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Cancer gene discovery using digital differential display.

The Cancer Gene Anatomy Project database of the National Cancer Institute has thousands of expressed sequences, both known and novel, in the form of expressed sequence tags (ESTs). These ESTs, derived from diverse normal and tumor cDNA libraries, offer an attractive starting point for cancer gene discovery. Using a data-mining tool called Digital Differential Display (DDD) from the Cancer Gene Anatomy Project database, ESTs from six different solid tumor types (breast, colon, lung, ovary, pancreas, and prostate) were analyzed for differential expression. An electronic expression profile and chromosomal map position of these hits were generated from the Unigene database. The hits were categorized into major classes of genes including ribosomal proteins, enzymes, cell surface molecules, secretory proteins, adhesion molecules, and immunoglobulins and were found to be differentially expressed in these tumorderived libraries. Genes known to be up-regulated in prostate, breast, and pancreatic carcinomas were discovered by DDD, demonstrating the utility of this technique. Two hundred known genes and 500 novel sequences were discovered to be differentially expressed in these select tumor-derived libraries. Test genes were validated for expression specificity by reverse transcription-PCR, providing a proof of concept for gene discovery by DDD. A comprehensive database of hits can be accessed at http:// www.fau.edu/cmbb/publications/cancergenes. htm. This solid tumor DDD database should facilitate target identification for cancer diagnostics and therapeutics.

Biological Specimen Banks↗

Digital image processing as a tool to monitor biomass growth in Aspergillus niger 3T5B8 solid-state fermentation: preliminary results.

The estimation of biomass is an essential parameter for controlling fermentation processes. However, monitoring biomass growth in filamentous fungi solid-state fermentation is laborious. The aim of this study was to provide a better insight into the monitoring of biomass growth in Aspergillus niger 3T5B8 solid-state fermentation using a digital image-processing technique. The images were acquired with a stereomicroscope and a digital camera, and processed using KS400 software. Growth was evaluated every 24 h for 5 days, and quantified as the total area occupied by the hyphae. The correlation between the results of the proposed methodology and the polygalacturonase data was greater than 0.9, showing that a direct and linear relationship can be expected among these parameters. This work indicates that the digital processing technique can be used for indirect biomass estimation in a solid-state fermentation process.

Aspergillus niger↗

Experimental validation of an AI-driven digital healthcare platform for oral health behavior and plaque assessment among vietnamese children.

BACKGROUND: Oral health among children in developing countries, including Vietnam, remains a significant public health concern. Innovative approaches leveraging artificial intelligence AI-based digital health platforms may offer effective strategies for managing dental plaque and promoting better oral hygiene behaviors among school-aged children. This study aimed to evaluate the effectiveness of an AI-driven oral healthcare platform (Denti-i Vietnam) in improving oral hygiene and behavioral outcomes among Vietnamese primary school students. METHODS: A total of 204 primary school students aged 8-10&#xa0;years in Hanoi, Vietnam, participated in this experimental study. Participants were randomly assigned to an intervention group (n&#xa0;=&#xa0;107), which used the AI-driven oral healthcare platform, and a comparison group (n&#xa0;=&#xa0;97), which received traditional oral health education via pamphlets. Oral health behaviors, dental plaque levels (Simplified Oral Hygiene Index; OHI-S), and caries indices (dft/DMFT) were assessed at baseline and after the intervention period. RESULTS: The intervention group demonstrated a significant reduction in the OHI-S score compared to baseline (2.49&#xa0;&#xb1;&#xa0;0.60 to 1.70&#xa0;&#xb1;&#xa0;0.76, p&#xa0;<&#xa0;0.001), particularly in the debris component, indicating enhanced plaque control. Notable improvements were also observed in oral hygiene behaviors, including increased frequency of toothbrushing before and after breakfast (p&#xa0;<&#xa0;0.01) and more frequent parental assistance during brushing (p&#xa0;=&#xa0;0.03). Furthermore, parental awareness of dental caries significantly increased in the intervention group (p&#xa0;=&#xa0;0.001). CONCLUSIONS: The AI-driven oral healthcare platform significantly improved both oral hygiene behaviors and plaque control among Vietnamese primary school children. These findings suggest that AI-driven digital health tools can serve as practical and scalable solutions for promoting oral health in developing countries.

