Learning-based landmark detection in pelvis x-rays with attention mechanism: data from the osteoarthritis initiative.

Patients with developmental dysplasia of the hip can have this problem throughout their lifetime. The problem is difficult to detect by radiologists throughout x-ray because of an abrasion of anatomical structures. Thus, the landmarks should be automatically and precisely located. In this paper, we propose an attention mechanism of combining multi-dimension information on the basis of separating spatial dimension. The proposed attention mechanism decouples spatial dimension and forms width-channel dimension and height-channel dimension by 1D pooling operations in the height and width of spatial dimension. Then non-local means operations are performed to capture the correlation between long-range pixels in width-channel dimension, as well as that in height-channel dimension at different resolutions. The proposed attention mechanism modules are inserted into the skipped connections of U-Net to form a novel landmark detection structure. This landmark detection method was trained and evaluated through five-fold cross-validation on an open-source dataset, including 524 pelvis x-ray, each containing eight landmarks in pelvis, and achieved excellent performance compared to other landmark detection models. The average point-to-point errors of U-Net, HR-Net, CE-Net, and the proposed network were 3.5651 mm, 3.6118 mm, 3.3914 mm and 3.1350 mm, respectively. The results indicate that the proposed method has the highest detection accuracy. Furthermore, an open-source pelvis dataset is annotated and released for open research.

Immunomodulatory drugs and the risk of serious infection in multiple myeloma: systematic review and meta-analysis of randomized and observational studies.

The effect of immunomodulatory drugs (IMiDs) on serious infection remains uncertain. We therefore conducted a systematic review and meta-analysis to assess the possible impact of IMiDs on serious infection in patients with multiple myeloma (MM). We searched randomized controlled trials (RCTs) and observational studies from databases that addressed the effect of IMiDs on serious infection in patients with MM. We pooled data from RCTs and observational studies separately and used the GRADE approach to rate the quality of evidence. Rates in patients with individual IMiDs at different treatment status ranged from 7.00 to 23.00%. The use of thalidomide- or lenalidomide-based regimen induction therapy for autologous stem cell transplantation (ASCT)-ineligible patients suggests increase in serious infection (RR = 1.59, 95% CI 1.31-1.93, p < 0.01). Compared to conventional therapy, IMiDs' induction in ASCT-eligible patients significantly decreases the risk of serious infection (RR = 0.82, 95% CI 0.72-0.94, p < 0.01). Lenalidomide-based therapy was associated with a significant increase in risk of serious infection in patients treated compared with conventional therapy (RR = 2.45, 95% CI 1.57-3.83, p < 0.01). The current evidence suggests that patients with MM treated with IMiDs are at a high risk of serious infection.

Association between vascular endothelial growth factor polymorphism and recurrent pregnancy loss: A systematic review and meta-analysis.

PURPOSE: Some studies have reported that vascular endothelial growth factor (VEGF) genetic polymorphisms are associated with recurrent pregnancy loss (RPL), but the results are controversial. This study is aimed to quantify the strength of this association. METHODS: A systematic review of the published literature from Medline, Springer, and China National Knowledge Infra structure (CNKI) databases was conducted and investigations of VEGF genetic polymorphisms in RPL were selected. We estimated the pooled odds ratio (OR) to assess this possible association. RESULTS: Fifteen case-control studies comprising 2702 cases and 2667 controls and including five genetic polymorphisms (rs3025039, rs833061, rs15703060, rs2010963 and rs699947) were eligible for this meta-analysis. The overall analysis suggested that only two genetic polymorphisms (rs1570360, rs3025039) were associated with increased risk of RPL. A significant increased risk between VEGF rs1570360 polymorphism and RPL was only found under the dominant model in Caucasians (OR=1.70, 95% CI 1.02-2.82, P=0.04). Whereas, we found that VEGF rs3025039 polymorphism was significantly associated with RPL both under the dominant and recessive model in East Asians, and their summary odd ratios and 95% CIs were 1.26, 1.04-1.53, P=0.02 and 2.94, 1.80-4.83, P=0, respectively. CONCLUSIONS: This meta-analysis showed that only rs1570360 (especially in Caucasians) and rs3025039 (especially in East Asians) may be risk factors for RPL.