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Prompt-based portrait image style transfer aims at translating an input content image to a desired style described by text without a style image. In many practical situations, users may not only attend to the entire portrait image but also the local parts (e.g., eyes, lips, and hair). To address such applications, we propose a new framework that enables style transfer on specific regions described by a text description of the desired style. Specifically, we incorporate semantic segmentation to identify the intended area without requiring edit masks from the user while utilizing a pre-trained CLIP-based model for stylizing. Besides, we propose a text-to-patch matching loss by randomly dividing the stylized image into smaller patches to ensure the consistent quality of the result. To comprehensively evaluate the proposed method, we use several metrics, such as FID, SSIM, and PSNR on a dataset consisting of portraits from the CelebAMask-HQ dataset and style descriptions of other related works. Extensive experimental results demonstrate that our framework outperforms other state-of-the-art methods in terms of both stylization quality and inference time. [ABSTRACT FROM AUTHOR]

The large pre-trained vision-language models (VLMs) utilized in text-video retrieval have demonstrated strong cross image-text understanding ability. Existing works leverage VLMs to extract features and design fine-grained uni-directional interaction from text to video to enhance the visual understanding ability of the model. However, the vast cross-modal gap makes it difficult to fully match video-text mutual information solely through uni-directional cross-modal interaction techniques. To this end, we propose a novel hierarchical bi-directional conceptual interaction (HBCI) method, which utilizes multi-granularity video-text decoupled features mutual attention to enhance cross-modal alignment. Firstly, we introduce the text-guided attention to extract visual representations among hierarchical concepts, and decouple the multi-granularity features from video and text to find representation subspaces with maximal relevance to each other. Furthermore, we construct an iterative bi-directional conceptual interaction (BCI) module to reason semantic associations across text and video modalities, which generates attention weights adaptively based on video-text decoupled concepts and projects them into the other modality to facilitate profound cross-modal interaction. Finally, we implement the cross-level similarity distillation to progressively propagate the knowledge-aware similarity. Extensive experiments consistently deliver exceptional performance of our proposed HBCI across MSR-VTT, DiDeMo and ActivityNet datasets. [ABSTRACT FROM AUTHOR]

Grounded Situation Recognition (GSR) aims to generate structured image descriptions. For a given image, GSR needs to identify the key verb, the nouns corresponding to roles, and their bounding-box groundings. However, current GSR research demands numerous meticulously labeled images, which are labor-intensive and time-consuming, making it costly to expand detection categories. Our study enhances model accuracy in detecting and localizing under data scarcity, reducing dependency on large datasets and paving the way for broader detection capabilities. In this paper, we propose the Grounded Situation Recognition under Data Scarcity (GSRDS) model, which uses the CoFormer model as the baseline and optimizes three subtasks: image feature extraction, verb classification, and bounding-box localization, to better adapt to data-scarce scenarios. Specifically, we replace ResNet50 with EfficientNetV2-M for advanced image feature extraction. Additionally, we introduce the Transformer Combined with CLIP for Verb Classification (TCCV) module, utilizing features extracted by CLIP's image encoder to enhance verb classification accuracy. Furthermore, we design the Multi-source Verb-Role Queries (Multi-VR Queries) and the Dual Parallel Decoders (DPD) modules to improve the accuracy of bounding-box localization. Through extensive comparative experiments and ablation studies, we demonstrate that our method achieves higher accuracy than mainstream approaches in data-scarce scenarios. Our code will be available at https://github.com/Zhou-maker-oss/GSRDS. [ABSTRACT FROM AUTHOR]

Multi-label image classification (MLIC) is a highly practical and challenging task in computer vision. Compared to traditional single-label image classification, MLIC not only focuses on the dependencies between images and labels but also places significant emphasis on the spatial relationships within images and the internal dependencies of labels. In this paper, we propose the Dual-Stream Classification Network (DSCN) for multi-label image classification. In one branch, we capture more spatial information by segmenting the image. A feature reconstruction layer based on self-attention mechanism is used to recover the boundary information lost after segmentation, while the dependency between the image and label is captured by a transformer encoder. The other branch enhances the label’s semantics using multimodal features by employing templates to extend categories into prompts, thus improving the reliability of the features. The CLIP model provides multimodal association features between images and prompts. The final labels of the images are generated by a weighted fusion of the results from the two branches. We tested our model on three popular datasets: MSCOCO2014, VOC2007 and NUS-WIDE. DSCN outperformed state-of-the-art methods, demonstrating the effectiveness of our approach. [ABSTRACT FROM AUTHOR]

Image captioning is a task in the bimodal context of computer vision and natural language processing, where the model outputs textual information captions for given input images. Traditional Transformer architectures based on image encoder and language decoder have shown promising results in the image captioning domain. However, there are still two challenges present: heavy parameters and additional data preprocessing. In this paper, we propose a lightweight based-CLIP early fusion transformer (BCEFT) to tackle this challenge. The BCEFT use CLIP as the data encoder for images and text, then add a multi-modal fusion model to generate image captions. Specifically, the multi-modal fusion model comprises a multi-modal fusion attention module, which reduces computational complexity by more than a half. At last, we utilize reinforcement learning to train our model with beam search algorithm after cross-entropy training. Our approach only requires relatively quick training to produce a high-qualified captioning model. Without the demand for additional annotations or pre-training, it can effectively generate meaningful captions for large-scale and diverse datasets. The experimental results on the MSCOCO dataset demonstrate the superiority of our model. Meanwhile, our model achieves significant efficiency gains, including a nearly 50% decrease in model parameters and an eight-fold improvement in runtime speed. [ABSTRACT FROM AUTHOR]

Background: Gastric endoscopic submucosal dissection (ESD) for lesions located on the greater curvature of the upper and middle (U/M) third of the stomach remains challenging, even for experienced endoscopists. Accordingly, we have developed a novel traction technique, termed the outside-lesion clip-thread method (O-CTM). In this method, a clip thread is attached to the healthy mucosa outside the circumferential incision line, and traction is applied to bring the scope and lesion into proximity for ESD. Here, we assessed the efficacy of ESD using the O-CTM compared to ESD without the O-CTM. Methods: We retrospectively reviewed data from 63 consecutive patients who underwent gastric ESD for 63 lesions located on the greater curvature of the U/M third of the stomach between September 2015 and April 2024. The primary outcome was the operation time, and secondary outcomes were resection speed, en bloc resection, R0 resection and complications in the O-CTM and without O-CTM ESD groups. Results: Of the 63 included lesions, 37 were resected without the O-CTM between September 2015 and June 2022 (without O-CTM group), and 26 lesions were resected using the O-CTM between July 2022 and April 2024 (O-CTM group). The O-CTM group had significantly shorter operation times (40 min vs. 77 min, p = 0.01) than the without O-CTM group. The resection speed was also significantly faster (20.1 mm2/min vs. 11.3 mm2/min, p = 0.02). No significant differences in en bloc resection rate, R0 resection rate, and complications were observed. Conclusions: Gastric ESD using O-CTM is beneficial when compared with the ESD without O-CTM in reducing operation time and improving resection speeds for treating lesions located on the greater curvature of the U/M region. [ABSTRACT FROM AUTHOR]

