Multi-level Trainable Segmentation for Measuring Gestational and Yolk Sacs from Ultrasound Images

As a non-hazardous and non-invasive approach to medical diagnostic imaging, ultrasound serves as an ideal candidate for tracking and monitoring pregnancy development. One critical assessment during the first trimester of the pregnancy is the size measurements of the Gestation Sac (GS) and the Yolk Sac (YS) from ultrasound images. Such measurements tend to give a strong indication on the viability of the pregnancy. This paper proposes a novel multi-level trainable segmentation method to achieve three objectives in the following order: (1) segmenting and measuring the GS, (2) automatically identifying the stage of pregnancy, and (3) segmenting and measuring the YS. The first level segmentation employs a trainable segmentation technique based on the histogram of oriented gradients to segment the GS and estimate its size. This is then followed by an automatic identification of the pregnancy stage based on histogram analysis of the content of the segmented GS. The second level segmentation is used after that to detect the YS and extract its relevant size measurements. A trained neural network classifier is employed to perform the segmentation at both levels. The effectiveness of the proposed solution has been evaluated by comparing the automatic size measurements of the GS and YS against the ones obtained gynaecologist. Experimental results on 199 ultrasound images demonstrate the effectiveness of the proposal in producing accurate measurements as well as identifying the correct stage of pregnancy

Medical evaluation for suspected sexual violence against girls

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesInngangur: Kynferðisofbeldi gegn börnum hefur verið falið vandamál. Læknisskoðun er æskileg til að leita áverka, útiloka sýkingar, safna réttarlæknisfræðilegum gögnum og tryggja velferð barnsins. Samantekt var gerð á framkvæmd og niðurstöðum læknisfræðilegs mats á Landspítala og í Barnahúsi. Efniviður og aðferðir: Rannsóknin var afturskyggn og lýsandi fyrir árin 2001-2010. Upplýsingum um staðlaðar skoðanir var safnað í Barnahúsi og úr læknabréfum og matsblöðum á Landspítala um aldur, kyn, biðtíma frá tilvísun að skoðun og skráð frábrigði á ytri kynfærum. Lýsingar á frábrigðum voru flokkaðar með tilliti til tengsla við kynferðisofbeldi í samræmi við læknisfræðilegt flokkunarkerfi Adams. Upplýsingar um alvarleikastig meintra kynferðisbrota fengust frá Barnahúsi. Niðurstöður: Fjöldi læknisskoðana/-mats var 224 hjá 220 stúlkum á aldrinum 1-17 ára. Í gögnum um 218 staðlaðar skoðanir hjá stúlkum voru fullnægjandi skoðanir 201 (92%). Flestar skoðanir fóru fram innan mánaðar frá tilkynningu (meðalbiðtími 28 dagar; bil 1-166). Meyjarhaftslýsingar voru í 24 tilvikum metnar sem mögulegt kynferðislegt ofbeldi, þar með talið 21 tilvik „rofins meyjarhafts“ hjá stúlku sem var ekki kynferðislega virk. Tvö kynfæravörtutilvik greindust (1%) og ein klamýdíusýking (0,5%). Hjá stúlkum sem ekki voru kynferðislega virkar voru skoðanir eðlilegar hjá 85% (165/193); 28 sýndu hugsanleg ummerki kynferðisofbeldis eða höfðu frábrigði með óljósa/umdeilda þýðingu. Efsta alvarleikastigi var lýst hjá 71 stúlku. Ályktun: Meirihluti læknisskoðananna voru hjá ókynþroska stúlkum, töldust ekki bráðatilvik, og niðurstaðan innan eðlilegra marka. Hugsanleg ummerki um kynferðisofbeldi voru hjá einni af 8. Frábrigðum frá eðlilegri skoðun var sjaldan lýst og sýkingar sjaldgæfar. Vanda þarf aðferðir og verkferla við valkvæðar og bráðar læknisskoðanir vegna gruns um kynferðisofbeldi.Introduction: Sexual violence against children is a hidden problem. Medical examination and evaluation is needed to search for possible injuries, exclude infections, procure legal evidence and ensure the child´s welfare. We assessed medical evaluations done at Landspitali University Hospital and in the Reykjavik Children's House, a specialized clinic for childhood abuse cases. Material and methods: Retrospective descriptive analysis was performed on the standardized medical examinations. Age, sex, waiting time from reported violence until examination and recorded aberrant external genitalia findings were noted, and classified by the medically-­oriented Adams system. Offence severity stages were assigned. Results: Medical examination cases numbered 224 for 220 girls aged 1-17 years. Records were available on 218 standarized examinations among girls; 201 were adequate (92%). Most were conducted within a month (medium waiting-time 28 days; range 1-166). Hymenal changes were in 24 cases possibly associated with sexual violence, including 21 in a girl not sexually active. Two girls had human papillomavirus warts (1%) and one chlamydial infection (0.5%). Medical examination was normal in 85% (165/193) of girls who were not sexually active; 24 had possibly experienced sexual violence and four results were uncertain/controversial. For 71 offence severity was serious. Conclusion: Most examinations were conducted on prepubertal girls, were not a matter of urgency and showed normal results. Possible relation to sexual violence was described for one in eight. Infections were rare. When child sexual abuse is suspected, care with methodology and procedures is needed, both for elective and acute medical examinations

