Search

Background and Objective: Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection., Materials and Methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed., Results: Risk-adapted prostate cancer screening involves PSA testing in the age group of 45-70 years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6 million men will undergo PSA testing, a reduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards., Conclusions: The presented algorithm provides clear recommendations for risk-adapted PSA-based early detection for prostate cancer for urologists and patients. The goal is to improve diagnosis of clinically significant prostate cancer, while reducing overdiagnosis and overtreatment., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background:  With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (1) determine the potential contribution of the DOAC to spontaneous or trauma-induced hemorrhage; (2) identify appropriate candidates for reversal, or (3) optimize the timing of urgent surgery or intervention., Methods and Results:  The DOAC Dipstick test uses a disposable strip to identify factor Xa- or thrombin inhibitors in a urine sample. Based on the results of a systematic literature search followed by an analysis of a simple pooling of five retrieved clinical studies, the test strip has a high sensitivity and an acceptably high negative predictive value when compared with levels measured with liquid chromatography tandem mass spectrometry or calibrated chromogenic assays to reliably exclude plasma DOAC concentrations ≥30 ng/mL., Conclusion:  Based on these data, a simple algorithm is proposed to enhance medical decision-making in acute care indications useful primarily in hospitals not having readily available quantitative tests and 24/7. This algorithm not only determines DOAC exposure but also differentiates between factor Xa and thrombin inhibitors to better guide clinical management., Competing Interests: J.H. is general manager and founder of DOASENSE GmbH, J.D. is CEO of Qualiblood SA. All other authors declare no conflicts of interest., (Thieme. All rights reserved.)

Introduction: Pen-on-paper pain drawing are an easily administered self-reported measure that enables patients to report the spatial distribution of their pain. The digitalization of pain drawings has facilitated the extraction of quantitative metrics, such as pain extent and location. This study aimed to assess the reliability of pen-on-paper pain drawing analysis conducted by an automated pain-spot recognition algorithm using various scanning procedures., Methods: One hundred pain drawings, completed by patients experiencing somatic pain, were repeatedly scanned using diverse technologies and devices. Seven datasets were created, enabling reliability assessments including inter-device, inter-scanner, inter-mobile, inter-software, intra- and inter-operator. Subsequently, the automated pain-spot recognition algorithm estimated pain extent and location values for each digitized pain drawing. The relative reliability of pain extent analysis was determined using the intraclass correlation coefficient, while absolute reliability was evaluated through the standard error of measurement and minimum detectable change. The reliability of pain location analysis was computed using the Jaccard similarity index., Results: The reliability analysis of pain extent consistently yielded intraclass correlation coefficient values above 0.90 for all scanning procedures, with standard error of measurement ranging from 0.03% to 0.13% and minimum detectable change from 0.08% to 0.38%. The mean Jaccard index scores across all dataset comparisons exceeded 0.90., Conclusions: The analysis of pen-on-paper pain drawings demonstrated excellent reliability, suggesting that the automated pain-spot recognition algorithm is unaffected by scanning procedures. These findings support the algorithm's applicability in both research and clinical practice., Competing Interests: Disclosures and Acknowledgments No conflict of interest exists in the submission of this manuscript, and the manuscript is approved by all authors for publication., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: In the healthcare domain today, despite the substantial adoption of electronic health information systems, a significant proportion of medical reports still exist in paper-based formats. As a result, there is a significant demand for the digitization of information from these paper-based reports. However, the digitization of paper-based laboratory reports into a structured data format can be challenging due to their non-standard layouts, which includes various data types such as text, numeric values, reference ranges, and units. Therefore, it is crucial to develop a highly scalable and lightweight technique that can effectively identify and extract information from laboratory test reports and convert them into a structured data format for downstream tasks., Methods: We developed an end-to-end Natural Language Processing (NLP)-based pipeline for extracting information from paper-based laboratory test reports. Our pipeline consists of two main modules: an optical character recognition (OCR) module and an information extraction (IE) module. The OCR module is applied to locate and identify text from scanned laboratory test reports using state-of-the-art OCR algorithms. The IE module is then used to extract meaningful information from the OCR results to form digitalized tables of the test reports. The IE module consists of five sub-modules, which are time detection, headline position, line normalization, Named Entity Recognition (NER) with a Conditional Random Fields (CRF)-based method, and step detection for multi-column. Finally, we evaluated the performance of the proposed pipeline on 153 laboratory test reports collected from Peking University First Hospital (PKU1)., Results: In the OCR module, we evaluate the accuracy of text detection and recognition results at three different levels and achieved an averaged accuracy of 0.93. In the IE module, we extracted four laboratory test entities, including test item name, test result, test unit, and reference value range. The overall F1 score is 0.86 on the 153 laboratory test reports collected from PKU1. With a single CPU, the average inference time of each report is only 0.78 s., Conclusion: In this study, we developed a practical lightweight pipeline to digitalize and extract information from paper-based laboratory test reports in diverse types and with different layouts that can be adopted in real clinical environments with the lowest possible computing resources requirements. The high evaluation performance on the real-world hospital dataset validated the feasibility of the proposed pipeline., (© 2023. The Author(s).)

