Online Learning With Uncertain Feedback Graphs.

Online learning with expert advice is widely used in various machine learning tasks. It considers the problem where a learner chooses one from a set of experts to take advice and make a decision. In many learning problems, experts may be related, henceforth the learner can observe the losses associated with a subset of experts that are related to the chosen one. In this context, the relationship among experts can be captured by a feedback graph, which can be used to assist the learner's decision-making. However, in practice, the nominal feedback graph often entails uncertainties, which renders it impossible to reveal the actual relationship among experts. To cope with this challenge, the present work studies various cases of potential uncertainties and develops novel online learning algorithms to deal with uncertainties while making use of the uncertain feedback graph. The proposed algorithms are proved to enjoy sublinear regret under mild conditions. Experiments on real datasets are presented to demonstrate the effectiveness of the novel algorithms.

The Association between Tumor-associated Macrophages and Glioblastoma: A Potential Target for Therapy.

Glioblastoma multiforme (GBM) is the most common malignant brain tumor in adults, causing many deaths each year. The life expectancy of patients from the time of diagnosis does not exceed 15 months. Tumoral cells are generally surrounded by a bed of tumor microenvironment (TME), composed of various components such as different immune cells, stromal cells, and blood vessels. Previous studies on the treatment of this tumor have generally focused on cancerous cells and, therefore, have introduced conventional therapies for eradicating this tumor, including maximal safe surgery, chemotherapy with temozolomide (TMZ), and radiotherapy. Despite treatment with this method, tumors almost always recur, and life expectancy has not increased much. Recently, due to the discovery of the various roles of immune cells (including tumor-associated macrophages or TAMs) in the pathogenesis of this disease, the path of studies has moved towards targeting them as a treatment for glioblastoma. In this review, we aimed to investigate recent studies on the different roles of TME components, the role of TAM in the pathogenesis, and novel methods that target TAMs, including induction of TAM repolarization, inhibition of TAM-produced cytokines, and prohibition of immune system suppression induced by TAMs. In this regard, various targets, including colony-stimulating factor-1 (CSF- 1) receptors, Nuclear factor-kappa B (NF-κB), or chemokine receptor (CXCR) pathways, are investigated.

Three-Level De-Multiplexed Dual-Branch Complex Delta-Sigma Transmitter.

In this paper, a dual-branch topology driven by a Delta-Sigma Modulator (DSM) with a complex quantizer, also known as the Complex Delta Sigma Modulator (CxDSM), with a 3-level quantized output signal is proposed. By de-multiplexing the 3-level Delta-Sigma-quantized signal into two bi-level streams, an efficiency enhancement over the operational frequency range is achieved. The de-multiplexed signals drive a dual-branch amplification block composed of two switch-mode back-to-back power amplifiers working at peak power. A signal processing technique known as quantization noise reduction with In-band Filtering (QNRIF) is applied to each of the de-multiplexed streams to boost the overall performances; particularly the Adjacent Channel Leakage Ratio (ACLR). After amplification, the two branches are combined using a non-isolated combiner, preserving the efficiency of the transmitter. A comprehensive study on the operation of this topology and signal characteristics used to drive the dual-branch Switch-Mode Power Amplifiers (SMPAs) was established. Moreover, this work proposes a highly efficient design of the amplification block based on a back-to-back power topology performing a dynamic load modulation exploiting the non-overlapping properties of the de-multiplexed Complex DSM signal. For experimental validation, the proposed de-multiplexed 3-level Delta-Sigma topology was implemented on the BEEcube™ platform followed by the back-to-back Class-E switch-mode power amplification block. The full transceiver is assessed using a 4th-Generation mobile communications standard LTE (Long Term Evolution) standard 1.4 MHz signal with a peak to average power ratio (PAPR) of 8 dB. The dual-branch topology exhibited a good linearity and a coding efficiency of the transmitter chain higher than 72% across the band of frequency from 1.8 GHz to 2.7 GHz.