Wildlife observation with camera traps has great potential for ethology and ecology, as it gathers data non-invasively in an automated way. However, camera traps produce large amounts of uncurated data, which is time-consuming to annotate. Existing methods to label these data automatically commonly use a fixed pre-defined set of distinctive classes and require many labeled examples per class to be trained. Moreover, the attributes of interest are sometimes rare and difficult to find in large data collections. Large pretrained vision-language models, such as contrastive language image pretraining (CLIP), offer great promises to facilitate the annotation process of camera-trap data. Images can be described with greater detail, the set of classes is not fixed and can be extensible on demand and pretrained models can help to retrieve rare samples. In this work, we explore the potential of CLIP to retrieve images according to environmental and ecological attributes. We create WildCLIP by fine-tuning CLIP on wildlife camera-trap images and to further increase its flexibility, we add an adapter module to better expand to novel attributes in a few-shot manner. We quantify WildCLIP's performance and show that it can retrieve novel attributes in the Snapshot Serengeti dataset. Our findings outline new opportunities to facilitate annotation processes with complex and multi-attribute captions. The code is available at https://github.com/amathislab/wildclip. [ABSTRACT FROM AUTHOR]

Multimodal machine translation (MMT) is a method that uses visual information to guide text translation. However, recent studies have engendered controversy regarding the extent to which MMT can contribute to the improvement of text-enhanced translation. To explore whether the MMT model can improve translation performance, we use the current Neural Machine Translation (NMT) system for evaluation at Multi30K dataset. Specifically, we judge the performance of the MMT model by comparing the difference between the NMT model and the MMT model. At the same time, we conduct text and multimodal degradation experiments to verify whether vision can play a role. We explored the performance of the NMT model and the MMT model for sentences of different lengths to clarify the pros and cons of the MMT model. We found that the performance of the current NMT model surpasses that of the MMT model, suggesting that the impact of visual features might be less significant. Visual features seem to exert influence primarily when a substantial number of words in the source text are masked. [ABSTRACT FROM AUTHOR]

Objective: Intraoperative rupture (IOR) is the most common adverse event encountered during surgical clip obliteration of ruptured intracranial aneurysms. Besides increasing surgeon experience and early proximal control, no methods exist to decrease IOR risk. Thus, our objective was to assess if partial endovascular coil embolization to protect the aneurysm before clipping decreases IOR. Methods: We conducted a retrospective analysis of patients with ruptured intracranial aneurysms that were treated with surgical clipping at two tertiary academic centers. We compared patient characteristics and outcomes of those who underwent partial endovascular coil embolization to protect the aneurysm before clipping to those who did not. The primary outcome was IOR. Secondary outcomes were inpatient mortality and discharge destination. Results: We analyzed 100 patients. Partial endovascular aneurysm protection was performed in 27 patients. Age, sex, subarachnoid hemorrhage severity, and aneurysm location were similar between the partially-embolized and non-embolized groups. The median size of the partially-embolized aneurysms was larger (7.0 mm [interquartile range 5.95–8.7] vs. 4.6 mm [3.3–6.0]; P < 0.001). During surgical clipping, IOR occurred less frequently in the partially-embolized aneurysms than non-embolized aneurysms (2/27, 7.4%, vs. 30/73, 41%; P = 0.001). Inpatient mortality was 14.8% (4/27) in patients with partially-embolized aneurysms and 28.8% (21/73) in patients without embolization (P = 0.20). Discharge to home or inpatient rehabilitation was 74.0% in patients with partially-embolized aneurysms and 56.2% in patients without embolization (P = 0.11). A complication from partial embolization occurred in 2/27 (7.4%) patients. Conclusions: Preoperative partial endovascular coil embolization of ruptured aneurysms is associated with a reduced frequency of IOR during definitive treatment with surgical clip obliteration. These results and the impact of preoperative partial endovascular coil embolization on functional outcomes should be confirmed with a randomized trial. [ABSTRACT FROM AUTHOR]

Contrastive language-image pre-trained (CLIP) models have zero-shot ability of classifying an image belonging to " [ CLASS ] " by using similarity between the image and the prompt sentence "a [ CONTEXT ] of [ CLASS ] ". Based on exhaustive text cues in " [ CONTEXT ] ", CLIP model is aware of different contexts, e.g. background, style, viewpoint, and exhibits unprecedented robustness against a wide range of distribution shifts. However, recent works find further fine-tuning of CLIP models improves accuracy but sacrifices the robustness on downstream tasks. We conduct an empirical investigation to show fine-tuning will corrupt the context-aware ability of pre-trained CLIP features. To solve this problem, we propose Context-Aware Robust Fine-tuning (CAR-FT). CAR-FT regularizes the model during fine-tuning to capture the context information. Specifically, we use zero-shot prompt weights to get the context distribution contained in the image. By minimizing the Kullback–Leibler divergence (KLD) between context distributions induced by original/fine-tuned CLIP models, CAR-FT makes the context-aware ability of CLIP inherited into downstream tasks, and achieves both higher in-distribution (ID) and out-of-distribution (OOD) accuracy. The experimental results show CAR-FT achieves superior robustness on five OOD test datasets of ImageNet, and meanwhile brings accuracy gains on nine downstream tasks. Additionally, CAR-FT surpasses previous domain generalization (DG) methods and gets 78.5% averaged accuracy on DomainBed benchmark, building the new state-of-the-art. [ABSTRACT FROM AUTHOR]

Weakly supervised salient object detection (SOD) using image-level category labels has been proposed to reduce the annotation cost of pixel-level labels. However, existing methods mostly train a classification network to generate a class activation map, which suffers from coarse localization and difficult pseudo-label updating. To address these issues, we propose a novel Category-aware Saliency Enhance Learning (CSEL) method based on contrastive vision-language pre-training (CLIP), which can perform image-text classification and pseudo-label updating simultaneously. Our proposed method transforms image-text classification into pixel-text matching and generates a category-aware saliency map, which is evaluated by the classification accuracy. Moreover, CSEL assesses the quality of the category-aware saliency map and the pseudo saliency map, and uses the quality confidence scores as weights to update the pseudo labels. The two maps mutually enhance each other to guide the pseudo saliency map in the correct direction. Our SOD network can be trained jointly under the supervision of the updated pseudo saliency maps. We test our model on various well-known RGB-D and RGB SOD datasets. Our model achieves an S-measure of 87.6 % on the RGB-D NLPR dataset and 84.3 % on the RGB ECSSD dataset. Additionally, we obtain satisfactory performance on the weakly supervised E-measure, F-measure, and mean absolute error metrics for other datasets. These results demonstrate the effectiveness of our model. [ABSTRACT FROM AUTHOR]

Recent large vision-language models such as CLIP have shown remarkable out-of-distribution (OOD) detection and generalization performance. However, their zero-shot in-distribution (ID) accuracy is often limited for downstream datasets. Recent CLIP-based fine-tuning methods such as prompt learning have demonstrated significant improvements in ID classification and OOD generalization where OOD labels are available. Nonetheless, it remains unclear whether the model is reliable to semantic shifts without OOD labels. In this paper, we aim to bridge the gap and present a comprehensive study to understand how fine-tuning impact OOD detection for few-shot downstream tasks. By framing OOD detection as multi-modal concept matching, we establish a connection between fine-tuning methods and various OOD scores. Our results suggest that a proper choice of OOD scores is essential for CLIP-based fine-tuning. In particular, the maximum concept matching (MCM) score provides a promising solution consistently. We also show that prompt learning demonstrates the state-of-the-art OOD detection performance over the zero-shot counterpart. [ABSTRACT FROM AUTHOR]