Humans↗

Technology failure analysis: understanding why a diabetes management tool developed for a Personal Digital Assistant (PDA) didn't work in a randomized controlled trial.

Managing Type 1 Diabetes Mellitus is a challenging feat especially for young patients. It is a tedious and demanding disease which requires painful self-monitoring and injections multiple times per day. Many patients are unable to achieve good blood sugar control, in spite of strong evidence that good control leads to better outcomes. Many caregivers believe that more communication between caregivers and patients could lead to better control. This paper describes a tool that was developed to improve communication between caregivers and patients, its testing, how it failed to achieve its outcomes and recommendations for improvement.

Blood Glucose Self-Monitoring↗

Multicenter randomized effectiveness/implementation trial of a digital self-management support tool to improve the quality of life during adjuvant hormonal therapy for patients with early breast cancer: The HOPE trial.

BACKGROUND: For patients with hormone receptor (HR) positive early breast cancer (BC), adjuvant endocrine therapy (ET) represents the cornerstone of treatment. However, 75% of patients experience ET-related symptoms that negatively affect their quality of life (QOL). Despite their high prevalence, these symptoms are often underestimated and under-addressed during consultations. As a result, non-adherence to ET is common and remains a major barrier for optimal disease and survival outcomes. METHODS: National, prospective, randomized, open-label hybrid type 1 effectiveness/implementation trial conducted in France comparing a personalized digital health pathway plus standard of care (SoC) vs. SoC alone in patients with HR+ early BC reporting ET-related symptoms. 180 patients will be randomized 1:1 to receive either 12&#xa0;weeks of the digital health pathway or 12&#xa0;weeks of SoC. The intervention is anchored by the Resilience&#xa9; digital companion including remote symptom and needs assessment, an introductory nurse-navigator phone call, and access to personalized, symptom-specific online educational and self-management programs (physical activity, yoga, meditation or cognitive behavioral therapy). In both arms, patients will be invited to wear a wearable device to objectively monitor behavioral parameters. The primary endpoint is the ET symptoms scale of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 over 12-weeks. Secondary endpoints include other QOL domains, self-reported ET adherence, eHealth literacy, self-efficacy, and evaluation of the implementation process. DISCUSSION: This study should provide evidence on the effectiveness and real-world implementation of a personalized digital health pathway to improve QOL in patients experiencing ET-related symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT06781996; Protocol version 3.0.

Humans↗

Integrating digital teaching-file systems with off-the-shelf presentation software to facilitate speaker-led conferences.

OBJECTIVE: Develop methods for automated transfer of images and associated text from a teaching-file repository into presentation material for speaker-led conferences. MATERIALS/METHODS: Our institution uses a Microsoft Windows (Microsoft Corp, Redmond, WA) software application to maintain a digital teaching-file database that can store and retrieve content in a case-centric fashion. Virtually any number of images can be stored with any given case. Cases and their associated images can be retrieved via a module that supports searches by American College of Radiology (ACR) code and by free-text Boolean queries on the history, findings, diagnosis, and discussion components of a case. In addition to the software system serving directly as an interactive teaching tool, the digital teaching file itself serves as an image repository and resource for attending radiologists who create their own presentations and lectures. To better support this use, software modules were developed for interprocess communication and automated creation of Powerpoint slides. These modules are fully integrated with the teaching-file software application. A single image or a set of selected images can be automatically made into individual slides with two mouse clicks. Images are automatically centered and optimally sized. A slide title is automatically rendered from the user's preference of the case history or diagnosis (stored with the case), or via the entry of freeform text. We describe the programming techniques that are used, as well as how several features of the operating system and Powerpoint itself can be integrated with a customized software application to facilitate this objective. RESULTS: The creation of presentation-ready Powerpoint slides is fully automated from within our teaching-file application, and the time required to create a presentation compared to the conventional method of manually seeking and inserting files from within Powerpoint itself, on a per-slide basis, is drastically reduced. The benefits are magnified by having all imagery stored within an organized and searchable database system so that desired images can be easily located. CONCLUSION: A digital teaching-file system can serve as a useful image repository for purposes ancillary to direct computerized instruction. Software that supports these uses, such as the automated creation of presentation material for speaker-led conferences, facilitates the radiologist's role as an educator.