Systematic reviews rely on identification of studies, initially through electronic searches yielding potentially thousands of studies, and then reviewer-led screening studies for inclusion. This standard method is time- and resource-intensive. We designed and applied an algorithm written in Python involving computer-aided identification of keywords within each paper for an exemplar systematic review of arm impairment after stroke. The standard method involved reading each abstract searching for these keywords. We compared the methods in terms of accuracy in identification of keywords, abstracts' eligibility, and time taken to make a decision about eligibility. For external validation, we adapted the algorithm for a different systematic review, and compared eligible studies using the algorithm with those included in that review. For the exemplar systematic review, the algorithm failed on 72 out of 2,789 documents retrieved (2.6%). Both methods identified the same 610 studies for inclusion. Based on a sample of 21 randomly selected abstracts, the standard screening took 1.58 ± 0.26 min per abstract. Computer output screening took 0.43 ± 0.14 min per abstract. The mean difference between the two methods was 1.15 min ( P  < 0.0001), saving 73% per abstract. For the other systematic review, use of the algorithm resulted in the same studies being identified. One study was excluded based on the interpretation of the comparison intervention. Our purpose-built software was an accurate and significantly time-saving method for identifying eligible abstracts for inclusion in systematic reviews. This novel method could be adapted for other systematic reviews in future for the benefit of authors, reviewers and editors., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

In recent years, the wide application of deep neural network models has brought serious risks of intellectual property rights infringement. Embedding a watermark in a network model is an effective solution to protect intellectual property rights. Although researchers have proposed schemes to add watermarks to models, they cannot prevent attackers from adding and overwriting original information, and embedding rates cannot be quantified. Therefore, aiming at these problems, this paper designs a high embedding rate and tamper-proof watermarking scheme. We employ wet paper coding (WPC), in which important parameters are regarded as wet blocks and the remaining unimportant parameters are regarded as dry blocks in the model. To obtain the important parameters more easily, we propose an optimized probabilistic selection strategy (OPSS). OPSS defines the unimportant-level function and sets the importance threshold to select the important parameter positions and to ensure that the original function is not affected after the model parameters are changed. We regard important parameters as an unmodifiable part, and only modify the part that includes the unimportant parameters. We selected the MNIST, CIFAR-10, and ImageNet datasets to test the performance of the model after adding a watermark and to analyze the fidelity, robustness, embedding rate, and comparison schemes of the model. Our experiment shows that the proposed scheme has high fidelity and strong robustness along with a high embedding rate and the ability to prevent malicious tampering.

The amount of available scientific literature is increasing, and studies have proposed various methods for evaluating document-document similarity in order to cluster or classify documents for science mapping and knowledge discovery. In this paper, we propose hybrid methods for bibliographic coupling (BC) and linear evaluation of text or content similarity: We combined BC with BM25, Cosine, and PMRA to compare their performances with single methods in paper recommendation tasks using TREC Genomics Track 2005datasets. For paper recommendation, BC and text-based methods complement each other, and hybrid methods were better than single methods. The combinations of BC with BM25 and BC with Cosine performed better than BC with PMRA. The performances were best when the weights of BM25, Cosine, and PMRA were 0.025, 0.2, and 0.2, respectively, in hybrid methods. For paper recommendation, the combinations of BC with text-based methods were better than BC or text-based methods used alone. The choice of method should depend on the actual data and research needs. In the future, the underlying reasons for the differences in performance and the specific part or type of information they complement in text clustering or recommendation need to be examined.

Today, computer graphics and graphic image processing techniques have been widely used in daily life and industrial production. Due to the development of computers, computer graphics has brought more convenience to our daily life. In order to give full play to the value of computers, this paper takes the Hakka paper-cut art with local characteristics as the starting point, first of all its development history, artistic characteristics, compositional forms, expression techniques, cultural connotations, Hakka paper-cut patterns, and the symbolic meaning of folk customs, and then we design a visualization system for the paper-cut works of Gannan Hakka based on computer graphics. In addition, the system provides a solution for the integration of Gannan Hakka paper-cut art and Jiangxi native product packaging design and provides a reference for the theory and practice of modern native product packaging design., Competing Interests: The author declares that he has no conflicts of interest., (Copyright © 2022 Xingping Li.)

