Shape-aware Surface Reconstruction from Sparse 3D Point-Clouds

Publication date: Available online 14 February 2017
Source:Medical Image Analysis
Author(s): Florian Bernard, Luis Salamanca, Johan Thunberg, Alexander Tack, Dennis Jentsch, Hans Lamecker, Stefan Zachow, Frank Hertel, Jorge Goncalves, Peter Gemmar
The reconstruction of an object's shape or surface from a set of 3D points plays an important role in medical image analysis, e.g. in anatomy reconstruction from tomographic measurements or in the process of aligning intra-operative navigation and preoperative planning data. In such scenarios, one usually has to deal with sparse data, which significantly aggravates the problem of reconstruction. However, medical applications often provide contextual information about the 3D point data that allow to incorporate prior knowledge about the shape that is to be reconstructed. To this end, we propose the use of a statistical shape model (SSM) as a prior for surface reconstruction. The SSM is represented by a point distribution model (PDM), which is associated with a surface mesh. Using the shape distribution that is modelled by the PDM, we formulate the problem of surface reconstruction from a probabilistic perspective based on a Gaussian Mixture Model (GMM). In order to do so, the given points are interpreted as samples of the GMM. By using mixture components with anisotropic covariances that are "oriented" according to the surface normals at the PDM points, a surface-based fitting is accomplished. Estimating the parameters of the GMM in a maximum a posteriori manner yields the reconstruction of the surface from the given data points. We compare our method to the extensively used Iterative Closest Points method on several different anatomical datasets/SSMs (brain, femur, tibia, hip, liver) and demonstrate superior accuracy and robustness on sparse data.

Graphical abstract

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Food and Beverage Selection Patterns among Menu Label Users and Nonusers: Results from a Cross-Sectional Study

Publication date: Available online 13 February 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jessie Gruner, Punam Ohri-Vachaspati
BackgroundBy May 5, 2017, restaurants with 20 or more locations nationwide will be required to post calorie information on menus and menu boards. Previous research shows that those who use menu labels purchase fewer calories, but how users are saving calories is unknown.ObjectiveTo assess food and beverage selection patterns among menu label users and nonusers.DesignSecondary, cross-sectional analysis using data from a study examining sociodemographic disparities in menu label usage at a national fast-food restaurant chain.Participants/settingParticipants were recruited outside restaurant locations, using street-intercept survey methodology. Consenting customers submitted receipts and completed a brief oral survey. Receipt data were used to categorize food and beverage purchases.Main outcome measureSide, beverage, and entrée purchases. Sides and beverages were classified as healthier and less-healthy options consistent with the 2015 Dietary Guidelines for Americans. Healthier options contained items promoted in the guidelines, such as whole fruits, vegetables, low-fat dairy, and 100% fruit juice; less-healthy options contained solid fat or added sugar. Entrées were categorized as lower-, medium-, and higher-calorie options, based on quartile cutoffs.Statistical analysesMultinomial logistic regression models were used to estimate prevalence ratios (PRs) for purchases among menu label users and nonusers, controlling for sociodemographic characteristics and total price paid.ResultsHealthier sides were selected by 7.5% of users vs 2.5% of nonusers; healthier beverages were selected by 34.0% of users vs 11.6% of nonusers; and lowest-calorie entrées were selected by 28.3% of users vs 30.1% of nonusers. Compared with nonusers (n=276), users (n=53) had a higher probability of purchasing healthier sides (PR=5.44; P=0.034), and healthier beverages (PR=3.37; P=0.005). No significant differences were seen in the purchasing patterns of entrées.ConclusionsTargeting educational campaigns to side and beverage purchasing behaviors may increase the effectiveness of menu labeling.



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Erosive pustular dermatosis of the scalp: Clinical, trichoscopic, and histopathologic features of 20 cases

Publication date: Available online 14 February 2017
Source:Journal of the American Academy of Dermatology
Author(s): Michela Starace, Camilla Loi, Francesca Bruni, Aurora Alessandrini, Cosimo Misciali, Annalisa Patrizi, Bianca Maria Piraccini
BackgroundErosive pustular dermatosis of the scalp is a chronic eruption that leads to scarring alopecia.ObjectiveThe clinical, dermoscopic, and histopathological features and the course of the disease in 20 patients were reviewed and compared with the reports in the literature.MethodsGender, age at diagnosis, age at onset, duration, topography, predisposing factors, concomitant diseases, trichoscopy, histology, treatment, and outcome were taken into consideration.ResultsThe mean age was 59.4 years. Androgenetic alopecia was present in 12 patients, 6 of whom showed actinic damage. Trauma was reported in 9 patients. Four patients were affected by autoimmune disorders. The vertex was the most common location. In all 20 patients trichoscopy showed an absence of follicular ostia with skin atrophy. Histopathology revealed 3 different features, depending on the disease duration. A reduction of inflammatory signs was observed in 14 patients treated with topical steroids and in all 3 patients treated with topical tacrolimus 0.1%.LimitationsThe rarity of this disease is a limitation.ConclusionsThe relatively high number of patients allowed us to identify a better diagnostic approach, using trichoscopy, and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.