Computer-Assisted Instruction↗

Pelvic floor muscle surface electromyography. Reliability and clinical predictive validity.

OBJECTIVE: To study the reliability and clinical predictive validity of pelvic floor muscle surface electromyography (sEMG) for use in early detection and prophylaxis of urogynecologic disorders. STUDY DESIGN: Fifty-seven women ranging from 19 to 69 years of age completed a written questionnaire and underwent digital pelvic examination followed by pelvic floor muscle sEMG using an intravaginal sensor. Thirty-seven subjects underwent repeat evaluations one week or more later. RESULTS: sEMG data demonstrated significant test-retest reliability (P < .001) and significant clinical predictive validity (P < .05) for undifferentiated urinary incontinence, stress incontinence, urge incontinence, menstrual status and parity on both initial and repeat examinations. CONCLUSIONS: Pelvic floor muscle sEMG is reliable and consistently predictive of several important clinical status variables, suggesting that it can be a useful tool in early at-risk detection and prophylactic intervention for disorders of pelvic floor muscle laxity. Recent advances in sEMG technology make it cost-effective, convenient, noninvasive and easy to learn and administer by assisting staff. This technology is a powerful complementary tool for digital assessment of pelvic floor muscles and should be considered for use in gynecologic practice.

Adult↗

Some computational and statistical tools for paired comparisons of digital images.

This article is a case-based review that introduces applied statisticians to a number of issues and methods that arise in clinical studies with paired digital images as outcomes. Single photon emission computed tomography (SPECT) is the imaging modality used in two examples. The first is a physical simulation of relevant clinical features of SPECT images using a customized head phantom scanned under different experimental conditions. The objective is to demonstrate and compare several current methods for image registration, i.e., image superimposition in some optimal manner to obtain a common frame of reference within which to make pixel-by-pixel comparisons. Image registration together with image normalization to correct for spurious differences in background activity levels enable quantification of differences in paired images. The physical simulation assesses quantification accuracy. The second example involves two SPECT images of the same brain tumour patient taken about two months apart. The objective here is to demonstrate several tools from morphological image analysis for image segmentation, i.e., separation of 'figure' and 'ground', and simple image regression to detect patterns of differences in time, again after registration and normalization. The clinical context of both examples helps to keep the review in practical focus and is a useful starting point for descriptions of many standard tools in applied medical image analysis. References to relevant literature are provided for readers wanting to study particular subjects in depth. As medical image analysis becomes more sophisticated, more cost-conscious and scrutinized more intensively, proper attention to the computational and statistical bases for practical conclusions become even more crucial.

Brain Neoplasms↗

Digital radiogrammetry as a new diagnostic tool for estimation of disease-related osteoporosis in rheumatoid arthritis compared with pQCT.

