discussion of the strengths and challenges encountered with each approach.http://ift.tt/2tmjTnG
Dual-Energy Computed Tomography
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
Author(s): Reza Forghani, Bruno De Man, Rajiv Gupta
Teaser
There are increasing applications and use of spectral computed tomography or dual-energy computed tomography (DECT) in neuroradiology and head and neck imaging in routine clinical practice. Part 1 of this 2-part review covered fundamental physical principles underlying DECT scanning and the different approaches for scanning. Part 2 focuses on important and practical considerations for implementing and using DECT in clinical practice, including a review of different images and reconstructions produced by these scanners and important and practical issues, ranging from image quality and radiation dose to workflow-related aspects of DECT scanning, that routinely come up during operationalization of DECT.http://ift.tt/2tPKNaN
Applications of Dual-Energy Computed Tomography for the Evaluation of Head and Neck Squamous Cell Carcinoma
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
Author(s): Reza Forghani, Hillary R. Kelly, Hugh D. Curtin
Teaser
There are multiple emerging applications of dual-energy computed tomography (DECT) for the evaluation of pathology in the head and neck, in particular head and neck squamous cell carcinoma. Studies suggest that DECT image sets reconstructed as supplements to routine diagnostic images may improve lesion visualization, determination of tumor extent, and identification of invasion of critical anatomic structures. This article reviews the evidence for the use and potential advantages of supplementary DECT reconstructions for the evaluation of head and neck squamous cell carcinoma. A summary of potentially useful reconstructions and a suggested approach for multiparametric DECT evaluation of head and neck cancer based on current evidence are presented.http://ift.tt/2vk3ce2
Dual Energy Computed Tomography Applications for the Evaluation of the Spine
Publication date: August 2017
Source:Neuroimaging Clinics of North America, Volume 27, Issue 3
Author(s): Peter Komlosi, Max Wintermark
Teaser
Capturing the energy-dependent x-ray attenuation of different tissues, dual-energy computed tomography offers multiple benefits in the imaging of the spine, such as bone and iodinated contrast removal, monosodium urate imaging, and robust reduction of beam-hardening artifacts. The emerging new applications of this technique include bone marrow imaging in acute trauma and myeloinfiltrative disorders, improved bone density determination, and noninvasive assessment of spinal gout.http://ift.tt/2tmoRki
Scholar : These new articles for Aging & Mental Health are available online
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Botulinum Toxin A as an Adjunct to Abdominal Wall Reconstruction for Incisional Hernia
Background: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. Methods: The electronic databases PubMed and Embase were searched for eligible studies. Two independent investigators evaluated the literature. Data were sought regarding primary fascial closure with and without CST, safety, hernia recurrence, method of application, and preoperative radiological imaging. Results: Six cohort studies including a total of 133 patients receiving BTA were identified. No randomized or case–control studies were found. In total, 83.5% of the patients achieved primary fascial closure. Supplemental CST was necessary in 24.1% of the patients. Two patients developed hernia recurrence during follow-up. No postoperative complications or adverse events were considered related to the administration of BTA, except for impairment of postoperative coughing and sneezing. Additionally, radiological imaging showed that BTA increased the length of lateral abdominal muscles before surgery. Conclusions: Preoperative administration of BTA increases muscle length and may facilitate primary fascial closure. Optimal administration is at least 2 weeks before repair, whereas the optimal dose of BTA remains to be defined. Carefully designed randomized controlled trials are warranted to identify patients who would benefit from BTA and to eliminate the confounding effect of CST.http://ift.tt/2sWzcnz
Simply Do Not Go Snowboarding 2 Weeks after Augmentation
No abstract availablehttp://ift.tt/2sWPddc
Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol
Background: The optimal timing for cleft lip repair has yet to be established. Advances in neonatal anesthesia, along with a growing body of literature, suggesting benefits of earlier cleft lip and nasal repair, have set the stage for a reexamination of current practices. Methods: In this prospective study, cleft lip and nasal repair occurred on average at 34.8 days (13–69 days). Nasal correction was achieved primarily through molding the nasal cartilage without the placement of nasal sutures at the time of repair. A standardized anesthetic protocol aimed at limiting neurotoxicity was utilized in all cases. Anesthetic and postoperative complications were assessed. A 3-dimensional nasal analysis compared pre- and postoperative nasal symmetry for unilateral clefts. Surveys assessed familial response to repair. Results: Thirty-two patients were included (27 unilateral and 5 bilateral clefts). In this study, the overall complication rate was 3.1%. Anthropometric measurements taken from 3-dimensional-image models showed statistically significant improvement in ratios of nostril height (preoperative mean, 0.59; postoperative mean, 0.80), nasal base width (preoperative mean, 1.96; postoperative mean, 1.12), columella length (preoperative mean, 0.62; postoperative mean, 0.89; and columella angle (preoperative mean, 30.73; postoperative mean, 9.1). Survey data indicated that families uniformly preferred earlier repair. Conclusions: We present evidence that early cleft lip and nasal repair can be performed safely and is effective at improving nasal symmetry without the placement of any nasal sutures. Utilization of this protocol has the potential to be a paradigm shift in the treatment of cleft lip and nasal deformity.http://ift.tt/2tKaOsf
