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• Cardiac amyloidosis can cause heart failure, but remains under-recognised. • Over 11 years, wild-type transthyretin amyloidosis (ATTRwt) became predominant. • Cardiac involvement was more severe in amyloid light chain (AL) vs ATTRwt. • Among variant ATTRv, ATTR Val122Ile became the predominant mutation diagnosed. Early cardiac amyloidosis (CA) diagnosis enables patients to access effective treatments for better long-term outcomes, yet it remains under-recognised, misdiagnosed and inadequately managed. To reduce diagnostic delays, we aimed to describe the epidemiological and clinical characteristics and changes over an 11-year period. This was a retrospective, observational cohort study of all patients referred to the Henri-Mondor Hospital for suspected CA. Overall, 3194 patients were identified and 3022 were included and analysed. Our patients came from varied ethnic backgrounds, and more than half (55.2%) had confirmed CA. Over 11 years, referrals increased 4.4-fold, mostly from cardiologists. Notably, wild-type transthyretin amyloidosis (ATTRwt) became the predominant diagnosis, with referrals increasing 15-fold from 20 in 2010–2012 to 308 in 2019–2020. The number of amyloid light chain (AL) diagnoses increased, whilst variant transthyretin amyloidosis (ATTRv) numbers remained relatively stable. Concerning disease severity, AL patients presented more frequently with severe cardiac involvement whereas an increasing number of ATTRwt patients presented with National Amyloid Centre stage I (22.0% in 2013–2014 to 45.9% in 2019–2020). Lastly, among patients diagnosed with ATTRv in 2019–2020, 83.9% had ATTR Val122Ile cardiac phenotype. This study shows that increasing cardiologist awareness and referrals have increased CA diagnoses. With improved awareness and non-invasive diagnostic techniques, more patients with ATTRwt with milder disease and more ATTRv Val122Ile mutations are being referred and diagnosed. Although more AL cases are being recognised, patients are diagnosed with severe cardiac involvement. [ABSTRACT FROM AUTHOR]

Cardiac uptake on technetium-99m whole-body scintigraphy (WBS) is almost pathognomonic of transthyretin cardiac amyloidosis. The rare false positives are often related to light-chain cardiac amyloidosis. However, this scintigraphic feature remains largely unknown, leading to misdiagnosis despite characteristic images. A retrospective review of all WBSs in a hospital database to detect those with cardiac uptake may allow the identification of undiagnosed patients. The authors sought to develop and validate a deep learning–based model that automatically detects significant cardiac uptake (Perugini grade ≥2) on WBS from large hospital databases in order to retrieve patients at risk of cardiac amyloidosis. The model is based on a convolutional neural network with image-level labels. The performance evaluation was performed with C-statistics using a 5-fold cross-validation scheme stratified so that the proportion of positive and negative WBSs remained constant across folds and using an external validation data set. The training data set consisted of 3,048 images: 281 positives (Perugini grade ≥2) and 2,767 negatives. The external validation data set consisted of 1,633 images: 102 positives and 1,531 negatives. The performance of the 5-fold cross-validation and external validation was as follows: 98.9% (± 1.0) and 96.1% for sensitivity, 99.5% (± 0.4) and 99.5% for specificity, and 0.999 (SD = 0.000) and 0.999 for the area under the curve of the receiver-operating characteristic curves. Sex, age <90 years, body mass index, injection-acquisition delay, radionuclides, and the indication of WBS only slightly affected performances. The authors' detection model is effective at identifying patients with cardiac uptake Perugini grade ≥2 on WBS and may help in the diagnosis of patients with cardiac amyloidosis. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: We evaluated the diagnostic performance of 18F-NaF PET/MRI in patients with suspected cardiac amyloidosis (CA).Methods: Twenty-seven consecutive patients underwent myocardial PET 1 hour after injection of 4 MBq/kg 18F-NaF with simultaneous MRI including cine-MRI, T1 and T2 mapping, first-pass and late gadolinium enhancement (LGE). 18F-NaF uptake was measured visually and semi-quantitatively by calculating myocardium-to-blood pool (M/B) ratios. CA was confirmed histologically.Results: Transthyretin (TTR)-CA was diagnosed in 16 patients, light-chain (AL)-CA in 7, and no-CA in 4. Visual interpretation of 18F-NaF images revealed a relative increase in myocardial uptake in only 3 patients, all with TTR CA, and a relative decrease in 13, including 7 AL CA, 3 no-CA, and 3 TTR CA. M/B ratios were significantly higher in TTR CA (1.00 ± 0.12) than in AL CA (0.81 ± 0.06, P = 0.001) or in no-CA (0.73 ± 0.16, P = 0.006). The optimal M/B cut-off to distinguish TTR CA from AL CA was ≥ 0.90 (Fischer, P = 0.0005). By comparison, classification of patients using 99mTc-HMDP heart-to-mediastinum ratios with the previously published cut-off ≥ 1.21 reached higher significance (P < 0.0001). Among MRI parameters, myocardial T1, LGE score, and extracellular volume were higher in CA than in no-CA patients, 1409 ± 76 vs 1278 ± 35 ms (P = 0.004), 10.35 ± 5.30 vs 3.50 ± 3.42 (P = 0.03), and 46 ± 10 vs 33 ± 8 % (P = 0.01), respectively.Conclusion: 18F-NaF PET/MRI shows good diagnostic performance when semi-quantification is used. However, contrast is low and visual interpretation may be challenging in routine. PET/MRI could constitute a one-stop-shop evaluation of amyloid load and cardiac function in patients needing rapid work-up. [ABSTRACT FROM AUTHOR]

