The Coronavirus disease (COVID-19) caused by a novel coronavirus, SARS-CoV-2, has been declared as a global pandemic. Due to its infection rate and severity, it has emerged as one of the major global threats of the current generation. To support the current combat against the disease, this research aims to propose a Machine Learning based pipeline to detect the COVID-19 infection using the lung Computed Tomography scan images (CTI). This implemented pipeline consists of a number of sub-procedures ranging from segmenting the COVID-19 infection to classifying the segmented regions. The initial part of the pipeline implements the segmentation of the COVID-19 affected CTI using Social-Group-Optimization and Kapur’s Entropy thresholding, followed by k-means clustering and morphology-based segmentation. The next part of the pipeline implements feature extraction, selection and fusion to classify the infection. PCA based serial fusion technique is used in fusing the features and the fused feature vector is then employed to train, test and validate four different classifiers namely Random Forest, k-Nearest Neighbors (KNN), Support Vector Machine with Radial Basis Function, and Decision Tree. Experimental results using benchmark datasets show a high accuracy (> 91%) for the morphology-based segmentation task and for the classification task the KNN offers the highest accuracy among the compared classifiers (> 87%). However, this should be noted that this method still awaits clinical validation, and therefore should not be used to clinically diagnose the ongoing COVID-19 infection.

Imaging techniques such as computed tomographies (CT) play a major role in clinical imaging and diagnosis of malignant lesions. In recent years, spectral CT has emerged in the field of computed tomographies, utilizing detailed information from extracted spectral parameters of the specimen. Metal nanoparticle platforms enable effective payload delivery for this technique. Due to the possibility of surface modification, metal nanoparticles are predestined to facilitate molecular tumor targeting. In this work, we demonstrate the feasibility of anti-plasma membrane Heat shock protein 70 functionalized gold nanoparticles (AuNPs) for tumor specific multimodal imaging. Membrane-associated Hsp70 is exclusively presented on the plasma membrane of malignant cells of multiple tumor entities, but not on corresponding normal tissue cells, predestining this target epitope for tumor-selective in vivo targeting. In vitro microscopical analysis revealed the presence of cmHsp70.1-AuNP in the cytosol of tumor cell lines, being internalized via the endosomal-lysosomal pathway. In tumor bearing mice the biodistribution as well as the intratumorally enrichment of AuNP were examined 24h after i.v. application, in vivo. In parallel to spectral CT analysis, histological analysis confirmed the presence of tumor cells. In contrast to control NP, a significant enrichment of cmHsp70.1-AuNPs has been detected selectively in tumors of different preclinical mouse models. Furthermore, the biodistribution of AuNP, following i.v. injection, was analyzed by a machine-learning approach on digitalized slides. In summary, utilizing mHsp70 on tumor cells for guidance of cmHsp70.1 antibody functionalized nanoparticles enables sufficient enrichment and uniform distribution of AuNPs in mHsp70-expressing tumor cells, adequate for various microscopical imaging techniques and spectral-CT-based tumor delineation, in vivo.

Introduction Blunt carotid injuries (BCI) in pediatric trauma are quite rare. Due to the low number of cases, only a few reports and studies have been conducted on this topic. This review will discuss how frequent BCI/ BCVI on pediatric patients after blunt trauma is, what routine diagnostics look like, if a CT/ CTA scan on pediatric patients after blunt trauma is always necessary and if there are any negative health effects? Methods This literature review includes reviews, systematic reviews, case reports and original studies in english language between 1999 and 2020 that have dealt with pediatric blunt trauma and the diagnostics of BCI and BCVI. Furthermore, publications on the risk of radiation exposure on children were included in the study. For literature research, Medline (PubMed) and the Cochrane library were used. Results Pediatric BCI/ BCVI, shows an overall incidence between 0.03 – 0.5% of confirmed BCI/ BCVI cases due to pediatric blunt trauma. 1.1 – 3.5% of pediatric blunt trauma patients underwent CTA to detect BCI. Only 0.17 – 1.2% of all CTA scans shows a positive diagnosis for BCI. In children, the median volume CT dose index on a non-contrast head CT is 33 milligray, a computed tomography angiography needs at least 138 mGy. A cumulative doses of about 50 mGy almost triples the risk of leukemia, and doses of about 60 mGy triples the risk of brain cancer. Discussion Knowing that a BCI could have extensive neurologic consequences for children, it is necessary to evaluate routine pediatric diagnostics after blunt trauma. Computed tomography scans (CT) and computed tomography angiography (CTA) are mostly used in routine BCI diagnostics. However, since radiation exposure in children should be as low as reasonably achievable, it should be asked if other diagnostic methods could be used to identify risk groups. Trauma guidelines and clinical scores like the McGovern score are reflect established BCI screening options, as well as using duplex ultrasound.

