A recent joint meeting was held on January 30, 2014, with the US Food and Drug Administration (FDA), National Cancer Institute (NCI), clinical scientists, imaging experts, pharmaceutical and biotech ...companies, clinical trials cooperative groups, and patient advocate groups to discuss imaging endpoints for clinical trials in glioblastoma. This workshop developed a set of priorities and action items including the creation of a standardized MRI protocol for multicenter studies. The current document outlines consensus recommendations for a standardized Brain Tumor Imaging Protocol (BTIP), along with the scientific and practical justifications for these recommendations, resulting from a series of discussions between various experts involved in aspects of neuro-oncology neuroimaging for clinical trials. The minimum recommended sequences include: (i) parameter-matched precontrast and postcontrast inversion recovery-prepared, isotropic 3D T1-weighted gradient-recalled echo; (ii) axial 2D T2-weighted turbo spin-echo acquired after contrast injection and before postcontrast 3D T1-weighted images to control timing of images after contrast administration; (iii) precontrast, axial 2D T2-weighted fluid-attenuated inversion recovery; and (iv) precontrast, axial 2D, 3-directional diffusion-weighted images. Recommended ranges of sequence parameters are provided for both 1.5 T and 3 T MR systems.
The goal was to compare patterns of physical activity (PA) behaviors (sedentary behavior SB, light PA, moderate-to-vigorous PA MVPA, and sleep) measured via accelerometers for 7 days between patients ...with incident cerebrovascular disease (CeVD) (n=2141) and controls (n=73 938).
In multivariate models, cases spent 3.7% less time in MVPA (incidence rate ratio IRR, 0.963 95% CI, 0.929-0.998) and 1.0% more time in SB (IRR, 1.010 95% CI, 1.001-1.018). Between 12 and 24 months before diagnosis, cases spent more time in SB (IRR, 1.028 95% CI, 1.001-1.057). Within the year before diagnosis, cases spent less time in MVPA (IRR, 0.861 95% CI, 0.771-0.964). Although SB time was not associated with CeVD risk, MVPA time, both total min/d (hazard ratio HR, 0.998 95% CI, 0.997-0.999) and guideline threshold adherence (≥150 min/wk) (HR, 0.909 95% CI, 0.827-0.998), was associated with decreased CeVD risk. Comorbid burden had a significant partial mediation effect on the relationship between MVPA and CeVD. Cases slept more during 12:00 to 17:59 hours (IRR, 1.091 95% CI, 1.002-1.191) but less during 0:00 to 5:59 hours (IRR, 0.984 95% CI, 0.977-0.992). No between-group differences were significant at subgroup analysis.
Daily behavior patterns were significantly different in patients before CeVD. Although SB was not associated with CeVD risk, the association between MVPA and CeVD risk is partially mediated by comorbid burden. This study has implications for understanding observable behavior patterns in cerebrovascular dysfunction and may help in developing remote monitoring strategies to prevent or reduce cerebrovascular decline.
Significant advances in artificial intelligence (AI) over the past decade potentially may lead to dramatic effects on clinical practice. Digitized histology represents an area ripe for AI ...implementation. We describe several current needs within the world of gastrointestinal histopathology, and outline, using currently studied models, how AI potentially can address them. We also highlight pitfalls as AI makes inroads into clinical practice.
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