Assessment of glomerular morphological patterns by deep learning algorithms

Background Compilation of different morphological lesion signatures is characteristic of renal pathology. Previous studies have documented the potential value of artificial intelligence (AI) in recognizing relatively clear-cut glomerular structures and patterns, such as segmental or global sclerosis or mesangial hypercellularity. This study aimed to test the capacity of deep learning algorithms to recognize complex glomerular structural changes that reflect common diagnostic dilemmas in nephropathology. Methods For this purpose, we defined nine classes of glomerular morphological patterns and trained twelve convolutional neuronal network (CNN) models on these. The two-step training process was done on a first dataset defined by an expert nephropathologist (12,253 images) and a second consensus dataset (11,142 images) defined by three experts in the field. Results The efficacy of CNN training was evaluated using another set with 180 consensus images, showing convincingly good classification results (kappa-values 0.838–0.938). Furthermore, we elucidated the image areas decisive for CNN-based decision making by class activation maps. Finally, we demonstrated that the algorithm could decipher glomerular disease patterns coinciding in a single glomerulus (e.g. necrosis along with mesangial and endocapillary hypercellularity). Conclusions In summary, our model, focusing on glomerular lesions detectable by conventional microscopy, is the first sui generis to deploy deep learning as a reliable and promising tool in recognition of even discrete and/or overlapping morphological changes. Our results provide a stimulus for ongoing projects that integrate further input levels next to morphology (such as immunohistochemistry, electron microscopy, and clinical information) to develop a novel tool applicable for routine diagnostic nephropathology.

A Vertical stratification of arthropods in the dry ecosystems of Colombian Guyana: morphological patterns and their ecological implications

Introduction: Despite growing interest by the ecosystems derived from the Guyanese formations, the vertical structure of the communities and relationships of the biota with the climatic conditions in these ecosystems are unknown. Objective: Characterize the structure and vertical composition of the arthropod fauna associated with three of the most representative ecosystems of the Northern area of the serranía de La Lindosa in Colombia based on morphological and ecological parameters. Methods: The arthropod fauna was sampled, from the subsurface soil level to the shrub and tree stratum. The fauna was determined up to the level of family or supraspecific group and the values of Alfa and Beta diversity were determined. Body length measurements were made, and the coloration and trophic level of each group were determined. Results: The composition and diversity of the arthropod fauna was different in each ecosystem and vertical stratum and most of the groups in all the ecosystems studied present low abundances. Groups of phytophagous and predatory habits were frequent in all ecosystems and the highest biomass of arthropod fauna comes from groups of polyphagous habits, of medium size and great abundance. Light and dark colorations are the most frequent in landscape-scale. Conclusion: The ecosystems studied are characterized by the low values of diversity and replacement and the large number of non-shared groups that apparently respond to the microclimatic characteristics; however, there are some generalities on a landscape scale such as the greater richness and abundance of groups in the intermediate strata, the greater proportion of groups with phytophagous habits and medium body sizes, and the predominance of dark colorations in the lower strata.

Correlating the patterns of Diabetic macular edema, Optical Coherence Tomography Biomarkers and Grade of Diabetic Retinopathy With Stage of Renal Disease

PurposeTo correlate Optical coherence tomography (OCT) based morphological patterns of diabetic macular edema (DME), prognostic biomarkers and grade of diabetic retinopathy (DR) in patients with various stages of chronic kidney disease (CKD) secondary to diabetes. DesignMulticentric retrospective cross-sectional study conducted at seven centres across India.MethodsData from medical records of patients with DME and CKD was entered in a common excel sheet across all seven centers. Staging of CKD was based on estimated glomerular filtration rate (eGFR). ResultsThe most common morphological pattern of DME was cystoid pattern (42%) followed by the mixed pattern (31%). The proportion of different morphological patterns did not significantly vary across various CKD stages (p=0.836). Presence of external limiting membrane-ellipsoid zone (ELM-EZ) defects (p<0.001) and foveal sub-field thickness (p=0.024) showed a direct correlation with the stage of CKD which was statistically significant. Presence of hyper reflective dots (HRD) and disorganization of inner retinal layers (DRIL) showed no significant correlation with the stage of CKD. Sight threatening DR was found to increase from 70% in CKD stage-3 to 82% in stage-4 and 5 of CKD and this was statistically significant (p=0.03).ConclusionsCystoid morphological pattern followed by mixed type was the most common pattern of DME on OCT found in patients suffering from stage 3 to 5 of CKD. However, the morphological patterns of DME did not significantly vary across various CKD stages. ELM-EZ defects may be considered as an important OCT biomarker for advanced stage of CKD.