Introduction: Participation from racial and ethnic minorities in clinical trials has been burdened by issues surrounding mistrust and access to healthcare. There is emerging use of machine learning (ML) in clinical trial recruitment and evaluation. However, for individuals from groups who are recipients of societal biases, utilisation of ML can lead to the creation and use of biased algorithms. To minimise bias, the design of equitable ML tools that advance health equity could be guided by community engagement processes. The Howard University Partnership with the National Institutes of Health for Equitable Clinical Trial Participation for Racial/Ethnic Communities Underrepresented in Research (HoPeNET) seeks to create an ML-based infrastructure from community advisory board (CAB) experiences to enhance participation of African-Americans/Blacks in clinical trials., Methods and Analysis: This triphased cross-sectional study (24 months, n=56) will create a CAB of community members and research investigators. The three phases of the study include: (1) identification of perceived barriers/facilitators to clinical trial engagement through qualitative/quantitative methods and systems-based model building participation; (2) operation of CAB meetings and (3) development of a predictive ML tool and outcome evaluation. Identified predictors from the participant-derived systems-based map will be used for the ML tool development., Ethics and Dissemination: We anticipate minimum risk for participants. Institutional review board approval and informed consent has been obtained and patient confidentiality ensured., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In the last 15 years, the segmentation of vessels in retinal images has become an intensively researched problem in medical imaging, with hundreds of algorithms published. One of the de facto benchmarking data sets of vessel segmentation techniques is the DRIVE data set. Since DRIVE contains a predefined split of training and test images, the published performance results of the various segmentation techniques should provide a reliable ranking of the algorithms. Including more than 100 papers in the study, we performed a detailed numerical analysis of the coherence of the published performance scores. We found inconsistencies in the reported scores related to the use of the field of view (FoV), which has a significant impact on the performance scores. We attempted to eliminate the biases using numerical techniques to provide a more realistic picture of the state of the art. Based on the results, we have formulated several findings, most notably: despite the well-defined test set of DRIVE, most rankings in published papers are based on non-comparable figures; in contrast to the near-perfect accuracy scores reported in the literature, the highest accuracy score achieved to date is 0.9582 in the FoV region, which is 1% higher than that of human annotators. The methods we have developed for identifying and eliminating the evaluation biases can be easily applied to other domains where similar problems may arise., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: This study aims to evaluate the performance of a deep learning system for the evaluation of tooth development stages on images obtained from panoramic radiographs from child patients., Methods: The study collected a total of 1500 images obtained from panoramic radiographs from child patients between the ages of 5 and 14 years. YOLOv5, a convolutional neural network (CNN)-based object detection model, was used to automatically detect the calcification states of teeth. Images obtained from panoramic radiographs from child patients were trained and tested in the YOLOv5 algorithm. True-positive (TP), false-positive (FP), and false-negative (FN) ratios were calculated. A confusion matrix was used to evaluate the performance of the model., Results: Among the 146 test group images with 1022 labels, there were 828 TPs, 308 FPs, and 1 FN. The sensitivity, precision, and F1-score values of the detection model of the tooth stage development model were 0.99, 0.72, and 0.84, respectively., Conclusions: In conclusion, utilizing a deep learning-based approach for the detection of dental development on pediatric panoramic radiographs may facilitate a precise evaluation of the chronological correlation between tooth development stages and age. This can help clinicians make treatment decisions and aid dentists in finding more accurate treatment options., (© 2024. The Author(s).)

Purpose: We present SCAMPI (Sparsity Constrained Application of deep Magnetic resonance Priors for Image reconstruction), an untrained deep Neural Network for MRI reconstruction without previous training on datasets. It expands the Deep Image Prior approach with a multidomain, sparsity-enforcing loss function to achieve higher image quality at a faster convergence speed than previously reported methods., Methods: Two-dimensional MRI data from the FastMRI dataset with Cartesian undersampling in phase-encoding direction were reconstructed for different acceleration rates for single coil and multicoil data., Results: The performance of our architecture was compared to state-of-the-art Compressed Sensing methods and ConvDecoder, another untrained Neural Network for two-dimensional MRI reconstruction. SCAMPI outperforms these by better reducing undersampling artifacts and yielding lower error metrics in multicoil imaging. In comparison to ConvDecoder, the U-Net architecture combined with an elaborated loss-function allows for much faster convergence at higher image quality. SCAMPI can reconstruct multicoil data without explicit knowledge of coil sensitivity profiles. Moreover, it is a novel tool for reconstructing undersampled single coil k-space data., Conclusion: Our approach avoids overfitting to dataset features, that can occur in Neural Networks trained on databases, because the network parameters are tuned only on the reconstruction data. It allows better results and faster reconstruction than the baseline untrained Neural Network approach., (© 2024 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: To introduce a novel deep model-based architecture (DMBA), SPICER, that uses pairs of noisy and undersampled k-space measurements of the same object to jointly train a model for MRI reconstruction and automatic coil sensitivity estimation., Methods: SPICER consists of two modules to simultaneously reconstructs accurate MR images and estimates high-quality coil sensitivity maps (CSMs). The first module, CSM estimation module, uses a convolutional neural network (CNN) to estimate CSMs from the raw measurements. The second module, DMBA-based MRI reconstruction module, forms reconstructed images from the input measurements and the estimated CSMs using both the physical measurement model and learned CNN prior. With the benefit of our self-supervised learning strategy, SPICER can be efficiently trained without any fully sampled reference data., Results: We validate SPICER on both open-access datasets and experimentally collected data, showing that it can achieve state-of-the-art performance in highly accelerated data acquisition settings (up to 10 × $$ 10\times $$ ). Our results also highlight the importance of different modules of SPICER-including the DMBA, the CSM estimation, and the SPICER training loss-on the final performance of the method. Moreover, SPICER can estimate better CSMs than pre-estimation methods especially when the ACS data is limited., Conclusion: Despite being trained on noisy undersampled data, SPICER can reconstruct high-quality images and CSMs in highly undersampled settings, which outperforms other self-supervised learning methods and matches the performance of the well-known E2E-VarNet trained on fully sampled ground-truth data., (© 2024 International Society for Magnetic Resonance in Medicine.)