Is Intra-Articular Steroid Injection to the Temporomandibular Joint for Juvenile Idiopathic Arthritis More Effective and Efficient When Performed With Image Guidance?

PURPOSE: To compare short-term outcomes and procedure times for intra-articular steroid injection (IASI) to the temporomandibular joint (TMJ) with and without the use of intraoperative image guidance for patients with juvenile idiopathic arthritis (JIA). MATERIALS AND METHODS: This is a retrospective study of children with JIA who underwent TMJ IASI at Boston Children's Hospital (Boston, MA). Patients were divided into groups according to IASI technique: 1) "landmark" group if performed by an oral and maxillofacial surgeon using an anatomic landmark technique with no intraoperative image guidance or 2) "image-guided" group if performed by an interventional radiologist using intraoperative ultrasound and computed tomography. Predictor variables included IASI technique (landmark vs image guided), age, gender, JIA subtype, category of medications for arthritis, and presence of family history of autoimmune disease. Outcome variables were changes in patient-reported pain, maximal incisal opening (MIO), synovial enhancement ratio (ER), and total procedure time. RESULTS: Forty-five patients with 71 injected TMJs were included. Twenty-two patients with 36 injected TMJs were in the landmark group and 23 patients with 35 injected joints were in the image-guided group. There were no relevant differences in age, gender, family history of rheumatologic disease, or disease subtype between groups. There were no differences in resolution of pain (P = 1.00), increase in MIO (P = .975), or decrease in ER (P = .492) between groups, but procedure times averaged 49 minutes longer for the image-guided group (P < .008). CONCLUSIONS: There were no statistical differences in short-term outcomes, but procedure times were longer for the image-guided group. Although specific indications for the use of image guidance might exist, routine use of this procedure cannot be justified.

Quantifying the Effect of Temporomandibular Joint Intra-Articular Steroid Injection on Synovial Enhancement in Juvenile Idiopathic Arthritis.

PURPOSE: To quantify the effect of intra-articular steroid injections (IASIs) on temporomandibular joint (TMJ) synovitis in children with juvenile idiopathic arthritis (JIA) using gadolinium-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: The present study was a retrospective study of children with JIA who had undergone TMJ IASIs at Boston Children's Hospital. The patients were included if they had undergone contrast-enhanced MRI both before and after IASI and if the pre-IASI MRI had demonstrated synovitis (enhancement ratio [ER] >1.55). Patients with TMJ pathology or pain unrelated to JIA or a history of facial trauma were excluded. The predictor variables were age, gender, JIA subtype, exposure to medications for arthritis, and a family history of autoimmune disease. The primary outcome variable was the ER. Additional outcome variables included patient-reported pain and the maximal incisal opening (MIO). RESULTS: Twenty-nine subjects (83% female) with a total of 50 injected TMJs were included. The average age at JIA diagnosis and at IASI was 6.8 ± 1.7 years and 12.1 ± 1.9 years, respectively. The mean follow-up period was 22.9 ± 4.3 months (range 5 to 48). The ER decreased in all injected joints, with a mean reduction of 1.05 ± 1.01 (P < .001). The post-IASI ER was less than the normal threshold (1.55) in 18% of the injected TMJs. IASI was associated with an elimination of pain in 89% of the subjects (P < .001) and in augmentation of the MIO by 5.8 ± 2.6 mm (P < .001). CONCLUSIONS: In children with JIA and TMJ synovitis, TMJ IASI was associated with a reduction in synovial enhancement, decreased pain, and an increased MIO. Only 18% of injected joints, however, experienced complete resolution of synovitis. These results support the use of IASI in the management of the pain and dysfunction associated with TMJ synovitis. Further study is required to determine the efficacy of IASI in limiting inflammation and future joint destruction.

Quantifying Temporomandibular Joint Synovitis in Children With Juvenile Idiopathic Arthritis.