Self-reported questionnaires are useful for estimating the health-related quality of life (HR-QoL), impact of interventions, and prognosis. To our knowledge, no HR-QoL questionnaire has been developed for cardiac amyloidosis (CA). This study aimed to validate Amylo-AFFECT-QOL questionnaire to assess HR-QoL and its prognostic value in CA. A self-reported questionnaire, "Amylo-AFFECT" had been designed and validated for CA symptoms evaluation and screening by physicians. It was adapted here to assess HR-QoL (Amylo-AFFECT-QOL) and its prognostic value in CA. To validate the theoretical model, internal consistency and convergent validity were assessed, particularly correlations between Amylo-AFFECT-QOL and the HR-QoL Minnesota Living Heart Failure (MLHF) questionnaire. Amylo-AFFECT-QOL was completed by 515 patients, 425 of whom (82.5%) had CA. Wild-type and hereditary transthyretin amyloidosis (ATTRwt and ATTRv) and immunoglobulin light-chain amyloidosis (AL) were diagnosed in 47.8%, 14.7%, and 18.8% of cases, respectively. The best HR-QoL evaluation was obtained with five dimensions: "Heart failure", "Vascular dysautonomia", "Neuropathy", "Ear, gastrointestinal and urinary dysautonomia" and "Skin or mucosal involvement". The global Amylo-AFFECT-QOL and MLHF scores showed significant positive correlations (rs = 0.72, P < 0.05). Patients with a final diagnosis of CA had a global Amylo-AFFECT-QOL score significantly higher than the control group composed by patients with other diagnoses (22.2 ± 13.6 vs. 16.2 ± 13.8, respectively; P -value < 0.01). According to the Amylo-AFFECT-QOL global results, ATTRv patients' QoL was more affected than AL patients' QoL or ATTRwt patients' QoL. Patients with a higher HR-QoL score had a greater risk of death or heart transplant after 1 year of follow-up (log-rank < 0.01). Amylo-AFFECT-QOL demonstrates good psychometric properties and is useful for quantifying HR-QoL and estimating CA prognosis. Its use may help to improve overall management of patients with CA. [ABSTRACT FROM AUTHOR]