Variants in the fetal genome near FLT1 are associated with risk of preeclampsia.

: Preeclampsia, which affects approximately 5% of pregnancies, is a leading cause of maternal and perinatal death. The causes of preeclampsia remain unclear, but there is evidence for inherited susceptibility. Genome-wide association studies (GWAS) have not identified maternal sequence variants of genome-wide significance that replicate in independent data sets. We report the first GWAS of offspring from preeclamptic pregnancies and discovery of the first genome-wide significant susceptibility locus (rs4769613; P = 5.4 × 10(-11)) in 4,380 cases and 310,238 controls. This locus is near the FLT1 gene encoding Fms-like tyrosine kinase 1, providing biological support, as a placental isoform of this protein (sFlt-1) is implicated in the pathology of preeclampsia. The association was strongest in offspring from pregnancies in which preeclampsia developed during late gestation and offspring birth weights exceeded the tenth centile. An additional nearby variant, rs12050029, associated with preeclampsia independently of rs4769613. The newly discovered locus may enhance understanding of the pathophysiology of preeclampsia and its subtypes.<br/

Post-eruptive volcano inflation following major magma drainage: Interplay between models of viscoelastic response influence and models of magma inflow at Bárðarbunga caldera, Iceland, 2015-2018

&amp;lt;p&amp;gt;Unrest at B&amp;amp;#225;r&amp;amp;#240;arbunga after a caldera collapse in 2014-2015 includes elevated seismicity beginning about six months after the eruption ended, including nine Mw&amp;gt;4.5 earthquakes. The earthquakes occurred mostly on the northern and southern parts of a caldera ring fault. Global Navigation Satellite System (GNSS, in particular, Global Positioning System; GPS) and Interferometric Synthetic Aperture Radar (InSAR) geodesy are applied to evaluate the spatial and temporal pattern of ground deformation around B&amp;amp;#225;r&amp;amp;#240;arbunga caldera outside the icecap, in 2015-2018, when deformation rates were relatively steady. The aim is to study the role of viscoelastic relaxation following major magma drainage versus renewed magma inflow as an explanation for the ongoing unrest.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The largest horizontal velocity is measured at GPS station KISA (3 km from caldera rim), 141 mm/yr in direction N47&amp;lt;sup&amp;gt;o&amp;lt;/sup&amp;gt;E relative to the Eurasian plate in 2015-2018. GPS and InSAR observations show that the velocities decay rapidly outward from the caldera. We correct our observations for Glacial Isostatic Adjustment and plate spreading to extract the deformation related to volcanic activity. After this correction, some GPS sites show subsidence.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;We use a reference Earth model to initially evaluate the contribution of viscoelastic processes to the observed deformation field. We model the deformation within a half-space composed of a 7-km thick elastic layer on top of a viscoelastic layer with a viscosity of 5 x 10&amp;lt;sup&amp;gt;18&amp;lt;/sup&amp;gt; Pa s, considering two co-eruptive contributors to the viscoelastic relaxation: &amp;amp;#8220;non-piston&amp;amp;#8221; magma withdrawal at 10 km depth (modelled as pressure drop in a spherical source) and caldera collapse (modelled as surface unloading). The other model we test is the magma inflow in an elastic half-space. Both the viscoelastic relaxation and magma inflow create horizontal outward movements around the caldera, and uplift at the surface projection of the source center in 2015-2018. Viscoelastic response due to magma withdrawal results in subsidence in the area outside the icecap. Magma inflow creates rapid surface velocity decay as observed.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;We explore further two parameters in the viscoelastic reference model: the viscosity and the &amp;quot;non-piston&amp;quot; magma withdrawal volume. Our comparison between the corrected InSAR velocities and viscoelastic models suggests a viscosity of 2.6&amp;amp;#215;10&amp;lt;sup&amp;gt;18&amp;lt;/sup&amp;gt; Pa s and 0.36 km&amp;lt;sup&amp;gt;3&amp;lt;/sup&amp;gt; of &amp;amp;#8220;non-piston&amp;amp;#8221; magma withdrawal volume, given by the optimal reduced Chi-squared statistic. When the deformation is explained using only magma inflow into a single spherical source (and no viscoelastic response), the optimal model suggests an inflow rate at 1&amp;amp;#215;10&amp;lt;sup&amp;gt;7&amp;lt;/sup&amp;gt; m&amp;lt;sup&amp;gt;3&amp;lt;/sup&amp;gt;/yr at 700 m depth. A magma inflow model with more model parameters is also a possible explanation, including sill inflation at 10 km together with slip on caldera ring faults. Our reference Earth model and the two end-member models suggest that there is a trade-off between the viscoelastic relaxation and the magma inflow, since they produce similar deformation signals outside the icecap. However, to reproduce details of the observed deformation, both processes are required. A viscoelastic-only model cannot fully explain the fast velocity decay away from the caldera, whereas a magma inflow-only model cannot explain the subsidence observed at several locations.&amp;lt;/p&amp;gt; </jats:p