Purpose: The aim of this work is to develop a method to solve the ill-posed inverse problem of accelerated image reconstruction while correcting forward model imperfections in the context of subject motion during MRI examinations., Methods: The proposed solution uses a Bayesian framework based on deep generative diffusion models to jointly estimate a motion-free image and rigid motion estimates from subsampled and motion-corrupt two-dimensional (2D) k-space data., Results: We demonstrate the ability to reconstruct motion-free images from accelerated two-dimensional (2D) Cartesian and non-Cartesian scans without any external reference signal. We show that our method improves over existing correction techniques on both simulated and prospectively accelerated data., Conclusion: We propose a flexible framework for retrospective motion correction of accelerated MRI based on deep generative diffusion models, with potential application to other forward model corruptions., (© 2024 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: In MRI, motion artifacts can significantly degrade image quality. Motion artifact correction methods using deep neural networks usually required extensive training on large datasets, making them time-consuming and resource-intensive. In this paper, an unsupervised deep learning-based motion artifact correction method for turbo-spin echo MRI is proposed using the deep image prior framework., Theory and Methods: The proposed approach takes advantage of the high impedance to motion artifacts offered by the neural network parameterization to remove motion artifacts in MR images. The framework consists of parameterization of MR image, automatic spatial transformation, and motion simulation model. The proposed method synthesizes motion-corrupted images from the motion-corrected images generated by the convolutional neural network, where an optimization process minimizes the objective function between the synthesized images and the acquired images., Results: In the simulation study of 280 slices from 14 subjects, the proposed method showed a significant increase in the averaged structural similarity index measure by 0.2737 in individual coil images and by 0.4550 in the root-sum-of-square images. In addition, the ablation study demonstrated the effectiveness of each proposed component in correcting motion artifacts compared to the corrected images produced by the baseline method. The experiments on real motion dataset has shown its clinical potential., Conclusion: The proposed method exhibited significant quantitative and qualitative improvements in correcting rigid and in-plane motion artifacts in MR images acquired using turbo spin-echo sequence., (© 2024 International Society for Magnetic Resonance in Medicine.)

Subject motion is a long-standing problem of magnetic resonance imaging (MRI), which can seriously deteriorate the image quality. Various prospective and retrospective methods have been proposed for MRI motion correction, among which deep learning approaches have achieved state-of-the-art motion correction performance. This survey paper aims to provide a comprehensive review of deep learning-based MRI motion correction methods. Neural networks used for motion artifacts reduction and motion estimation in the image domain or frequency domain are detailed. Furthermore, besides motion-corrected MRI reconstruction, how estimated motion is applied in other downstream tasks is briefly introduced, aiming to strengthen the interaction between different research areas. Finally, we identify current limitations and point out future directions of deep learning-based MRI motion correction., (© 2024. The Author(s), under exclusive licence to European Society for Magnetic Resonance in Medicine and Biology (ESMRMB).)

Predicting and modeling human behavior and finding trends within human decision-making processes is a major problem of social science. Rock Paper Scissors (RPS) is the fundamental strategic question in many game theory problems and real-world competitions. Finding the right approach to beat a particular human opponent is challenging. Here we use an AI (artificial intelligence) algorithm based on Markov Models of one fixed memory length (abbreviated as "single AI") to compete against humans in an iterated RPS game. We model and predict human competition behavior by combining many Markov Models with different fixed memory lengths (abbreviated as "multi-AI"), and develop an architecture of multi-AI with changeable parameters to adapt to different competition strategies. We introduce a parameter called "focus length" (a positive number such as 5 or 10) to control the speed and sensitivity for our multi-AI to adapt to the opponent's strategy change. The focus length is the number of previous rounds that the multi-AI should look at when determining which Single-AI has the best performance and should choose to play for the next game. We experimented with 52 different people, each playing 300 rounds continuously against one specific multi-AI model, and demonstrated that our strategy could win against more than 95% of human opponents.

Purpose: To develop neural network (NN)-based quantitative MRI parameter estimators with minimal bias and a variance close to the Cramér-Rao bound., Theory and Methods: We generalize the mean squared error loss to control the bias and variance of the NN's estimates, which involves averaging over multiple noise realizations of the same measurements during training. Bias and variance properties of the resulting NNs are studied for two neuroimaging applications., Results: In simulations, the proposed strategy reduces the estimates' bias throughout parameter space and achieves a variance close to the Cramér-Rao bound. In vivo, we observe good concordance between parameter maps estimated with the proposed NNs and traditional estimators, such as nonlinear least-squares fitting, while state-of-the-art NNs show larger deviations., Conclusion: The proposed NNs have greatly reduced bias compared to those trained using the mean squared error and offer significantly improved computational efficiency over traditional estimators with comparable or better accuracy., (© 2024 International Society for Magnetic Resonance in Medicine.)

