Data-driven Shape Sensing of Continuum Dexterous Manipulators Using Embedded Capacitive Sensor.

We propose a novel inexpensive embedded capacitive sensor (ECS) for sensing the shape of Continuum Dexterous Manipulators (CDMs). Our approach addresses some limitations associated with the prevalent Fiber Bragg Grating (FBG) sensors, such as temperature sensitivity and high production costs. ECSs are calibrated using a vision-based system. The calibration of the ECS is performed by a recurrent neural network that uses the kinematic data collected from the vision-based system along with the uncalibrated data from ECSs. We evaluated the performance on a 3D printed prototype of a cable-driven CDM with multiple markers along its length. Using data from three ECSs along the length of the CDM, we computed the angle and position of its tip with respect to its base and compared the results to the measurements of the visual-based system. We found a 6.6% tip position error normalized to the length of the CDM. The work shows the early feasibility of using ECSs for shape sensing and feedback control of CDMs and discusses potential future improvements.

Current Status and Future Opportunities in Modeling Clinical Characteristics of Multiple Sclerosis.

Development of effective treatments requires understanding of disease mechanisms. For diseases of the central nervous system (CNS), such as multiple sclerosis (MS), human pathology studies and animal models tend to identify candidate disease mechanisms. However, these studies cannot easily link the identified processes to clinical outcomes, such as MS severity, required for causality assessment of candidate mechanisms. Technological advances now allow the generation of thousands of biomarkers in living human subjects, derived from genes, transcripts, medical images, and proteins or metabolites in biological fluids. These biomarkers can be assembled into computational models of clinical value, provided such models are generalizable. Reproducibility of models increases with the technical rigor of the study design, such as blinding, control implementation, the use of large cohorts that encompass the entire spectrum of disease phenotypes and, most importantly, model validation in independent cohort(s). To facilitate the growth of this important research area, we performed a meta-analysis of publications (n = 302) that model MS clinical outcomes extracting effect sizes, while also scoring the technical quality of the study design using predefined criteria. Finally, we generated a Shiny-App-based website that allows dynamic exploration of the data by selective filtering. On average, the published studies fulfilled only one of the seven criteria of study design rigor. Only 15.2% of the studies used any validation strategy, and only 8% used the gold standard of independent cohort validation. Many studies also used small cohorts, e.g., for magnetic resonance imaging (MRI) and blood biomarker predictors, the median sample size was <100 subjects. We observed inverse relationships between reported effect sizes and the number of study design criteria fulfilled, expanding analogous reports from non-MS fields, that studies that fail to limit bias overestimate effect sizes. In conclusion, the presented meta-analysis represents a useful tool for researchers, reviewers, and funders to improve the design of future modeling studies in MS and to easily compare new studies with the published literature. We expect that this will accelerate research in this important area, leading to the development of robust models with proven clinical value.

The Southern California Lupus Registry: I. Baseline characteristics of lupus patients in uncharted territory.

OBJECTIVE: This study aimed to determine the baseline characteristics of a multi-ethnic systemic lupus erythematosus (SLE) cohort in Southern California established with the intent of addressing regional health inequity. METHODS: Patients ≥18 years of age with SLE per the Systemic Lupus International Collaborating Clinics (SLICC) criteria were recruited into the Southern California Lupus Registry (SCOLR) if they resided in San Bernardino and Riverside counties in California. Individuals were categorized according to their stated ethnicity as non-Hispanic White, Hispanic, Black, or Asian. Descriptive statistics were utilized for analysis. Predictors of renal disease were assessed by binomial regression. RESULTS: The SCOLR cohort comprised 162 patients: 57 non-Hispanic White, 58 Hispanic, 17 Asian, and 30 Black. A difference in the rate of renal involvement and SLE duration was found among the four ethnic groups. Renal involvement was significantly higher in Hispanics compared with non-Hispanic Whites. CONCLUSION: In line with other cohorts, this study shows greater renal involvement in Hispanics than non-Hispanic Whites, demonstrating a need for more aggressive screening and early intervention to improve long-term outcomes. As a multi-ethnic SLE cohort, the SCOLR serves as a foundation for longitudinal studies addressing health inequity in this region.