Learning a one-shot domain adaptation model is an exciting and challenging topic in computer vision and graphics. A feasible solution is to fine-tune a pre-trained generator to the target domain by leveraging the powerful semantic capabilities of CLIP (Contrastive Language-Image Pretraining). Unfortunately, when the target image shows a significant difference from the source domain, existing methods would result in overfitting, and generated images do not correctly reflect the texture of the target image. To address this issue, we propose a Dynamic Domain Transfer Strategy (DDTS) to align the texture information between the source and target domain by dynamically adjusting the direction of domain transfer. Furthermore, the delicately designed dual-path hypernetworks of style and text (Dual-HyperST) for one-shot domain adaptation characterize the target domain's textual style and visual style with a text-guide path and a style-guide path. Specifically, the style-guided path predicts a set of style weight offsets by the target image, followed by the text-guided path predicts a set of text weight offsets by a text prompt. To better integrate the information between these two paths, we introduce a hypernetwork that learns to modulate the pre-trained generator instead of fine-tuning. Qualitative and quantitative experiments demonstrate the superiority of Dual-HyperST, which surpasses the state-of-the-art methods in the diversity and high quality of the generated images. [ABSTRACT FROM AUTHOR]

Recent machine learning advances demonstrate the effectiveness of zero-shot models trained on large amounts of data collected from the internet. Among these, CLIP (Contrastive Language-Image Pre-training) has been introduced as a multimodal model with high accuracy on a number of different tasks and domains. However, the unconstrained nature of the model begs the question whether it can be deployed in open-domain real-word applications effectively in front of non-technical users. In this paper, we evaluate whether CLIP can be used for multimodal video retrieval in a real-world environment. For this purpose, we implemented impa, an efficient shot-based retrieval system powered by CLIP. We additionally implemented advanced query functionality in a unified graphical user interface to facilitate an intuitive and efficient usage of CLIP for video retrieval tasks. Finally, we empirically evaluated our retrieval system by performing a user study with video editing professionals and journalists working in the TV news media industry. After having the participants solve open-domain video retrieval tasks, we collected data via questionnaires, interviews, and UI interaction logs. Our evaluation focused on the perceived intuitiveness of retrieval using natural language, retrieval accuracy, and how users interacted with the system’s UI. We found that our advanced features yield higher task accuracy, user ratings, and more efficient queries. Overall, our results show the importance of designing intuitive and efficient user interfaces to be able to deploy large models such as CLIP effectively in real-world scenarios. [ABSTRACT FROM AUTHOR]

Purpose: An anterior communicating artery is a common location for both ruptured and unruptured intracranial aneurysms, and microsurgery is sometimes necessary for their successful treatment. However, postoperative infarction should be considered during clipping due to the complex surrounding structures of anterior communicating artery aneurysms. This study aimed to evaluate the risk factors of postoperative infarction after surgical clipping of unruptured anterior communicating artery aneurysms and its clinical outcomes. Methods: The data of patients who underwent microsurgical clipping of an unruptured anterior communicating artery aneurysm in our hospital between January 2008 and December 2020 were retrospectively analyzed. The patients' demographic data, anatomical features of the anterior communicating artery complex and aneurysm, surgical technique, characteristics of postoperative infarction, and its clinical course were evaluated. Results: Notably, among 848 patients, 66 (7.8%) and 34 (4%) patients had radiologic and symptomatic infarctions, respectively. Univariate and multivariate logistic regression analyses showed that hypertension (odds ratio (OR), 1.99; p = 0.022 ), previous stroke (OR, 3.89; p = 0.009 ), posterior projection (OR, 5.58; p < 0.001 ), aneurysm size (OR, 1.17; optimal cut-off value, 6.14 mm; p = 0.002 ), and skull base-to-aneurysm distance (OR, 1.15; optimal cut-off value, 11.09 mm; p < 0.001 ) were associated with postoperative infarction. In the pterional approach, a closed A2 plane was an additional risk factor (OR, 1.88; p = 0.041 ). Infarction of the subcallosal and hypothalamic branches was significantly associated with symptomatic infarction ( p = 0.001 ). Conclusion: Hypertension, previous stroke, posteriorly projecting aneurysms, aneurysm size, and highly positioned aneurysms are independent risk factors for postoperative infarction during surgical clipping of an unruptured anterior communicating artery aneurysm. Additionally, a closed A2 plane is an additional risk factor of postoperative infarction in patients undergoing clipping via the pterional approach. [ABSTRACT FROM AUTHOR]

Large-scale language-vision pre-training models, such as CLIP, have achieved remarkable results in text-guided image morphing by leveraging several unconditional generative models. However, existing CLIP-guided methods face challenges in achieving photorealistic morphing when adapting the generator from the source to the target domain. Specifically, current guidance methods fail to provide detailed explanations of the morphing regions within the image, leading to misguidance and catastrophic forgetting of the original image’s fidelity. In this paper, we propose a novel approach considering proper regularization losses to overcome these difficulties by addressing the SP dilemma in CLIP guidance. Our approach consists of two key components: (1) a geodesic cosine similarity loss that minimizes inter-modality features (i.e., image and text) in a projected subspace of CLIP space, and (2) a latent regularization loss that minimizes intra-modality features (i.e., image and image) on the image manifold. By replacing the naive directional CLIP loss in a drop-in replacement manner, our method achieves superior morphing results for both images and videos across various benchmarks, including CLIP-inversion. [ABSTRACT FROM AUTHOR]

Purpose: This meta-analysis aims to investigate the role of prophylactic clipping after endoscopic colorectal polypectomy or endoscopic mucosal resection (EMR) in prevention of delayed bleeding (DB) following polypectomy. Methods: We searched the PubMed, Embase, and Cochrane Library databases for randomized controlled trials comparing the effect of prophylactic clipping versus no clipping on DB since inception to 22nd April 2022. We then performed a meta-analysis using a random-effects model. Results: We included 8 studies with 5648 patients and 10,436 lesions. Prophylactic clipping did not reduce the overall risk of DB compared with no clipping (1.54% vs 2.05%; Log RR, −0.29; 95% confidence interval [CI], −0.59, 0.01; P = 0.06). In subgroup analyses, clipping significantly reduced DB rate in polyps ≥ 2 cm (Log RR, −0.63; 95% CI, −1.08, −0.18; P = 0.01), in non-pedunculated polyps (Log RR, −0.63; 95% CI, −1.01, −0.24; P = 0.00), and in large (≥ 2 cm) proximal polyps (Log RR, −0.81; 95% CI, −1.56, 0.05; P = 0.04), but not in polyps < 2 cm (Log RR, 0.01; 95% CI, −.40, 0.42; P = 0.95). Conclusion: Prophylactic clipping does not prevent post-polypectomy bleeding after all EMR and should not be performed as a routine practice. Although prophylactic clipping may reduce DB rate following resection of large proximal polyps and non-pedunculated polyps, more high-quality studies are needed to determine the effects of factors such as polyp location, polyp morphology, antithrombotic drug use and complete or partial closure on the effectiveness of prophylactic clipping. [ABSTRACT FROM AUTHOR]

Background: The excimer laser-assisted non-occlusive anastomosis (ELANA) bypass technique may have the advantage of its non-occlusive design in the treatment of last-resort cases where endovascular treatment or direct clipping is considered to be unsafe. However, the technique remains technically challenging. Therefore, a sutureless ELANA Clip device (SEcl) was developed to simplify the technique avoiding tedious anastomosis stitching in depth. The present study investigates the clinical feasibility and safety of the SEcl technique. Methods: Three patients with complex and large aneurysms in the anterior circulation were selected after multidisciplinary consensus that the aneurysms were too complex for endovascular or direct clipping treatment options. Bypass surgery was considered as a last-resort treatment option, and after preoperative evaluation and informed consent, SEcl bypass surgery was performed. Applicability, technical aspects and patient outcomes are assessed. Results: All aneurysms were excluded from the circulation. The creation of the intracranial anastomosis was easier and faster. No device-related serious adverse events were encountered, and all outcomes were favorable (one patient stable Modified Rankin Scale, two patients improved). Conclusion: The SEcl anastomosis technique is feasible and, considering the severity of the disease, relatively safe. It can be considered a treatment option in very difficult-to treat last-resort aneurysm cases. From this study, further developments in minimizing clip size and application in cardiac surgery are initiated. [ABSTRACT FROM AUTHOR]

