Neural network and statistical analysis showed that the blotch detection method was somewhat more effective using relative color than using absolute color. The relative-color blotch detection method gave a diagnostic accuracy of about 77%.
Granularity, also called peppering and multiple blue-gray dots, is defined as an accumulation of tiny, blue-gray granules in dermoscopy images. Granularity is most closely associated with a diagnosis of malignant melanoma. This study analyzes areas of granularity with color and texture measures to discriminate granularity in melanoma from similar areas in non-melanoma skin lesions. The granular areas in dermoscopy images of 74 melanomas and 14 melanomas in situ were identified and manually selected. For 200 non-melanoma dermoscopy images, those areas which most closely resembled granularity in color and texture were similarly selected. Ten texture and twenty-two color measures were studied. The texture measures consisted of the average and range of energy, inertia, correlation, inverse difference, and entropy. The color measures consisted of absolute and relative RGB averages, absolute and relative RGB chromaticity averages, absolute and relative G/B averages, CIE X, Y, Z, X/Y, X/Z and Y/Z averages, R variance, and luminance. These measures were calculated for each granular area of the melanomas and the comparable areas in the non-melanoma images. Receiver operating characteristic (ROC) curve analysis showed that the best separation of melanoma images from non-melanoma images by granular area features was obtained with a combination of color and texture measures. Comparison of ROC results showed greater separation of melanoma from benign lesions using relative color than using absolute color. Statistical analysis showed that the four most significant measures of granularity in melanoma are two color measures and two texture measures averaged over the spots: relative blue, relative green, texture correlation, and texture energy range. The best feature set, utilizing texture and relative color measures, achieved an accuracy of 96.4% based on area under the receiver operating characteristic curve.
Topic: Systems-based Practice M aternal and neonatal mortality rates remain high in many low-income and middle-income countries. To attain the Millennium Development Goals 4 and 5, different approaches to improve birth outcomes have been tried, including community-based interventions. Effects on survival have been heterogeneous and uncertain. This systematic review and meta-analysis of randomized controlled trials (RCTs) was done to assess the effects of women's groups practicing participatory learning and action on birth outcomes in low-resource settings.Seven databases and citations from reference lists were searched for RCTs carried out in Bangladesh, India, Malawi, and Nepal. Inclusion criteria for studies in the systematic review included: RCT, the intervention contained the stages of a participatory learning and action cycle, most participants were aged 15-49 years, and outcomes reported included maternal mortality, neonatal mortality, and stillbirths. The participatory learning and action cycle had 4 phases: (1) identify and prioritize problems during pregnancy, delivery, and postpartum; (2) plan;(3) implement locally feasible strategies to address the priority problems; and (4) assess the activities. Subgroup analyses were carried out to identify population-level predictors of effect. Incremental cost-effectiveness ratios were used for trials in which significant effects on the neonatal mortality rate were reported. Cost-effectiveness was expressed as the incremental cost per neonatal death averted and life-year saved.Seven RCTs performed between 1999 and 2011 that included a total of 119,428 births met the inclusion criteria. Group facilitators in the participatory programs were local women who were not health workers; they coordinated 9-13 group meetings per month after receiving 7-11 days of training in maternal and newborn health and participatory facilitation techniques. Exposure to women's groups was associated with 37% and 23% reductions in maternal and neonatal mortality, respectively. No association was found between participatory learning programs and a reduction in stillbirths. The proportion of pregnant women participating in the groups was linearly associated with reductions in both maternal and neonatal mortality, but no evidence of associations was found between the effects of the intervention and background mortality or institutional delivery rates. In studies in which Z30% of pregnant women participated in women's groups, a 55% reduction in maternal mortality and a 33% reduction in neonatal morality was observed. The women's participatory learning and action groups had strong effects on clean delivery practices for home deliveries and noticeable effects on breastfeeding. Women's groups were a highly cost-effective intervention as determined by World Health Organization standards. The intervention could save an estimated 283,000 newborns and 41,100 mothers per year if implemented in rural areas of 74 countdown countries (those countries targeted for attaining Millennium Goals by 2015).Wome...
Background The presence of an atypical (irregular) pigment network (APN) can indicate a diagnosis of melanoma. This study sought to analyze the APN with texture measures. Methods For 106 dermoscopy images including 28 melanomas and 78 benign dysplastic nevi, the areas of APN were selected manually. Ten texture measures in the CVIPtools image analysis system were applied. Results Of the 10 texture measures used, correlation average provided the highest discrimination accuracy, an average of 95.4%. Discrimination of melanomas was optimal at a pixel distance of 20 for the 768 × 512 images, consistent with a melanocytic lesion texel size estimate of 4–5 texels per mm. Conclusion Texture analysis, in particular correlation average at an optimized pixel spacing, may afford automatic detection of an irregular pigment network in early malignant melanoma.
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