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#32746093   2020/05/28 To Up

Iterative augmentation of visual evidence for weakly-supervised lesion localization in deep interpretability frameworks: application to color fundus images.

Interpretability of deep learning (DL) systems is gaining attention in medical imaging to increase experts' trust in the obtained predictions and facilitate their integration in clinical settings. We propose a deep visualization method to generate interpretability of DL classification tasks in medical imaging by means of visual evidence augmentation. The proposed method iteratively unveils abnormalities based on the prediction of a classifier trained only with image-level labels. For each image, initial visual evidence of the prediction is extracted with a given visual attribution technique. This provides localization of abnormalities that are then removed through selective inpainting. We iteratively apply this procedure until the system considers the image as normal. This yields augmented visual evidence, including less discriminative lesions which were not detected at first but should be considered for final diagnosis. We apply the method to grading of two retinal diseases in color fundus images: diabetic retinopathy (DR) and age-related macular degeneration (AMD).We evaluate the generated visual evidence and the performance of weakly-supervised localization of different types of DR and AMD abnormalities, both qualitatively and quantitatively. We show that the augmented visual evidence of the predictions highlights the biomarkers considered by experts for diagnosis and improves the final localization performance. It results in a relative increase of 11.2±2.0% per image regarding sensitivity averaged at 10 false positives/image on average, when applied to different classification tasks, visual attribution techniques and network architectures. This makes the proposed method a useful tool for exhaustive visual support of DL classifiers in medical imaging.
Cristina Gonzalez-Gonzalo, Bart Liefers, Bram van Ginneken, Clara I Sanchez

1446 related Products with: Iterative augmentation of visual evidence for weakly-supervised lesion localization in deep interpretability frameworks: application to color fundus images.

1 G100ug Lyophilized 100ul0.1 ml0.25 mg 100ul1 mg250 mg600 Tests / Kit 100ul 100ul

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#32745970   2020/07/31 To Up

Heart failure and diabetes: role of ATM.

Heart failure is a leading cause of death in the United States. Diabetes, also known as diabetes mellitus (DM), exponentially increases the risk of heart failure. The increase in oxidative stress and metabolic dysfunction caused by DM can lead to DNA damage and the development of diabetic cardiomyopathy. Ataxia telangiectasia mutated kinase (ATM) is a DNA damage response protein with a primary nuclear function to regulate cell cycle progression in response to double-strand DNA breaks, acts as a redox sensor, and facilitates DNA repair. ATM deficiency associates with the development of insulin resistance and DM. Consequently, patients with Ataxia telangiectasia, a rare autosomal recessive disorder, have an increased risk of developing heart failure. The main objective of this review is to summarize the shared metabolic and cardiac abnormalities associated with DM and ATM deficiency, with a focus on the development of heart failure.
Mary C Wingard, Chad R Frasier, Mahipal Singh, Krishna Singh

2414 related Products with: Heart failure and diabetes: role of ATM.

100 UG1,000 tests100ul 50 UG1 mg1 ml0.25 mg1 mL100ug100 mg 5 G

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#32745956   2020/07/13 To Up

Sleep and orexin: A new paradigm for understanding behavioural-variant frontotemporal dementia?

Behavioural variant frontotemporal dementia (bvFTD) is a complex and heterogeneous disorder with as yet unidentified unifying pathophysiological mechanism. There is emerging evidence that hypothalamic dysfunction, manifesting as disturbances in sleep and metabolism, is an integral component of neurodegeneration in bvFTD. Although sleep and metabolic disturbances and the behavioural abnormalities of bvFTD may appear disparate on the surface, there may be a common underlying hormonal mechanism involving orexin. Orexin is a hypothalamic neurotransmitter directly responsible for control of sleep and metabolism in healthy individuals and is implicated in many abnormal behaviours commonly seen in bvFTD - such as impulsive behaviour, hedonistic reinforcement and binge-consumption of ethanol. Further characterising orexin's role in pathophysiology of bvFTD could lead to a new paradigm for understanding this disease and may provide a new direction towards effective management and treatment.
Yun Tae Hwang, Olivier Piguet, John R Hodges, Ron Grunstein, James R Burrell

1596 related Products with: Sleep and orexin: A new paradigm for understanding behavioural-variant frontotemporal dementia?

100ug1.0 mg100ug25 mg250 ml100ug Lyophilized 5 G25 g100ug 1 G100.00 ug

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#32745912   2020/07/31 To Up

Therapeutic investigation of quercetin nanomedicine in a zebrafish model of diabetic retinopathy.