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Aims and Scope and Editorial Board

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Cost-Utility of First-Line Disease-Modifying Treatments for Relapsing–Remitting Multiple Sclerosis

Publication date: Available online 14 February 2017
Source:Clinical Therapeutics
Author(s): Erkki Soini, Jaana Joutseno, Marja-Liisa Sumelahti
PurposeThis study evaluated the cost-effectiveness of first-line treatments of relapsing–remitting multiple sclerosis (RRMS) (dimethyl fumarate [DMF] 240 mg PO BID, teriflunomide 14 mg once daily, glatiramer acetate 20 mg SC once daily, interferon [IFN]-β1a 44 µg TIW, IFN-β1b 250 µg EOD, and IFN-β1a 30 µg IM QW) and best supportive care (BSC) in the health care payer setting in Finland.MethodsThe primary outcome was the modeled incremental cost-effectiveness ratio (ICER; €/quality-adjusted life-year [QALY] gained, 3%/y discounting). Markov cohort modeling with a 15-year time horizon was employed. During each 1-year modeling cycle, patients either maintained the Expanded Disability Status Scale (EDSS) score or experienced progression, developed secondary progressive MS (SPMS) or showed EDSS progression in SPMS, experienced relapse with/without hospitalization, experienced an adverse event (AE), or died. Patients׳ characteristics, RRMS progression probabilities, and standardized mortality ratios were derived from a registry of patients with MS in Finland. A mixed-treatment comparison (MTC) informed the treatment effects. Finnish EuroQol Five-Dimensional Questionnaire, Three-Level Version quality-of-life and direct-cost estimates associated with EDSS scores, relapses, and AEs were applied. Four approaches were used to assess the outcomes: cost-effectiveness plane and efficiency frontiers (relative value of efficient treatments); cost-effectiveness acceptability frontier, which demonstrated optimal treatment to maximize net benefit; Bayesian treatment ranking (BTR); and an impact investment assessment (IIA; a cost-benefit assessment), which increased the clinical interpretation and appeal of modeled outcomes in terms of absolute benefit gained with fixed drug-related budget. Robustness of results was tested extensively with sensitivity analyses.FindingsBased on the modeled results, teriflunomide was less costly, with greater QALYs, versus glatiramer acetate and the IFNs. Teriflunomide had the lowest ICER (24,081) versus BSC. DMF brought marginally more QALYs (0.089) than did teriflunomide, with greater costs over the 15 years. The ICER for DMF versus teriflunomide was 75,431. Teriflunomide had >50% cost-effectiveness probabilities with a willingness-to-pay threshold of <€77,416/QALY gained. According to BTR, teriflunomide was first-best among the disease-modifying therapies, with potential willingness-to-pay thresholds of up to €68,000/QALY gained. In the IIA, teriflunomide was associated with the longest incremental quality-adjusted survival and time without cane use. Generally, primary outcomes results were robust, based on the sensitivity analyses. The results were sensitive only to large changes in analysis perspective or mixed-treatment comparison.ImplicationsThe results were sensitive only to large changes in analysis perspective or MTC. Based on the analyses, teriflunomide was cost-effective versus BSC or DMF with the common threshold values, was dominant versus other first-line RRMS treatments, and provided the greatest impact on investment. Teriflunomide is potentially the most cost-effective option among first-line treatments of RRMS in Finland.



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Scalp Cooling for Patients With Breast Cancer

This review looks at scalp cooling, an intervention that can prevent or reduce the severity of chemotherapy-induced alopecia.