In response to a threefold increase in osteoporotic vertebral fractures (OVF) at our institution over the past decade and the subsequent development of new fractures within a year in a third of cases, we evaluated the effectiveness of STIR MRI scans in conjunction with CT scans for initial OVF diagnosis. This study, conducted over five months, involved full spine sagittal STIR MRI scans alongside CT scans for patients over 50 with minor injury-related vertebral fractures. The independent assessments by radiologists and neurosurgeons of 64 patients revealed that while CT scans identified 161 fresh fractures, of which only 68 were previously reported, MRI detected 266 fractures, 1.65 times more than CT. CT scans showed single fractures in 27% of patients and multiple fractures in 73%, whereas MRI identified single fractures in 9% and multiple fractures in 91% of patients. Additionally, MRI demonstrated a 1.5-fold increase in adjacent fracture detection. The use of MRI influenced treatment plans in 67% of cases. Given these findings, we advocate for including a STIR MRI of the entire spine alongside CT scans in OVF cases, as it significantly enhances fracture detection and can alter treatment strategies.

Bone marrow mononuclear cells (BMMNCs) have emerged as a potential therapeutic strategy for various incurable conditions including autism spectrum disorder (ASD). To study its safety and efficacy, we analyzed 1011 patients who underwent intrathecal administration of autologous BMMNCs along with neurorehabilitation. At mean follow-up of 19.3 months after intervention, 90.6% patients showed overall improvement. Improvements were observed in attention concentration, command following, eye contact, sitting tolerance, social interaction, hyperactivity, communication, speech, aggressiveness, stereotypical and self-injurious behavior. Statistically significant changes were observed in scores of Indian Scale of Autism Assessment and Childhood Autism Rating Scale (p<0.05). On subgroup analysis, improvements were recorded irrespective of age and disease severity and better outcome was observed in patients who took multiple doses of cell therapy compared to single dose. Comparative Brain PET-CT scan of 401 patients showed improved brain metabolism after the intervention. No major adverse events were reported. Only 9 out of 1011 patients experienced seizures which were managed using medications. 4 out of 9 had history of seizures while 5 had normal EEG with no history. However, improvements were still observed in these 9 patients. Thus, intrathecal transplantation of autologous BMMNCs along with neurorehabilitation is safe and efficacious in patients with ASD.

The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55-69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as Lung Cancer associated with Cystic Airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs biennial pace of LDCT, choice between opportunistic or population-based recruitment and between uni or multi-center screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention and prospective validation of the biomarkers.

Geometrical assessments of human skull have been done based on the anatomical landmarks. Automatic detection of the landmarks, if developed, will be a great help not only medically, but also anthropologically. An automated system with multi-phased deep learning networks to predict three-dimensional coordinate values of cranio-facial landmarks, was developed. From a publicly available database, computed tomography images of craniofacial area were obtained. They were digitally reconstructed into three-dimensional models. Sixteen anatomical landmarks were plotted on each of the models and coordinate values of them were recorded. Three-phased regression deep learning networks were trained respectively with 90 training datasets. For evaluation, 30 testing datasets were employed. Three-dimensional error for the first phase, testing 30 data, was 11.60 pixels in average. (1 pixel = 500 / 512 mm) For the second phase, it was significantly improved to 4.66 pixels. For the third phase, it was significantly progressed to 2.88. This was comparable to the gaps between the landmarks, plotted by two experienced practitioners. Our proposing method of multi-phased prediction, coarse detection first and narrowing down the detection area, may be a possible solution, within the physical limitation of memory and computation.

The use of additive manufacturing in fabricating composite components has been gaining traction in the past decade. However, some issues with mechanical perfor-mance still need to be resolved. The issue of material porosity remains a pertinent one that needs more understanding to be able to determine viable solutions. Different re-searchers have examined the subject of porosity issues in AM-fabricated CFRP compo-sites. However, more research to quantitatively determine the effects of fabrication temperatures at the micro-scale is still needed. This study employed micro CT scan analysis to quantitatively compare the effects of fabrication temperatures at 230°C, 250°C, 270°C, and 290°C for CF-PA and CF-ABS composites. This followed an SEM evaluation which was used to determine the effects of the temperatures on interlayer and intralayer porosity generation. The porosity volume was related to the mechanical properties results in which it was determined how deposition temperatures affect the porosity volumes. It was also determined that semicrystalline composites are generally more affected by fabrication temperatures than amorphous composites, with the rela-tionship between porosity and mechanical properties also established. The overall po-rosity volume from the interlayer and intralayer voids was also determined, with the interlayer voids found to play a more determinant role in influencing the mechanical properties.

This paper presents an overview of tomography and different tomographic imaging modalities. The goal of this paper is to provide an understanding of various imaging modalities; in particular, how the imaging is performed, working principles, and applications. It was not intended to provide the in-depth mathematical principles of these imaging modalities, rather this paper focuses on providing the knowledge in an easy-to-grasp manner for the readers' benefit. Imaging modalities are categorized based on the physics behind image generation. First, the paper explains the general tomography principle. Then explains Ultrasound Imaging, Electrical Impedance Tomography, Computed Tomography, Magnetic Resonance Imaging (MRI), Photoacoustic Tomography (PAT), and Positron Emission Tomography (PET). In the end, the paper provides the fundamentals and review of two relatively new imagining modalities, Diffuse Optical Tomography (DOT) and functional Near-infrared Spectroscopy (fNIRS).