Contrastive language and image pre-training (CLIP) achieves great success in various computer vision tasks and also presents an opportune avenue for enhancing weakly-supervised image understanding with its large-scale pre-trained knowledge. As an effective way to reduce the reliance on pixel-level human-annotated labels, weakly-supervised semantic segmentation (WSSS) aims to refine the class activation map (CAM) and produce high-quality pseudo masks. Weakly-supervised semantic segmentation (WSSS) aims to refine the class activation map (CAM) as pseudo masks, but heavily relies on inductive biases like hand-crafted priors and digital image processing methods. For the vision-language pre-trained model, i.e. CLIP, we propose a novel text-to-pixel matching paradigm for WSSS. However, directly applying CLIP to WSSS is challenging due to three critical problems: (1) the task gap between contrastive pre-training and WSSS CAM refinement, (2) lacking text-to-pixel modeling to fully utilize the pre-trained knowledge, and (3) the insufficient details owning to the 116\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\frac{1}{16}$$\end{document} down-sampling resolution of ViT. Thus, we propose WeakCLIP to address the problems and leverage the pre-trained knowledge from CLIP to WSSS. Specifically, we first address the task gap by proposing a pyramid adapter and learnable prompts to extract WSSS-specific representation. We then design a co-attention matching module to model text-to-pixel relationships. Finally, the pyramid adapter and text-guided decoder are introduced to gather multi-level information and integrate it with text guidance hierarchically. WeakCLIP provides an effective and parameter-efficient way to transfer CLIP knowledge to refine CAM. Extensive experiments demonstrate that WeakCLIP achieves the state-of-the-art WSSS performance on standard benchmarks, i.e., 74.0% mIoU on the val set of PASCAL VOC 2012 and 46.1% mIoU on the val set of COCO 2014. The source code and model checkpoints are released at https://github.com/hustvl/WeakCLIP. [ABSTRACT FROM AUTHOR]

Video dehazing is a critical research area in computer vision that aims to enhance the quality of hazy frames, which benefits many downstream tasks, e.g. semantic segmentation. Recent work devise CNN-based structure or attention mechanism to fuse temporal information, while some others utilize offset between frames to align frames explicitly. Another significant line of video dehazing research focuses on constructing paired datasets by synthesizing foggy effect on clear video or generating real haze effect on indoor scenes. Despite the significant contributions of these dehazing networks and datasets to the advancement of video dehazing, current methods still suffer from spatial–temporal inconsistency and poor generalization ability. We address the aforementioned issues by proposing a triplane smoothing module to explicitly benefit from spatial–temporal smooth prior of the input video and generate temporally coherent dehazing results. We further devise a query base decoder to extract haze-relevant information while also aggregate temporal clues implicitly. To increase the generalization ability of our dehazing model we utilize CLIP guidance with a rich and high-level understanding of hazy effect. We conduct extensive experiments to verify the effectiveness of our model to generate spatial–temporally consistent dehazing results and produce pleasing dehazing results of real-world data. [ABSTRACT FROM AUTHOR]

Background: This is a prospective study evaluating the role of stereotactic body radiotherapy (SBRT) with CyberKnife (CK) in Indian patients suffering from hepatocellular carcinoma with portal vein thrombosis (HCC-PVT). Methods: Patients with inoperable HCC-PVT, good performance score (PS), and liver function are accrued for treatment on CK (version M6) and planned with Multiplan (iDMS V2.0). Triple-phase contrast computed tomography (CT) scan was done for contouring, and the gross tumor volume (GTV) included contrast-enhancing mass within main portal vein and adjacent parenchymal disease. Dose prescription was as per-risk stratification protocol (22–50 Gy in 5 fractions) while achieving the constraints of mean liver dose <15 Gy, 800 cc liver <8 Gy, and the duodenum max of ≤24 Gy). Results: Seventy-two HCC-PVT accrued till date (mean age 63 years [38–76 years], 96% male; Child-Pugh [CP] A 84%, B 9%; Barcelona-Clinic Liver Cancer [BCLC] C 96%; PS0-1: 80%, Karnofsky performance score [KPS]>70: 88%; co-morbidities 42%; infective 12%, alcohol intake 31%, adjuvant sorafenib 39%). CP scores 5, 6, 7, and 8 were in 35%, 32%, 8%, and 18%, respectively. Focal disease with portal vein thrombus (PVT) in 21%, liver involvement >50% and <50% in 46% and 32%. Liver cancer study group of Japan staging–based portal vein invasion VP2, VP3, and VP4 in 22%, 29%, and 40%. Cancer of the Liver Italian Programm (CLIP) scores 1, 2, 3, 4, and 5 were in 8%, 26%, 31%, 26%, and 7%, respectively. Mean follow-up was 7.3 months (median 6 months, standard deviation [SD] 6; range 3–30 months). Mean actuarial overall survival (OS) was 11.4 months (SE 1.587; 95% CI: 8–14.2 months). Six months and 12 months actuarial OS 55% and 38%, respectively. At last follow-up, 25/69 (36%) were alive and 44/69 (64%) were dead. Among 54 patients evaluated for response assessment, 23 (30%) had radiological confirmed PVT response, 1 (3%) had response of IVC thrombus, and 30 (42%) had no or minimal response to SBRT. Actuarial OS in responders and non-responders were 14.4 months (95% CI 9.4–19.2) and 7.4 months (95% CI 4.9–9.7), p-value: 0.022. Six and 12 months survival in responders and non-responders were 65.7% and 37% and 49% and 24.6%, respectively. Post-SBRT, 4 (12%) patients underwent transarterial chemoembolization (TACE) 3 patients (8%) and 1 patient (4%) transarterial radioembolization (TARE). Post-CK, (<4 weeks) 2 patients (4%) had decompensation. Conclusions: PVT response or recanalization after SBRT is a statistically significant prognostic factor for survival function in HCC-PVT. [ABSTRACT FROM AUTHOR]

Purpose: Endoscopic clipping closure after colorectal endoscopic submucosal dissection (ESD) did not reduce the incidence of post-ESD coagulation syndrome (PECS) in our recent randomized controlled trial (RCT); however, the definition of PECS is still controversial. The aim of this study is to establish optimal definition of PECS with additional analysis of RCT based on another definition. Methods: In this multicenter, single-blind RCT, individuals were randomly assigned to colorectal ESD followed by endoscopic clipping closure or non-closure. In this post hoc analysis, the definition of PECS was modified as both localized abdominal pain on visual analogue scale and inflammatory response (fever or leukocytosis), from either localized abdominal pain or inflammatory response in the original study. All participants underwent a computed tomography after ESD, and PECS was classified into type I, conventional PECS without extra-luminal air, and type II, PECS with peri-luminal air. Results: A total of 155 patients (84 in the non-closure group and 71 in the closure group) were analyzed. As a result of criteria modification, 21 type I PECS and four type II PECS cases in the original study, which included patients with clear pain and inflammatory response, were downgraded to no adverse event and simple peri-luminal air, respectively. The frequency of PECS showed no significant difference between non-closure and closure groups. Conclusion: Clipping closure after colorectal ESD does not reduce the incidence of PECS regardless of the diagnostic criteria. Either localized abdominal pain or inflammatory response might be optimal criteria of PECS (UMIN000027031). Trial registration number: UMIN000027031 Date of registration: April 18, 2017 [ABSTRACT FROM AUTHOR]