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The NAD+ precursor nicotinic acid improves genomic integrity in human peripheral blood mononuclear cells after X-irradiation

Publication date: Available online 13 February 2017
Source:DNA Repair
Author(s): Kathrin Weidele, Sascha Beneke, Alexander Bürkle
NAD⁺ is an essential cofactor for enzymes catalyzing redox-reactions as well as an electron carrier in energy metabolism. Aside from this, NAD⁺ consuming enzymes like poly(ADP-ribose) polymerases and sirtuins are important regulators involved in chromatin-restructuring processes during repair and epigenetics/transcriptional adaption. In order to replenish cellular NAD⁺ levels after cleavage, synthesis starts from precursors such as nicotinamide, nicotinamide riboside or nicotinic acid to match the need for this essential molecule. In the present study, we investigated the impact of supplementation with nicotinic acid on resting and proliferating human mononuclear blood cells with a focus on DNA damage and repair processes.We observed that nicotinic acid supplementation increased NAD⁺ levels as well as DNA repair efficiency and enhanced genomic stability evaluated by micronucleus test after x-ray treatment. Interestingly, resting cells displayed lower basal levels of DNA breaks compared to proliferating cells, but break-induction rates were identical. Despite similar levels of p53 protein upregulation after irradiation, higher NAD⁺ concentrations led to reduced acetylation of this protein, suggesting enhanced SIRT1 activity. Our data reveal that even in normal primary human cells cellular NAD⁺ levels may be limiting under conditions of genotoxic stress and that boosting the NAD⁺ system with nicotinic acid can improve genomic stability.



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Obituary—Ethel Moustacchi

Publication date: Available online 14 February 2017
Source:DNA Repair
Author(s): Errol Friedberg




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Food effect: The combined effect of media pH and viscosity on the gastrointestinal absorption of ciprofloxacin tablet

Publication date: 1 April 2017
Source:European Journal of Pharmaceutical Sciences, Volume 101
Author(s): Asma Radwan, Abdel Naser Zaid, Nidal Jaradat, Yousef Odeh
BackgroundThe clinical implications of food-drug interactions may have to be taken seriously into account with oral drugs administration in order to minimize variations in drug bioavailability. Food intake may alter physiological changes in the pH and viscosity of the gastrointestinal lumen, which could affect the oral absorption of drugs.PurposeThe aim of the present study was to have an insight on the effect of media parameters: viscosity and pHon the oral absorption of ciprofloxacin HCl from solid formulations using a model food: Corchorus olitorius (Jute) Soup.MethodsIn vitro disintegration and dissolution rates of ciprofloxacin tablet were evaluated using compendia buffer media in the presence/absence of C. olitorius leaves. These in vitro data were then input to GastroPlus™ to predict ciprofloxacin absorption profiles under fasted and fed states.ResultsThe present study demonstrated the significance of luminal pH and viscosity on the dissolution and disintegration of solid formulations following postprandial ingestion of the viscous soup. The tablets showed prolonged disintegration times and reduced dissolution rates in this soup, which could be attributed to the postprandial elevation in media viscosity and reduced solubility at elevated gastricpH. The predicted model under fed state showed no impact on AUC but prolonged Tmax and a decrease in Cmax.ConclusionConcomitant intake of C. olitorius soup with ciprofloxacin might have negative effect on the rate of drug release from conventional immediate release tablets.

Graphical abstract

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Cogan's Syndrome: State of the art of systemic immunosuppressive treatment in adult and pediatric patients

Publication date: Available online 14 February 2017
Source:Autoimmunity Reviews
Author(s): Paolo Mora, Calzetti Giacomo, S. Ghirardini, P. Rubino, S. Gandolfi, J. Orsoni
ObjectiveTo systematically evaluate the evidences for treatment of Cogan's syndrome (CS), with reference to adult and younger patients described in the literature.Systematic Review Methodology Data SourcesStudies reviewed were English language original articles ranging from 1990 to 2016 reporting data for subjects with CS (typical and atypical) undergoing any systemic treatment other than steroids alone. Medline/EMBASE, Cochrane Library were searched. The full text of articles meeting selection criteria was reviewed for: study type, diagnosis, number of subjects, treatment type and duration, clinical and/or functional outcomes, possible systemic manifestation or other autoimmune syndromes combined.Results and ConclusionsThe authors identified 76 relevant reports: 4 prospective studies, 2 retrospective studies, 12 case series and 58 case reports. The studies included a total of 141 new patients: based on the available data, 46 men and 50 women with a mean age of 33years (range 5–69). In the descriptive analysis adult patients (N=87) were separated from pediatric patients (<18years old) (N=17).Concerning treatment strategies, except for a first-line approach to check for a rapid remission, or for a drug sensibility often supporting the diagnosis, a long-term steroidal monotherapy is no longer recommended in CS. As in other autoimmune and rheumatologic diseases, combined treatment with steroid-sparing immunosuppressant agents, also considering "biological" drugs, is nowadays preferred. However, the evidence of clearly effective or preferable treatment options for CS remains lacking, mostly due to the rarity of the disease and to the consequent difficulty in organizing high-quality prospective trials.