Lung cancer is one of the leading causes of cancer-related mortality globally. Pulmonary nodules are one of the risk factors and their discovery rate has been increasing. Based on the nodule size and growth rate, their malignancy propensity is determined; however, it is very challenging to distinguish between benign and cancerous nodules. Many tumour-associated antigens (TAA) have been studied as blood biomarkers for lung cancer, most commonly the Cytokeratin 19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC Ag), carbohydrate antigen (CA19-9) and carcinoembryonic antigen (CEA). Due to their low sensitivity, TAAs are not recommended as tools for the early detection of lung cancer. However, cancer testis antigens (CTAs) are highly specific for carcinomas but their expression is more commonly associated with advanced stages of cancer and poor prognosis. Despite the fact that TAAs may provide useful insights for the diagnosis and prognosis of early lung cancer, their potential to do so has yet to be demonstrated.

Radiotherapy commonly utilizes CBCT for patient positioning and treatment monitoring. CBCT is deemed to be secure for patients, making it suitable for the delivery of fractional doses. However, limitations such as a narrow field of view, beam hardening, scattered radiation artifacts, and variability in pixel intensity hinder the direct use of raw CBCT for dose recalculation during treatment. To address this issue, reliable correction techniques are necessary to remove artifacts and remap pixel intensity into HU values. This study proposes a deep-learning framework for calibrating CBCT images acquired with narrow FOV systems and demonstrates its potential use in proton treatment planning updates. Cycle-consistent GAN processes raw CBCT to reduce scatter and remap HU. Monte Carlo simulation is used to generate CBCT scans, enabling the possibility to focus solely on the algorithm’s ability to reduce artifacts and cupping effects without considering intra-patient longitudinal variability and producing a fair comparison between planning CT and calibrated CBCT dosimetry. To showcase the viability of the approach using real-world data, experiments were also conducted using real CBCT. Tests were performed on a publicly available dataset of 40 patients who received ablative radiation therapy for pancreatic cancer. The simulated CBCT calibration led to a difference in proton dosimetry of less than 2%, compared to the planning CT. The potential toxicity effect on the organs at risk decreased from about 50% (uncalibrated) up the 2% (calibrated). The gamma pass rate at 3%/2mm produced an improvement of about 37% in replicating the prescribed dose before and after calibration (53.78% vs 90.26%). Real data also confirmed this with slightly inferior performances for the same criteria (65.36% vs 87.20%). These results may confirm that generative artificial intelligence brings the use of narrow FOV CBCT scans incrementally closer to clinical translation in proton therapy planning updates.

Since mid-December of 2019, coronavirus disease 2019 (COVID-19) has been spreading from Wuhan, China. As of February 21, total 75,773 confirmed cases worldwide have spread to more than two dozen countries. Transmission of COVID-19 can occur early in the course of infection since SARS-CoV-2 viral loads in asymptomatic patients are similar to that in the symptomatic patients. Therefore, more sensitive diagnostic methods are needed to detect early phase of the infection to prevent secondary or tertiary spreads. Here, we compare the RT-PCR confirmatory test results using two different SARS-CoV-2 viral RNAs from two Korean COVID-19 confirmed cases.RT-PCR method targeting the RdRP gene, which was recommended by WHO guideline, was less sensitive than targeting N genes (as per CDC guideline). Because many countries follow the WHO guideline, our findings may contribute to the early diagnosis of COVID-19.

The high demand for SARS-CoV-2 tests but limited supply to South African laboratories early in the COVID19 pandemic, resulted in a heterogenous diagnostic footprint of open and closed molecular testing platforms. Novel approaches were required to monitor test quality especially during the introduction of newly circulating variants. The National Health Laboratory Service centrally collected cycle threshold (Ct) values from 1,497,669 test results reported from six commonly used PCR assays in 36 months, and visually monitored changes in their median Ct within a 28-day centered moving average for each assays’ gene targets. This continuous quality monitoring rapidly identified delayed hybridization of RdRp in the Allplex™ SARS-CoV-2 assay due to the Delta (B.1.617.2) variant; S-gene target failure in the TaqPath™ COVID-19 assay due to B.1.1.7 (Alpha) and the B.1.1.529 (Omicron); and recently E-gene delayed hybridization in the Xpert® Xpress SARS-CoV-2 due to XBB.1.5. This near “real-time” monitoring helped inform the need for sequencing and the importance of multiplex molecular nucleic acid amplification technology designs used in diagnostics for patient care. This continuous quality monitoring approach at the granularity of Ct values should be included in ongoing surveillance and with application to other disease use cases that rely on molecular diagnostics.