Genetic correction of PSA values using sequence variants associated with PSA levels

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldMeasuring serum levels of the prostate-specific antigen (PSA) is the most common screening method for prostate cancer. However, PSA levels are affected by a number of factors apart from neoplasia. Notably, around 40% of the variability of PSA levels in the general population is accounted for by inherited factors, suggesting that it may be possible to improve both sensitivity and specificity by adjusting test results for genetic effects. To search for sequence variants that associate with PSA levels, we performed a genome-wide association study and follow-up analysis using PSA information from 15,757 Icelandic and 454 British men not diagnosed with prostate cancer. Overall, we detected a genome-wide significant association between PSA levels and single-nucleotide polymorphisms (SNPs) at six loci: 5p15.33 (rs2736098), 10q11 (rs10993994), 10q26 (rs10788160), 12q24 (rs11067228), 17q12 (rs4430796), and 19q13.33 [rs17632542 (KLK3: I179T)], each with P(combined) <3 × 10(-10). Among 3834 men who underwent a biopsy of the prostate, the 10q26, 12q24, and 19q13.33 alleles that associate with high PSA levels are associated with higher probability of a negative biopsy (odds ratio between 1.15 and 1.27). Assessment of association between the six loci and prostate cancer risk in 5325 cases and 41,417 controls from Iceland, the Netherlands, Spain, Romania, and the United States showed that the SNPs at 10q26 and 12q24 were exclusively associated with PSA levels, whereas the other four loci also were associated with prostate cancer risk. We propose that a personalized PSA cutoff value, based on genotype, should be used when deciding to perform a prostate biopsy.info:eu-repo/grantAgreement/EC/FP7/202059/ 218071 Urological Research Foundation P50 CA90386-05S2 Robert H. Lurie Comprehensive Cancer Center p30 CA60553 Health Technology Assessment Programme 96/20/06 96/20/99 Department of Health, England Cancer Research UK C522/A8649 Medical Research Council of England G0500966 ID 75466 National Cancer Research Institute (NCRI), UK Southwest National Health Service Research and Development NCRI National Institute for Health Resear

Risky use of alcohol, drugs and cigarettes in a psychosis unit: a 1 1/2 year follow-up of stability and changes after initial screening

<p>Abstract</p> <p>Background</p> <p>Co-morbidity with substance use disorders negatively influences overall functioning in patients with psychosis. However, frequencies and courses of risky use of alcohol, drugs and cigarettes are rarely investigated in patients at psychosis units.</p> <p>The purpose of this study is to describe the use of alcohol, drugs and cigarettes in patients at a psychosis unit over a 1 1/2 year period after them having taken part in a screening investigation including a feed-back of the results to personnel. Relationships with sex and age are also described.</p> <p>Methods</p> <p>The patients' use of the substances was examined at baseline and at follow-up using three self-reporting instruments: Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT) and Fagerstrom Test for Nicotine Dependence (FTND).</p> <p>Results</p> <p>One hundred and eighty-six patients out of 238 at baseline (78 percent) took part in the follow-up. Total AUDIT score decreased in women. Older men more often developed a risky alcohol use. Older women tended to reduce their risky drug habits. On a group level the habits mostly were stable, but 11 percent changed their alcohol habits and 15 percent changed their smoking habits from risky to no/low risky use, or vice versa. Nine percent changed their drug habits, predominantly from risky to no/low risky use.</p> <p>Conclusion</p> <p>A more active approach towards alcohol, drug and smoking habits in psychosis units would probably be beneficial.</p