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Molecular analysis of vascular smooth muscle cells from patients with giant cell arteritis: Targeting endothelin-1 receptor to control proliferation

Publication date: Available online 14 February 2017
Source:Autoimmunity Reviews
Author(s): Alexis Régent, Kim Heang Ly, Matthieu Groh, Chabha Khifer, Sébastien Lofek, Guilhem Clary, Philippe Chafey, Véronique Baud, Cédric Broussard, Christian Federici, François Labrousse, Laura Mesturoux, Claire Le Jeunne, Elisabeth Vidal, Antoine Brezin, Véronique Witko-Sarsat, Loïc Guillevin, Luc Mouthon
Objective.The pathophysiology of giant cell arteritis (GCA) and the mechanisms underlying vascular remodeling, are poorly understood. We aimed to compare vascular smooth muscle cells (VSMCs) from patients with GCA and controls by a proteomic and gene expression profile approach and to identify the signaling pathways involved in proliferation.MethodsVSMCs were cultured from temporal artery biopsies (TABs) from patients with biopsy-proven GCA (TAB⁺-GCA), biopsy-negative GCA (TAB⁻-GCA), and diagnosis other than GCA (GCA-control). VSMCs from normal human aorta (HAoSMC) were used as controls. 2D–differential in-gel electrophoresis and Affymetrix chips were used to compare proteomes and gene expression profiles of VSMCs. Proliferation was assessed by BrdU incorporation assay. TAB⁺-GCA and GCA-control TABs underwent immunohistochemistry staining for endothelin-1 (ET-1) and receptors ETAR and ETBR.ResultsWe identified 16, 30 and 2 protein spots differentially expressed between TAB⁺-GCA and GCA-control VSMCs, TAB⁺-GCA and TAB⁻-GCA VSMCs and TAB⁻-GCA and GCA-control VSMCs, respectively (fold change ≥1.5 and p≤0.05). Among the 153 proteins differentially expressed between TAB⁺-GCA and HAoSMC VSMCs, many were linked with ET-1. Genes differentially expressed between TAB⁺-GCA and GCA-control VSMCs were involved in proliferation. ET-1 was identified as a link between genes of interest. Proliferation was reduced for TAB⁺-GCA VSMCs on treatment with the endothelin antagonist macitentan and its active metabolite. Patients showing transmural expression of ET-1 in temporal artery lesions received a significantly higher glucocorticoid daily dose after 6-month follow-up.ConclusionInhibiting the proliferation with macitentan, combined with glucocorticoids, might be a promising therapeutic approach for patients with GCA.



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Feasibility Study of Navigated Endoscopy for the Placement of High Dose Rate Brachytherapy Applicators in the Esophagus and Lung

Conditions:   Esophagus Cancer;   Lung Cancer
Intervention:   Device: Navigated Endoscopy
Sponsor:   University Health Network, Toronto
Recruiting - verified February 2017

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Durvalumab, Cetuximab and Radiotherapy in Head Neck Cancer

Condition:   Head and Neck Neoplasms
Interventions:   Biological: Durvalumab;   Biological: Cetuximab;   Radiation: Intensity modulated radiation therapy (IMRT)
Sponsor:   Azienda Ospedaliero-Universitaria Careggi
Not yet recruiting - verified February 2017

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Comparison of the effects of recombinant human bone morphogenetic protein-2 and -9 on bone formation in rat calvarial critical-size defects

Abstract

Objectives

Among bone morphogenetic protein (BMP) family members, BMP-2 and BMP-9 have demonstrated potent osteoinductive potential. However, in vivo differences in their potential for bone regeneration remain unclear. The present study aimed to compare the effects of recombinant human (rh) BMP-2 and rhBMP-9 on bone formation in rat calvarial critical-size defects (CSD).

Materials and methods

Twenty-eight Wistar rats surgically received two calvarial defects bilaterally in each parietal bone. Defects (n = 56) were allocated into four groups: absorbable collagen sponge (ACS) alone, rhBMP-2 with ACS (rhBMP-2/ACS), rhBMP-9/ACS, or sham surgery (control), on the condition that the treatments of rhBMP-2/ACS and rhBMP-9/ACS, or the same treatments were not included in the same animal. Animals were sacrificed at 2 and 8 weeks post-surgery. The calvarial defects were analyzed for bone volume (BV) by micro-computed tomography and for percentages of defect closure (DC/DL), newly formed bone area (NBA/TA), bone marrow area (BMA/NBA), adipose tissue area (ATA/NBA), central bone height (CBH), and marginal bone height (MBH) by histomorphometric analysis.

