Effective CBMIR System Using Hybrid Features-Based Independent Condensed Nearest Neighbor Model.

In recent times, a large number of medical images are generated, due to the evolution of digital imaging modalities and computer vision application. Due to variation in the shape and size of the images, the retrieval task becomes more tedious in the large medical databases. So, it is essential in designing an effective automated system for medical image retrieval. In this research study, the input medical images are acquired from new Pap smear dataset, and then, the visible quality of acquired medical images is improved by applying image normalization technique. Furthermore, the hybrid feature extraction is accomplished using histogram of oriented gradients and modified local binary pattern to extract the color and texture feature vectors that significantly reduces the semantic gap between the feature vectors. The obtained feature vectors are fed to the independent condensed nearest neighbor classifier to classify the seven classes of cell images. Finally, relevant medical images are retrieved using chi square distance measure. Simulation results confirmed that the proposed model obtained effective performance in image retrieval in light of specificity, recall, precision, accuracy, and f-score. The proposed model almost achieved 98.88% of retrieval accuracy, which is better compared to other deep learning models such as long short-term memory network, deep neural network, and convolutional neural network.

Identification of disease genes and assessment of eye-related diseases caused by disease genes using JMFC and GDLNN.

Early detection of disease genes helps humans to recover from certain gene-related diseases, like genetic eye diseases. This work identifies the possibility of eye diseasesfor the disease genes utilizing a Gaussian-activation function (G)-centric deeplearning neural network (GDLNN) model. In this work, human genes are selected by computing structural similarity and genes are clustered as disease genesand normal genes by using the JMFC clustering algorithm. Levy flight and Crossover and Mutation (LCM) centric Chicken Swarm Optimization (LCM-CSO) is employed for feature selection and GDLNN classifies the eye-related diseases for the input genes using the selected features.

Deep Learning Framework for Automatic Bone Age Assessment.

Bone age Assessment or the skeletal age is a general clinical practice to detect endocrine and metabolic disarrangement in child development. The bone age indicates the level of structural and biological growth better than chronological age calculated from the birth date. The X-Ray of the wrist and hand is used in common to estimate the bone age of a person. The degree of agreement among the automated methods used to evaluate the X-rays is more than any other manual method. In this work, we propose a fully automated deep learning approach for bone age assessment. The dataset used is from the 2017 Pediatric Bone Age Challenge released by the Radiological Society of North America. Each X-Ray image in this dataset is an image of a left hand tagged with the age and gender of the patient. Transfer learning is employed by using pre-trained neural network architecture. InceptionV3 architecture is used in the present work, and the difference between the actual and predicted age obtained is 5.921 months.Clinical Relevance- This provides an AI-based computer assistance system as a supplement tool to help clinicians make bone age predictions.

Preferences and their correlation between children and their parents' attitudes towards non-pharmacological behaviour guidance techniques - A cross-sectional study.

INTRODUCTION: Dental treatment for children requires the use of behaviour guidance techniques (BGTs), which are used in the dental office to make children cope with dental treatment. AIM: Evaluate how children and parents felt towards BGTs used in a dental office, by attitude meter and to correlate them. MATERIALS AND METHOD: Children (200) from 7-17 years and their parents were selected randomly to participate in the study. Each child and parent was asked to watch four video scenes of live BGTs, which include Tell Show Do (TSD), Modeling, Reward system, and Hand holding. A questionnaire collected demographic data, and their expressive attitudes were assessed using Line of favour (LOF) scale and Kruskal-Wallis Test. RESULTS: Most preferred BGTs for Group I was modeling, Group II Reward, Group III Tell Show Do, and Group IV was Modeling, with a mean score of 5.95, 6.04, 5.57, and 5.78, respectively. Gender wise preferences, 32% of boys and 34% of girls preferred modeling in Group I, whereas, in Group II, 20% of boys and 21% of girls preferred reward, respectively. Chi-square test revealed that there is no significant difference between the groups and gender for the preference of BGTs in Group I (P=0.893) and Group II (P=0.592). There was no significant correlation between preferences of children and their parents. CONCLUSION: Modeling was the most preferred BGT for primary school children and parents of High school children. A reward was the most preferred BGT for high school children. TSD was the most preferred BGT for parents of primary school children.

Codon usage bias analysis of genes linked with esophagus cancer.