Background: A decreased longitudinal strain in basal segments with a base-to-apex gradient has been described in patients with cardiac amyloidosis (CA).Objectives: Aim was to investigate the left ventricular (LV) regional distribution of early-phase 99mTc-Hydroxymethylene diphosphonate (99mTc-HMDP) uptake in patients with transthyretin-related cardiac amyloidosis (TTR-CA).Methods: All patients underwent a whole-body planar 99mTc-HMDP scintigraphy acquired at 10-min post-injection (early-phase) followed by a thorax SPECT/CT. The segmental uptake (expressed as % of maximal myocardial HMDP uptake) was investigated on the AHA 17-segment model and 3-segment model (basal, mid-cavity, apical).Results: Sixty-one TTR-CA patients were included of whom 29 were wild-type (wt-TTR-CA) and 32 had hereditary TTR-CA (m-TTR-CA). Early myocardial 99mTc-HMDP uptake occurred in all TTR-CA. In all patients, segmental analysis of the LV myocardial distribution of 99mTc-HMDP uptake showed an increased median uptake (interquartile range) in basal/mid-cavity segments compared to the lowest median uptake of apical segments (respectively, 79% [72%-86%] vs. 72% [64%-81%]; P < 10-6). This pattern was similar in wt-TTR-CA group (78% [70%-84%] vs. 70% [61%-81%]; P < 10-6), in m-TTR-CA group (80% [74%-86%] vs. 73 [66%-82%]; P < 10-7) and remained constant independently of the TTR mutation subtype with P ranging 10-5 to 0.03.Conclusions: Early-phase myocardial scintigraphy identified regional distribution of 99mTc-HMDP uptake characterized by a base-to-apex gradient, corroborating echocardiographic, and cardiac magnetic resonance findings. This apical sparing pattern was similar across TTR-CA and TTR mutation subtypes. [ABSTRACT FROM AUTHOR]

Background: [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18FDG-PET/CT) has high sensitivity for detecting recurrences of colorectal cancer (CRC). Our objective was to determine whether adding routine 6-monthly 18FDG-PET/CT to our usual monitoring strategy improved patient outcomes and to assess the effect on costs. Patients and methods: In this open-label multicentre trial, patients in remission of CRC (stage II perforated, stage III, or stage IV) after curative surgery were randomly assigned (1 : 1) to usual monitoring alone (3-monthly physical and tumour marker assays, 6-monthly liver ultrasound and chest radiograph, and 6-monthly whole-body computed tomography) or with 6-monthly 18FDG-PET/CT, for 3 years. A multidisciplinary committee reviewed each patient's data every 3 months and classified the recurrence status as yes/no/doubtful. Recurrences were treated with curative surgery alone if feasible and with chemotherapy otherwise. The primary end point was treatment failure defined as unresectable recurrence or death. Relative risks were estimated, and survival was analysed using the Kaplan-Meier method, log-rank test, and Cox models. Direct costs were compared. Results: Of the 239 enrolled patients, 120 were in the intervention arm and 119 in the control arm. The failure rate was 29.2% (31 unresectable recurrences and 4 deaths) in the intervention group and 23.7% (27 unresectable recurrences and 1 death) in the control group (relative risk=1.23; 95% confidence interval, 0.80-1.88; P=0.34). The multivariate analysis also showed no significant difference (hazards ratio, 1.33; 95% confidence interval, 0.8-2.19; P=0.27). Median time to diagnosis of unresectable recurrence (months) was significantly shorter in the intervention group [7 (3-20) versus 14.3 (7.3-27), P=0.016]. Mean cost/ patient was higher in the intervention group (18 192627 679 e versus 11 131613 e, P<0.033). Conclusion: 18FDG-PET/CT, when added every 6 months, increased costs without decreasing treatment failure rates in patients in remission of CRC. The control group had very close follow-up, and any additional improvement (if present) would be small and hard to detect [ABSTRACT FROM AUTHOR]