Background. Chest CT is widely regarded as a dependable imaging technique for detecting pneumonia in COVID-19 patients, but there is growing interest in microwave radiometry (MWR) of the lungs as a possible substitute for diagnosing lung involvement. Aim. The aim of the study is to examine the utility of the MWR approach as a screening tool for diagnosing pneumonia with complications in patients with COVID-19. Methods. Our study involved two groups of participants. The control group consisted of 50 individuals (24 male and 26 female) between the ages of 20 to 70 years who underwent clinical evaluations and had no known medical conditions. The main group included 142 participants (67 men and 75 women) between the ages of 20 to 87 years who were diagnosed with COVID-19 complicated by pneumonia and were admitted to the emergency department between June 2020 to June 2021. Skin and lung temperatures were measured at 14 points, including 2 additional reference points, using a previously established method. Lung temperature data were obtained with the MWR2020 (RTM-01-RES) (MMWR LTD, Edinburgh, UK), a CE Class I device. All participants underwent clinical evaluations, laboratory tests, chest CT scans, MWR of the lungs, and reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2. Results. The MWR exhibits a high predictive capacity as demonstrated by its sensitivity of 98.6% and specificity of 84.0%. Conclusions. MWR of the lungs can be a valuable substitute for chest CT in diagnosing pneumonia in patients with COVID-19, especially in situations where chest CT is unavailable or impractical.

Lung cancer remains the leading cause of cancer-related death and it is usually diagnosed in advanced stages (stage III or IV). Recently, the availability of targeted strategies and of immunotherapy with checkpoint inhibitors (ICI) has favorably changed patient prognosis. Treatment outcome is closely related to tumor biology and interaction with the host immune microenvironment (TME). Whether for targeted therapies the response relies on the presence of specific genetic alterations in tumor cells, for ICI accurate biomarkers of response are lacking and clinical outcome likely depends on multiple factors, host and tumor-related. This paper is an overview of the ongoing research on predictive factors both from in-vitro/ex-vivo analysis (ranging from conventional pathology to molecular biology) and in-vivo analysis, where molecular imaging is showing an exponential growth and use due to the technological advancement and to the new bioinformatics approaches applied to image analyses that allow specific features recovery in specific tumor subclones.

Lung cancer is a deadly disease if not diagnosed in its early stages. However, early detection of lung cancer is a challenging task due to the shape and size of its nodules. Radiologists need support from automated tools for precise opinion. Automated detection of the affected lungs nodule is difficult because of the shape similarity among healthy tissues. Over the years, several expert systems have been developed that help radiologists to diagnose lung cancer. In this article, we propose a framework to precisely detect lungs cancer by classifying it between benign and malignant nodules. The framework is tested using the subset of the publicly available at the Lung Image Database Consortium image collection (LIDC-IDRI). Multiple techniques including filtering and noise removing are applied for pre-processing. Subsequently, the OTSU and the semantic segmentation are used to accurately detect the unhealthy lungs nodules. In total, 13 nodules features were extracted using Principal Components Analysis (PCA) algorithm. Four optimal features are selected based on the classification performance. In the classification phase, 9 different classifiers are used along with two types of validation schemes i.e. train test holdout validation with 70-30 data split and 10 fold cross-validation. Our experiments show that the proposed system provides 99.23\% accuracy using logic boost classifier.

In recent years, computer-aided analysis techniques have emerged as valuable tools in assisting dermatologists by providing objective and efficient analysis of skin cancer images. This paper utilizes the combination of the Contourlet Transform (CT) and Local Binary Pattern (LBP) techniques for accurately recognizing borders, contrast changes, and shapes of skin cancer images. These results often contain many features, leading to high computational costs and potential over-fitting issues. Hence, we applied Particle Swarm Optimization (PSO) to select the most informative and discriminating features, reducing the dimensionality while retaining important information for accurate classification. After reducing the feature set with PSO, we applied these sets to Machine learning classification algorithms: Support Vector Machine (SVM), Random Forest (RF), and Neural Networks (NN). The results show that SVM has the lowest time complexity of 0.0458 seconds, followed by the Neural Network at 0.08730 seconds, and the Random Forest model has the highest time complexity of 0.1622 seconds. The SVM and Neural Network models are faster to train than the Random Forest model, making them more suitable for real-time or latency-sensitive applications. We also compared our proposed model with the state-of-the-art models and obtained the accuracy of 86.9%, which is the highest among the models.

The paper demonstrates the analysis of Corona Virus Disease based on a probabilistic model. It involves a technique for classification and prediction by recognizing typical and diagnostically most important CT images features relating to Corona Virus. The main contributions of the research include predicting the probability of recurrences in no recurrence (first time detection) cases at applying our proposed approach for feature extraction. The combination of the conventional statistical and machine learning tools is applied for feature extraction from CT images through four images filters in combination with proposed composite hybrid feature extraction (CHFS). The selected features were classified by the stack hybrid classification system(SHC). Experimental study with real data demonstrates the feasibility and potential of the proposed approach for the said cause.