Hidden Markov models (HMMs), which can characterize dynamic heterogeneity, are valuable tools for analyzing longitudinal data. The order of HMMs (ie, the number of hidden states) is typically assumed to be known or predetermined by some model selection criterion in conventional analysis. As prior information about the order frequently lacks, pairwise comparisons under criterion-based methods become computationally expensive with the model space growing. A few studies have conducted order selection and parameter estimation simultaneously, but they only considered homogeneous parametric instances. This study proposes a Bayesian double penalization (BDP) procedure for simultaneous order selection and parameter estimation of heterogeneous semiparametric HMMs. To overcome the difficulties in updating the order, we create a brand-new Markov chain Monte Carlo algorithm coupled with an effective adjust-bound reversible jump strategy. Simulation results reveal that the proposed BDP procedure performs well in estimation and works noticeably better than the conventional criterion-based approaches. Application of the suggested method to the Alzheimer's Disease Neuroimaging Initiative research further supports its usefulness., (© 2024 John Wiley & Sons Ltd.)

Literature screening is the process of identifying all relevant records from a pool of candidate paper records in systematic review, meta-analysis, and other research synthesis tasks. This process is time consuming, expensive, and prone to human error. Screening prioritization methods attempt to help reviewers identify most relevant records while only screening a proportion of candidate records with high priority. In previous studies, screening prioritization is often referred to as automatic literature screening or automatic literature identification. Numerous screening prioritization methods have been proposed in recent years. However, there is a lack of screening prioritization methods with reliable performance. Our objective is to develop a screening prioritization algorithm with reliable performance for practical use, for example, an algorithm that guarantees an 80% chance of identifying at least 80 % of the relevant records. Based on a target-based method proposed in Cormack and Grossman, we propose a screening prioritization algorithm using sampling with replacement. The algorithm is a wrapper algorithm that can work with any current screening prioritization algorithm to guarantee the performance. We prove, with mathematics and probability theory, that the algorithm guarantees the performance. We also run numeric experiments to test the performance of our algorithm when applied in practice. The numeric experiment results show this algorithm achieve reliable performance under different circumstances. The proposed screening prioritization algorithm can be reliably used in real world research synthesis tasks., (© 2024 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.)

Analysing data from educational tests allows governments to make decisions for improving the quality of life of individuals in a society. One of the key responsibilities of statisticians is to develop models that provide decision-makers with pertinent information about the latent process that educational tests seek to represent. Mixtures of t $$ t $$ factor analysers (MtFA) have emerged as a powerful device for model-based clustering and classification of high-dimensional data containing one or several groups of observations with fatter tails or anomalous outliers. This paper considers an extension of MtFA for robust clustering of censored data, referred to as the MtFAC model, by incorporating external covariates. The enhanced flexibility of including covariates in MtFAC enables cluster-specific multivariate regression analysis of dependent variables with censored responses arising from upper and/or lower detection limits of experimental equipment. An alternating expectation conditional maximization (AECM) algorithm is developed for maximum likelihood estimation of the proposed model. Two simulation experiments are conducted to examine the effectiveness of the techniques presented. Furthermore, the proposed methodology is applied to Peruvian data from the 2007 Early Grade Reading Assessment, and the results obtained from the analysis provide new insights regarding the reading skills of Peruvian students., (© 2023 British Psychological Society.)

Zemblys et al. (Behavior Research Methods, 51(2), 840-864, 2019) reported on a method for the classification of eye-movements ("gazeNet"). I have found three errors and two problems with that paper that are explained herein. Error 1: The gazeNet classification method was built assuming that a hand-scored dataset from Lund University was all collected at 500 Hz, but in fact, six of the 34 recording files were actually collected at 200 Hz. Of the six datasets that were used as the training set for the gazeNet algorithm, two were actually collected at 200 Hz. Problem 1 has to do with the fact that even among the 500 Hz data, the inter-timestamp intervals varied widely. Problem 2 is that there are many unusual discontinuities in the saccade trajectories from the Lund University dataset that make it a very poor choice for the construction of an automatic classification method. Error 2 The gazeNet algorithm was trained on the Lund dataset, and then compared to other methods, not trained on this dataset, in terms of performance on this dataset. This is an inherently unfair comparison, and yet nowhere in the gazeNet paper is this unfairness mentioned. Error 3 arises out of the novel event-related agreement analysis employed by the gazeNet authors. Although the authors intended to classify unmatched events as either false positives or false negatives, many are actually being classified as true negatives. True negatives are not errors, and any unmatched event misclassified as a true negative is actually driving kappa higher, whereas unmatched events should be driving kappa lower.

An accurate diagnosis of clinically distinct subgroups of aggressive mature B cell lymphomas is crucial for the choice of proper treatment. Presently, precise recognition of these disorders relies on the combination of morphological, immunophenotypical, and cytogenetic/molecular features. The diagnostic workup in such situations implies the application of costly and time-consuming analyses, which are not always required, since an intensified treatment option is reasonably reserved to fit patients. The Italian Group of Haematopathology proposes herein a practical algorithm for the diagnosis of aggressive mature B cell lymphomas based on a stepwise approach, aimed to select cases deserving molecular analysis, in order to optimize time and resources still assuring the optimal management for any patient.