Dynamic Time Warping (DTW) is an algorithm to align temporal sequences with possible local non-linear distortions, and has been widely applied to audio, video and graphics data alignments. DTW is essentially a point-to-point matching method under some boundary and temporal consistency constraints. Although DTW obtains a global optimal solution, it does not necessarily achieve locally sensible matchings. Concretely, two temporal points with entirely dissimilar local structures may be matched by DTW. To address this problem, we propose an improved alignment algorithm, named shape Dynamic Time Warping (shapeDTW), which enhances DTW by taking point-wise local structural information into consideration. shapeDTW is inherently a DTW algorithm, but additionally attempts to pair locally similar structures and to avoid matching points with distinct neighborhood structures. We apply shapeDTW to align audio signal pairs having ground-truth alignments, as well as artificially simulated pairs of aligned sequences, and obtain quantitatively much lower alignment errors than DTW and its two variants. When shapeDTW is used as a distance measure in a nearest neighbor classifier (NN-shapeDTW) to classify time series, it beats DTW on 64 out of 84 UCR time series datasets, with significantly improved classification accuracies. By using a properly designed local structure descriptor, shapeDTW improves accuracies by more than 10% on 18 datasets. To the best of our knowledge, shapeDTW is the first distance measure under the nearest neighbor classifier scheme to significantly outperform DTW, which had been widely recognized as the best distance measure to date. Our code is publicly accessible at: https://github.com/jiapingz/shapeDTW . [ABSTRACT FROM AUTHOR]

Background: This study sought to compare the intensity of early-phase myocardial uptake of two phosphonate-based radiotracers, 99mTc-hydroxymethylene diphosphonate (HMDP) and 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD), in patients with hereditary transthyretin-related cardiac amyloidosis (TTR-CA).Methods: Six patients with biopsy-proven diagnosis of TTR-CA and characteristic amyloid fibril composition underwent early-phase 99mTc-HMDP myocardial scintigraphy as part of their routine workup; they were later assessed by 99mTc-DPD scintigraphy after having signed informed written consent. Heart-to-mediastinum-ratio was measured at both time points as well as regional distribution on 17-segment analysis.Results: All patients had an H/M ratio >1.28 on both imaging. 99mTc-DPD uptake was slightly higher than 99mTc-HMDP uptake in 3 patients, but no statistical difference was found (P = 0.13). Regional distribution of the two radiotracers was well correlated on bull's eyes analysis, with only slight underestimation of 99mTc-DPD uptake in the anterior/apical segments, compared with 99mTc-HMDP.Conclusion: 99mTc-HMDP and 99mTc-DPD show comparable myocardial uptake intensity on early-phase scintigraphy and can be used alternatively for the diagnosis of TTR-CA. [ABSTRACT FROM AUTHOR]

This paper enlightens the response or behavior of 3D RC frames with various configurations & amount of masonry in-fill, under dynamic loading conditions. A 1:3 scale, two bay three storey models of a typical office building were constructed with various locations and percentage of masonry in-fill. Components of structure ie, structural sub-assemblages of columns, beams and slabs were casted from the same materials. A series of various ground motion tests were performed on the building model using servo controlled hydraulic actuator. The dynamic characteristics, such as frequency, acceleration and amplitude were identified at each frequency level. The effect of de-bonding of masonry in-fill with RC frames with increase in base acceleration was also observed in this study. Analytical models were developed to predict the natural characteristics and dynamic properties of structure. In modal analysis, masonry in-fill was modeled as equivalent diagonal strut and thickness of strut was taken as equal to in-fill thickness. Material properties and boundary conditions were assigned suitably for in-fill. [ABSTRACT FROM AUTHOR]

Cardiac amyloidosis (CA) is recognized as a common cause of restrictive cardiomyopathy and heart failure due to the deposition of insoluble proteins in the myocardial interstitium. We emphasize the role of [18F]-sodium fluoride (NaF) PET/CT as a potential noninvasive tool to identify and differentiate the transthyretin-related cardiac amyloidosis from the light-chain cardiac amyloidosis. We report cases of a 73-year-old man and a 75-year-old woman followed in our center for congestive heart failure with marked alteration of the left ventricular ejection fraction due to familial transthyretin Val122Ile cardiac amyloidosis and light-chain cardiac amyloidosis, respectively, confirmed on endomyocardial biopsy. [ABSTRACT FROM AUTHOR]