Results

The BV in the rhBMP-2/ACS group (5.44 ± 3.65 mm³, n = 7) was greater than the other groups at 2 weeks post-surgery, and the rhBMP-2/ACS and rhBMP-9/ACS groups (18.17 ± 2.51 and 16.30 ± 2.46 mm³, n = 7, respectively) demonstrated significantly greater amounts of BV compared with the control and ACS groups (6.02 ± 2.90 and 9.30 ± 2.75 mm³, n = 7, respectively) at 8 weeks post-surgery. The rhBMP-2/ACS and rhBMP-9/ACS groups significantly induced new bone formation compared to the control and ACS groups at 8 weeks post-surgery. However, there were no statistically significant differences found between the rhBMP-2/ACS and rhBMP-9/ACS groups in any of the histomorphometric parameters. The ATA/NBA in the rhBMP-2/ACS group (9.24 ± 3.72%, n = 7) was the highest among the treatment groups at 8 weeks post-surgery.

Conclusions

Within the limits of this study, it can be concluded that rhBMP-2/ACS induced a slight early increase in new bone formation at 2 weeks and that rhBMP-9/ACS provided comparable new bone formation to rhBMP-2/ACS with less adipose tissues after a healing period of 8 weeks in rat CSD.

Clinical relevance

RhBMP-9/ACS treatment provided new bone formation with less adipose tissues compared with rhBMP-2/ACS.

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Histopathology of Bilateral Lower Extremity Inflammatory Lymphedema in Military Basic Trainees: A leukocytoclastic vasculitis of the deep vascular plexus

Abstract

Bilateral lower extremity inflammatory lymphedema (BLEIL) is a recently described condition that presents with exquisite tenderness, erythema, and edema of the lower leg, ankle and dorsal foot resembling an acute cellulitis. It was first reported in healthy, young adult military basic trainees with a normal body mass index during the first 72 hours of arrival to basic training. It occurs while standing at attention for many hours, and shows rapid resolution with elevation and rest. We report an additional case of BLEIL and describe the histopathology of this case and two of the previously reported cases. All three biopsies showed a deep perivascular infiltrate of neutrophils with karyorrhectic debris and prominent red blood cell extravasation. One of the three cases was positive for complement by direct immunofluorescence. We postulate this condition represents a deep leukocytoclastic vascultis with secondary reactive lymphedematous changes.

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Interventions to Improve Pharmacological Adherence Among Adults with Psychotic Spectrum Disorders, Bipolar Disorder, and Posttraumatic Stress Disorder [Internet].

Non-adherence to medication is a serious problem in the United States (US). It is associated with increased emergency department visits and hospitalizations, higher costs of care, and greater mortality. For patients with serious mental illness, including schizophrenia and other psychotic spectrum disorders, bipolar disorder, and posttraumatic stress disorder (PTSD), adherence to psychopharmacological and/or non-psychopharmacological medications is an important concern.

http://ift.tt/2lctb5I

Massage for Pain: An Evidence Map [Internet].

Given the widespread use of various massage therapies for pain, we conducted an evidence mapping process to determine the distribution of evidence available for various pain indications as well as different forms of massage therapy, identify gaps in evidence, and inform future research priorities. This mapping project provides a visual overview of the distribution of evidence for massage therapy for indications of pain, as well as an accompanying narrative that will help stakeholders interpret the state of evidence to inform policy and clinical decision-making.

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Autologous chondrocyte implantation in the knee: systematic review and economic evaluation.

Autologous chondrocyte implantation is likely to be a cost-effective option for the NHS compared with microfracture.

http://ift.tt/2lcjwMw

Surgical Implants and Other Foreign Bodies.

Evaluates the carcinogenic risks to humans of surgical implants and other foreign bodies. Foreign bodies are defined as any exogenous object that has been introduced into the tissues or cavities of the body and is not rapidly absorbed. The evaluation focuses on exposures caused by the presence in the body of a solid metallic or non-metallic object as a result either of surgery or of involuntary penetration, as through a war wound. Medical and dental devises are grouped together as metallic, non-metallic, and mixed materials, which have different profiles of biological activity.

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Vitamin D Fact Sheet for Health Professionals

Vitamin D

Fact Sheet for Health Professionals

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com