OBJECTIVES: To investigate the potential of a new osteogeometric technology based on digital X-ray radiogrammetry (DXR) as a diagnostic tool for quantification of severity-dependent osteoporosis, and to distinguish between inflammation-mediated and corticoid-induced variations of bone mineralisation in patients suffering from rheumatoid arthritis. METHODS: Ninety-six patients (duration of disease: <18 months) underwent retrospective calculations of bone mineral density (DXR-BMD) and metacarpal index (MCI) by DXR, which were calculated from plain radiographs of the non-dominant hand. For comparison, pQCT-calculated BMD (total, cortical-subcortical and trabecular partition of bone tissue) was done on the distal radius. Severity was classified using Ratingen Score by two independent radiologists, and divided into three main groups. In addition, the patients were separated into those with corticoid medication (n=44; 5 mg/day over a half year period) and a control group (n=52) without any corticoid therapy. RESULTS: Correlations between DXR-BMD and MCI versus pQCT parameters were all significant (0.36<R<0.71; p<0.01), independent of corticoid therapy. Only in the group without corticoid application, the correlation between DXR-BMD and pQCT-BMD (cortical) showed no significant association. For patients with corticoid therapy, our data revealed the lowest correlation coefficient between DXR parameters and pQCT-BMD (trabecular). Without a difference in comparison to corticoid therapy, the significant relative decrease of BMD estimated by DXR between the highest and lowest score was between 11.1% and 14.3% and for MCI between 15.8% and 17.8%. The also significant relative decrease of trabecular BMD using pQCT varied from 10.3% to 16.9%, whereas no significant results could be verified for pQCT-BMD (cortical and total). CONCLUSIONS: Digital radiogrammetry can precisely estimate severity-dependent cortical reduction of bone mineral density in patients suffering from rheumatoid arthritis both with and without corticoid therapy, and seems to be able to distinguish the side effects of antirheumatic treatment from the disease-related periarticular bone loss. The detection and quantification of periarticular osteoporosis by DXR could be an important diagnostic tool in early rheumatoid arthritis.

Absorptiometry, Photon↗

Quantitative fractography by digital image processing: NIH Image macro tools for stereo pair analysis and 3-D reconstruction.

A set of NIH Image macro programs was developed to make qualitative and quantitative analyses from digital stereo pictures produced by scanning electron microscopes. These tools were designed for image alignment, anaglyph representation, animation, reconstruction of true elevation surfaces, reconstruction of elevation profiles, true-scale elevation mapping and, for the quantitative approach, surface area and roughness calculations. Limitations on time processing, scanning techniques and programming concepts are also discussed.

Journal Article↗

Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen.

OBJECTIVES: To determine the extent of functional changes in the first-order kernel multifocal electroretinogram (mfERG) responses in patients with large drusen by means of a localized analysis and to determine correlations between mfERG responses and morphologic changes. METHODS: Thirty-one eyes from 20 patients ages 58 to 84 years with large drusen (> or =5 drusen > or =63 microm diameter) were studied. The mfERGs were recorded with a stimulus of 103 hexagons and a flash intensity of 2.67 candela (cd).s-1.m-2. Each of the 103 single first-order kernel mfERG responses was analyzed and compared with those of age-matched healthy control subjects. Imaging studies, including color stereo fundus photography, red-free fundus photography, and fluorescein angiography, were performed in all patients, and morphologic changes (drusen in red-free fundus photography, staining or window defect in fluorescein angiography) were determined with a digital measurement tool. The mfERG responses were correlated to areas with and without morphologic changes. RESULTS: Reduced responses were found in 10.0% (scalar products) and 4.0% (response densities) and delayed implicit times in 13.8% (N1), 18.9% (P1), and 23.8% (N2) of all mfERGs. Abnormal mfERG responses extended up to 25 degrees in radius. Significant morphologic-functional relations were detected in only a few patients. Abnormal mfERG variables were present in areas without morphologic changes. CONCLUSIONS: Patients with large drusen exhibit functional changes in the cone-driven pathways evaluated by the mfERG, indexed particularly by implicit times. Morphologically visible changes do not predict retinal function. Large drusen are associated with a more general retinal dysfunction.

Aged↗

Running discrete cosine transform.