Radiosurgery for mesial temporal lobe epilepsy following ROSE trial guidelines - A planning comparison between Gamma Knife, Eclipse, and Brainlab.

PURPOSE: This study aims to compare stereotactic radiosurgery (SRS) planning of epilepsy that complies with Radiosurgery or Open Surgery for Epilepsy (ROSE) guidelines in GammaKnife, non-coplanar conformal (NCC) plan in Eclipse, dynamic conformal arc (DCA) plan in Brainlab, and a volumetric modulated arc therapy (VMAT) plan in Eclipse. METHODS: Twenty plans targeting Mesial temporal lobe epilepsy (MTLE) was generated using GammaKnife, Eclipse with 20 NCC beams, Brainlab with 5 DCA, and Eclipse VMAT with 4 arcs observing ROSE trial guidelines. Multivariate analysis of variance and Wilcoxon signed-rank test were used to compare dosimetric data of the plans and perform pairwise comparison, respectively. RESULTS: The plans obeyed the recommended prescription isodose volume (PIV) within 5.5-7.5 cc and maximum doses to brainstem, optic apparatus (OA) of 10 and 8 Gy, respectively, for a prescription dose of 24 Gy. The volumes of the target were in the range 4.0-7.4 cc. Mean PIV, maximum dose to brainstem, OA were 6.5 cc, 10 Gy, 7.9 Gy in GammaKnife; 7.2 cc, 6.1 Gy, 4.5 Gy in Eclipse NCC; 7.2 cc, 6.4 Gy, 5.7 Gy in Brainlab DCA; and 5.2 cc, 8.4 Gy, 6.1 Gy in Eclipse VMAT plans, respectively. Multivariate analysis of variance showed significant differences among the 4 SRS planning techniques (P-values < 0.01). CONCLUSIONS: Among the 4 SRS planning methods, VMAT with least PIV and acceptable maximum doses to brainstem and OA showed highest compliance with ROSE trial. Having the most conformal dose distribution and least dose inhomogeneity, VMAT scored higher than GK, Eclipse NCC, and Brainlab DCA plans.

Nonbacterial Thrombotic Endocarditis: Pathogenesis, Diagnosis, and Management.

Nonbacterial thrombotic endocarditis (NBTE), formerly known as marantic endocarditis, is a potentially overlooked condition that involves the formation of sterile, fibrin vegetations on heart valve leaflets. Often confused with classic infective endocarditis during its early stages, NBTE can lead to valvular dysfunction, heart failure, and systemic embolization when unchecked. The pathogenesis is not entirely clear but involves a preexisting hypercoagulable state. Diagnosis requires ruling out infection and establishing the presence of valvular vegetations using echocardiography. Therapy for NBTE includes treating the underlying disease, systemic anticoagulation and surgical intervention.

Imaging intracellular quantum dots: fluorescence microscopy and transmission electron microscopy.

Quantum dots (QDs) and other nanoparticles require delivery and targeting for most intracellular applications. Despite many advances, intracellular delivery and targeting remains inefficient with many QDs remaining bound to the plasma membrane rather than internalized into the cell. The fluorescence resulting from these extracellular QDs results in a background signal that competes with intracellular QDs of interest. We present two methods for the reduction and discrimination of signal resulting from plasma membrane-bound QDs. The first method, a photophysical approach, uses an extracellular quencher to greatly reduce the fluorescence signal from extracellular QDs. This method is compatible with fast, widefield, fluorescence imaging in live cells. Results are presented for two extracellular quenchers, QSY-21 and trypan blue, used in combination with 655 nm emitting QDs. The use of an extracellular quencher can be extended to a wide variety of fluorophores. The second method uses transmission electron microscopy (TEM) to image thin (60-70 nm) slices of resin-embedded cells. The use of sectioned cells and high-resolution TEM makes it possible to discriminate between plasma membrane-bound and intracellular QDs. To overcome the difficulties associated with using TEM to image individual QDs in cells, we have utilized a silver enhancement method that significantly improves the contrast of QDs in TEM images.