Feasibility Study of "Snuffbox" Radial Access for Visceral Interventions.

"Snuffbox" radial access entails sheath insertion into the dorsal branch of the radial artery within the so-called anatomic snuffbox. The purpose of this report is to describe the technique and early experience in 50 visceral interventional procedures performed in 31 patients, which included liver embolotherapy, visceral arterial stent insertion, aneurysm embolization, and emergency embolization. In all cases, the procedures were successfully completed by using the snuffbox access, with a single case of asymptomatic pseudoaneurysm as the only access-related complication. Early experience showed that snuffbox radial access is technically feasible and represents a viable alternative to conventional radial access for visceral intervention procedures.

Efficacy of texture analysis of pre-operative magnetic resonance imaging in predicting microvascular invasion in hepatocellular carcinoma.

BACKGROUND: Presence of microvascular invasion (MVI) indicates poorer prognosis post-curative resection of hepatocellular carcinoma (HCC), with an increased chance of tumour recurrence. By present standards, MVI can only be diagnosed post-operatively on histopathology. Texture analysis potentially allows identification of patients who are considered 'high risk' through analysis of pre-operative magnetic resonance imaging (MRI) studies. This will allow for better patient selection, improved individualised therapy (such as extended surgical margins or adjuvant therapy) and pre-operative prognostication. AIM: This study aims to evaluate the accuracy of texture analysis on pre-operative MRI in predicting MVI in HCC. METHODS: Retrospective review of patients with new cases of HCC who underwent hepatectomy between 2007 and 2015 was performed. Exclusion criteria: No pre-operative MRI, significant movement artefacts, loss-to-follow-up, ruptured HCCs, previous hepatectomy and adjuvant therapy. Fifty patients were divided into MVI (n = 15) and non-MVI (n = 35) groups based on tumour histology. Selected images of the tumour on post-contrast-enhanced T1-weighted MRI were analysed. Both qualitative (performed by radiologists) and quantitative data (performed by software) were obtained. Radiomics texture parameters were extracted based on the largest cross-sectional area of each tumor and analysed using MaZda software. Five separate methods were performed. Methods 1, 2 and 3 exclusively made use of features derived from arterial, portovenous and equilibrium phases respectively. Methods 4 and 5 made use of the comparatively significant features to attain optimal performance. RESULTS: Method 5 achieved the highest accuracy of 87.8% with sensitivity of 73% and specificity of 94%. CONCLUSION: Texture analysis of tumours on pre-operative MRI can predict presence of MVI in HCC with accuracies of up to 87.8% and can potentially impact clinical management.

Deep Supervised Domain Adaptation for Pneumonia Diagnosis From Chest X-Ray Images.

Pneumonia is one of the most common treatable causes of death, and early diagnosis allows for early intervention. Automated diagnosis of pneumonia can therefore improve outcomes. However, it is challenging to develop high-performance deep learning models due to the lack of well-annotated data for training. This paper proposes a novel method, called Deep Supervised Domain Adaptation (DSDA), to automatically diagnose pneumonia from chest X-ray images. Specifically, we propose to transfer the knowledge from a publicly available large-scale source dataset (ChestX-ray14) to a well-annotated but small-scale target dataset (the TTSH dataset). DSDA aligns the distributions of the source domain and the target domain according to the underlying semantics of the training samples. It includes two task-specific sub-networks for the source domain and the target domain, respectively. These two sub-networks share the feature extraction layers and are trained in an end-to-end manner. Unlike most existing domain adaptation approaches that perform the same tasks in the source domain and the target domain, we attempt to transfer the knowledge from a multi-label classification task in the source domain to a binary classification task in the target domain. To evaluate the effectiveness of our method, we compare it with several existing peer methods. The experimental results show that our method can achieve promising performance for automated pneumonia diagnosis.

Predictors of allergen sensitization in Singapore children from birth to 3 years.

BACKGROUND: Immune responses in allergic diseases begin with allergen sensitization, which usually occurs in childhood. Allergen sensitization involves a complex interplay of genetic and environmental factors, and sensitization patterns may change with age. OBJECTIVE: To determine the predictors of allergen sensitization in the first 3 years of life in the growing up in Singapore towards healthy outcomes (GUSTO) prospective birth cohort study. METHODS: Interviewers collected information on demographics, family history of allergy, social and lifestyle factors, and the child's health. We analyzed data from 849 children who completed skin prick testing (SPT) to inhalant allergens (house dust mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis) and food allergens (egg, peanut and cow's milk) to assess risk factors for allergen sensitization at 18 months. To ensure that clinical phenotypes preceded allergen sensitization, we also analyzed data from 649 children who had a negative skin prick test at 18 months and completed skin prick testing at 36 months. RESULTS: We observed a significant association between eczema reported before 18 months and a positive SPT at 18 months [aOR 4.5 (1.9-10.7)]. Ninety-five (14.6 %) children with negative SPTs at 18 months developed positive tests at 36 months. Onset of eczema before 18 months was associated with an increased risk of new allergen sensitization at 36 months among children non-sensitized at 18 months [aOR 3.4 (1.2-9.3)]. An association was seen between wheeze reported before 18 months and new allergen sensitization at 36 months [aOR 3.2 (1.1-9.1)]. We found no significant association, however, between rhinitis reported before 18 months and new allergen sensitization at 36 months. CONCLUSIONS: Early onset of eczema and wheeze are risk factors for later allergen sensitization, suggesting a possible increased susceptibility to allergen exposure through an impaired skin barrier or defective airway epithelium. Trial registration NCT01174875 Registered 1 July 2010, retrospectively registered.