Purpose: No consensus exists regarding the most appropriate staging system to predict overall survival (OS) for hepatocellular carcinoma (HCC) in surgical candidates. Thus, we aimed to determine the prognostic ability of eight different staging systems in a European cohort of patients undergoing liver resection for HCC. Methods: Patients resected for HCC between 2010 and 2019 at our institution were analyzed with Kaplan-Meier and Cox regression analyses. Likelihood ratio (LR) χ2 (homogeneity), linear trend (LT) χ2 (discriminatory ability), and Akaike Information Criterion (AIC, explanatory ability) were used to determine the staging system with the best overall prognostic performance. Results: Liver resection for HCC was performed in 160 patients. Median OS was 39 months (95% confidence interval (CI): 32–46 months) and median RFS was 26 months (95% CI: 16–34 months). All staging systems (BCLC, HKLC, Okuda, CLIP, ITA.LI.CA staging and score, MESH, and GRETCH) showed significant discriminatory ability regarding OS, with ITA.LI.CA score (LR χ2 30.08, LT χ2 13.90, AIC 455.27) and CLIP (LR χ2 28.65, LT χ2 18.95, AIC 460.07) being the best performing staging systems. Conclusions: ITA.LI.CA and CLIP are the most suitable staging system to predict OS in European HCC patients scheduled for curative-intent surgery. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the treatment outcomes of large (15–25 mm) and giant (> 25 mm) intracranial aneurysms (IAs), according to different treatment modalities. Methods: In total, 112 patients with large and giant IAs treated with various treatment modalities between January 2009 and December 2018 were retrospectively reviewed. Clinical and radiological parameters were analyzed and correlated with the treatment modality. Results: A total of 141 procedures were performed on 112 patients. We initially treated 47 cases with coil embolization, 39 with flow diverter (FD), 13 with direct clipping, and 13 with parent artery occlusion (PAO). Recurrence (46.8%) and retreatment (31.9%) rates were significantly higher in the coiling group (p < 0.001). Complete occlusion rate (36.3%) was significantly lower in the coiling group (p = 0.027). PAO could achieve a high complete occlusion rate (90.9%) with low complication rate (12.5%). The total complication rate was 17%. In the multivariate logistic regression analysis, FD (OR 3.406, p = 0.036) and direct clipping (OR 5.732, p = 0.017) showed a significantly higher complication rate than coiling. The overall mortality rate was 8% (8/139 procedures). At the last follow-up (mean 30.6 ± 26.4 months), 70 of 96 patients (72.9%) showed complete or near-complete occlusion. Good functional outcome (mRS ≤ 2) was observed in 90 of 112 (80.3%) patients at the last follow-up (mean 33.2 ± 30.5 months). Conclusions: Good clinical and radiologic outcomes with acceptable complication and mortality rates can be achieved by various treatment modalities. The selection of appropriate modality should be individualized based on the angiographic findings and clinical symptoms. [ABSTRACT FROM AUTHOR]

Background/aims: Spontaneous retrograde migration of nasoenteral feeding tubes is common in clinical practice. The aim of the present study was to evaluate the effectiveness of nasoenteral feeding tube tip fixation with hemoclips to prevent tube dislodgement.Methods: We retrospectively reviewed patients who underwent insertion of an endoscopic nasoenteral feeding tube with or without tube tip fixation with hemoclips at the Asan Medical Center in Korea from January 2016 to December 2017. We compared the incidence of tube dislodgment and procedure-related complications between the two groups.Results: Of the total 225 procedures, 72 were performed using the clip-assisted method, while 153 were performed using the standard non-clip-assisted method. Tube dislodgement occurred in two (2.8%) cases in the clipping group and in 26 (17.0%) in the non-clipping group (p = 0.003). Non-clipping group had a sevenfold higher risk of tube dislodgement compared to clipping group after adjustments in multivariable logistic regression (adjusted OR 7.97, 95% CI 1.82-35.00). The procedure time was not significantly different between the two groups (17.6 ± 8.5 min in the clipping group vs. 17.8 ± 9.4 min in the non-clipping group, p = 0.872). In addition, procedure-related complications, such as bleeding, aspiration pneumonia, Mallory-Weiss tear, ileus, and tube obstruction, were not different between the two groups. Achieving target calorie intake took 10.4 ± 10.5 days in the clipping group and 7.9 ± 7.9 days in the non-clipping group (p = 0.293).Conclusion: Clip-assisted fixation of nasoenteral feeding tube was effective in preventing tube dislodgement. [ABSTRACT FROM AUTHOR]

The 'twinkle' or 'twinkling' artifact represents a phenomenon observed using color Doppler ultrasound that leads to a rapid alternation of color in and immediately behind an echogenic and highly reflective object. It occurs during sonographic examination of kidney stones, and has been also described in clips used for marking breast and axillary lesions. [ABSTRACT FROM AUTHOR]

Both aging and treated human immunodeficiency virus (HIV) infection are characterized by low-level chronic inflammation and immune activation which contribute to the development of age-related diseases, frailty, and early mortality. Chronic cytomegalovirus (CMV) infection is highly prevalent in older adults and HIV-infected populations. A number of studies have shown that CMV induces broad and strong T-cell responses in CMV-seropositive older adults and HIV-infected individuals. CMV infection rarely develops into clinical disease in immunocompetent individuals. However, a large body of literature has shown adverse effects of chronic CMV infection on the health and longevity of these populations. It has been hypothesized that chronic CMV infection may be a driver of chronic inflammation and immune activation, and may further contribute to the development of frailty. Thus, there is a need to better understand the extent of the impact of chronic CMV infection on T-cell immunity and health in aging and HIV infection. In this review, we will address important considerations and challenges in the assessment of chronic CMV infection and CMV-specific T-cell responses. We will then review recent data on relationships between T-cell responses to CMV and levels of inflammatory markers and immune activation, as well as the onset of frailty. [ABSTRACT FROM AUTHOR]

Background: Delayed bleeding is an important complication after gastric endoscopic submucosal dissection (ESD). The search, coagulation, and clipping (SCC) method can be used to prevent delayed bleeding after ESD. However, its safety and efficacy are unclear. We compared the SCC method with post-ESD coagulation (PEC) to clarify the safety and efficacy of the SCC method for preventing delayed bleeding after gastric ESD. Methods: This retrospective study included 438 patients (478 lesions) who underwent gastric ESD. Multivariate logistic regression analysis was performed to identify the significant independent factors associated with delayed bleeding and we performed propensity-score matching (PSM) to reduce the effect of procedure-selection bias of SCC method. Results: Of the 438 patients, 216 underwent PEC and 222 underwent SCC. Delayed bleeding was significantly less common in the SCC than in the PEC (2.6% vs. 7.2%; P = 0.013). Among patients treated with antithrombotic therapy, the delayed bleeding rate was lower in the SCC group than in the PEC group; however, the difference was not significant (P = 0.15). The SCC method was found to be a significant independent factor for the prevention of delayed bleeding. PSM was performed in 156 patients in the PEC group and SCC group. There was a significant difference in the incidence of bleeding in the PEC and SCC groups (P = 0.013). No patient had perforation/bleeding associated with the SCC method. Conclusions: Our findings suggest that the SCC method is a simple, safe, and effective approach for preventing delayed bleeding after gastric ESD. [ABSTRACT FROM AUTHOR]