Diabetic retinopathy (DR) is progressive damage to the retina and it's caused by damage to the blood-retinal barrier. Quercetin has pleiotropic action like anti-oxidant, regulation cell cycle &vascular integrity, and preventive effect of neuroinflammation. The present study is designed to investigate the nano-formulation of quercetin (NQ) in a zebrafish model of DR. The DR was developed by a single intraperitoneal injection of streptozotocin (STZ; 350 mg/kg). The acceleration of retinopathy was made on 7 days of diabetic zebrafish by intravitreal injection of STZ (20 μL of 7 % w/v of STZ stock solution). The treatment of NQ (5 and 10 mg/kg; i.p.) was administered for 21 consecutive days. The reference control i.e., dexamethasone (DEX, 10 mg/kg; i.p.) was also administered for 21 consecutive days. The sign of DR was assessed by eyeball/body weight ratio, eyeball weight, optomotor response (OMR), startle response (SR), phototactic response (PTR), and escape response (ER). Furthermore, the biochemical changes like plasma glucose and homocysteine (HCY) levels; and eye retinal tissue lipid peroxidation, reduced glutathione (GSH), and arginase reductase (AR) activity levels were assessed. The NQ found to attenuate the effect of STZ induced DR along with the regulation of biochemical abnormalities. And, it also comparable with reference drug treatment i.e., DEX treated group. Hence, NQ can be used for the treatment of diabetic associated retinopathy and neurosensory disorder visits anti-hyperglycemic, regulation of homocysteine pathway, reduction of lipid peroxidation, and free radical scavenging actions.
Shuai Wang, Shanshan Du, Wenzhan Wang, Fengyan Zhang

2661 related Products with: Therapeutic investigation of quercetin nanomedicine in a zebrafish model of diabetic retinopathy.

100 μg100 μg100 μg100 μg100 μg100 μg100 μg100 μg100 μg

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#32745805   2020/07/22 To Up

Bilateral thalamic changes in anti-NMDAR encephalitis presenting with hemichorea and dystonia and acute transient psychotic disorder.

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is one of the most common causes of autoimmune encephalitis. Both movement disorders and neuropsychiatric manifestations are considered core features of anti-NMDAR encephalitis. Strong clinical suspicion, along with NMDAR antibody positivity in paired sample of serum and cerebrospinal fluid, with supportive MRI changes clinch diagnosis in majority. We herein report a case of a middle-aged woman with subacute behavioral abnormalities, which were so severe that forced her to attempt suicide. Hemichorea and dystonia, which appeared later in course, are not previously reported movement disorders in combination in anti-NMDAR encephalitis. Further, magnetic resonance imaging showed bilateral thalamic hyperintensities with diffusion restriction, which are in turn not described in this entity. After amalgamation of history, especially the presence of neuropsychiatric symptoms, clinical features, physical examination, and investigations, the diagnosis of anti-NMDAR encephalitis could be established. Our case not only highlights that the combination of hemichorea and dystonia can be features of anti-NMDAR encephalitis, but adds novelty by bilateral symmetric thalamic changes.
Souvik Dubey, Ritwik Ghosh, Mahua Jana Dubey, Samya Sengupta, Julián Benito-León, Biman Kanti Ray

1548 related Products with: Bilateral thalamic changes in anti-NMDAR encephalitis presenting with hemichorea and dystonia and acute transient psychotic disorder.

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#32745763   2020/07/31 To Up

The role of glutathione redox imbalance in autism spectrum disorder: A review.

The role of glutathione in autism spectrum disorder (ASD) is emerging as a major topic, due to its role in the maintenance of the intracellular redox balance. Several studies have implicated glutathione redox imbalance as a leading factor in ASD, and both ASD and many other neurodevelopmental disorders involve low levels of reduced glutathione (GSH), high levels of oxidized glutathione (GSSG), and abnormalities in the expressions of glutathione-related enzymes in the blood or brain. Glutathione metabolism, through its impact on redox environment or redox-independent mechanisms, interferes with multiple mechanisms involved in ASD pathogenesis. Glutathione-mediated regulation of glutamate receptors [e.g., N-methyl-d-aspartate (NMDA) receptor], as well as the role of glutamate as a substrate for glutathione synthesis, may be involved in the regulation of glutamate excitotoxicity. However, the interaction between glutathione and glutamate in the pathogenesis of brain diseases may vary from synergism to antagonism. Modulation of glutathione is also associated with regulation of redox-sensitive transcription factors nuclear factor kappa B (NF-κB) and activator protein 1 (AP-1) and downstream signaling (proinflammatory cytokines and inducible enzymes), thus providing a significant impact on neuroinflammation. Mitochondrial dysfunction, as well as neuronal apoptosis, may also provide a significant link between glutathione metabolism and ASD. Furthermore, it has been recently highlighted that glutathione can affect and modulate DNA methylation and epigenetics. Review analysis including research studies meeting the required criteria for analysis showed statistically significant differences between the plasma GSH and GSSG levels as well as GSH:GSSG ratio in autistic patients compared with healthy individuals (P = 0.0145, P = 0.0150 and P = 0.0202, respectively). Therefore, the existing data provide a strong background on the role of the glutathione system in ASD pathogenesis. Future research is necessary to investigate the role of glutathione redox signaling in ASD, which could potentially also lead to promising therapeutics.
Geir Bjørklund, Alexey A Tinkov, Božena Hosnedlová, Rene Kizek, Olga P Ajsuvakova, Salvatore Chirumbolo, Margarita G Skalnaya, Massimiliano Peana, Maryam Dadar, Afaf El-Ansary, Hanan Qasem, James B Adams, Jan Aaseth, Anatoly V Skalny

2732 related Products with: The role of glutathione redox imbalance in autism spectrum disorder: A review.