CT scans are currently the most common imaging modality used for suspected stroke patients due to their short acquisition time and wide availability. However, MRI offers superior tissue contrast and image quality. In this study, eight deep learning models are developed, trained, and tested using a dataset of 181 CT/MR pairs from stroke patients. The resultant synthetic MRIs generated by these models are compared through a variety of qualitative and quantitative methods. The synthetic MRIs generated by a 3D UNet model consistently demonstrated superior performance across all methods of evaluation. Overall, the generation of synthetic MRIs from CT scans using the methods described in this paper produces realistic MRIs that can guide the registration of CT scans to MRI atlases. The synthetic MRIs enable the segmentation of white matter, gray matter, and cerebrospinal fluid using algorithms designed for MRIs, exhibiting a high degree of similarity to true MRIs.

Objectives: Studies evaluating machine learning (ML) algorithms on cross-lingual RadLex® mappings for developing context-sensitive radiological reporting tools are lacking. Therefore, we investigated whether ML-based approaches can be utilized to assist radiologists in providing key imaging biomarkers – such as The Alberta stroke programme early CT score (APECTS). Material and Methods: A stratified random sample (age, gender, year) of CT reports (n=206) with suspected ischemic stroke was generated out of 3997 reports signed off between 2015-2019. Three independent, blinded readers assessed these reports and manually annotated clinico-radiologically relevant key features. The primary outcome was whether ASPECTS should have been provided (yes/no: 154/52). For all reports, both the findings and impressions underwent cross-lingual (German to English) RadLex®-mappings using natural language processing. Well-established ML-algorithms including classification trees, random forests, elastic net, support vector machines (SVMs) and boosted trees were evaluated in a 5 x 5-fold nested cross-validation framework. Further, a linear classifier (fastText) was directly fitted on the German reports. Ensemble learning was used to provide robust importance rankings of these ML-algorithms. Performance was evaluated using derivates of the confusion matrix and metrics of calibration including AUC, brier score and log loss as well as visually by calibration plots. Results: On this imbalanced classification task SVMs showed the highest accuracies both on human-extracted- (87%) and fully automated RadLex® features (findings: 82.5%; impressions: 85.4%). FastText without pre-trained language model showed the highest accuracy (89.3%) and AUC (92%) on the impressions. Ensemble learner revealed that boosted trees, fastText and SVMs are the most important ML-classifiers. Boosted trees fitted on the findings showed the best overall calibration curve. Conclusions: Contextual ML-based assistance suggesting ASPECTS while reporting neuroradiological emergencies is feasible, even if ML-models are restricted to be developed on limited and highly imbalanced data sets.

Neutron computed tomography (nCT) has been established at many major neutron sources worldwide, using high-end equipment requiring major investment and development. Many older and smaller reactors would be capable of doing nCT as well, but cannot afford the investment before feasibility is proven. We have developed a compact low-cost but high-quality detection system using a new cooled CMOS camera that can either be fully integrated into a sophisticated setup, or used with a rudimentary CT control and motion system to quickly evaluate feasibility of neutron CT at a given beam line facility. Exchanging the scintillation screen makes it feasible for X-rays as well, even for visible light (and transparent samples) using a matte screen. The control system uses a hack to combine motion control with existing imaging software so it can be used to test several dozen different cameras without writing specific drivers. Freeware software can do reconstruction and 3D imaging.

Fatigue-related subchondral bone injury of the third metacarpal/ metatarsal (McIII/ MtIII) bone is a common cause of wastage and welfare concern in racehorses. Better understanding of bone health and strength would improve animal welfare and be of benefit for the racing industry. Porosity index (PI) of bone is an indirect measure of osseous pore size and number and is therefore an interesting indicator of bone strength. MRI of compact bone using traditional methods even with short echo times fails to generate enough signal to assess bone architecture as the water protons are tightly bound. Ultrashort echo time (UTE) sequences aim to increase the amount of signal detected in the equine McIII/MtIII condyle. Cadaver specimens were imaged using a novel dual-echo UTE MRI technique and PI was calculated and validated against quantitative CT-derived bone mineral density (BMD). BMD and PI are inversely correlated in the equine distal Mc/ MtIII with a mean r value of -0.29. The r value is significantly different between fore- and hindlimbs. Further work is needed to assess how correlation patterns behave in different areas of the bone and to evaluate PI in horses with and without clinically relevant stress injury.