Background: Electrocardiograms (ECGs) are routinely recorded and stored in a variety of paper or scanned image format. Current ECG recording machines record ECG on graph paper, also it provides digitized ECG signal along with automated cardiovascular diagnosis (CVD). However, such recording machines cannot analyse preserved paper ECG records as it requires input in terms of digitized signal. Therefore, it is important to extract ECG signal from these preserved paper ECG records using digitization method. There are different paper degradations that adversely affect digitization process. The purpose of this work is to perform an image enhancement and digitization of the degraded ECG images to extract continuous ECG signal., Methods: In this paper, we propose entropy-based bit plane slicing (EBPS) algorithm in which pre-processing is done using dominant color detection and local bit plane slicing. Maximum entropy based adaptive bit plane selection is applied to the pre-processed image. Discontinuous ECG correction (DECGC) is then done to produce continuous ECG signal., Results: The algorithm is tested on 836 different degraded paper ECG records obtained from various diagnostic centers. After analysis with 101 known ground truth ECG signals the accuracy, sensitivity, specificity and overall F-measure of ECG is 99.42%, 99.69%, 99.81% and 99.26% respectively. The RMS error and correlation between the extracted digitized signal and ground truth for 101 cases is 0.040 and 99.89% respectively., Conclusions: The EBPS method is able to remove all types of degradation in paper ECG records to generate a uniform digitized signal. Instead of manual measurement and prediction from archived paper ECG records, automated prediction (using already existing cardiovascular diagnosis software) is possible with the help of extracted digitized signal obtained using proposed digitization method, which will also help retrospective cardiovascular analysis., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Children form a specific group of patients, as there are significant differences between children and adults in both anatomy and physiology. Difficult airway may be unanticipated or anticipated. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There are few paediatric difficult-airway guidelines available in the current literature, and some of these have significant limitations. This position paper, intended for unanticipated difficult airway, was elaborated by the panel of specialists representing the Polish Society of Anaesthesiology and Intensive Care as well as the Polish Neonatal Society. It covers both elective intubation and emergency situations in children in all age groups. An integral part of the paper is an algorithm. The paper describes in detail all stages of the algorithm considering some modification in specific age groups, i.e. neonates.

Discourse analysis enables the identification of what social actors say and do but also of what they represent in terms of values and motivation Such an analysis can also unearth ideological representations which legitimize the reproduction of social structures, irrespective of whether such representations reflect some objective reality or not. In their turn, such structures are contingent and incomplete, and are subject to changes. Discourse analysis examines their political and historical construction and functioning. What this approach does is help us understand how certain facts and non-facts make it to the political agenda whilst others do not, and how they are interpreted within the public sphere., (Copyright © 2019. Published by Elsevier B.V.)

Background: Commissioning of treatment planning systems (TPS) and beam delivery for scanned light ion beams is an important quality assurance task. This requires measurement of large sets of high quality dosimetric data in anthropomorphic phantoms to benchmark the TPS and dose delivery under realistic conditions., Method: A novel measurement setup is described, which allows for an efficient collection of a large set of accurate dose data in complex phantom geometries. This setup allows dose measurements based on a set of 24 small volume ionization chambers calibrated in dose to water and mounted in a holder, which can be freely positioned in a water phantom with various phantoms mounted in front of the water tank. The phantoms can be scanned in a CT and a CT-based treatment planning can be performed for a direct benchmark of the dose calculation algorithm in various situations., Results: The system has been used for acceptance testing in scanned light ion beam therapy at Heidelberg Ion Beam Therapy Center for scanned proton and carbon ion beams. It demonstrated to be useful to collect large amounts of high quality data for comparison with the TPS calculation using various phantom geometries., Conclusion: The setup is an efficient tool for commissioning and verification of treatment planning systems. It is especially suited for dynamic beam delivery, as many data points can be obtained during a single plan delivery, but can be adapted also for other dynamic therapies, like rotational IMRT.

Objectives: To develop and evaluate methods for assembling radiopaque printed paper sheets to realistic patient phantoms for CT dose and image quality testing., Methods: CT images of two patients were radiopaque printed with aqueous potassium iodide solution (0.6 g/ml) on paper. Two methods were developed for assembling the paper sheets to head and neck phantoms. (1) Printed sheets were fed to a paper-based 3D printer along with corresponding 3D printable STL files. (2) Paper stacks of 5-mm thickness were glued with toner, cut to the patient shape and assembled to a phantom. In a sample application study, both phantoms were examined with five different tube current settings. Images were reconstructed using filtered-back projection (FBP) and iterative reconstruction (AIDR 3D) with three strength levels. Dose length product (DLP), signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNRs) were analysed. Data were analysed using 2-way analysis of variance (ANOVA)., Results: Both methods achieved anthropomorphic phantoms with detailed patient anatomy. The 3D printer yielded a precise reproduction of the external patient shape, but caused visible glue artefacts. Gluing with toner avoided these artefacts and yielded more flexibility with regard to phantom size. In the sample application study, non-inferior SNR and CNR and up to 83.7% lower DLP were achieved on the phantoms with AIDR 3D compared with FBP., Conclusions: Two methods for assembling radiopaque printed paper sheets to phantoms of individual patients are presented. The sample application demonstrates potential for simulation of patient imaging and systematic CT dose and image quality assessment., Key Points: • Two methods were developed to create realistic CT phantoms of individual patients from radiopaque printed paper sheets. • Analysis of five tube current and four reconstruction settings on two radiopaque 3D printed patient phantoms yielded non-inferior SNR and CNR and up to 83.7% lower dose with iterative reconstruction in comparison with filtered back projection. • Radiopaque 3D printed phantoms can simulate patients and allow systematic analysis of CT dose and image quality parameters.