The discrete cosine transform (DCT) has become an important tool in digital signal processing because its performance is close to the optimal Karhunen-Loeve transform. In this work the running discrete cosine transform (RDCT) is introduced. Using the properties of the discrete Fourier transform kernel W = exp (-2 pi j/N), a fast recursive algorithm was developed for real-time computation of the RDCT coefficients. For N-point RDCT the present algorithm needs only 2N real multiplications. The hardware implementations of the RDCT algorithm and applications in real-time data processing are discussed.

Algorithms↗

Boehler's angle and the critical angle of Gissane are of limited use in diagnosing calcaneus fractures in the ED.

STUDY OBJECTIVES: The aim of this study was to determine the use of Boehler's angle (BA) and the critical angle of Gissane (CAG) in diagnosing calcaneus fractures in the ED. DESIGN: The study was conducted as a randomized, blinded, case-control trial. CASES: One hundred thirty-three patients older than 15 years were included in the study. Sixty-five patients with computed tomography-verified calcaneus fractures (gold standard) and 68 ED patients with lateral foot or ankle x-rays without calcaneus fractures were included in the study. METHODS: One second-year emergency medicine resident, 1 third-year emergency medicine resident, 2 board-certified emergency medicine attending physicians, and 1 board-certified radiologist prospectively reviewed all films using the Picture Archival and Communication System digital radiology system. Cases and controls were randomized and the participants were blinded to final radiographic diagnoses. Participants determined whether there was a fracture on each x-ray and measured BA and the CAG using the digital angle tool in the Picture Archival and Communication System. RESULTS: Emergency physicians were 97.9% accurate in diagnosing calcaneus fractures (range, 97% to 99%). The mean kappa value for emergency physicians was 0.96 (range, 0.94-0.985). Receiver operating characteristic curves were constructed for BA and the CAG. When compared with the gold standard, the area under the curve for BA ranged from 0.82 to 0.88. The area under the curve for the CAG ranged from 0.45 to 0.67. BA had an interclass correlation coefficient of 0.84 (95% confidence interval, 0.79-0.87). The CAG interclass correlation was 0.52 (95% confidence interval, 0.43-0.60). One fracture was missed by the radiologist and all of the emergency physicians because it was only visible on computed tomography. CONCLUSION: BA is somewhat helpful and the CAG is not useful in diagnosing calcaneus fractures in the ED. Interrater reliability for BA is excellent, but for the CAG, it is poor. Emergency physicians were 97.9% accurate in making the diagnosis by reviewing the plain films without "assistance" of the angle measurements.

Area Under Curve↗

Fingerprint image enhancement by differential hysteresis processing.

A new method to enhance defective fingerprints images through image digital processing tools is presented in this work. When the fingerprints have been taken without any care, blurred and in some cases mostly illegible, as in the case presented here, their classification and comparison becomes nearly impossible. A combination of spatial domain filters, including a technique called differential hysteresis processing (DHP), is applied to improve these kind of images. This set of filtering methods proved to be satisfactory in a wide range of cases by uncovering hidden details that helped to identify persons. Dactyloscopy experts from Policia Federal Argentina and the EAAF have validated these results.

Dermatoglyphics↗

Gender and age effects in structural brain asymmetry as measured by MRI texture analysis.

Effects of gender and age on structural brain asymmetry were studied by 3D texture analysis in 380 adults. Asymmetry is detected by comparing the complex 3D gray-scale image patterns in the left and right cerebral hemispheres as revealed by anatomical T1-weighted MRI datasets. The Talairach and Tournoux parcellation system was applied to study the asymmetry on five levels: the whole cerebrum, nine coronal sections, 12 axial sections, boxes resulting from both coronal and axial subdivisions, and by a sliding spherical window of 9 mm diameter. The analysis revealed that the brain asymmetry increases in the anterior-posterior direction starting from the central region onward. Male brains were found to be more asymmetric than female. This gender-related effect is noticeable in all brain areas but is most significant in the superior temporal gyrus, Heschl's gyrus, the adjacent white matter regions in the temporal stem and the knee of the optic radiation, the thalamus, and the posterior cingulate. The brain asymmetry increases significantly with age in the inferior frontal gyrus, anterior insula, anterior cingulate, parahippocampal gyrus, retrosplenial cortex, coronal radiata, and knee region of the internal capsule. Asymmetry decreases with age in the optic radiation, precentral gyrus, and angular gyrus. The texture-based method reported here is based on extended multisort cooccurrence matrices that employ intensity, gradient, and anisotropy features in a uniform way. It is sensitive, simple to reproduce, robust, and unbiased in the sense that segmentation of brain compartments and spatial transformations are not necessary. Thus, it should be considered as another tool for digital morphometry in neuroscience.