Case alignment in Kabyle Amazigh

This paper examines the state alternation in Kabyle, arguing that state is the morphological realization of Case. The free state is accusative case, and the construct state is nominative case. Taking morphological patterns and syntactic distribution into account, Kabyle is found to be a Type 2 marked nominative language. Both states, or cases, are morphologically marked. The free state is the default case. This analysis accounts for the bulk of the distribution of free state and construct state nouns, and situates Kabyle as belonging to a typologically rare alignment system that is concentrated in Afroasiatic and African languages.

Relevance of leaf morphology and biometrics: a study with species of Aphelandra R. Br. (Acanthaceae)

Morphological characteristics, as well as biometrics, govern the description of species. However, systematical comparative analyzes of these aspects between taxa are scarce. The aim of the work was to evaluate the relevance of these characteristics in species of Aphelandra. Leaves of A. longiflora, A. harleyi, A. espirito-santensis, A. nitida, A. sinclairiana and A. squarosa were collected and analyzed for morphologic patterns: phyllotaxis, texture, leaf blade form, symmetry, apex, base, margin, venation and coloring pattern; and for biometric parameters: total length, length and width of the leaf blade, length and diameter of the petiole. We calculated mean and standard deviations. Among the relevant morphological patterns are the shape of the blade, apex and base, and the biometric data showed differences. As conclusion, this analysis proposal proves to be an instrument of accuracy and detail for descriptions.

Climate change and indoor temperature variation in Venetian buildings: the role of density and urban form

Although the influence of urban form on microclimate and building thermal processes has been acknowledged, few studies have addressed the influence of overheating mechanisms on heterogeneous urban fabrics for existing historical cities. This study investigates the impact of changing urban climate on indoor temperatures by focusing on three Venice morphological patterns. Through microclimate modelling techniques, outdoor and indoor temperatures are simulated in 2020 and 2050 scenarios. Results show that the compactness of the urban fabric contributes to reducing indoor building temperatures. The analysis suggests that the increased density of shadow areas can mitigate the outdoor temperature values and reduce direct radiation on façades. When comparing the two climate scenarios 2020 and 2050, average indoor temperatures increase in the latter. However, the analysis highlights that the absence of insulation and the relatively high thermal mass of typical Venetian envelopes plays a crucial role in the building thermal processes preserving indoor comfort in a warmer climate future.

Dedifferentiated Melanoma: A Diagnostic Histological Pitfall! Review of the Literature with Case Presentation

Dedifferentiated melanoma is a particular form of malignant melanoma with a progressive worsening of the patient’s clinical outcome. It is well known that melanoma can assume different histo-morphological patterns, to which specific genetic signatures correspond, sometimes but not always. In this review we address the diagnostic difficulties in correctly recognizing this entity, discuss the major differential diagnoses of interest to the dermatopathologist, and conduct a review of the literature with particular attention and emphasis on the latest molecular discoveries regarding the dedifferentiation/undifferentiation mechanism and more advanced therapeutic approaches.