(1) Background: Stereological estimations significantly contributed to our anatomical and physiological understanding of the lung by providing an average distribution of measured parameters over the entire lung parenchyma. However, most structural lung diseases show a very inhomogeneous pattern of alterations. (2) Methods: We developed a novel protocol for the analysis of all pulmonary airspaces. Our pipeline starts with high-resolution synchrotron radiation-based X-ray tomographic microscopy (SRXTM) and consists of (i) image segmentation with the combination of the free machine-learning tool Ilastik and ImageJ and (ii) calculation of the airspace diameter distribution of an entire lung using a diameter map function. To evaluate the new pipeline, lungs from adult mice with cystic fibrosis (CF)-like lung disease (ENaC-transgenic mice) or mice with elastase-induced emphysema were compared to healthy controls. (3) Results: We were able to show the distribution of airspace diameters throughout the entire lung, as well as separately for the conducting airways and the gas-exchange area. In the pathobiological context, we observed an irregular widening of parenchymal airspaces in mice with CF-like lung disease and elastase-induced emphysema. Comparable results were obtained when analyzing lungs imaged with μCT, suggesting that our pipeline is applicable to different kinds of imaging modalities. (4) Conclusions: We conclude that the airspace diameter map is well suited for a detailed analysis of unevenly distributed structural alterations in chronic muco-obstructive lung diseases such as cystic fibrosis and COPD.

Introduction: The aim of our study was to assess the role of ECG-gated Coronary CT Angiography (CCTA) in the diagnosis, imaging follow-up, and treatment guidance in post-procedural/surgical interventions of the heart and thoracic aorta (PTCA, TAVI, PMK/ICD placement, CABGs).

Quantitative biomarkers derived from positron-emission tomography/computed tomography (PET/CT) have been suggested as prognostic variables in immune-checkpoint inhibitor (ICI) treated non-small cell lung cancer (NSCLC). As such data for first-line ICI therapy and especially for chemotherapy-ICI combinations are still scarce, we retrospectively evaluated baseline 18F-FDG-PET/CT of 85 consecutive patients receiving first-line pembrolizumab with chemotherapy (n=70) or as monotherapy (n=15). Maximum and mean standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis and bone marrow-/ spleen to liver ratio (BLR/SLR) were calculated. Kaplan-Meier analyses and Cox-regression models were used to assess progression-free/overall survival (PFS/OS) and their determinant variables. Multivariate selection for PFS/OS revealed MTV as most relevant PET/CT biomarker (p<0.001). Median PFS/OS were significantly longer in patients with MTV≤70mL versus >70mL (PFS: 10 months (M; 95% confidence interval 4-16) vs. 4M (3-5), p=0.001; OS: not reached vs. 10M (5-15), p=0.004). Disease control rate was 81% vs. 53% for MTV≤/>70mL (p=0.007). BLR ≤1.06 versus >1.06 was associated with better outcomes (PFS: 8M (4-13) vs. 4M (3-6), p=0.034; OS: 19M (12-/) vs. 6M (4-12), p=0.005). In patients with MTV>70mL, concomitant BLR≤1.06 indicated a better prognosis. Higher MTV is associated with inferior PFS/OS in first-line ICI treated NSCLC, with BLR allowing additional risk stratification.

World is now experiencing a major health calamity due to the coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus clade 2 (SARS-CoV- 2). The foremost challenge facing the scientific community is to explore the growth and transmission capability of the virus. Use of artificial intelligence (AI), such as, deep learning, in (i) rapid disease detection from x-ray/computerized tomography (CT)/ high-resolution computed tomography (HRCT) images, (ii) accurate prediction of the epidemic patterns and their saturation throughout the globe, (iii) identification of the epicenter in each country/state and forecasting the disease from social networking data, (iv) prediction of drug-protein interactions for repurposing the drugs, and (v) socio-economic impact and prediction of future relapses, has attracted much attention. In the present manuscript, we describe the role of various AI-based technologies for rapid and efficient detection from CT images complementing quantitative real time polymerase chain reaction (qRT-PCR) and immunodiagnostic assays. AI-based technologies to anticipate the current pandemic pattern, possibility of future relapses and socio-economic impact are also discussed. We inspect how the virus transmits depending on different factors, such as, population density and mobility among others. We depict how AI-based mobile app for contact tracing and surveys can prevent the transmission. A modified deep learning technique can assess affinity of the most probable drugs to treat COVID-19. Here a few effective antiviral drugs, such as, Geneticin, Avermectin B1, and Ancriviroc among others, have been reported with their appropriate validation from previous investigations.

A method for generating fluoroscopic (time-varying) volumetric images using patient-specific motion models derived from 4-dimensional cone-beam CT (4D-CBCT) images is developed. 4D-CBCT images acquired immediately prior to treatment have the potential to accurately represent patient anatomy and respiration during treatment. Fluoroscopic 3D image estimation is done in two steps: 1) deriving motion models and 2) optimization. To derive motion models, every phase in a 4D-CBCT set is registered to a reference phase chosen from the same set using deformable image registration (DIR). Principal components analysis (PCA) is used to reduce the dimensionality of the displacement vector fields (DVFs) resulting from DIR into a few vectors representing organ motion found in the DVFs. The PCA motion models are optimized iteratively by comparing a cone-beam CT (CBCT) projection to a simulated projection computed from both the motion model and a reference 4D-CBCT phase, resulting in a sequence of fluoroscopic 3D images. Patient datasets were used to evaluate the method by estimating the tumor location in the generated images compared to manually defined ground truth positions. Experimental results showed that the average tumor mean absolute error (MAE) along the superior-inferior (SI) direction and the 95th percentile in two patient datasets were (2.29 mm and 5.79 mm) for patient 1 and (1.89 mm and 4.82 mm) for patient 2. This study has demonstrated the feasibility of deriving 4D-CBCT-based PCA motion models that have the potential to account for the 3D non-rigid patient motion and localize tumors and other patient anatomical structures on the day of treatment.