Background: Colon perforation is the most serious complication associated with colonoscopic procedures. We performed a novel purse-string suture technique to close the iatrogenic colonic perforation using dual-channel endoscope with an endoloop and clips.Methods: Iatrogenic colon perforations developed during diagnostic colonoscopy referred to a tertiary hospital over 10 years were considered for this endoscopic closure. An endoloop was inserted through the left channel of the endoscope and placed around the defect. The first clip was placed at the proximal site of the defect through the other channel of the endoscope, and the endoloop was anchored on the mucosa around the defect. Then, subsequent clips were placed next to previous clips and the endoloop was fixed. After the defect was encircled by the endoloop and clips, the rim of the opening was approximated by fastening the endoloop with a purse-string technique.Results: A total of 8 patients were admitted to our hospital because of iatrogenic colon perforations during diagnostic colonoscopy. Of these, 2 underwent laparoscopic surgery and 6 underwent endoscopic closure by this novel purse-string suture technique. The estimated diameters of the perforations were 20 mm. All cases were successfully treated in the endoscopy unit without sedation or general anesthesia, and recovered without any complication or subsequent operation. Abdominal pain had nearly resolved within 3 days after the procedure in all patients, and only mild peritonitis was observed.Conclusions: Iatrogenic colon perforation can be treated with a purse-string suture technique using dual-channel endoscope with an endoloop and clips. This technique can be useful for relatively large colon perforations associated with diagnostic colonoscopy. [ABSTRACT FROM AUTHOR]

Upstream open reading frames (uORFs) in 5′ UTRs of eukaryotic mRNAs are increasingly recognized as important elements that regulate cellular protein synthesis. Since uORFs can start from non-AUG codons, an enormous number of potential uORF initiation sites exists in 5′UTRs. However, only a subset of these sites is used and it has been unclear how actual start sites are selected. Studies of the DEAD-box helicase Ded1p from S. cerevisiae show that translation of uORFs with non-AUG initiation codons occurs upstream of mRNA structures that emerge with defective Ded1p. The data designate mRNA structure as important determinant for non-AUG initiation sites of uORFs. Ded1p can control this RNA structure and thereby regulate uORF translation. [ABSTRACT FROM AUTHOR]

Endovascular techniques are still expanding in their capability by introducing novel technologies. Nevertheless, anterior communicating artery (ACoA) remains the region with high propensity for aneurysm (AN) re-growth after endovascular intervention. The purpose of this study is to highlight the ongoing importance for microsurgical treatment. The authors conducted a single-institution retrospective study of ACoA AN treatment between January 2000 and December 2016 maintaining “coil mainly” policy. The results are supplied with a systematic review of the literature. A total of n = 398 ACoA ANs were treated in n = 398 consecutive patients (207 females, 191 males). Microsurgical treatment was performed for 79 AN patients (54 ruptured, 25 unruptured), and 319 AN patients (250 ruptured, 69 unruptured) underwent coiling procedure. Treatment-related morbidity and mortality (MM) for unruptured ANs was 0% in the microsurgical and 1.5% in the endovascular group (p = 1.000). The percentage of patients with none or minor permanent deficits after subarachnoid hemorrhage was 74% in the microsurgical and 70% in the endovascular group (p = 0.693). The re-treatment rate was 3.8% in microsurgical group and 9.2% in endovascular group (p = 0.883). A literature review identified 39 studies concerning ACoA AN treatment. Clinical results of both modalities were comparable, with microsurgery being superior regarding radiological outcomes. This study demonstrates that both treatment techniques bring comparable clinical benefit to the patient. Microsurgery seemed superior regarding radiological outcomes. The decision about the treatment strategy should be made by a multi-disciplinary team consisting of specialists from both teams, bearing in mind the higher occlusion rate and longevity of the surgical treatment. [ABSTRACT FROM AUTHOR]

Keywords: Dissecting aneurysm; Child; Clip EN Dissecting aneurysm Child Clip 1427 1428 2 07/28/22 20220801 NES 220801 Chao Peng is the first author. In our case, there was thrombosis inside the aneurysm according to MRI and DSA. Magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) showed middle cerebral artery (MCA) dilation (Fig. [Extracted from the article]

Background: Endoscopic removal of a duodenal lesion is still considered to be a challenging procedure that can be fraught with potentially serious complications, specifically perforation or delayed bleeding. This study was to assess the safety of endoscopic resection for duodenal subepithelial lesions (SELs) with wound closure using clips and an endoloop.Methods: From October 2010 to July 2015, a total of 68 consecutive patients with duodenal SELs were treated with endoscopic resection with wound closure using clips and an endoloop. The main outcome measures considered were the incidence of complete resection, perioperative perforation, delayed perforation, delayed bleeding, residual lesions, and lesion recurrence.Results: Complete resection was successfully achieved for all 68 patients. The median lesion size was 1.7 cm. The median procedure time was 62 min. The mean hospital stay was 5.5 days. During the procedure, five patients developed perioperative perforations (7.4 %) and no patients developed delayed bleeding, delayed perforation, or other serious complications. The five patients with perioperative perforations recovered after conservative treatment. The perioperative perforation rate was significantly higher for lesions originating in the muscularis propria layer (18.2 %) than in the submucosal layer (2.2 %; p < 0.05). No residual or recurrent lesions were detected during the follow-up period (median: 27 months).Conclusions: Endoscopic resection with wound closure using clips and an endoloop is an effective and reasonably safe therapeutic method for treating/removing duodenal SELs when managed by an experienced endoscopic team, and it can provide an alternative treatment option for patients with duodenal SELs. [ABSTRACT FROM AUTHOR]

There are several techniques described to close the appendicular stump during laparoscopic appendectomy. The aim of this study was to investigate the safety and usefulness of the Hem-o-lok clip for the closure of appendicular stump, comparing these data with those concerning the endo-loop. We conducted a retrospective study that compared two groups of patients who underwent laparoscopic appendectomy from 2010 to 2015 at our institution. We used the Endoloop to close the stump in the first group (group I) and the Hem-o-lok in the second group (group II). We reviewed patient's data including: complications, operative time, length of stay, costs. There were 121 patients in group I and 138 patients in group II. The mean operative times were 40.5 min in group I and 36.4 min in the group II. No intraoperative complications and no mortality were observed in either group. The mean postoperative length of hospital stay was similar for both groups. There was no rehospitalization after discharge. The complication rate did not reach statistical significance between the groups. The cost of the procedure using the Hem-o-lok has been lower than using the Endoloop. Both the Endoloop and Hem-o-lok are safe for the closure of the appendicular stump. Hem-o-lok appears to be superior than Endoloop in terms of easeness of use and cheapness, maintaining the same safety. [ABSTRACT FROM AUTHOR]

Background and Aims: Esophagorespiratory fistulas (ERF) are a devastating complication of benign and malignant etiologies. ERF are associated with high mortality, short survival, and poor quality of life. We performed a multicenter analysis of patients with ERF undergoing endoscopic treatment.Methods: Multicentre retrospective study.Results: We analyzed 25 patients undergoing 35 procedures over an 8-year period. Our data showed high technical success rates (97.1% of procedures) and with good, but not ideal, clinical success rates (60% of procedures, 80% of patients), which were defined as fistula closure confirmed by radiographic or repeat endoscopic evaluation and/or a lack of recurrent episodes of clinical aspiration to focus on durable ERF closure as opposed to only initial success. Proximal ERF were the most difficult to manage with the lowest overall clinical success rates, highest rates of recurrent aspiration despite endoscopic therapy, highest adverse events, and shortest survival times. Adverse events occurred in 40.0% of our patients and were all minor. Treatment allowed for diet advancement in 75% of patients.Conclusion: This represents the largest recent collection of US data and the first multicenter study evaluating the clinical success of multiple treatment modalities while stratifying data by fistula etiology and esophageal location. The endoscopic approaches detailed in this study offer a minimally invasive and safe choice for intervention with the potential to improve quality of life despite overall suboptimal clinical success and survivorship rates for in with ERF. [ABSTRACT FROM AUTHOR]