1100 ml. 100 UG

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#32745637   2020/07/31 To Up

Methods to evaluate serogroup B meningococcal vaccines: From predictions to real-world evidence.

Serogroup B meningococci (MenB) remain a prominent cause of invasive meningococcal disease (IMD). The protein-based multicomponent 4CMenB and the bivalent MenB-FHbp are the only currently available vaccines against MenB-caused IMD. Efficacy studies are not possible, due to the low incidence of IMD. Therefore, the vaccines' immunogenicity has been evaluated against several target strains chosen to quantify complement-mediated killing induced by each vaccine component in the serum bactericidal antibody assay. However, due to the wide genetic diversity and different expression levels of vaccine antigens across MenB strains, vaccine performance may differ from one strain to another. Here, we review the methods used to predict MenB strain coverage for 4CMenB and MenB-FHbp. Phenotypic assays such as the meningococcal antigen typing system (MATS, 4CMenB-specific) and the flow cytometric meningococcal antigen surface expression assay (MEASURE; MenB-FHbp-specific) were developed. Genomic approaches are also available, such as genetic MATS (gMATS) and the Bexsero antigen sequence type (BAST) scheme, both 4CMenB-specific. All methods allow tentative predictions of coverage across MenB strains, including that afforded by each vaccine antigen, and are rapid and reproducible. Real-world data on vaccine effectiveness are needed to confirm predictions obtained by these methods.
Ray Borrow, Muhamed-Kheir Taha, Marzia Monica Giuliani, Mariagrazia Pizza, Angelika Banzhoff, Rafik Bekkat-Berkani

1639 related Products with: Methods to evaluate serogroup B meningococcal vaccines: From predictions to real-world evidence.

30 m Pcs Per Pack100 mg30 m Pcs Per Pack25 mg100 ul500 mg1 mg100 extractions100 480/kit5 g600 Tests / Kit

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#32745634   2020/07/31 To Up

Perioperative mortality as a meaningful indicator: Challenges and solutions for measurement, interpretation, and health system improvement.

Expanding global access to safe surgical and anaesthesia care is crucial to meet the health targets of the Sustainable Development Goals (SDGs). As global surgical volume increases, improving safety throughout the patient care pathway is a public health priority. At present, an estimated 4.2 million individuals die within 30 days of surgery each year, and many of these deaths are preventable. Important considerations for the collection and reporting of perioperative mortality data have been identified in the literature, but consensus has not been established on the best methodology for the quantification of excess surgical mortality at a hospital or health system level. In this narrative review, we address challenges in the use of perioperative mortality rates (POMR) for improving patient safety. First, we discuss controversies in the use of POMR as a health system indicator and suggest advantages for using a "basket" of procedure-specific mortality rates as an adjunct to gross POMR. We offer then solutions to challenges in the collection and reporting of POMR data, and propose interventions for improving care in the preoperative, operative, and postoperative periods. Finally, we discuss how health systems leaders and frontline clinicians can integrate surgical safety into both national health plans and patient care pathways to drive a sustainable safety revolution in perioperative care.
Joshua S Ng-Kamstra, Dmitri Nepogodiev, Ismaïl Lawani, Aneel Bhangu

2049 related Products with: Perioperative mortality as a meaningful indicator: Challenges and solutions for measurement, interpretation, and health system improvement.

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#32745555   2020/07/31 To Up

Rituximab and antimetabolite treatment of granulomatous and lymphocytic interstitial lung disease in common variable immunodeficiency.

Granulomatous and lymphocytic interstitial lung disease (GLILD) is a life-threatening complication in patients with CVID, but the optimal treatment is unknown.
James W Verbsky, Mary K Hintermeyer, Pippa M Simpson, Mingen Feng, Jody Barbeau, Nagarjun Rao, Carlyne D Cool, Luis A Sosa-Lozano, Dhiraj Baruah, Erin Hammelev, Alyssa Busalacchi, Amy Rymaszewski, Jeff Woodliff, Shaoying Chen, Mary Bausch-Jurken, John M Routes

2410 related Products with: Rituximab and antimetabolite treatment of granulomatous and lymphocytic interstitial lung disease in common variable immunodeficiency.

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