Because of its flexibility, intuitiveness, and expressivity, the graph edit distance (GED) is one of the most widely used distance measures for labeled graphs. Since exactly computing GED is
NP
...-hard, over the past years, various heuristics have been proposed. They use techniques such as transformations to the linear sum assignment problem with error correction, local search, and linear programming to approximate GED via upper or lower bounds. In this paper, we provide a systematic overview of the most important heuristics. Moreover, we empirically evaluate all compared heuristics within an integrated implementation.
Abstract
Background
The diagnosis of the neglected tropical skin and soft tissue disease Buruli ulcer (BU) is made on clinical and epidemiological grounds, after which treatment with BU-specific ...antibiotics is initiated empirically. Given the current decline in BU incidence, clinical expertise in the recognition of BU is likely to wane and laboratory confirmation of BU becomes increasingly important. We therefore aimed to determine the diagnostic accuracy of clinical signs and microbiological tests in patients presenting with lesions clinically compatible with BU.
Methods
A total of 227 consecutive patients were recruited in southern Benin and evaluated by clinical diagnosis, direct smear examination (DSE), polymerase chain reaction (PCR), culture, and histopathology. In the absence of a gold standard, the final diagnosis in each patient was made using an expert panel approach. We estimated the accuracy of each test in comparison to the final diagnosis and evaluated the performance of 3 diagnostic algorithms.
Results
Among the 205 patients with complete data, the attending clinicians recognized BU with a sensitivity of 92% (95% confidence interval CI, 85%-96%), which was higher than the sensitivity of any of the laboratory tests. However, 14% (95% CI, 7%-24%) of patients not suspected to have BU at diagnosis were classified as BU by the expert panel. The specificities of all diagnostics were high (≥91%). All diagnostic algorithms had similar performances.
Conclusions
A broader clinical suspicion should be recommended to reduce missed BU diagnoses. Taking into consideration diagnostic accuracy, time to results, cost-effectiveness, and clinical generalizability, a stepwise diagnostic approach reserving PCR to DSE-negative patients performed best.
A broader clinical suspicion of Buruli ulcer should be recommended to improve accuracy of its clinical diagnosis. Taking into consideration diagnostic accuracy, time to results, cost-effectiveness, and clinical generalizability, a stepwise approach reserving polymerase chain reaction to microscopy-negative patients performed best.
Abstract The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: ...progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen–progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids. When pregnancy is desired, whether or not infertility is being treated by assisted reproductive technology, hysteroscopic resection in one or two separate procedures of submucosal fibroids less than 4 cm in length is recommended, regardless of whether they are symptomatic. Interstitial, also known as intramural, fibroids have a negative effect on fertility but treating them does not improve fertility. Myomectomy is therefore indicated only for symptomatic fibroids; depending on their size and number, and may be performed by laparoscopy or laparotomy. Physicians must explain to women the potential consequences of myomas and myomectomy on future pregnancy. For perimenopausal women who have been informed of the alternatives and the risks, hysterectomy is the most effective treatment for symptomatic fibroids and is associated with a high rate of patient satisfaction. When possible, the vaginal or laparoscopic routes should be preferred to laparotomy for hysterectomies for fibroids considered typical on imaging. Because uterine artery embolization is an effective treatment with low long-term morbidity, it is an option for symptomatic fibroids in women who do not want to become pregnant, and a validated alternative to myomectomy and hysterectomy that must be offered to patients. Myolysis is under assessment, and research on its use is recommended. Isolated laparoscopic ligation of the uterine arteries is a potential alternative to uterine artery embolization; it also complements myomectomy by reducing intraoperative bleeding. It is possible to use second-generation techniques of endometrial ablation to treat submucosal fibroids in women whose families are complete. Subtotal hysterectomy is a possible alternative to total hysterectomy for fibroid treatment, given that by laparotomy the former has a lower complication rate than the latter, while by laparoscopy, these rates are the same. In each case, the patient is informed about the benefit and risk associated with each therapeutic option.
Purpose
To determine clinical, pathological and virological factors predicting the spontaneous regression of HSIL/CIN2.
Methods
This retrospective study included 73 patients with HSIL/CIN2 diagnosed ...by biopsy between 2012 and 2016 and followed-up without treatment in the department of gynecology at Bordeaux University Hospital. All biopsies sampled inside or outside our department were reviewed and immunolabelled for p16 and Ki67. The response rate was the regression or the disappearance of HSIL/CIN2 as defined by the regression or the disappearance of initial colposcopic findings, cytological and/or histological results.