Esophageal cancer involves multiple genetic alternations. A systematic codon usage bias analysis was completed to investigate the bias among the esophageal cancer responsive genes. GC-rich genes were low (average effective number of codon value was 49.28). CAG and GTA are over-represented and under-represented codons, respectively. Correspondence analysis, neutrality plot, and parity rule 2 plot analysis confirmed the dominance over mutation pressure in modulating the codon usage pattern of genes linked with esophageal cancer.

Assessing the risk factors for injuries to maxillary permanent incisors and soft tissues among school children - A cross-sectional study.

Aim: The present study aimed to determine the risk factors related to permanent maxillary incisors and soft tissue injuries along with providing information about the age distribution of trauma, overjet, lip competence and physical activity. Methods and Materials: The sample consisted of 2100 school children aged 8-14 years from 15 schools in the Nellore district. The sample was selected adopting a stratified random sampling method and screened applying WHO criteria for the oral examination. The screening was done in classrooms to obtain demographic data, including name, age, gender and children's experience to the maxillary incisor and soft tissue injuries. The injuries were categorized according to Andreasen classification. Overjet and lip competences were recorded, and physical activity was assessed using a questionnaire (PAQ-C). Results: Of the 2100 children, 228 (10.8%) had suffered traumatic injuries. Boys were 1.6 fold more prone to trauma than girls. Enamel fractures were a common type of trauma, and the commonly involved were maxillary central incisors. The relative risk for trauma is 1.215 times higher in increased overjet when compared to normal overjet. Incompetent lips showed 1.189 times greater risk of trauma. The high physical activity showed 1.692 times higher risk for trauma when compared to low physical activity. Conclusion: The prevalence of traumatic dental injuries among 8-14 year children was 10.8%. Boys were more commonly injured than girls. Increased overjet incompetent lips and high physical activities are risk factors for trauma. Enamel fracture was the most common type, and maxillary central incisors were the most common teeth having traumatic injuries.

Cell-Type-Specific Immune Dysregulation in Severely Ill COVID-19 Patients.

Recent studies have demonstrated immunologic dysfunction in severely ill coronavirus disease 2019 (COVID-19) patients. We use single-cell RNA sequencing (scRNA-seq) to analyze the transcriptome of peripheral blood mononuclear cells (PBMCs) from healthy (n = 3) and COVID-19 patients with moderate disease (n = 5), acute respiratory distress syndrome (ARDS, n = 6), or recovering from ARDS (n = 6). Our data reveal transcriptomic profiles indicative of defective antigen presentation and interferon (IFN) responsiveness in monocytes from ARDS patients, which contrasts with higher responsiveness to IFN signaling in lymphocytes. Furthermore, genes involved in cytotoxic activity are suppressed in both natural killer (NK) and CD8 T lymphocytes, and B cell activation is deficient, which is consistent with delayed viral clearance in severely ill COVID-19 patients. Our study demonstrates that COVID-19 patients with ARDS have a state of immune imbalance in which dysregulation of both innate and adaptive immune responses may be contributing to a more severe disease course.

Cell type-specific immune dysregulation in severely ill COVID-19 patients.

Coronavirus disease 2019 (COVID-19) has quickly become the most serious pandemic since the 1918 flu pandemic. In extreme situations, patients develop a dysregulated inflammatory lung injury called acute respiratory distress syndrome (ARDS) that causes progressive respiratory failure requiring mechanical ventilatory support. Recent studies have demonstrated immunologic dysfunction in severely ill COVID-19 patients. To further delineate the dysregulated immune response driving more severe clinical course from SARS-CoV-2 infection, we used single-cell RNA sequencing (scRNAseq) to analyze the transcriptome of peripheral blood mononuclear cells (PBMC) from hospitalized COVID-19 patients having mild disease (n = 5), developing ARDS (n = 6), and recovering from ARDS (n = 6). Our data demonstrated an overwhelming inflammatory response with select immunodeficiencies within various immune populations in ARDS patients. Specifically, their monocytes had defects in antigen presentation and deficiencies in interferon responsiveness that contrasted the higher interferon signals in lymphocytes. Furthermore, cytotoxic activity was suppressed in both NK and CD8 lymphocytes whereas B cell activation was deficient, which is consistent with the delayed viral clearance in severely ill COVID-19 patients. Finally, we identified altered signaling pathways in the severe group that suggests immunosenescence and immunometabolic changes could be contributing to the dysfunctional immune response. Our study demonstrates that COVID-19 patients with ARDS have an immunologically distinct response when compared to those with a more innocuous disease course and show a state of immune imbalance in which deficiencies in both the innate and adaptive immune response may be contributing to a more severe disease course in COVID-19.

