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Marietta Iacucci - One of the best experts on this subject based on the ideXlab platform.
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an international multicenter real life prospective study of electronic chromoendoscopy score Picasso in ulcerative colitis
Gastroenterology, 2021Co-Authors: Marietta Iacucci, Samuel C Smith, Alina Bazarova, Uday N Shivaji, Pradeep Bhandari, Rosanna CannatelliAbstract:Background & Aims Endoscopic and histologic remission are important goals in the treatment of ulcerative colitis (UC). We investigated the correlation of the recently developed Paddington International Virtual ChromoendoScopy ScOre (Picasso) and other established endoscopic scores against multiple histological indices and prospectively assessed outcomes. Methods In this prospective multicenter international study, inflammatory activity was assessed with high-definition and virtual chromoendoscopy in the rectum and sigmoid using the Mayo Endoscopic Score (MES), UC Endoscopic Index of Severity (UCEIS), and Picasso. Targeted biopsies were taken for assessment using Robarts Histological Index (RHI), Nancy Histological index (NHI), ECAP (Extent, Chronicity, Activity, Plus score), Geboes, and Villanacci. Follow-up data were obtained at 6 and 12 months after colonoscopy. Results A total of 307 patients were recruited. There was strong correlation between Picasso and histology scores, significantly superior to correlation coefficients of MES and UCEIS with histology scores. A Picasso score of ≤3 detected histologic remission by RHI (≤3 + absence of neutrophils) with area under the receiver operating characteristic curve (AUROC) 0.90 (95% confidence interval [CI] 0.86–0.94) and NHI (≤1) AUROC 0.82 (95% CI 0.77–0.87). The interobserver agreement for Picasso was 0.88 (95% CI 0.83–0.92). At 6- and 12-months follow-up, Picasso score ≤3 predicted better outcomes than Picasso >3 (hazard ratio [HR] 0.19 [0.11–0.33] and 0.22 [0.13–0.34], respectively),} as well as Picasso 4–8 (HR 0.25 [0.12–0.53] and 0.22 (0.12–0.39), respectively) and similar to histologic remission. Conclusion In this first real-life multicenter study, the Picasso score correlated strongly with multiple histological indices. Furthermore, Picasso score predicted specified clinical outcomes at 6 and 12 months, similar to histology. Thus, Picasso can be a useful endoscopic tool in the therapeutic management of UC.
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o4 multicentre prospective validation study of the paddington international virtual chromoendoscopy score Picasso in ulcerative colitis
Gut, 2021Co-Authors: Marietta Iacucci, Samuel C Smith, Alina Bazarova, Uday N Shivaji, Pradeep Bhandari, Rosanna Cannatelli, Marco Daperno, Jose G FerrazAbstract:Introduction Mucosal healing (MH)is an important goal in the treatment of ulcerative colitis (UC). The newly published Picasso score characterises subtle mucosal and vascular changes and defines MH. We aimed to validate in real-life the Picasso score and assess its ability to predict relapse. Methods Patients with UC were prospectively recruited from 11 international centres. Participating endoscopists experienced in IBD received training on Picasso before starting the study. The rectum and sigmoid were examined using iScan 1,2&3 (Pentax, Japan) and inflammatory activity was assessed using Mayo, UCEIS and Picasso. Biopsies were taken for histological assessment using Robarts Histological Index (RHI), Nancy, ECAP, Geboes and Villanacci. Follow up data was obtained at 12 months. Results A total of 307 patients were recruited.The interobserver agreement for the Picasso score was 0.879 (95% CI 0.826–0.924). The Picasso total and Picasso mucosal scores strongly correlated with histology scores and was statistically better than MES and UCEIS as show in figure 1. When using a Picasso total score of ≤3 the AUROC to predict MH by RHI (≤3 + absence of neutrophils) was 0.90 (95% CI 0.86–0.94) and when we compare the AUROC of Picasso vs Mayo p was =0.06. When using the Nancy score (≤1) the AUROC was 0.816 (95% CI 0.77–0.87). A Kaplan-Meier curve shows a significant favourable survival probability without relapse with a Picasso score of ≤3 Likelihood ratio test=26.41, p Conclusions This real-life validation study shows the electronic chromoendoscopy score, Picasso, can predict accurately histological healing and long-term remission and can be a useful tool in the management of UC.
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development and reliability of the new endoscopic virtual chromoendoscopy score the Picasso paddington international virtual chromoendoscopy score in ulcerative colitis
Gastrointestinal Endoscopy, 2017Co-Authors: Marietta Iacucci, Marco Daperno, Xianyong Gui, Mark Lazarev, Razvan Arsenascu, Gian Eugenio Tontini, Oluseyi Akinola, Vincenzo Villanacci, Martin GoetzAbstract:Background and Aims Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC. Methods Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (Picasso) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed. Results The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the Picasso endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall Picasso in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%). Conclusions The EVC score "Picasso" showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.