Background: Viability and left ventricular ejection fraction (LVEF) are essential measures for the assessment of myocardial infarction (MI). These 2 variables may be evaluated simultaneously by means of thallium-201 gated single photon emission computed tomography (SPECT); however, the precision and accuracy of LVEF measurements with this isotope remain controversial, particularly in cases of extended perfusion defects and poor count densities.Methods and Results: Fifty patients with a history of MI underwent a 20-minute rest and a 4-hour redistribution Tl-201 gated SPECT viability protocol, immediately followed by a technetium-99m planar equilibrium radionuclide angiography (ERNA). On gated SPECT images, various count statistics were calculated, and perfusion was automatically quantified by means of CardioMatch, which provided both the size and severity of MI defects. Rest and redistribution LVEFs were determined from gated SPECT with Germano's algorithm, whereas LVEFs were calculated from ERNA using the manufacturer's software. Mean LVEF values calculated with rest gated SPECT, redistribution gated SPECT, and planar ERNA were 30% +/- 13%, 30% +/- 13% and 33% +/- 13%, respectively. Significant differences between repeated gated SPECT LVEFs were not shown by means of the paired t test. Correlation coefficients were high between 20-minute and 4-hour scans (r = 0.89) and between gated SPECT and ERNA (r = 0.88 and r = 0.92 at 20 minutes and 4 hours, respectively). Additionally, close agreement between gated SPECT and ERNA was shown by means of the Bland-Altman plot, despite an underestimation of 3 units. Finally, neither the technical conditions (count density, heart rate, lung uptake, etc) nor the perfusion alteration (size, severity, redistribution) appeared to interfere with the precision and accuracy of gated SPECT LVEF measurement.Conclusion: Tl-201 gated SPECT is a precise method for assessing LVEF within the same patient at 4-hour intervals, even with a substantial count decay, and it gives accurate results compared with planar ERNA, even in the case of large perfusion defects. [ABSTRACT FROM AUTHOR]

A 71-year-old African man without history of cardiac disease was referred to our center for dyspnea. Transthoracic echocardiogram and cardiac MRI were suggestive of cardiac amyloidosis (CA). The diagnosis of the light-chain cardiac amyloidosis (AL-CA) was made after a first endomyocardial biopsy. Accordingly chemotherapy was started. Systematic 99mTc-HMDP scintigraphy showed moderate cardiac uptake (visual score of 2), unusual for AL-CA, and permitted to rectify the diagnosis. Hereditary transthyretin cardiac amyloidosis was confirmed by a second endomyocardial biopsy with a positive Congo-red and anti-transthyretin antibody stainings, mass spectrometry and genetic analysis (Val122Ile mutation). [ABSTRACT FROM AUTHOR]

A 71-year-old African man without history of cardiac disease was referred to our center for dyspnea. Transthoracic echocardiogram and cardiac MRI were suggestive of cardiac amyloidosis (CA). The diagnosis of the light-chain cardiac amyloidosis (AL-CA) was made after a first endomyocardial biopsy. Accordingly chemotherapy was started. Systematic 99mTc-HMDP scintigraphy showed moderate cardiac uptake (visual score of 2), unusual for AL-CA, and permitted to rectify the diagnosis. Hereditary transthyretin cardiac amyloidosis was confirmed by a second endomyocardial biopsy with a positive Congo-red and anti-transthyretin antibody stainings, mass spectrometry and genetic analysis (Val122Ile mutation). [ABSTRACT FROM AUTHOR]