Background and Aim: It is usually difficult to obtain a good view of the dissection plane during esophageal endoscopic submucosal dissection (ESD). Therefore, the aim of this study was to investigate the efficacy and safety of clip traction in ESD for the treatment of early esophageal carcinoma (EEC) or precancerous lesions.Methods: This is a case-matched comparative study. We selected 100 EEC patients who had undergone ESD. Fifty cases underwent ESD without clip traction (non-clip group), and 50 cases underwent ESD with clip traction (clip group). The patient-related variables, dissection time, data regarding muscularis propria injury, etc. were statistically analyzed.Results: ESD was successful in all cases without complication. There were no significant differences between the two groups with respect to age, gender, the longitudinal diameter of the lesions, etc. Wide visual field exposure of the submucosal tissue below the lesion was obtained by applying clip traction. The dissection time of ESD was shorter in the clip group than in the non-clip group [22.02 (6.77) min vs 26.48 (12.56); P = 0.018] when the extent of lesion was less than half of the circumference of the esophagus; otherwise, there was no difference between the two groups (P = 0.252). Moreover, the muscularis propria injuries in the clip group were obviously less than the non-clip group (10 vs 30 %, P = 0.007).Conclusion: Clip traction can decrease the rate of muscularis propria injury and shorten the dissection time. It is recommended as a safe and effective auxiliary procedure for the treatment of esophageal ESD. [ABSTRACT FROM AUTHOR]

Background: One hundred consecutive applications of a new clipping device, the OTSC Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas. Methods: In patients with anorectal fistulas, minimally invasive surgery with the OTSC Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening. In some of the patients, postoperative pain was evaluated using a visual analog scale. After 6 months, the postoperative clinical course and the fistula healing were assessed. Results: A total of 100 OTSC Proctology procedures were performed in 96 patients with 55 transsphincteric, 38 suprasphincteric, 2 extrasphincteric, and 5 rectovaginal fistulas. In all but 11 fistulas (8 Crohn's disease, 3 ulcerative colitis), the fistulas were of cryptoglandular origin. The median operation time was 32 min (range 17-66 min). There were no major intraoperative technical problems. All patients found the postoperative pain to be tolerable with standard pain medication. The short-term results of 99 clip applications were analyzed: the healing rate for first-line fistula therapy was 79 %, whereas in recurrent fistulas, the success rate was 26 %. OTSC Proctology was successful in 45 % of fistulas associated with inflammatory bowel disease and in 20 % of rectovaginal fistulas. Conclusions: OTSC Proctology provides convincing results as first-line treatment for complex cryptoglandular fistulas. It is a safe, effective, minimally invasive, and sphincter-sparing procedure with postoperative pain comparable to other types of fistula surgery. [ABSTRACT FROM AUTHOR]

Purpose: Polymeric clips (hem-o-lok ligation system) are a novel alternative for securing the base of the appendix during laparoscopic appendectomy. There is a lack of systematic evaluation of polymeric clips to close the appendiceal stump with regard to postoperative intra-abdominal abscesses. The aim of this study was to compare the hem-o-lok ligation system with conventional devices. Methods: The outcome of 813 consecutive patients, operated between 2009 and 2013 receiving laparoscopic appendectomy either with hem-o-look or endoloop for acute appendicitis, was analysed. The risk of postoperative intra-abdominal abscesses was investigated for two different techniques to close the appendiceal stump using univariate and multivariate analyses. Results: Hem-o-lok clips were used in 54 % ( n = 435) and endoloop sutures were applied in 46 % ( n = 378) of the patients. Based on the multivariate analysis, the postoperative lack of antibiotics as well as the application of endoloop was identified as an independent predictive factor for the development of postoperative intra-abdominal abscesses. Comparing the closure techniques, the odds ratio (OR) was 0.25 (95 % CI 0.09-0.69; p < 0.008). Conclusion: Closure of the appendiceal stump using the non-absorbable hem-o-lok ligation system did result in a reduced rate of intra-abdominal surgical abscesses as compared to the application of endoloops. [ABSTRACT FROM AUTHOR]

Regulation of the microtubule cytoskeleton is of pivotal importance for neuronal development and function. One such regulatory mechanism centers on microtubule plus-end tracking proteins (+TIPs): structurally and functionally diverse regulatory factors, which can form complex macromolecular assemblies at the growing microtubule plus-ends. +TIPs modulate important properties of microtubules including their dynamics and their ability to control cell polarity, membrane transport and signaling. Several neurodevelopmental and neurodegenerative diseases are associated with mutations in +TIPs or with misregulation of these proteins. In this review, we focus on the role and regulation of +TIPs in neuronal development and associated disorders. [ABSTRACT FROM AUTHOR]

Superiorly projecting (SP) anterior communicating artery (AComA) aneurysms are typically described as a homogenous group. Clinically and microsurgically, these aneurysms vary in multiple important characteristics. We propose a microsurgical classification system for these complex aneurysms and review its implications regarding presentation, microsurgical techniques, and outcome. This retrospective analysis reviews patients undergoing clipping of SP AComA aneurysms (2005-2013). The classification system is based on the virtual plane created by the A2 segments and its relationship to the aneurysm. Aneurysm type was assessed by intraoperative images and videos. Type 1 is defined by bisection of the dome by the virtual plane. Type 2 is defined by dome projection posterior to this plane. Sagittal rotation of the plane defines type 3. We analyzed clinical presentation, morphology, angiographic characteristics, operative technique, and outcome relative to the classification types. There were 44 SP AComA aneurysms. 3D angiographic images predicted classification type in 83 %. Type 1 presented more often with SAH (95.5 %, p = 0.0046). There was no statistically significant difference between the types regarding patient demographics or aneurysm characteristics. In type 2, fenestrated clips were used frequently (87.5 % p= 0.0016), and there was higher rate of intraoperative rupture (37.5 %). Although there was no statistically significant difference between the types in respect to HH grade upon presentation, patients with type 2 aneurysms experienced higher rates of poor GOS (50 %). The proposed classification system for SP AComA aneurysms has implications regarding surgical planning, micro-dissection, clipping, and outcome. Type 2 aneurysms carry significant surgical risk. [ABSTRACT FROM AUTHOR]

Background: The results of microsurgical treatment for middle cerebral artery (MCA) aneurysms (ANs) have been highly satisfying for decades, notoriously posing a challenge for interventional neuroradiologists. Following the International Subarachnoid Aneurysm Trial (ISAT) study results, most centres across Europe and the USA switched to a "coil first" policy. The purpose of this study is to evaluate and critically review the substantiation of this change. Methods: The authors conducted a single-institution retrospective study of MCA AN treatment between January 2000 and December 2013 maintaining a 'clip first' policy. The results are supplied with a literature review. Results: A total of 315 MCA ANs were treated in 288 consecutive patients (209 females, 79 males). Microsurgical treatment was performed for 238 AN patients (116 ruptured, 122 unruptured) and 77 AN patients (46 ruptured, 31 unruptured) who underwent a coiling procedure. Treatment-related morbidity and mortality (MM) for unruptured ANs was 2.8 % in the microsurgical group and 10.3 % in the endovascular group. The percentage of patients with no/minor permanent neurological deficits after SAH in a good initial clinical state (HH 1-2) was 93 % in the microsurgical and 76 % in the endovascular group. A literature review identified 21 studies concerning MCA AN treatment with a specified decision-making algorithm. Microsurgery seemed superior to endovascular management regarding both clinical and radiological outcomes, although several aspects of the analysed reports might appear questionable. Conclusion: Although this study has its inherent limitations, the effect brought about by microsurgical clipping of MCA ANs remains superior to that of endovascular embolisation and it should be sustained as the first treatment choice. The decision about the treatment strategy should be made by a multi-disciplinary team consisting of specialists from both teams, bearing in mind the higher occlusion rate and longevity of the surgical treatment. [ABSTRACT FROM AUTHOR]