Shri Pathmakanthan - One of the best experts on this subject based on the ideXlab platform.
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the paddington international virtual chromoendoscopy score in ulcerative colitis exhibits very good inter rater agreement after computerized module training a multicenter study across academic and community practice with video
Gastrointestinal Endoscopy, 2018Co-Authors: Palak J Trivedi, Ralf Kiesslich, James Hodson, Neeraj Bhala, Ralph Boulton, Rachel Cooney, Tariq Iqbal, Kakit Li, Saqib Mumtaz, Shri PathmakanthanAbstract:Abstract Introduction Electronic virtual chromoendoscopy (EVC) can demonstrate ongoing disease activity in ulcerative colitis (UC), even when Mayo subscores suggest healing. However, applicability of EVC technology outside the expert setting has yet to be determined. Methods 15 participants across 5 centers reviewed a computerized training module outlining high-definition (HD) and EVC (i-Scan) colonoscopy modes. Interobserver agreement was then tested (Mayo score, UCEIS and the P addington I nternational virtual C hromoendo S copy S c O re [Picasso] for UC), using a colonoscopy video library (n=30 cases reviewed pre- and n=30 post-training). Knowledge sustainability was re-tested in a second round (n=42 cases; 9/15 participants), 6 months after training provision. Results Pre-training intraclass correlation coefficients (ICC) were good for the Mayo endoscopic subscore (ICC:0.775), UCEIS scoring erosions/ulcers (ICC:0.770) and UCEIS overall (ICC:0.786), and for mucosal (ICC:0.754) and vascular components of Picasso (ICC:0.622). For the vascular components of UCEIS, agreement was only moderate (ICC:0.429), and did not enhance post-training (ICC:0.417); unlike for Picasso, which improved (mucosal ICC:0.848; vascular: 0.746). Histological correlation using the New York Mt. Sinai System was strong for both Picasso components (Spearman's rho for mucosal: 0.925, and vascular: 0.873; p 0.001 for both). Moreover, accuracy in specifically discriminating quiescent from mild histological strata was strongest for Picasso (AUROC for mucosal: 0.781; vascular: 0.715), compared with Mayo (AUROC:0.708) and UCEIS (AUROC for UCEIS overall: 0.705; vascular: 0.562; bleeding: 0.645; erosions/ulcers: 0.696). Inter-rater reliability for Picasso was sustained by round 2 participants (Round 1 and 2 ICC for mucosal: 0.873 and 0.869, respectively; and vascular: 0.715 and 0.783, respectively), together with histological correlation ( rho mucosal: 0.934, vascular: 0.938; p 0.001 for both). Conclusion Picasso demonstrates good interobserver agreement across all levels of experience, providing excellent correlation with histology. Given ability to discriminate subtle endoscopic features, Picasso may be applied to refine stratified treatment paradigms for UC patients.
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the paddington international virtual chromoendoscopy score in ulcerative colitis exhibits very good inter rater agreement after computerized module training a multicenter study across academic and community practice with video
Gastrointestinal Endoscopy, 2018Co-Authors: Palak J Trivedi, Ralf Kiesslich, James Hodson, Neeraj Bhala, Ralph Boulton, Rachel Cooney, Tariq Iqbal, Saqib Mumtaz, Xianyong Gui, Shri PathmakanthanAbstract:Background and Aims Electronic virtual chromoendoscopy (EVC) can demonstrate ongoing disease activity in ulcerative colitis (UC), even when Mayo subscores suggest healing. However, applicability of EVC technology outside the expert setting has yet to be determined. Methods Fifteen participants across 5 centers reviewed a computerized training module outlining high-definition and EVC (iScan) colonoscopy modes. Interobserver agreement was then tested (Mayo score, Ulcerative Colitis Endoscopic Index of Severity [UCEIS], and the Paddington International Virtual Chromoendoscopy Score [Picasso] for UC), using a colonoscopy video library (30 cases reviewed pretraining and 30 post-training). Knowledge sustainability was retested in a second round (42 cases; 9/15 participants), 6 months after training provision. Results Pretraining intraclass correlation coefficients (ICC) were good for the Mayo endoscopic subscore (ICC, .775), UCEIS scoring erosions/ulcers (ICC, .770), and UCEIS overall (ICC, .786) and for mucosal (ICC, .754) and vascular components of Picasso (ICC, .622). For the vascular components of UCEIS, agreement was only moderate (ICC, .429) and did not enhance post-training (ICC, .417); conversely, use of Picasso improved post-training (mucosal ICC, .848; vascular, .746). Histologic correlation using the New York Mt. Sinai System was strong for both Picasso components (Spearman’s ρ for mucosal: .925; vascular, .873; P Conclusions Picasso demonstrates good interobserver agreement across all levels of experience, providing excellent correlation with histology. Given the ability to discriminate subtle endoscopic features, Picasso may be applied to refine stratified treatment paradigms for UC patients.