Background: The functional improvements resulting from coronary revascularization (CABG) in patients with depressed ventricular function may be described by the use of a model combining global or local quantification of myocardial perfusion, viability, and contraction. An illustration of this model, with data provided by conventional radionuclide studies as they are performed routinely in many centers, is presented and the limitations of this approach for predicting the results of CABG are discussed.Methods and Results: The model is based on three independent variables, which can be approximated in this preliminary study by parameters derived from standard stress and redistribution/reinjection thallium-201 single-photon emission computed tomography (SPECT) acquisitions with quantification of the tracer uptake defects and from a planar gated blood pool left ventricular ejection fraction (LVEF) measurement: Perfusion is assumed to correspond to 100-stress defect (in percentage), viability is 100-redistribution/reinjection defect, and contraction is 100(LVEF/70), assuming that a normal 70% LVEF corresponds to 100% contraction. In a group of 30 patients prospectively evaluated with this protocol and included in the study on the basis of a pre-CABG LVEF <40%, a significant improvement in LVEF was demonstrated (28.2% +/- 8.5% before CABG vs 35.8% +/- 7.3% after CABG), which is accompanied by a significant decrease of the stress thallium defects (34.8% +/- 13.8% vs 25.6% +/- 10.6%), whereas the average (but not the individual) redistribution/reinjection defects remain almost stable (27.7% +/- 10.9% vs 25.7% +/- 10.1%). As reported in the three-dimensional model, pre-CABG and post-CABG representative points clearly demonstrate the functional improvements for the main variables, but there is a large spectrum of responses to revascularization. It appears that the border between reversible and nonreversible thallium defects does not match the limit between ischemic myocardium (with no contraction alteration and therefore without contraction improvement potential) and hibernating myocardium, which is able to recover mechanical function and therefore is responsible for the improvement of global LVEF.Conclusions: Thallium SPECT is far from ideal for use as an independent characterization of perfusion and viability because hibernating myocardium may be present in both the fixed and reversible parts of thallium defects. Prediction of functional recovery is conditioned by an accurate identification of viable but underperfused and noncontracting myocardium. In the future, with the use of adequate study protocols that are able to measure viability without interference of perfusion and perfusion independent of viability, the proposed model may be able to characterize regional function as a cluster of representative points for each territory and to delineate areas of the theoretical volume corresponding to a potentially recoverable situation. [ABSTRACT FROM AUTHOR]

Abstract: In conversation, women have a small advantage in decoding non-verbal communication compared to men. In light of these findings, we sought to determine whether sex differences also existed in visual attention during a related listening task, and if so, if the differences existed among attention to high-level aspects of the scene or to conspicuous visual features. Using eye-tracking and computational techniques, we present direct evidence that men and women orient attention differently during conversational listening. We tracked the eyes of 15 men and 19 women who watched and listened to 84 clips featuring 12 different speakers in various outdoor settings. At the fixation following each saccadic eye movement, we analyzed the type of object that was fixated. Men gazed more often at the mouth and women at the eyes of the speaker. Women more often exhibited “distracted” saccades directed away from the speaker and towards a background scene element. Examining the multi-scale center-surround variation in low-level visual features (static: color, intensity, orientation, and dynamic: motion energy), we found that men consistently selected regions which expressed more variation in dynamic features, which can be attributed to a male preference for motion and a female preference for areas that may contain nonverbal information about the speaker. In sum, significant differences were observed, which we speculate arise from different integration strategies of visual cues in selecting the final target of attention. Our findings have implications for studies of sex in nonverbal communication, as well as for more predictive models of visual attention. [Copyright &y& Elsevier]

Abstract: Background: Rapalogs are emerging as promising targeted anticancer drugs. Activation of the PI3K/Akt/mTOR pathway has been observed in 15–50% of hepatocellular carcinomas. Methods: In this phase II study, patients with advanced hepatocellular carcinoma and underlying cirrhosis received sirolimus (20mg/week for 1 month then 30mg/week). Tumour response was assessed every 8 weeks. The primary endpoint was the objective tumour response rate according to the Response Evaluation Criteria in Solid Tumours criteria. Secondary endpoints included the objective response according to the modified Response Evaluation Criteria in Solid Tumours criteria, safety, and pharmacokinetic parameters. Results: Twenty-five patients received sirolimus for a median of 20.6 weeks. Two patients had an objective response (8%, 95CI: 0.98–26.03), including one complete response, and 8 patients had stable disease. There were 2 cases of grade 5 toxicity (infections) and 5 cases of grade 3 toxicity. The main grade 1/2 toxicity was mild transient fatigue (76%). Median time to radiological progression and overall survival were 15.3 weeks (range: 8.2–173.9) and 26.4 weeks (range: 8.2–173.9) respectively. Use of the modified Response Evaluation Criteria in Solid Tumours criteria did not identify any further responders. Conclusion: These data suggest that first-line sirolimus shows antitumoural efficacy in advanced hepatocellular carcinoma. Larger trials with Child A patients are needed. [Copyright &y& Elsevier]