The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions

Endometriosis is a common condition associated with debilitating pelvic pain and infertility. A genome-wide association study meta-analysis, including 60,674 cases and 701,926 controls of European and East Asian descent, identified 42 genome-wide significant loci comprising 49 distinct association signals. Effect sizes were largest for stage 3/4 disease, driven by ovarian endometriosis. Identified signals explained up to 5.01% of disease variance and regulated expression or methylation of genes in endometrium and blood, many of which were associated with pain perception/maintenance (SRP14/BMF, GDAP1, MLLT10, BSN and NGF). We observed significant genetic correlations between endometriosis and 11 pain conditions, including migraine, back and multisite chronic pain (MCP), as well as inflammatory conditions, including asthma and osteoarthritis. Multitrait genetic analyses identified substantial sharing of variants associated with endometriosis and MCP/migraine. Targeted investigations of genetically regulated mechanisms shared between endometriosis and other pain conditions are needed to aid the development of new treatments and facilitate early symptomatic intervention

The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions

Endometriosis is a common condition associated with debilitating pelvic pain and infertility. A genome-wide association study meta-analysis, including 60,674 cases and 701,926 controls of European and East Asian descent, identified 42 genome-wide significant loci comprising 49 distinct association signals. Effect sizes were largest for stage 3/4 disease, driven by ovarian endometriosis. Identified signals explained up to 5.01% of disease variance and regulated expression or methylation of genes in endometrium and blood, many of which were associated with pain perception/maintenance (SRP14/BMF, GDAP1, MLLT10, BSN and NGF). We observed significant genetic correlations between endometriosis and 11 pain conditions, including migraine, back and multisite chronic pain (MCP), as well as inflammatory conditions, including asthma and osteoarthritis. Multitrait genetic analyses identified substantial sharing of variants associated with endometriosis and MCP/migraine. Targeted investigations of genetically regulated mechanisms shared between endometriosis and other pain conditions are needed to aid the development of new treatments and facilitate early symptomatic intervention

Temperature Control of Fimbriation Circuit Switch in Uropathogenic Escherichia coli: Quantitative Analysis via Automated Model Abstraction

Uropathogenic Escherichia coli (UPEC) represent the predominant cause of urinary tract infections (UTIs). A key UPEC molecular virulence mechanism is type 1 fimbriae, whose expression is controlled by the orientation of an invertible chromosomal DNA element—the fim switch. Temperature has been shown to act as a major regulator of fim switching behavior and is overall an important indicator as well as functional feature of many urologic diseases, including UPEC host-pathogen interaction dynamics. Given this panoptic physiological role of temperature during UTI progression and notable empirical challenges to its direct in vivo studies, in silico modeling of corresponding biochemical and biophysical mechanisms essential to UPEC pathogenicity may significantly aid our understanding of the underlying disease processes. However, rigorous computational analysis of biological systems, such as fim switch temperature control circuit, has hereto presented a notoriously demanding problem due to both the substantial complexity of the gene regulatory networks involved as well as their often characteristically discrete and stochastic dynamics. To address these issues, we have developed an approach that enables automated multiscale abstraction of biological system descriptions based on reaction kinetics. Implemented as a computational tool, this method has allowed us to efficiently analyze the modular organization and behavior of the E. coli fimbriation switch circuit at different temperature settings, thus facilitating new insights into this mode of UPEC molecular virulence regulation. In particular, our results suggest that, with respect to its role in shutting down fimbriae expression, the primary function of FimB recombinase may be to effect a controlled down-regulation (rather than increase) of the ON-to-OFF fim switching rate via temperature-dependent suppression of competing dynamics mediated by recombinase FimE. Our computational analysis further implies that this down-regulation mechanism could be particularly significant inside the host environment, thus potentially contributing further understanding toward the development of novel therapeutic approaches to UPEC-caused UTIs