J Farine - One of the best experts on this subject based on the ideXlab platform.
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final results of the Picasso dark matter search experiment
Astroparticle Physics, 2017Co-Authors: E Behnke, Pijushpani Bhattacharjee, X Dai, Mala Das, A Davour, F Debris, N Dhungana, M Besnier, J FarineAbstract:The Picasso dark matter search experiment operated an array of 32 superheated droplet detectors containing 3.0 kg of C 4 F 10 and collected an exposure of 231.4 kgd at SNOLAB between March 2012 and January 2014. We report on the final results of this experiment which includes for the first time the complete data set and improved analysis techniques including acoustic localization to allow fiducialization and removal of higher activity regions within the detectors. No signal consistent with dark matter was observed. We set limits for spin-dependent interactions on protons of σ p S D = 1.32 × 10 −2 − 2 pb (90% C.L.) at a WIMP mass of 20 GeV/c 2 . In the spin-independent sector we exclude cross sections larger than σ p S I = 4.86 × 10 −5 − 5 pb (90% C.L.) in the region around 7 GeV/c 2 . The pioneering efforts of the Picasso experiment have paved the way forward for a next generation detector incorporating much of this technology and experience into larger mass bubble chambers.
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searching for dark matter with Picasso
Physics Procedia, 2015Co-Authors: S Archambault, E Behnke, Pijushpani Bhattacharjee, X Dai, Mala Das, A Davour, F Debris, N Dhungana, M Besnier, J FarineAbstract:Abstract The Project In CAnada to Search for Supersymmetric Objects (Picasso) at SNOLAB searches for Weakly Interacting Massive Particle (WIMP) interactions with 19 F. It is particularly sensitive to spin-dependent particle interactions. It uses a droplet technique, based on the principle of a bubble chamber, in which phase transitions in superheated liquids can be triggered by WIMP induced nuclear recoils. The detection process allows a highly e ffi cient suppression of backgrounds from cosmic muons, γ rays and electrons. Recent results and progress are presented and future plans to scale this technique to large masses with the PICO collaboration are briefly discussed.
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constraints on low mass wimp interactions on 19 f from Picasso
Physics Letters B, 2012Co-Authors: S Archambault, E Behnke, Pijushpani Bhattacharjee, S Bhattacharya, X Dai, Mala Das, A Davour, F Debris, N Dhungana, J FarineAbstract:Abstract Recent results from the Picasso dark matter search experiment at SNOLAB are reported. These results were obtained using a subset of 10 detectors with a total target mass of 0.72 kg of 19F and an exposure of 114 kgd. The low backgrounds in Picasso allow recoil energy thresholds as low as 1.7 keV to be obtained which results in an increased sensitivity to interactions from Weakly Interacting Massive Particles (WIMPs) with masses below 10 GeV/c 2 . No dark matter signal was found. Best exclusion limits in the spin dependent sector were obtained for WIMP masses of 20 GeV/c 2 with a cross section on protons of σ p S D = 0.032 pb (90% C.L.). In the spin independent sector close to the low mass region of 7 GeV/c 2 favoured by CoGeNT and DAMA/LIBRA, cross sections larger than σ p S I = 1.41 × 10 − 4 pb (90% C.L.) are excluded.
Deborah Queiroz Freitas - One of the best experts on this subject based on the ideXlab platform.
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evaluation of metal artefact reduction in cone beam computed tomography images of different dental materials
Clinical Oral Investigations, 2018Co-Authors: Polyane Mazucatto Queiroz, Matheus Lima Oliveira, Francisco Carlos Groppo, Francisco Haiterneto, Deborah Queiroz FreitasAbstract:The aim of this study is to evaluate the efficacy of metal artefact reduction (MAR) in different dental materials with Picasso Trio cone-beam computed tomography (CBCT) scanner. Three imaging phantoms were custom-made of acrylic resin. Each phantom presented three cylinders of the same material: dental amalgam alloy, gutta-percha or aluminium-copper alloy. CBCT scans were performed on Picasso Trio unit with and without MAR, and artefact expression (standard deviation of grey values) was obtained and compared by Kruskal-Wallis and Student-Newman-Keuls (post hoc) (α = 0.05). Significant reduction of artefact expression (p 0.05) was observed with or without MAR when gutta-percha was scanned. MAR was effective in reducing artefacts arising from dental alloys on CBCT images. Dental materials of high atomic number and density are widely used in dentistry and can produce artefact that compromise CBCT image. The present study demonstrated that metal artefact reduction algorithm is an effective tool to improve image quality.
Palak J Trivedi - One of the best experts on this subject based on the ideXlab platform.