Direct to Implant Reconstruction in Nipple Sparing Mastectomy: Patient Selection by Preoperative Digital Mammogram
Background: Digital mammography clearly distinguishes gland tissue density from the overlying nonglandular breast tissue coverage, which corresponds to the existing tissue between the skin and the superficial layer of the fascia superficialis surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning and reducing the rate of necrotic complications after direct to implant (DTI) reconstruction in nipple sparing mastectomy (NSM). Methods: Thirty NSMs in 22 patients with type 3 tissue coverage (subcutaneous tissue thickness of 2 cm or more) were selected for DTI reconstruction after NSM to evaluate immediate skin flap/nipple areola complex ischemic complications and patient satisfaction. Results: We experienced no wound healing problems or ischemic complications immediately after surgery in our population. Only 1 seroma was observed as a short-term complication. Quality of life and patients' satisfaction level were optimal at 3 and 6 months follow-up, respectively. The aesthetic results have been evaluated as good/excellent in all cases. Conclusions: DTI immediate reconstruction with silicone implants following NSM appears to be a safe option in selected cases with enough tissue coverage, also providing a high level of patient satisfaction. The possibility of selecting cases for this procedure according to the preoperative digital mammogram showing more than 2 cm of superficial tissues thickness may help reducing the risk of immediate ischemic complications.http://ift.tt/2tfL8QR
Acral lentiginous melanoma - a skin cancer with unfavourable prognostic features. A study of the German Central Malignant Melanoma Registry (CMMR) in 2050 patients
Abstract
Background
Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors of ALM have been verified only in small-sized cohorts because of the low incidence of ALM worldwide.
Objectives
To investigate clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society.
Methods
The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using log-rank test. A cox proportional hazards model was used to identify independent prognostic factors for DSS.
Results
2,050 ALM patients were identified from 58,949 CM patients recorded by CMMR with follow-up data. In multivariate analyses, age (p=0.006), ulceration (p = 0.013), tumour thickness (p < 0.001) and tumour spread (p < 0.001) turned out to be significant prognostic factors for DSS in ALM whereas gender, nevus association and level of invasion were not independent factors.
Conclusion
Acral lentiginous melanoma has the same prognostic factors as the other subtypes of melanoma. Unfavourable prognosis probably derives from the delay of diagnosis in comparison to other melanoma subtypes.
This article is protected by copyright. All rights reserved.
http://ift.tt/2sWOWab
Role of sentinel lymph node biopsy as a staging procedure in patients with melanoma: A critical appraisal
Abstract
Worldwide, sentinel node (SN) biopsy for accurate staging is now part of the standard work-up of patients with melanomas ≥1.0 mm Breslow thickness, as it is for staging patients with breast cancer. Nuclear medicine imaging and surgical techniques have evolved to such a degree that a SN can be identified and removed in virtually every patient. Nevertheless, some opposition to a routine SN biopsy remains, perhaps due to a failure to appreciate the serious implications of incomplete or inaccurate staging. Guided by a critical appraisal of the available evidence, this review elucidates the definition of an SN, discusses the sensitivity and specificity of the information it provides, emphasises that it is a minor staging procedure that can lead to improved survival when followed by appropriate therapy, and explains the necessarily unconventional and complex design of the only randomised trial that addresses this subject. It also describes other benefits and risks of an SN biopsy and outlines its role in current melanoma management.
http://ift.tt/2uYzNq6
Melanocytic lesion evolution patterns with targeted therapies and immunotherapies for advanced metastatic melanoma: An observational study
Abstract
Background/Objectives
Various cutaneous side-effects have been reported with anti-melanoma systemic therapies. This study investigated the changes in melanocytic lesion pigmentation in patients on four different therapies.
Methods
We analysed the serial dermatoscopic photographs of atypical melanocytic lesions taken from patients with advanced metastatic melanoma on four different systemic therapies (selective BRAF-inhibitor monotherapy, dabrafenib combined with trametinib [D&T], anti-programmed cell death protein 1 [anti-PD1] therapies, and anti-PD1 combined with ipilimumab) seen from February 2013 to May 2016. We compared these changes with the melanocytic lesions of 10 control patients.