STUDY AND ANALYSIS OF MORPHOLOGICAL PATTERNS OF ANEMIA IN GERIATRIC PATIENTS

INTRODUCTION:Anemia in elderly population is a frequently diagnosed problem and if it is untreated ,it can lead to impaired functional capacity, poor quality of life and increased morbidity and mortality. In view of high prevelance of anemia in geriatric population,the study was conducted to evaluate the morphological patterns of anemia in elderly population. METHODS:A Prospective observational study was conducted on 100 geriatric patients above 60 years of age,for a period of 3 months.Routine haematological investigations and peripheral smear study was done. RESULTS: In the present study, females were found to be more affected than males and patients in the age group of 60-69 years were affected the most. Normocytic normochromic anemia was the most common morphological type of anemia observed. CONCLUSION: Despite recent diagnostic advances, geriatric anemia remains under reported and inadequately investigated. Determining the morphological type of anemia can help in nding out the etiology and there by aid in proper diagnosis and better patient management.

Strong Association of the Myriad Discrete Speckled Nuclear Pattern With Anti-SS-A/Ro60 Antibodies: Consensus Experience of Four International Expert Centers

IntroductionThe morphological patterns in indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) reflect the autoantibodies in the sample. The International Consensus on ANA Patterns (ICAP) classifies 30 relevant patterns (AC-0 to AC-29). AC-4 (fine speckled nuclear pattern) is associated to anti-SS-A/Ro, anti-SS-B/La, and several autoantibodies. Anti-SS-A/Ro samples may contain antibodies to Ro60 and Ro52. A variation of AC-4 (herein designated AC-4a), characterized by myriad discrete nuclear speckles, was reported to be associated with anti-SS-A/Ro. The plain fine speckled pattern (herein designated AC-4b) seldom was associated with anti-SS-A/Ro. This study reports the experience of four expert laboratories on AC-4a and AC-4b.MethodsAnti-Ro60 monoclonal antibody A7 was used to investigate the HEp-2 IFA pattern. Records containing concomitant HEp-2 IFA and SS-A/Ro tests from Durand Laboratory, Argentina (n = 383) and Fleury Laboratory, Brazil (n = 144,471) were analyzed for associations between HEp-2 IFA patterns and disease-associated autoantibodies (DAA): double-stranded DNA, Scl-70, nucleosome, SS-B/La, Sm, and U1-RNP. A total of 381 samples from Dresden Technical University (TU-Dresden), Germany, were assayed for HEp-2 IFA and DAA.ResultsMonoclonal A7 recognized Ro60 in Western blot and immunoprecipitation, and yielded the AC-4a pattern on HEp-2 IFA. Analyses from Durand Laboratory and Fleury Laboratory yielded compatible results: AC-4a was less frequent (8.9% and 2.7%, respectively) than AC-4b (26.1% and 24.2%) in HEp-2 IFA-positive samples. Reactivity to SS-A/Ro occurred in 67.6% and 96.3% of AC-4a-pattern samples against 23% and 6.8% of AC-4b pattern samples. Reciprocally, AC-4a occurred in 24% and 47.1% of anti-SS-A/Ro-positive samples, and in 3.8% and 0.1% of anti-SS-A/Ro-negative samples. Data from TU-Dresden show that the AC-4a pattern occurred in 69% of 169 anti-SS-A/Ro-monospecific samples (62% of all anti-SS-A/Ro-positive samples) and in 4% of anti-SS-A/Ro-negative samples, whereas anti-SS-A/Ro occurred in 98.3% of AC-4a samples and in 47.9% of AC-4b samples. In all laboratories, coexistence of anti-SS-B/La, but not other DAA, in anti-SS-A/Ro-positive samples did not disturb the AC-4a pattern. AC-4a was predominantly associated with anti-Ro60 antibodies.ConclusionsThis study confirms the association of AC-4a pattern and anti-SS-A/Ro in opposition to the AC-4b pattern. The results of four international expert laboratories support the worldwide applicability of these AC-4 pattern variants and their incorporation into ICAP classification under codes AC-4a and AC-4b, respectively. The AC-4 pattern should be maintained as an umbrella pattern for cases in which one cannot discriminate AC-4a and AC-4b patterns. The acknowledgment of the AC-4a pattern should add value to HEp-2 IFA interpretation.