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the paddington international virtual chromoendoscopy score in ulcerative colitis exhibits very good inter rater agreement after computerized module training a multicenter study across academic and community practice with video
Gastrointestinal Endoscopy, 2018Co-Authors: Palak J Trivedi, Ralf Kiesslich, James Hodson, Neeraj Bhala, Ralph Boulton, Rachel Cooney, Tariq Iqbal, Kakit Li, Saqib Mumtaz, Shri PathmakanthanAbstract:Abstract Introduction Electronic virtual chromoendoscopy (EVC) can demonstrate ongoing disease activity in ulcerative colitis (UC), even when Mayo subscores suggest healing. However, applicability of EVC technology outside the expert setting has yet to be determined. Methods 15 participants across 5 centers reviewed a computerized training module outlining high-definition (HD) and EVC (i-Scan) colonoscopy modes. Interobserver agreement was then tested (Mayo score, UCEIS and the P addington I nternational virtual C hromoendo S copy S c O re [Picasso] for UC), using a colonoscopy video library (n=30 cases reviewed pre- and n=30 post-training). Knowledge sustainability was re-tested in a second round (n=42 cases; 9/15 participants), 6 months after training provision. Results Pre-training intraclass correlation coefficients (ICC) were good for the Mayo endoscopic subscore (ICC:0.775), UCEIS scoring erosions/ulcers (ICC:0.770) and UCEIS overall (ICC:0.786), and for mucosal (ICC:0.754) and vascular components of Picasso (ICC:0.622). For the vascular components of UCEIS, agreement was only moderate (ICC:0.429), and did not enhance post-training (ICC:0.417); unlike for Picasso, which improved (mucosal ICC:0.848; vascular: 0.746). Histological correlation using the New York Mt. Sinai System was strong for both Picasso components (Spearman's rho for mucosal: 0.925, and vascular: 0.873; p 0.001 for both). Moreover, accuracy in specifically discriminating quiescent from mild histological strata was strongest for Picasso (AUROC for mucosal: 0.781; vascular: 0.715), compared with Mayo (AUROC:0.708) and UCEIS (AUROC for UCEIS overall: 0.705; vascular: 0.562; bleeding: 0.645; erosions/ulcers: 0.696). Inter-rater reliability for Picasso was sustained by round 2 participants (Round 1 and 2 ICC for mucosal: 0.873 and 0.869, respectively; and vascular: 0.715 and 0.783, respectively), together with histological correlation ( rho mucosal: 0.934, vascular: 0.938; p 0.001 for both). Conclusion Picasso demonstrates good interobserver agreement across all levels of experience, providing excellent correlation with histology. Given ability to discriminate subtle endoscopic features, Picasso may be applied to refine stratified treatment paradigms for UC patients.
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the paddington international virtual chromoendoscopy score in ulcerative colitis exhibits very good inter rater agreement after computerized module training a multicenter study across academic and community practice with video
Gastrointestinal Endoscopy, 2018Co-Authors: Palak J Trivedi, Ralf Kiesslich, James Hodson, Neeraj Bhala, Ralph Boulton, Rachel Cooney, Tariq Iqbal, Saqib Mumtaz, Xianyong Gui, Shri PathmakanthanAbstract:Background and Aims Electronic virtual chromoendoscopy (EVC) can demonstrate ongoing disease activity in ulcerative colitis (UC), even when Mayo subscores suggest healing. However, applicability of EVC technology outside the expert setting has yet to be determined. Methods Fifteen participants across 5 centers reviewed a computerized training module outlining high-definition and EVC (iScan) colonoscopy modes. Interobserver agreement was then tested (Mayo score, Ulcerative Colitis Endoscopic Index of Severity [UCEIS], and the Paddington International Virtual Chromoendoscopy Score [Picasso] for UC), using a colonoscopy video library (30 cases reviewed pretraining and 30 post-training). Knowledge sustainability was retested in a second round (42 cases; 9/15 participants), 6 months after training provision. Results Pretraining intraclass correlation coefficients (ICC) were good for the Mayo endoscopic subscore (ICC, .775), UCEIS scoring erosions/ulcers (ICC, .770), and UCEIS overall (ICC, .786) and for mucosal (ICC, .754) and vascular components of Picasso (ICC, .622). For the vascular components of UCEIS, agreement was only moderate (ICC, .429) and did not enhance post-training (ICC, .417); conversely, use of Picasso improved post-training (mucosal ICC, .848; vascular, .746). Histologic correlation using the New York Mt. Sinai System was strong for both Picasso components (Spearman’s ρ for mucosal: .925; vascular, .873; P Conclusions Picasso demonstrates good interobserver agreement across all levels of experience, providing excellent correlation with histology. Given the ability to discriminate subtle endoscopic features, Picasso may be applied to refine stratified treatment paradigms for UC patients.