Attention exhibits characteristic neural signatures in brain regions that process sensory signals. An important area of future research is to understand the nature of top-down signals that facilitate attentional guidance towards behaviorally relevant locations and features. In this review, we discuss recent studies that have made progress towards understanding: (i) the brain structures and circuits involved in attentional allocation; (ii) top-down attention pathways, particularly as elucidated by microstimulation and lesion studies; (iii) top-down modulatory influences involving subcortical structures and reward systems; (iv) plausible substrates and embodiments of top-down signals; and (v) information processing and theoretical constraints that might be helpful in guiding future experiments. Understanding top-down attention is crucial for elucidating the mechanisms by which we can filter sensory information to pay attention to the most behaviorally relevant events. [ABSTRACT FROM AUTHOR]

Abstract: Humans employ interacting bottom-up and top-down processes to significantly speed up search and recognition of particular targets. We describe a new model of attention guidance for efficient and scalable first-stage search and recognition with many objects (117,174 images of 1147 objects were tested, and 40 satellite images). Performance for recognition is on par or better than SIFT and HMAX, while being, respectively, 1500 and 279 times faster. The model is also used for top-down guided search, finding a desired object in a search array within four attempts, and improving performance for finding houses in satellite images. [Copyright &y& Elsevier]

Abstract: The amount of information contained in a piece of data can be measured by the effect this data has on its observer. Fundamentally, this effect is to transform the observer’s prior beliefs into posterior beliefs, according to Bayes theorem. Thus the amount of information can be measured in a natural way by the distance (relative entropy) between the prior and posterior distributions of the observer over the available space of hypotheses. This facet of information, termed “surprise”, is important in dynamic situations where beliefs change, in particular during learning and adaptation. Surprise can often be computed analytically, for instance in the case of distributions from the exponential family, or it can be numerically approximated. During sequential Bayesian learning, surprise decreases as the inverse of the number of training examples. Theoretical properties of surprise are discussed, in particular how it differs and complements Shannon’s definition of information. A computer vision neural network architecture is then presented capable of computing surprise over images and video stimuli. Hypothesizing that surprising data ought to attract natural or artificial attention systems, the output of this architecture is used in a psychophysical experiment to analyze human eye movements in the presence of natural video stimuli. Surprise is found to yield robust performance at predicting human gaze (ROC-like ordinal dominance score ∼0.7 compared to ∼0.8 for human inter-observer repeatability, ∼0.6 for simpler intensity contrast-based predictor, and 0.5 for chance). The resulting theory of surprise is applicable across different spatio-temporal scales, modalities, and levels of abstraction. [Copyright &y& Elsevier]

Abstract: We propose a formal Bayesian definition of surprise to capture subjective aspects of sensory information. Surprise measures how data affects an observer, in terms of differences between posterior and prior beliefs about the world. Only data observations which substantially affect the observer’s beliefs yield surprise, irrespectively of how rare or informative in Shannon’s sense these observations are. We test the framework by quantifying the extent to which humans may orient attention and gaze towards surprising events or items while watching television. To this end, we implement a simple computational model where a low-level, sensory form of surprise is computed by simple simulated early visual neurons. Bayesian surprise is a strong attractor of human attention, with 72% of all gaze shifts directed towards locations more surprising than the average, a figure rising to 84% when focusing the analysis onto regions simultaneously selected by all observers. The proposed theory of surprise is applicable across different spatio-temporal scales, modalities, and levels of abstraction. [Copyright &y& Elsevier]

Hereditary (ATTRv) and senile (ATTRwt) transthyretin amyloidosis are severe and fatal systemic diseases, characterised by amyloid fibrillar accumulation principally in the heart or peripheral nerves (or both). Since 2012, tafamidis is used in France to treat patients with ATTRv with neuropathy (alone or with cardiomyopathy). Recently, the Phase III ATTRACT trial showed that tafamidis decreased the relative risk of mortality in ATTR amyloidosis with cardiomyopathy. The aims of this study were to assess the clinical characteristics of ATTR amyloidosis in a real-life population in comparison to the population included in the ATTRACT trial and to assess the impact of tafamidis on major cardiovascular outcome-free (MCO-free) survival time without cardiac decompensation, heart transplant, or death. From June 2008 to November 2018, 648 patients with ATTR amyloidosis (423 ATTRwt and 225 ATTRv) consecutively referred to the French Referral Center for cardiac amyloidosis were included. 467 (72%) patients matched the inclusion criteria of the ATTRACT study. For the 631 patients with cardiomyopathy, median MCO-free survival time increased with tafamidis treatment (N = 98): 1565 (1010–2400) days vs. 771 (686–895) days without treatment (log-rank P < 0.001). This beneficial effect was confirmed after considering confounding factors (age at inclusion, Nt-proBNP and amyloidosis type) with a propensity score based on (hazard ratio: 0.546, P = 0.0132). In a large cohort of ATTRwt and ATTRv patients, representative of the inclusion criteria of the ATTRACT trial, the present results confirm the positive impact of tafamidis treatment on preventing the occurrence of cardiovascular outcome in a real-life population. [ABSTRACT FROM AUTHOR]