Cultural Tourism (CT), which enhances the economic development of a region, aids a country in reinforcing its identities, enhancing cross-cultural understanding, and preserving the heritage culture of an area. Designing a proper tourism model assists the tourists in understanding the point of interest without the help of a local guide. However, owing to the need for the analysis of different factors, designing such a model is a complex process. Therefore, this article proposes a CT model for Riyadh for peak visitor time. Primarily, the map data and cultural event dataset are processed for location, such as grouping with Kriging Interpolation-based Chameleon (KIC), tree forming, and feature extraction. After that, the event dataset’s attributes are processed with word embedding. Meanwhile, the Social Network Sites (SNS) data like reviews and news are extracted with an external Application Programming Interface (API). The review data is processed with keyword extraction and word embedding, whereas the news data is processed with score value estimation. Lastly, the data are fused corresponding to a historical site and given to the Multi-Quadratic-Long Short Term Memory (MQ-LSTM) Recommendation System (RS); also, the recommended result with the map is stored in a database. Lastly, the database security is maintained with Locality Sensitive Hashing (LSH); moreover, by attaining higher performance values, the proposed model is experimentally verified.

“White matter disease” identifies series of different conditions and pathological mechanisms: autoimmune, infectious, toxic-metabolic and vascular. Each of these leads to a global impairment of the neural myelination process through the secondary destruction of previously myelinated structures. To date, the imaging spectrum represents an irreplaceable tool to detect these lesions, describe their distribution patterns and stage them over time. This study aims presents a pictorial review of white matter disease, from pathology to imaging spectrum, reporting current main staging systems with greater emphasis to relationship between cerebrovascular disease and white matter hyper-intensity appearance, and the newest advances in this field.

With the availability of wearable health monitoring sensor modules like 3-Lead Electrocardiogram (ECG), Pulse Oximeter (SpO2), Galvanic Skin Response (GSR), Hall effect sensor (for measuring Respiratory Rate), Blood Pressure and Temperature measuring and sensing elements, it has now become possible to device a composite health status monitoring kit that can measure vital signs and other physiological parameters pertaining to human health in real time. Traditionally, the physiological parameters along with vital signs related examination was possible only in a hospitalized or ambulatory environment, however due to advances in sensing and embedded system technology and miniaturization of data acquisition and processing elements health monitoring has become possible even when individuals remain engaged in their day to day activities at the convenience of space and location. The patients or individuals subject to monitoring may suffer from a traumatic experience due to their medical condition and may need emergent incidence response and the critical care team may have to prepare for the treatment only after the patient arrives, which often is too late, as in case of cardiac arrests or severe injuries. The research focused on real-time health status monitoring and trauma scoring using standard physiological parameters along with standard telemetry protocols to make the critical care team aware of an emergent situation and prepare for a medical emergency. Vital signs and physiological parameters (heart rate, temperature, respiratory rate, and blood pressure, SpO2) were measured in real time from human subjects non-invasively. In order to enable monitoring of the patients engaged in day to day activities, errors due to the motion were removed using stationary wavelet transform correction (correlation coefficient of 0.9 after correction) and signals from various sensors were denoised, filtered and were encoded in a format suitable for further data analysis. A composite sensor kit capable of monitoring vital signs and physiological parameters can be very useful in incident response when an individual undergoes a traumatic experience related to stroke, cardiac arrest, fits or even injury, as along with monitoring information the kit can calculate scores related to trauma like the Injury Severity Score (ISS), National Early Warning Signs (NEWS), Revised Trauma Score (RTS). Trauma Injury Severity Score (TRISS), Probability of Survival (Ps) score. An open access database of vital signs and physiological parameters from Physionet, MIMIC 2 Numerics (mimicdb/numerics) database was used to calculate NEWS and RTS and to generate correlation and regression models using the vital signs/physiological parameters for a clinical class of patients with respiratory failure and admitted to Intensive Care Unit (ICU). NEWS and RTS scores showed no significant correlation (r = 0.25, p<0.001) amongst themselves, however together NEWS and RTS showed significant correlation with Ps (blunt) (r = 0.70, p<0.001). RTS and Ps (blunt) scores showed some correlation (r = 0.63, p<0.001) and NEWS score showed significant correlation (r = 0.79, p<0.001) with Ps (blunt) scores. Furthermore, since individuals have to be monitored regardless of location, these kits have to have a built-in capability to locate the individual so that the incident response team can locate the individual based on Global Positioning System coordinates (GPS). A Quantum GIS (Geographical Information System) application using real-time GPS coordinates (OpenStreetMap coordinates) was used to calculate the shortest path using QGIS Network Analysis tool to demonstrate the calculation of shortest path and direction to locate the nearest service provider in shortest time. Along with locating the nearest healthcare service provider, it would help if the critical care team could be made aware of the physiological parameters and trauma scores using standard protocols accepted across the globe. The physiological parameters from the sensors along with the calculated trauma scores were encoded according to a standard Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) coding system and International Code of Diseases (ICD) codes and the trauma information was logged to Electronic Health Records (EHR) using Fast Health Interoperability Resources (FHIR) servers. FHIR servers provided interoperable web services to log the event information in real time. It could be concluded that analytical models trained on existing datasets can help in analyzing a traumatic experience or an injury and the information can be logged using a standard telemetry protocol as a telemedicine initiative. These scores enable the healthcare service providers to estimate the extent of trauma and prepare for medical emergency procedures and find applications in general and military healthcare.

