Notes

Measurement problem of the Mini-Mental Condition Examination amongst people with dementia in which live in nursing homes.
e proposed multi-step strategy is in part related to iterative refinement of coordinate localization as well as explicit image cropping which focuses algorithm attention to key anatomic regions of interest.Automated segmentation templates can save clinicians time compared to de novo segmentation but may still take substantial time to review and correct. It has not been thoroughly investigated which automated segmentation-corrected segmentation similarity metrics best predict clinician correction time. Bilateral thoracic cavity volumes in 329 CT scans were segmented by a UNet-inspired deep learning segmentation tool and subsequently corrected by a fourth-year medical student. Eight spatial similarity metrics were calculated between the automated and corrected segmentations and associated with correction times using Spearman's rank correlation coefficients. Nine clinical variables were also associated with metrics and correction times using Spearman's rank correlation coefficients or Mann-Whitney U tests. The added path length, false negative path length, and surface Dice similarity coefficient correlated better with correction time than traditional metrics, including the popular volumetric Dice similarity coefficient (respectively ρ = 0.69, ρ = 0.65, ρ =  - 0.48 versus ρ =  - 0.25; correlation p values  less then  0.001). Clinical variables poorly represented in the autosegmentation tool's training data were often associated with decreased accuracy but not necessarily with prolonged correction time. Metrics used to develop and evaluate autosegmentation tools should correlate with clinical time saved. To our knowledge, this is only the second investigation of which metrics correlate with time saved. Validation of our findings is indicated in other anatomic sites and clinical workflows. Novel spatial similarity metrics may be preferable to traditional metrics for developing and evaluating autosegmentation tools that are intended to save clinicians time.The recent introduction of wireless head-mounted displays (HMD) promises to enhance 3D image visualization by immersing the user into 3D morphology. This work introduces a prototype holographic augmented reality (HAR) interface for the 3D visualization of magnetic resonance imaging (MRI) data for the purpose of planning neurosurgical procedures. The computational platform generates a HAR scene that fuses pre-operative MRI sets, segmented anatomical structures, and a tubular tool for planning an access path to the targeted pathology. The operator can manipulate the presented images and segmented structures and perform path-planning using voice and gestures. On-the-fly, the software uses defined forbidden-regions to prevent the operator from harming vital structures. In silico studies using the platform with a HoloLens HMD assessed its functionality and the computational load and memory for different tasks. A preliminary qualitative evaluation revealed that holographic visualization of high-resolution 3D MRI data offers an intuitive and interactive perspective of the complex brain vasculature and anatomical structures. This initial work suggests that immersive experiences may be an unparalleled tool for planning neurosurgical procedures.
A positive microscopic margin (R1) following resection of pancreatic ductal adenocarcinoma (PDAC) can occur in up to 80% of patients and is associated with reduced survival and increased recurrence. Our aim was to characterize the impact of neoadjuvant therapy (NAT) on survival and recurrence in patients with PDAC following an R1 resection.

A retrospective analysis of patients with PDAC who underwent pancreatectomy from 2008 to 2017 was performed. Patients were staged according to the American Joint Committee on Cancer 8th edition and stratified based on resection margin (R0 vs. Sirtinol ic50 R1) and treatment sequence (NAT vs. surgery first [SF]). Conditional survival analysis was performed using Cox regression and inverse probability weighted estimates.

Among 580 patients, 59% received NAT and 41% underwent SF. On final pathology, the NAT cohort had smaller tumors and less lymph node (LN) positivity (p<0.05). NAT was not associated with an R1 resection (50%, p=0.653). Compared with the R1 cohort, the R0 cohort had a higher median overall survival (OS; 39.6 vs. 22.8months; hazard ratio [HR] 1.6, p<0.001) and disease-free survival (DFS; 19 vs. 13months; HR 1.35, p=0.004). After risk adjustment, NAT was not associated with OS, regardless of margin status (R0, 95% confidence interval [CI] (-)7.31-27.07, p=0.26; or R1, 95% CI (-)36.99-15.25, p=0.42). However, NAT was associated with improved DFS in the R1 cohort (95% CI 1.79-11.91, p=0.008) but not in the R0 cohort (95% CI (-)11.22-10.54, p=0.95).

An R0 resection remains an important determinant of overall and disease-free survival, even when NAT is administered. For patients with an R1 resection, receipt of NAT may prolong DFS.
An R0 resection remains an important determinant of overall and disease-free survival, even when NAT is administered. For patients with an R1 resection, receipt of NAT may prolong DFS.
Exosomes are extracellular vesicles secreted by cells, which can transport different molecules, including nucleic acids. Dietary habits may induce gene regulation through the modulation of exosomal RNAs. We aimed at characterizing exosomal lncRNAs, mRNA and miRNAs modulation after a 1-year adherence to a low-fat diet (LFD) or to Mediterranean-based diets enriched in extra-virgin olive oil (MedDiet + EVOO) or in a mixture of nuts (MedDiet + Nuts).

Plasma samples were collected, at baseline and after 1year of dietary interventions, from 150 participants included in the PREDIMED study (Reus Center). LncRNAs, mRNAs and miRNAs were isolated from plasma exosomes and screened. RT-qPCR validation was performed for miRNAs.

Compared with LFD, 413 lncRNAs and 188 mRNAs, and 476 lncRNAs and 235 mRNAs were differentially modulated in response to the MedDiet + EVOO and MedDiet + Nuts interventions, respectively. In addition, after 1year of dietary interventions, 26 circulating miRNAs were identified as differentially expressed between groups.
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