Cell type-specific immune dysregulation in severely ill COVID-19 patients

Coronavirus disease 2019 (COVID-19) has quickly become the most serious pandemic since the 1918 flu pandemic. In extreme situations, patients develop a dysregulated inflammatory lung injury called acute respiratory distress syndrome (ARDS) that causes progressive respiratory failure requiring mechanical ventilatory support. Recent studies have demonstrated immunologic dysfunction in severely ill COVID-19 patients. To further delineate the dysregulated immune response driving more severe clinical course from SARS-CoV-2 infection, we used single-cell RNA sequencing (scRNAseq) to analyze the transcriptome of peripheral blood mononuclear cells (PBMC) from hospitalized COVID-19 patients having mild disease (n = 5), developing ARDS (n = 6), and recovering from ARDS (n = 6). Our data demonstrated an overwhelming inflammatory response with select immunodeficiencies within various immune populations in ARDS patients. Specifically, their monocytes had defects in antigen presentation and deficiencies in interferon responsiveness that contrasted the higher interferon signals in lymphocytes. Furthermore, cytotoxic activity was suppressed in both NK and CD8 lymphocytes whereas B cell activation was deficient, which is consistent with the delayed viral clearance in severely ill COVID-19 patients. Finally, we identified altered signaling pathways in the severe group that suggests immunosenescence and immunometabolic changes could be contributing to the dysfunctional immune response. Our study demonstrates that COVID-19 patients with ARDS have an immunologically distinct response when compared to those with a more innocuous disease course and show a state of immune imbalance in which deficiencies in both the innate and adaptive immune response may be contributing to a more severe disease course in COVID-19.

Analysis of Articulation Errors in Dysarthric Speech.

Imprecise articulation is the major issue reported in various types of dysarthria. Detection of articulation errors can help in diagnosis. The cues derived from both the burst and the formant transitions contribute to the discrimination of place of articulation of stops. It is believed that any acoustic deviations in stops due to articulation error can be analyzed by deriving features around the burst and the voicing onsets. The derived features can be used to discriminate the normal and dysarthric speech. In this work, a method is proposed to differentiate the voiceless stops produced by the normal speakers from the dysarthric by deriving the spectral moments, two-dimensional discrete cosine transform of linear prediction spectrum and Mel frequency cepstral coefficients features. These features and cosine distance based classifier is used for the classification of normal and dysarthic speech.

Minimally invasive lateral transpsoas approach for lumbar corpectomy and stabilization.

BACKGROUND: Here, we present our experience with the minimally invasive (MI) transpsoas approach for lumbar corpectomy and stabilization. Transpsoas approach accesses the lumbar spine and includes both the direct lateral interbody fusion and extreme lateral interbody fusion techniques. Both procedures utilize a tubular retractor system which facilitates adequate retraction and direct visualization of the target, while supposedly reducing soft tissue trauma. CASE DESCRIPTION: We evaluated two patients, one with a traumatic L2 wedge compression fracture and the other with an L3 pathological compression fracture due to multiple myeloma. Both patients underwent MI transpsoas lumbar corpectomy, anterior column reconstruction with an expandable cage, and posterior pedicle screw instrumentation to correct a kyphotic deformity. Both patients were mobilized on the 1st postoperative day and experienced significant postoperative pain relief. CONCLUSION: In two cases involving L2 and L3 compression fractures, MI transpsoas lumbar corpectomy was safely performed, with reduced perioperative and postoperative morbidity. Here, the transpsoas approach also allowed for early mobilization, adequate postoperative biomechanical stability, and resulted in immediate good outcomes.

Clinical and Radiographic Success of Three Adhesive Restorative Materials in Primary Molar Proximal Lesions: A Randomized Clinical Trial.