Background: The benefit of endoscopic full-thickness resection is the improved diagnostic work-up with an integral wall specimen which allows a precise determination of the tumor or its precursor and its infiltration depth into the wall. Materials and methods: A new endoscopic full-thickness resection device (FTRD), which is a combination of a modified over-the-scope-clip (OTSC) system with an electrocautery snare, has been tested in an experimental setting. In eleven pigs, divided into three groups, endoscopic full-thickness resection was performed in the colon at one or two sites, respectively. Seven days ( n = 7) or 28 days ( n = 4) after the intervention, the animals were euthanized following endoscopic examination of the resection and clip application sites. Furthermore, two different clips were tested during these animal trials in order to evaluate the most effective clip design. Results: The average diameter of the tissue resected with the FTRD was 3.1, 3.6, and 5.4 cm in the three groups. On follow-up endoscopy 7 days after the intervention, fibrin coating and stool residues were found at all clips, causing minor inflammatory reactions. However, the colon wall under the clip was non-inflamed. After 28 days, the serosa had primarily healed in all cases. There were also stool residues at all clips; however, no acute inflammatory reactions were seen anymore, due to complete healing. Histological assessment did not show any signs of dehiscence in the region of the scar, or ischemia in the clip area. In addition, no wound infections, such as abscess formation, were observed. Conclusions: This study demonstrates the safety and efficacy of the clip-and-cut technique using the new FTRD system. With the device, a local full-thickness colon resection can be easily created, and the resulting wall defect is reliably sealed by the endoluminal application of a modified OTSC clip. [ABSTRACT FROM AUTHOR]

Background: One of the major causes for performing unplanned re-exploration of a craniotomy after microsurgery for unruptured intracranial aneurysms (UIAs) is compromised distal blood flow after clipping. Therefore, it is important to identify the causes of compromised distal blood flow after clipping and the factors that influence the prognosis for re-exploration in order to decrease ischemic complications related to clipping UIAs. Method: Between January 2007 and December 2013, 1954 patients underwent microsurgery for UIAs. In this cohort, 20 patients (1.0 %) required unplanned re-exploration of the craniotomy for several reasons, and 11 patients (0.6 %) underwent unplanned re-exploration with clip repositioning or changing of the previous clip because of compromised distal blood flow after clipping. Patient characteristics, aneurysm properties, intraoperative findings, annual incidence and prognosis were analyzed in these 11 patients. Results: The annual incidence of re-exploration has gradually decreased since the introduction of several intraoperative monitoring techniques. In total, 3.0 % of UIAs in the M1 trunk, 0.8 % of UIAs at the origin of the anterior choroidal artery (AchA) and 0.5 % of UIAs at the bifurcation of the middle cerebral artery (MCA) required re-exploration. Here, all 11 UIAs had broad necks, and atherosclerosis was identified around 10 UIAs. Six patients with compromised MCA flow demonstrated relatively better outcomes following re-exploration than five patients with a compromised lenticulostriate artery (LSA) or AchA flow. Four patients with delayed ischemic symptoms demonstrated relatively better outcomes than the seven patients who developed ischemic symptoms immediately postoperatively. Conclusion: Clinicians need to be more careful not to compromise distal blood flow when clipping UIAs at the MCA and AchA origin. Various intraoperative monitoring techniques can help reduce the incidence of compromised distal blood flow after clipping. [ABSTRACT FROM AUTHOR]

Background and aims: Closing the internal opening by a clip ovesco has been recently proposed for healing the fistula tract, but, to date, data on benefit are poorly analyzed. The aim was to report a preliminary multicenter experience. Materials and methods: Retrospective study was undertaken in six different French centers: surgical procedure, immediate complications, and follow-up have been collected. Results: Nineteen clips were inserted in 17 patients (M/F, 4/13; median age, 42 years [29-54]) who had an anal fistula: 12 (71 %) high fistulas (including 4 rectovaginal fistulas), 5 (29 %) lower fistulas (with 3 rectovaginal fistulas), and 6 (35 %) Crohn's fistulas. Out of 17 patients, 15 had a seton drainage beforehand. The procedure was easy in 8 (47 %) patients and the median operative time was 27.5 min (20-36.5). Postoperative period was painful for 11 (65 %) patients. A clip migration was noted in 11 patients (65 %) after a median follow-up of 10 days (5.5-49.8). Eleven patients (65 %) who failed had reoperation including 10 new drainages within the first month (0.5-5). After a mean follow-up of 4 months (2-7),, closing the tract was observed in 2 patients (12 %) following the first insertion of the clip and in another one after a second insertion. Conclusion: Treatment of anal fistula by placing a clip on the internal opening is disappointing and deleterious for some patients. A better assessment before dissemination is recommended. [ABSTRACT FROM AUTHOR]

RNA-binding proteins (RBPs) play an important role in regulating gene expression at the post-transcriptional level, including the steps of pre-mRNA splicing, polyadenylation, mRNA stabilization, mRNA export from the nucleus to the cytoplasm, mRNA localization, and translation. RBPs regulate these processes primarily by binding to specific sequence elements in newly synthesized or mature transcripts. While many RPBs are known to recognize certain nucleotide sequences in RNA, information is insufficient for others. In particular, RBPs often compete for RNA binding or interact with RNA cooperatively. Hence, it is of importance to study the RNA-protein interactions in vivo. Numerous methods have been developed to identify the target nucleotide sequences of RBPs. The methods include the electrophoretic mobility shift assay (EMSA), systematic evolution of ligands by exponential enrichment (SELEX), RNA pull-down assay, RNA footprinting, RNA immunoprecipitation (RIP), UV-induced crosslinking immunoprecipitation (CLIP) and its variants, and measurement of the level for newly synthesized transcripts. Each of the methods has its limitation, and several methods supplementing each other should be employed in order to detect the RNA sequence to which a protein binds. [ABSTRACT FROM AUTHOR]

The pervasive transcription of the genome creates many types of non-coding RNAs (ncRNAs). However, we know very little regarding the functions and the regulatory mechanisms of these ncRNAs. Exploring the interactions of RNA and RNA binding proteins (RBPs) is vital because it can allow us to truly understand how these ncRNAs behave in vivo. High-throughput sequencing of RNA isolated by cross-linking immunoprecipitation (HITS-CLIP or CLIP-seq) and its variants have been successfully used as systemic techniques to study RBP binding sites. In this review, we will explain the major differences between the CLIP techniques, summarize successful applications of these techniques, discuss limitations of CLIP, present some suggested solutions and project their promising future roles in studying the RNA world. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a major health problem worldwide. Moreover, the liver cancer field is evolving rapidly, with early diagnosis, new therapies, and a better understanding of HCC's biology and development. Accurate staging is important for determining prognosis and selecting the most appropriate treatment for each patient. Surgical intervention remains the most effective treatment for HCC and is the only potentially curative modality. However, in HCC patients, overall survival is also independently affected by underlying liver disease and cirrhosis, which in turn affect the applicability and efficacy of treatment. Although several staging classification and prognostic scoring systems have been proposed for determining the stage and prognosis of HCC, no consensus exists on the best classification method. The most common staging classification systems include tumor-node-metastasis stage, Okuda staging, Cancer of the Liver Italian Program score, Barcelona Clinic Liver Cancer staging classification, the French, the Chinese University Prognostic Index, Japanese Integrated Scoring, and the Tokyo score. Radiologists should be aware of the different staging classification systems for HCC and familiar with the system relevant to their respective referring clinicians, as it will provide pertinent radiological evaluation for multidisciplinary management. [ABSTRACT FROM AUTHOR]