Fuzzy c-means method (FCM) is a popular tool for a fuzzy data processing. In the current study, a FCM-based method of fuzzy clustering in a kernel space has been implemented. First, a "kernel trick" is applied to the fuzzy c-means algorithm. Then, the new method is employed for a fast automated segmentation of demyelination plaques in Multiple Sclerosis (MS). The clusters in a Gaussian kernel space are analysed in the histogram context and used during the initial classification of the brain tissue. Received classification masks are then used to detect the region of interest, eliminate false positives and label MS lesions.
Clinical and biological assessment of the COVID-19 vaccine efficacy in the frail population is of crucial importance. The study focuses on measuring the levels of anti-SARS-CoV-2 IgG antibodies before and after BNT162b2 mRNA COVID-19 vaccination among long-term care facility (LTCF) elderly residents. We conducted a prospective, single-center, observational study among LTCF residents. The study protocol was based on three blood sample acquisitions: first taken at baseline—5 days before the first dose of the vaccine, second—20 days after the first dose, and third—12 days after the second shot of the vaccine. The comparison was made for two cohorts: patients with and without prior COVID-19 infection. The data was collected from January to March 2021. A total number of 78 LTCF residents (55 women and 23 men) aged 62–104, 85.72 ± 7.59 years (mean ± SD), were enrolled in the study. All study participants were investigated for the presence of SARS-CoV-2 anti-spike (S) protein IgG, using a chemiluminescent immunoassay. Frailty was assessed with the Clinical Frailty Scale. Among elderly COVID-19 survivors in LTCF, a single dose of vaccine significantly increased anti-SARS-CoV-2 IgG antibody levels. IgG concentration after a single and double dose was comparable, which may suggest that elderly COVID-19 survivors do not require a second dose of vaccine. For residents without a previous history of COVID-19, two doses are needed to achieve an effective serological response. The level of anti-SARS-CoV-2 IgG antibodies after vaccination with BNT162b2 mRNA COVID-19 did not correlate with the frailty and age of the studied individuals.
In this study an approach to open architecture computer-aided diagnosis (CAD) is presented. The traditional goal of a CAD system, to assist the physicians in performing the diagnosis and treatment, has been extended. The platform also supports the system designer in developing a new CAD workflow by implementing general-purpose modules as well as problem-dependent procedures. A new CAD may require new procedures to be added, yet some of the already implemented functions can be employed. The CAD environment is subjected to the developmental process of three systems: the multiple sclerosis CAD, the lung nodule CAD and the pneumothorax CAD. Modules and procedures are briefly described and the CAD systems are evaluated. Results obtained during the CAD evaluation show prospective flexibility of the infrastructure. The trade-offs, well known to CAD designers, can easily be handled by the operators in a user-friendly manner by choosing various workflow paths.
Deficiency in dopaminergic system function may be one of the hypothetical reasons of the frailty syndrome but its role still remains unclear. The aim of our study was to assess the frailty phenotype prevalence in geriatric inpatients with mild parkinsonian signs (MPS) and to investigate levodopa test in the frail patients with MPS. We examined 118 participants: 90 with MPS and 28 in control group (without MPS). The frailty syndrome presence was evaluated by the Fried criteria. Deficiency in dopaminergic system function was assessed by one of the modifications of an acute levodopa challenge test (LCT): in MPS group every patient was examined by performing Up and Go Test and also Step Test before and 3 h after taking 125 mg of Madopar (levodopa + benserazide). Sixty-nine study subjects (58%) met criteria for frailty. Fifty-five participants in MPS group (61.1% of MPS group) and fourteen (50%) in control group. All of the patients that scored positive in walk speed criterion of frailty were frail. When all MPS patients were considered, the number of components scored positive for frailty was directly related to the walk speed (r = -0.70, p < 0.0001). In MPS group LCT scores were significantly higher for frailty patients compared to non-frailty (p = 0.0027). When all MPS patients were considered, the number of components scored positive for frailty was directly related LCT score (r = 0.37, p = 0.0004). There was a relationship between LCT and walk speed (r = -0.31, p = 0.0032). Our observations provide new information about the relationship between frailty and MPS, suggest the need for increased awareness of frailty in MPS patients and conversely. Our study provides data for a discussion on pathophysiological background of the frailty syndrome (FS), emphasizing the theories of the important impact of dopaminergic system deficit and encourages further research on the role of LCT in measuring it.
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