AIM: The aim of this study was to evaluate and compare the clinical and radiographic success of primary molar proximal lesions in 4-8 years children restored with three adhesive restorative materials followed up for 12 months. MATERIALS AND METHODS: This study was carried out on 102 primary molars of 51 children in the age range of 4-8 years. In all the participants, Class II lesions were restored and randomly allocated into three material groups as giomer group, nano-ionomer group, and light-cured glass-ionomer cement (LC-GIC) group based on the restorative material used. All the restorations were evaluated and scored according to federation dentaire internationale (FDI) criteria for clinical and radiographic success rate at 3, 6, and 12 months' interval. Data were formulated in a predesigned format and were subjected to statistical analysis using the Chi-square test and Fisher's exact test. RESULTS: There was no statistically significant difference observed among the restorative material groups to all the properties of FDI criteria. The overall success rates of restorative materials at 3, 6, and 12 months' interval were as follows: giomer - 100%, 100%, and 94.1%; nano-ionomer - 97%, 94%, and 85.3%; and LC-GIC - 100%, 94%, and 88.2%. CONCLUSION: The highest clinical success rate was found for the giomer group followed by LC-GIC group and the least for the nano-ionomer group, whereas the highest radiographic success rate was found for giomer as well as LC-GIC group and the least for nano-ionomer group.

Optimal technique of radiotherapy for carcinoma cervix in developing countries: Dosimetric and logistic comparison.

PURPOSE: Carcinoma cervix is the most common malignancy affecting women in developing countries. Radical radiotherapy is the mainstay of treatment in more than 90% of patients. The present study is a dosimetric and logistic comparison of various techniques of radiotherapy, namely two-dimensional conventional radiotherapy (2DCRT), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT). METHODS: All the patients underwent contrast-enhanced computed tomography (CT) scans for simulation. 2DCRT, 3DCRT, and IMRT plans were generated in 24 patients and dosimetrically compared. Radiotherapy treatment time involved in each technique was analyzed in 27 treated patients. RESULTS: The planning target volume (PTV) coverage was best in 3DCRT technique with a median coverage of 99.9% as compared to IMRT (99.3%) and 2DCRT (82.2%). There was progressive sparing of all the organs at risk in IMRT as compared to 3DCRT. The total planning time was longest in IMRT (332.1 min) and shortest in 2DCRT (11.7 min). The mean treatment time for the delivery of each fraction of 2DCRT, 3DCRT, and IMRT were 14.3, 13.6, and 24.7 min, respectively. CONCLUSION: 3DCRT technique is the most optimal technique for radical radiotherapy of cervical cancers with optimum PTV coverage, acceptable planning time, and minimal treatment time as compared to IMRT. 2DCRT technique should be limited to the setting where CT simulation is unavailable.

Early Competing Deaths in Locally Advanced Head-and-Neck Cancer.

INTRODUCTION: The competing (noncancer) deaths have increased with aggressive treatment approach and better disease control in locally advanced head-and-neck cancer. AIM: The aim of this study is to find incidence, cause and predictors of early competing mortality in locally advanced head-and-neck cancer patients undergoing combined modality therapy. SUBJECTS AND METHODS: In this retrospective study, a total of 125 locally advanced head-and-neck patients treated from January 2013 to June 2017 were analyzed. The total number of deaths, cause, and the time of death from the start of therapy was recorded. To study the risk factors of competing deaths, univariate and multivariate logistic regression was applied. Data were analyzed using SPSS v. 24 software. RESULTS: A total of 51 deaths (31 cancer deaths and 20 competing deaths) recorded at a median follow-up of 16 months (1-62 months). The incidence of early competing mortality was 12% (n = 15) with a median time of 2.7 months from treatment initiation. Sepsis was major cause of early competing death (n = 13). On univariate and multivariate logistic regression analysis, competing death was significantly associated with pharyngeal (oropharynx, hypopharynx, and larynx) site primary (odds ratio [OR] = 3.562; 95% confidential interval [CI] = 1.207-10.517; P = 0.016), and Stage IVA/IVB disease (OR = 5.104; 95% CI = 1.123-23.202; P = 0.021). CONCLUSION: Competing deaths is one of the multifaceted problems in locally advanced head-and-neck cancer patients. Sepsis being single most cause of early competing deaths in Stage IVA/IVB pharyngeal and laryngeal cancer.

Does attachment profiles influence child's behavior in pediatric dental clinic?

Although it was believed that attachment was due to the food provided by the parent figure, later it was proved that attachment is because the child considers parent figure as secure base. Hence, when a child feels distressed in dental operatory, the type of attachment pattern will determine the behavior of a child. This, in turn, could determine the weather parental presence is needed or not in dental operatory. Hence, attachment patterns could affect the quality of dental treatment delivered.

Analgesic and Opioid Use in Pain Associated with Head-and-Neck Radiation Therapy.