Abstract: What are the visual causes, rather than mere correlates, of attentional selection and how do they compare to each other during natural vision? To address these questions, we first strung together semantically unrelated dynamic scenes into MTV-style video clips, and performed eye tracking experiments with human observers. We then quantified predictions of saccade target selection based on seven bottom-up models, including intensity variance, orientation contrast, intensity contrast, color contrast, flicker contrast, motion contrast, and integrated saliency. On average, all tested models predicted saccade target selection well above chance. Dynamic models were particularly predictive of saccades that were most likely bottom-up driven-initiated shortly after scene onsets, leading to maximal inter-observer similarity. Static models showed mixed results in these circumstances, with intensity variance and orientation contrast featuring particularly weak prediction accuracy (lower than their own average, and approximately 4 times lower than dynamic models). These results indicate that dynamic visual cues play a dominant causal role in attracting attention. In comparison, some static visual cues play a weaker causal role, while other static cues are not causal at all, and may instead reflect top-down causes. [Copyright &y& Elsevier]

Abstract: Lymph nodes are involved in a wide variety of diseases, particularly in cancer. In the latter, precise nodal staging is essential to guide therapeutic options and to determine prognosis. For long, imaging of the lymphatic system has been limited to lymph vessel,especially via the exclusive use of conventional lymphography, at the expense of invasive procedures and patient''s discomfort. Three main technical advances, however, have recently completed the clinical armamentarium for lymph node imaging: first, the refinement of cross sectional imaging, i.e. CT and MRI, combined or not with dedicated contrast agents, has progressively replaced conventional lymphography in oncology situations; second, the development of intra-operative sentinel node mapping has profoundly modified the diagnostic and therapeutic procedures in several cancer situations, mostly melanoma and breast cancer; finally, the increased availability of functional imaging, especially through the use of FDG-PET, has greatly contributed to the accuracy improvement of nodal metastases identification. The aim of this review will thus be to briefly review the anatomy and physiology of the lymphatic systems and to overview the basic principles of up-to-date lymph node imaging. [Copyright &y& Elsevier]

Abstract: We propose a computational model for the task-specific guidance of visual attention in real-world scenes. Our model emphasizes four aspects that are important in biological vision: determining task-relevance of an entity, biasing attention for the low-level visual features of desired targets, recognizing these targets using the same low-level features, and incrementally building a visual map of task-relevance at every scene location. Given a task definition in the form of keywords, the model first determines and stores the task-relevant entities in working memory, using prior knowledge stored in long-term memory. It attempts to detect the most relevant entity by biasing its visual attention system with the entity’s learned low-level features. It attends to the most salient location in the scene, and attempts to recognize the attended object through hierarchical matching against object representations stored in long-term memory. It updates its working memory with the task-relevance of the recognized entity and updates a topographic task-relevance map with the location and relevance of the recognized entity. The model is tested on three types of tasks: single-target detection in 343 natural and synthetic images, where biasing for the target accelerates target detection over twofold on average; sequential multiple-target detection in 28 natural images, where biasing, recognition, working memory and long term memory contribute to rapidly finding all targets; and learning a map of likely locations of cars from a video clip filmed while driving on a highway. The model’s performance on search for single features and feature conjunctions is consistent with existing psychophysical data. These results of our biologically-motivated architecture suggest that the model may provide a reasonable approximation to many brain processes involved in complex task-driven visual behaviors. [Copyright &y& Elsevier]