Results
The diagnosis of CIN2 was confirmed in 63 of 70 biopsies available for review. The Cohen’s kappa coefficient was κ = 90%, indicating almost perfect inter-observer agreement. The lesion spontaneously regressed or disappeared in 36 of 60 patients (60%) with confirmed CIN2 during a median follow-up of 20 months (range 6–55). Baseline factors influencing the response rate were colposcopic findings (69% with minor change vs 31% with major change,
p
= 0.033), cytological results (72% with ASCUS/LSIL vs 28% with ASC-H/HSIL,
p
= 0.018), and HPV genotyping (71% with HPV not 16 vs 42% with HPV-16,
p
= 0.027). The other factors (age, smoking, surface area of the lesion, p16 and Ki67 expressions) did not significantly influence the outcome.
Conclusion
Colposcopic findings, cytological results, and HPV genotyping were baseline factors predicting spontaneous regression of HSIL/CIN2.
•The context of Graph Edit Distance Contest (GDC), organized during ICPR2016, is presented.•Eight methods from three research groups are evaluated.•The evaluation Metrics, methods and datasets of GDC ...are described in detail.•A crystal clear picture of the accuracy and speed of each method is provided.•Future challenges and possible tracks in graph edit distance are highlighted.
Graph Distance Contest (GDC) was organized in the context of ICPR 2016. Its main challenge was to inspect and report performances and effectiveness of exact and approximate graph edit distance methods by comparison with a ground truth. This paper presents the context of this competition, the metrics and datasets used for evaluation, and the results obtained by the eight submitted methods. Results are analyzed and discussed in terms of computation time and accuracy. We also highlight the future challenges in graph edit distance regarding both future methods and evaluation metrics. The contest was supported by the Technical Committee on Graph-Based Representations in Pattern Recognition (TC-15) of the International Association of Pattern Recognition (IAPR).
Abstract Background Pelvic inflammatory disease (PID) is commonly encountered in clinical practice. Objectives To provide up-to-date guidelines on management of PID. Search strategy An initial search ...of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in May 2015. Selection criteria All identified reports relevant to the areas of focus were included. Data collection and analysis A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines. Main results PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade C). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (grade B). Microbiological diagnosis requires vaginal and endocervical sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ofloxacin and metronidazole for 14 days (grade B). Treatment of tubo-ovarian abscess is based on drainage if the collection measures more than 3 cm (grade B), with combined ceftriaxone, metronidazole, and doxycycline for 14–21 days. Conclusions Current management of PID requires easily reproducible investigations and treatment, and thus can be applied worldwide.
Highlights • Non severe VUA have spontaneous favorable outcome without recurrence. • Fertility is conserved after VUA even if embolization was performed. • Recurrences are more often observed for ...severe VUA. • Embolization must be proposed for anaemic patients or severe VUA on angiography. • Recurrence occurs more often when a history of curettage is found.
Buruli ulcer (BU) caused by Mycobacterium ulcerans is a necrotizing skin disease usually starting with a subcutaneous nodule or plaque, which may ulcerate and progress, if untreated, over months and ...years. During the currently recommended antibiotic treatment with rifampicin/streptomycin plaque lesions tend to ulcerate, often associated with retarded wound healing and prolonged hospital stays.
Included in this study were twelve laboratory reconfirmed, HIV negative BU patients presenting with plaque lesions at the CDTUB in Allada, Benin. Punch biopsies for histopathological and immunohistochemical analysis were taken before start of treatment and after four to five weeks of treatment. Where excision or wound debridement was clinically indicated, the removed tissue was also analyzed. Based on clinical judgment, nine of the twelve patients enrolled in this study received limited surgical excision seven to 39 days after completion of chemotherapy, followed by skin grafting. Lesions of three patients healed without further intervention. Before treatment, plaque lesions were characterized by a destroyed subcutis with extensive necrosis without major signs of infiltration. After completion of antibiotic treatment partial infiltration of the affected tissue was observed, but large necrotic areas remained unchanged.
Our histopathological analyses show that ulceration of plaque lesions during antibiotic treatment do not represent a failure to respond to antimycobacterial treatment. Based on our results we suggest formal testing in a controlled clinical trial setting whether limited surgical excision of necrotic tissue favours wound healing and can reduce the duration of hospital stays.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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