Objective: To evaluate the design characteristics of studies that evaluated the performance of artificial intelligence (AI) algorithms for the diagnostic analysis of medical images., Materials and Methods: PubMed MEDLINE and Embase databases were searched to identify original research articles published between January 1, 2018 and August 17, 2018 that investigated the performance of AI algorithms that analyze medical images to provide diagnostic decisions. Eligible articles were evaluated to determine 1) whether the study used external validation rather than internal validation, and in case of external validation, whether the data for validation were collected, 2) with diagnostic cohort design instead of diagnostic case-control design, 3) from multiple institutions, and 4) in a prospective manner. These are fundamental methodologic features recommended for clinical validation of AI performance in real-world practice. The studies that fulfilled the above criteria were identified. We classified the publishing journals into medical vs. non-medical journal groups. Then, the results were compared between medical and non-medical journals., Results: Of 516 eligible published studies, only 6% (31 studies) performed external validation. None of the 31 studies adopted all three design features: diagnostic cohort design, the inclusion of multiple institutions, and prospective data collection for external validation. No significant difference was found between medical and non-medical journals., Conclusion: Nearly all of the studies published in the study period that evaluated the performance of AI algorithms for diagnostic analysis of medical images were designed as proof-of-concept technical feasibility studies and did not have the design features that are recommended for robust validation of the real-world clinical performance of AI algorithms., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2019 The Korean Society of Radiology.)

Background: After several neutral telehealth trials, the positive findings and subsequent Food and Drug Administration approval of an implantable pulmonary arterial pressure monitor (PAPM) led to renewed interest in remote patient monitoring (RPM). Here we seek to provide contemporary guidance on the appropriate use of RPM technology., Results: Although early trials of external RPM devices suggested benefit, subsequent multicenter trials failed to demonstrate improved outcomes. Monitoring features of cardiac implantable electronic devices (CIEDs) also did not deliver improved HF outcomes, newer, multisensor algorithms may be better. Earlier technologies using direct pressure measurement via implanted devices failed to show benefit owing to complications or failure. Recently, 1 PAPM showed benefit in a randomized controlled trial. Although not showing cost reduction, cost-benefit analysis of that device suggests that it may meet acceptable standards. Additional research is warranted and is in progress. Consumer-owned electronic devices are becoming more pervasive and hold hope for future benefit in HF management. Practical aspects around RPM technology include targeting of risk populations, having mechanisms to ensure patient adherence to monitoring, and health care team structures that act on the data., Conclusions: Based on available evidence, routine use of external RPM devices is not recommended. Implanted devices that monitor pulmonary arterial pressure and/or other parameters may be beneficial in selected patients or when used in structured programs, but the value of these devices in routine care requires further study. Future research is also warranted to better understand the cost-effectiveness of these devices., (Copyright © 2018. Published by Elsevier Inc.)

Interaction between proteins and nucleic acids is crucial to many cellular activities. Accurately detecting nucleic acid-binding residues (NABRs) in proteins can help researchers better understand the interaction mechanism between proteins and nucleic acids. Structure-based methods can generally make more accurate predictions than sequence-based methods. However, the existing structure-based methods are sensitive to protein conformational changes, causing limited generalizability. More effective and robust approaches should be further explored. In this study, we propose iNucRes-ASSH to identify nucleic acid-binding residues with a self-attention-based structure-sequence hybrid neural network. It improves the generalizability and robustness of NABR prediction from two levels: residue representation and prediction model. Experimental results show that iNucRes-ASSH can predict the nucleic acid-binding residues even when the experimentally validated structures are unavailable and outperforms five competing methods on a recent benchmark dataset and a widely used test dataset., (© 2023 Wiley Periodicals LLC.)