Results
In the control group, 19% of naevi lightened, 64% did not change and 17% darkened. Only the BRAF inhibitor group showed more darkened lesions than controls (37%, P < 0.001). Meanwhile, there were more lightened naevi in the D&T therapy group (86%, P < 0.001) as well as the anti-PD1 and ipilimumab groups (59%, P < 0.001) than controls. Patients on anti-PD1 monotherapy had more lightened (49%) and fewer darkened naevi (9%) than controls, but differences were not significant.
Conclusions
Our study showed that different anti-melanoma systemic therapies have different effects on the pigmentation of melanocytic lesions. BRAF inhibitor may have the propensity to cause darkening while D&T therapy and anti-PD1 caused lightening compared with controls. The findings emphasise the importance of regular dermatological monitoring in specialised clinics for patients on anti-melanoma systemic therapy. Clinicians should expect changes in the global pigmentation of melanocytic lesions but be suspicious of lesions with structural changes.
http://ift.tt/2upIEUP
Perineural invasion present exclusively in central tissue blocks of Mohs surgical excisions of basal cell carcinoma
Abstract
Perineural invasion (PNI) may be present in basal cell carcinomas (BCC) treated with Mohs micrographic surgery. This single-centre, non-randomised, prospective study demonstrates the potential for PNI to exist exclusively within the central tissue blocks of Mohs specimens.
http://ift.tt/2ugnBUf
Πέμπτη 13 Ιουλίου 2017
New process for 3D printing of cellulose
Source:Materials Today
Author(s): Laurie Donaldson
http://ift.tt/2sWIHDo
Stereotactic Ablative Radiation Therapy in Renal Cell Carcinoma: from oligometastatic to localized disease
Publication date: Available online 13 July 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Filippo Alongi, Stefano Arcangeli, Luca Triggiani, Rosario Mazzola, Michela Buglione di Monale e Bastia, Sergio Fersino, Anna Baiguini, Barbara Alicja Jereczek-Fossa, Stefano Maria Magrini
Renal Cell Carcinoma (RCC) has historically been considered a radioresistant cancer, and radiotherapy was usually delivered with a palliative goal. Stereotactic ablative radiotherapy (SABR) allows the delivery of high doses on small treatment volumes in a safe and effective way, thus opening the doors to new applicationsof radiotherapy both in the treatment of the primary and oligometastasic disease. Aim of the current review is to explore the state of art of SABR in the therapeutic approach to RCC.
http://ift.tt/2tPq2ME
Validation, comparison, and combination of algorithms for automatic detection of pulmonary nodules in computed tomography images: the LUNA16 challenge
Publication date: Available online 13 July 2017
Source:Medical Image Analysis
Author(s): Arnaud Arindra Adiyoso Setio, Alberto Traverso, Thomas de Bel, Moira S.N. Berens, Cas van den Bogaard, Piergiorgio Cerello, Hao Chen, Qi Dou, Maria Evelina Fantacci, Bram Geurts, Robbert van der Gugten, Pheng Ann Heng, Bart Jansen, Michael M.J. de Kaste, Valentin Kotov, Jack Yu-Hung Lin, Jeroen T.M.C. Manders, Alexander Sóñora-Mengana, Juan Carlos García-Naranjo, Evgenia Papavasileiou, Mathias Prokop, Marco Saletta, Cornelia M Schaefer-Prokop, Ernst T. Scholten, Luuk Scholten, Miranda M. Snoeren, Ernesto Lopez Torres, Jef Vandemeulebroucke, Nicole Walasek, Guido C.A. Zuidhof, Bram van Ginneken, Colin Jacobs
Automatic detection of pulmonary nodules in thoracic computed tomography (CT) scans has been an active area of research for the last two decades. However, there have only been few studies that provide a comparative performance evaluation of different systems on a common database. We have therefore set up the LUNA16 challenge, an objective evaluation framework for automatic nodule detection algorithms using the largest publicly available reference database of chest CT scans, the LIDC-IDRI data set. In LUNA16, participants develop their algorithm and upload their predictions on 888 CT scans in one of the two tracks: 1) the complete nodule detection track where a complete CAD system should be developed, or 2) the false positive reduction track where a provided set of nodule candidates should be classified. This paper describes the setup of LUNA16 and presents the results of the challenge so far. Moreover, the impact of combining individual systems on the detection performance was also investigated. It was observed that the leading solutions employed convolutional networks and used the provided set of nodule candidates. The combination of these solutions achieved an excellent sensitivity of over 95% at fewer than 1.0 false positives per scan. This highlights the potential of combining algorithms to improve the detection performance. Our observer study with four expert readers has shown that the best system detects nodules that were missed by expert readers who originally annotated the LIDC-IDRI data. We released this set of additional nodules for further development of CAD systems.
Graphical abstract
http://ift.tt/2vjAHNm
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