Recombinant human collagen peptide (RCP) is a recombinantly created xeno-free biomaterial enriched in RGD (arginine-glycine-aspartic acid) sequences, with good processability that is being investigated for regenerative medicine applications. Recently, the biocompatibility and osteogenic ability of β-TCP/RCP (RCP granules combined with β-tricalcium phosphate (TCP) submicron particles) were demonstrated. In the present study, β-TCP/RCP was implanted into experimental periodontal tissue defects (three-walled bone defect) created in beagle dogs to investigate tissue responses and subsequent regenerative effects. Micro computed tomography image analysis at 8 weeks postoperatively showed that the amount of new bone after β-TCP/RCP graft was significantly greater (2.2 fold, P&lt;0.05) than that of the control (no graft) group. Histological findings showed that the transplanted β-TCP/RCP induced active bone-like tissue formation including TRAP-positive and OCN-positive cells as well as bioabsorbability. Ankylosis did not occur, and periostin-positive periodontal ligament-like tissue formation was observed. Histological measurements revealed that β-TCP/RCP implantation formed 1.7-fold more bone-like tissue and 2.1-fold more periodontal ligament-like tissue than the control, and significantly suppressed gingival recession and epithelial downgrowth (P&lt;0.05). These results suggest that β-TCP/RCP is effective as a periodontal tissue regenerative material.

Renal artery thrombosis is a sporadic serious clinical condition which potentially cause renal infarction. Diagnosis of renal infarction can be delayed or missed due to non specific clinical presentation and overlapping appearance of medical and surgical phenomena. Early diagnosis supported by biochemical and radiological findings while appropriate management potentially improve morbidity and mortality. Persistent abdominal or flank pain with raised LDH and proteinuria on background of thromboembolism risk factors supports the diagnosis. Despite the rarity of the disease rapid identification with prompt medical or endovascular intervention could prevent irreversible renal parenchymal damage.

A retrospective cohort study was performed to determine the likelihood of malignant stroke after mechanical thrombectomy via ASPECTS-PASS score(A-P score), a novel scoring system using ASPECT score and number of arterial-passes. This prediction score is designed to help clinicians take early measures. Malignant stroke is defined as a large MCA infarct with mass effect that develops during the first 5 days following presentation and is associated with approximately 80% mortality. Previous studies have shown an association of low ASPECTS and high number of passes with poor outcome.We performed a retrospective cohort analysis on 78 patients with anterior circulation stroke who underwent mechanical thrombectomy at our hospital. We analyzed the likelihood of developing malignant stroke post thrombectomy in the first 5 days following successful recanalization (TICI ≽ 2b). Malignant stroke is defined as severe symptoms secondary to edema as evidenced by midline shift, cistern engorgement, and hemorrhagic conversion with edema. Patients with ASPECTS of 0-5 were excluded. We used two variables to predict the outcome: ASPECT score and number-of-passes. We used the equation ASPECT score minus number-of-passes (A-P) to arrive at a single number to predict the risk of malignant stroke. A-P scoring scale ranged from 0-9. Our study showed a statistically significant inverse relationship of A-P score and risk of malignant stroke. Approximately 90% of patients with A-P score < 5 developed malignant stroke in our study. A-P score can help predict malignant stroke post thrombectomy even after successful recanalization. Thus, A-P score of ≤ 5 suggests very high risk. (A-P) Score can assist clinicians to take early measures, and thereby prevent worse outcomes.

In advanced world stroke is one of the disabling cause of death that can be managed with thrombolysis if presents early despite further risk of intracerebral haemorrhage. Secondary prevention is an important objective in ischaemic stroke where recurrence is very high with subsequent stroke. Carotid End Arterectomy impact a definitive and effective role for both symptomatic and asymptomatic carotid stenosis for secondary stroke prevention in selective cases. Thrombolysis is a potential primary management for certain group whereas carotid surgery employs secondary preventative measure in a specified ischaemic stroke group.