Adolescent↗

Nasopharyngeal polyps in cats.

Nasopharyngeal polyps are non-neoplastic, inflammatory growths that arise from the middle ear or the eustachian tube and extend into the pharynx. The exact etiology of nasopharyngeal polyps is unclear; proposed etiologies include a response to chronic upper respiratory tract infection, chronic otitis media, ascending infection from the nasopharynx, or a congenital origin. Clinical signs usually relate to obstruction of the nasopharynx, with Horner's syndrome and head tilt being consistent with otitis media and otitis interna, respectively. Diagnostic tools include digital or visual examination above the soft palate, flexible fiberoptic caudal rhinoscopy, radiography, computed tomography, and magnetic resonance imaging. Ventral bulla osteotomy combined with traction removal of the polyp is the recommended treatment, although traction only followed by prednisolone therapy can be considered in some cases, especially when there is no evidence of otitis media.

Animals↗

The return of measles: a dangerous comeback.

PURPOSE OF REVIEW: Measles has reemerged as a significant global public health threat, with increasing morbidity and mortality associated with declining vaccination rates. This review summarizes current global outbreaks, history of measles, vaccination and elimination status, vaccine hesitancy, and outbreak response and lessons learned highlighting different novel digital epidemiological tools. RECENT FINDINGS: Measles continues to surge worldwide with an estimated 11 million infections in 2024, which is more than prepandemic levels. Developing and developed countries are both facing measles outbreaks, with the United States at risk of losing measles elimination status. Recent studies have showed that worldwide percentages of two-dose measles vaccination were lower than 95% that is required to interrupt measles transmission in all WHO regions. Novel epidemiological tools such as interactive simulators, real-time use of dynamic models, serosurveillance, and others are transforming measles outbreak response and enable earlier outbreak detection, tracking, and targeted public health interventions. SUMMARY: Vaccine hesitancy is one of the top global health threats and developing a tailored evidence-based approach is necessary to establish and maintain measles elimination.

Humans↗

Phenotypic changes in mitochondrial membrane potential (Delta psi(m)) during valinomycin-induced depolarisation and apoptosis.

A large body of evidence has implicated mitochondria in control of cell death, where key apoptotic mechanisms involve change in mitochondrial membrane permeability and depolarisation of mitochondrial membrane potential (Delta psi(m)). Assessment of Delta psi(m) is traditionally conducted using the lipophilic cation JC-1 on the flow cytometer or by fluorescent microscopy. Here we assess JC-1 aggregation using the novel tool of digital texture analysis to establish mitochondrial phenotypic changes induced by the K+ ionophore, valinomycin in a unique model comprising SW480 and SW620 cell lines. This provides an opportunity to study these phenomena in the context of colorectal cancer. Valinomycin-induced apoptosis was detected using morphology and analysis of DNA content. Cells were treated with valinomycin, images digitally recorded on a calibrated video photometer and subjected to high resolution digital texture analysis. This demonstrated that the HARAM texture features (Mean of the Haralick texture features) were highly valuable in describing the transition of Delta psi(m) as the cell undergoes apoptosis. In conclusion this study illustrates the potential of texture analysis as a novel and additional technique for quantifying JC-1 aggregation and revealing the spectrum of collapse of Delta psi(m) during apoptosis.

Apoptosis↗