OBJECTIVE: Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joints (TMJs) and is often undetected by history, examination, and plain imaging. Qualitative assessment of gadolinium-enhanced magnetic resonance images (MRIs) is currently the standard for diagnosis of TMJ synovitis associated with JIA. The purpose of this study is to apply a quantitative analysis of synovial enhancement to MRIs of patients with and without JIA to establish a disease threshold and sensitivity and specificity for the technique. METHODS: This is a retrospective case-control study of children (age ≤16 years) who had MRIs with gadolinium including the TMJs. Subjects were divided into a JIA group and a control group. From a coronal T1-weighted image, a ratio (enhancement ratio [ER]) of the average pixel intensity within three 0.2-mm2 regions of interest (ROIs) in the TMJ synovium to that of a 50-mm2 ROI of the longus capitis muscle was calculated. Receiver operating characteristic curves were used to determine the sensitivity and specificity. The inter- and intraexaminer reliability was evaluated with Bland-Altman plots and 2-way mixed, absolute agreement intraclass correlation coefficients. RESULTS: There were 187 and 142 TMJs included in the JIA and control groups, respectively. An ER threshold of 1.55 had a sensitivity and specificity for detecting synovitis of 91% and 96%, respectively. The inter- and intraexaminer reliability was excellent. CONCLUSION: Calculating a ratio of pixel intensity between the TMJ synovium and the longus capitis muscle is a reliable way to quantify synovial enhancement. An ER of 1.55 differentiates normal TMJs from those affected by inflammatory arthritis.

[Bourneville tuberous sclerosis and colonic polyposis]. / Sclérose tubéreuse de Bourneville et polypose colique.

Tuberous sclerosis is an autosomal dominant genetic disorder that is characterized by epilepsy, mental retardation and facial angiofibromas. Usually, the disease is diagnosed in childhood but there are frustrates form of tuberous sclerosis with or without genetic mutation. This clinical case about a man who is diagnosed a colonic polyposis, a rectal adenocarcinoma and a tuberous sclerosis.

La sclérose tubéreuse de Bourneville (STB) est une maladie génétique autosomique dominante qui se manifeste principalement par la triade épilepsie, retard mental et angiofibromes faciaux. Généralement, elle est diagnostiquée dans l'enfance, mais il existe des formes cliniques frustres avec ou sans mutations génétiques. La recherche d'autres manifestations cliniques peut aider au diagnostic notamment l'atteinte intestinale. Notre cas clinique rapporte la découverte d'une polypose intestinale et d'un cancer du rectum chez un patient méconnu de sa maladie génétique. L'intérêt est de voir, à partir de la littérature, la fréquence de la polypose colique ainsi que du cancer colorectal dans la STB et de se poser la question d'un dépistage systématique dans cette population.

[Complications of intravesical mitomycin chemotherapy, apropos of 2 clinical case reports]. / Complications de la chimiothérapie intravésicale par la mitomycine, à propos de deux observations cliniques.

Administration of intravesical chemotherapy by mitomycin C (MMC) is an adjuvant treatment of the recurrent superficial bladder cancer. Since use of MMC in 1967, many different toxicities were reported. Those are local toxicities. Systemic toxicity is rare. At the hand of 2 cases reports and recent literature, we discuss the possible complications of intravesical therapy with MMC.

[Calcification of the bladder wall following instillation of mitomycin C. Apropos of a case report]. / Calcification de la paroi vésicale après instillation de la mitomycine C. A propos d'une observation.

Bladder wall calcification is a rare complication of intravesical therapy with mitomycin C. We report a new case and discuss the pathogenic mechanism of this complication.

[Mucous prolapse of the urethra]. / Le prolapsus muqueux de l'urètre.

Urethral prolapse represent a rare cause of urological consultation. Frequent in older women, it also happens in under 10-year-old little girls with a racial predominance. For most cases, medical treatment and follow-up are sufficient, but failure of these or possible complications may necessitate a surgical correction. Circumferential excision and muco-mucous suture are effective treatments with very few complications. About four case-reports, we are reviewing here the literature and discussing etiopathogenic mechanisms and therapeutic options for this disease.