AIM: The aim of the study is to find the incidence of analgesic and opioid use in pain associated in HNC patient undergoing radiation therapy. BACKGROUND: Radiation therapy with concurrent chemotherapy has become the standard of care in head and neck cancer. Acute toxicity like mucositis and dysphagia has increased with aggressive therapy. Pain is an invariable accompaniment of oropharyngeal mucositis, which leads to decreased quality of life and treatment break. MATERIALS AND METHODS: This is a retrospective review of radiation charts of head and neck patients treated from January 2013 to June 2017 at St. John's Medical college and Hospital, Bengaluru. RESULTS: A total of 138 (92%) patients required analgesia during the radiation course. The analgesic consumption started increasing from week 2, peaked at week 5, persist for 6 weeks and started declining after week 10. 52% patients required opioids, especially from week 4 to week 8. 15% of patients required Morphine, the maximum use in week 6 to week 8. The use of chemotherapy (P = 0.031), presence of grade 3 mucositis (P = 0.010) and grade 3 dysphagia (P = 0.001) were significantly associated with severe pain (use of strong opioids). All 80 (100%) patients receiving concurrent chemotherapy required analgesia. More than 80% patients required opioids and one fourth required strong analgesic in concurrent chemotherapy group. CONCLUSION: More than 90% of all head and neck cancer patient undergoing radiation therapy experience therapy related pain for more than 6 weeks. 53% of the patients require opioids and 15% require strong opioids. The use of concurrent chemotherapy was significantly associated with severe pain.

Green, unexpected synthesis of bis-coumarin derivatives as potent anti-bacterial and anti-inflammatory agents.

A green and efficient protocol has been developed and a series of coumarin based pyrano[3,2-c]chromene derivatives (2) have been synthesized using multi-component reaction (MCR) approach. Unexpected 3-coumarinyl-3-pyrazolylpropanoic acids (3) and C4-C4 chromenes (5) have been isolated instead of expected product 4 by the reaction of compound (2) in formic acid at 90 °C for about 4-5 h and at 130 °C for about 8-10 h respectively. Further, C4-C4chromenes (5) formation was confirmed by intramolecular cyclization of compounds (3). These compounds were screened for their biological activities and most of them exhibited promising antibacterial activity. The anti-inflammatory assay was evaluated against HRBC membrane stabilization method and the compounds exhibit excellent anti-inflammatory activity. Molecular docking study has been performed for all the synthesized compounds with Klebsiella pneumoni aeacetolactate synthase and results obtained are quite promising.

Synthesis of Naked-eye Detectable Fluorescent 2H-chromen-2-One 2, 6-Dicyanoanilines: Effect of Substituents and pH on Its Luminous Behavior.

A variety of new coumarin derivatives containing C-4 bridged 2,6-dicyanoanilines (4a-4d) were synthesized via multicomponent one pot approach. These novel sensors were characterized by spectral analysis and a series of pH sensing fluorescence studies were performed, the results indicating that the sensors are highly selective and more effective at various pH. The fluorescence colour changes at different pH could be directly detected by naked eyes.

The Effectiveness of Articaine and Lidocaine Single Buccal Infiltration versus Conventional Buccal and Palatal Injection Using Lidocaine during Primary Maxillary Molar Extraction: A Randomized Control Trial.

BACKGROUND: Despite the advent of modern injection techniques, palatal injection continues to be a painful experience for children. AIMS: To compare the pain experienced during extraction of maxillary primary molars with conventional lignocaine anesthesia versus lignocaine and articaine buccal infiltration in children aged 6-14 years. MATERIALS AND METHODS: A prospective randomized triple blinded study was conducted with ninety children (n = 90), randomly allocated to receive lignocaine conventional anesthesia (Group I [control group]), and buccal infiltration using articaine (Group II [articaine group]) or lignocaine (Group III [lignocaine group]). A composite score of self-report (faces pain scale-revised), behavioral measure (face legs activity cry consolability scale), and a physiological response (pulse rate) was measured following maxillary primary molar extraction. STATISTICAL ANALYSIS USED: To test the mean difference between two groups, Students' t-test was used and among the three groups, one-way ANOVA with post hoc test was used. RESULTS: Articaine group had significantly lower pain scores for self-report (P < 000.1) and behavioral measures (P < 000.1) while there was no significant difference (P > 0.05) between articaine and control groups during primary maxillary molar extraction. CONCLUSION: Maxillary primary molar extraction procedure can be successfully accomplished by bypassing the palatal injection. Articaine buccal infiltration can be considered as an alternative to conventional local anesthesia for the extraction of maxillary primary molars.