Background: Radiation dose reduction has been the focus of many research activities in x-ray CT. Various approaches were taken to minimize the dose to patients, ranging from the optimization of clinical protocols, refinement of the scanner hardware design, and development of advanced reconstruction algorithms. Although significant progress has been made, more advancements in this area are needed to minimize the radiation risks to patients., Purpose: Reconstruction algorithm-based dose reduction approaches focus mainly on the suppression of noise in the reconstructed images while preserving detailed anatomical structures. Such an approach effectively produces synthesized high-dose images (SHD) from the data acquired with low-dose scans. A representative example is the model-based iterative reconstruction (MBIR). Despite its widespread deployment, its full adoption in a clinical environment is often limited by an undesirable image texture. Recent studies have shown that deep learning image reconstruction (DLIR) can overcome this shortcoming. However, the limited availability of high-quality clinical images for training and validation is often the bottleneck for its development. In this paper, we propose a novel approach to generate SHD with existing low-dose clinical datasets that overcomes both the noise texture issue and the data availability issue., Methods: Our approach is based on the observation that noise in the image can be effectively reduced by performing image processing orthogonal to the imaging plane. This process essentially creates an equivalent thick-slice image (TSI), and the characteristics of TSI depend on the nature of the image processing. An advantage of this approach is its potential to reduce impact on the noise texture. The resulting image, however, is likely corrupted by the anatomical structural degradation due to partial volume effects. Careful examination has shown that the differential signal between the original and the processed image contains sufficient information to identify regions where anatomical structures are modified. The differential signal, unfortunately, contains significant noise and has to be removed. The noise removal can be accomplished by performing iterative noise reduction to preserve structural information. The processed differential signal is subsequently subtracted from TSI to arrive at SHD., Results: The algorithm was evaluated extensively with phantom and clinical datasets. For better visual inspection, difference images between the original and SHD were generated and carefully examined. Negligible residual structure could be observed. In addition to the qualitative inspection, quantitative analyses were performed on clinical images in terms of the CT number consistency and the noise reduction characteristics. Results indicate that no CT number bias is introduced by the proposed algorithm. In addition, noise reduction capability is consistent across different patient anatomical regions. Further, simulated water phantom scans were utilized in the generation of the noise power spectrum (NPS) to demonstrate the preservation of the noise-texture., Conclusions: We present a method to generate SHD datasets from regularly acquired low-dose CT scans. Images produced with the proposed approach exhibit excellent noise-reduction with the desired noise-texture. Extensive clinical and phantom studies have demonstrated the efficacy and robustness of our approach. Potential limitations of the current implementation are discussed and further research topics are outlined., (© 2023 American Association of Physicists in Medicine.)

The development and maintenance of the item bank is a critical element to a CD-CAT (cognitive diagnostic computerized adaptive testing; Cheng, 2009) system. For continuous testing, it is important to replenish the item bank with new items that have been calibrated. This requires pretesting to estimate the parameters of the new items. For CD-CAT, the structural parameters that need to be estimated include both item parameters and attribute vectors. In this paper, we propose three residual-statistic-based methods: RMA, ROEM, and RMEM, to estimate the attribute vectors and item parameters all together for new items. An iterative two-step online calibration procedure is developed to estimate the attribute vectors for the new items in the first step, and estimate the item parameters in the second step, then proceed iteratively until convergence is reached. An extensive simulation study was conducted to evaluate the performance of the three proposed methods and compare them with two existing methods, namely the Joint Estimation Algorithm (JEA; Chen & Xin, 2011) and Single Item Estimation (SIE; Chen et al., 2015) methods. In terms of the estimation of the attribute vector, the RMEM method performs the best in most of the cases. In terms of item parameter estimation, RMEM still has some advantages, and RMA outperforms JEA and SIE. Taken together, results suggest that the RMEM is superior to the other methods, especially when sample size is relatively small. A real-data example is provided to illustrate the application of RMEM in practice., (© 2022. The Psychonomic Society, Inc.)

Image processing (IP) in digital radiography has been steadily refined to improve image quality. Adaptable settings enable users to adjust systems to their specific requirements. This prospective, analytical study aimed to investigate the influence of different IP settings and dose reductions on image quality. Included were 20 cadaveric equine limb specimens distal to the metacarpophalangeal and metatarsophalangeal joints. Images were processed with the Dynamic Visualization II system (Fujifilm) using five different IP settings including multiobjective frequency processing, flexible noise control (FNC), and virtual grid processing (VGP). Seven criteria were assessed by three veterinary radiology Diplomates and one veterinary radiology resident in a blinded study using a scoring system. Algorithm comparison was performed using an absolute visual grading analysis. The rating of bone structures was improved by VGP at full dose (P < .05; AUC VGC  = 0.45). Überschwinger artifact perception was enhanced by VGP (P < .001; AUC VGC  = 0.66), whereas image noise perception was suppressed by FNC (P < .001; AUC VGC  = 0.29). The ratings of bone structures were improved by FNC at 50% dose (P < .05; AUC VGC  = 0.44), and 25% dose (P < .001; AUC VGC  = 0.32), and clinically acceptable image quality was maintained at 50% dose (mean rating 2.16; 95.8% ratings sufficient or better). The favored IP setting varied among observers, with higher agreement at lower dose levels. These findings supported using individualized IP settings based on the radiologist's preferences and situational image requirements, rather than using default settings., (© 2023 The Authors. Veterinary Radiology & Ultrasound published by Wiley Periodicals LLC on behalf of American College of Veterinary Radiology.)

The pipeline of drug discovery consists of a number of processes; drug-target interaction determination is one of the salient steps among them. Computational prediction of drug-target interactions can facilitate in reducing the search space of experimental wet lab-based verifications steps, thus considerably reducing time and other resources dedicated to the drug discovery pipeline. While machine learning-based methods are more widespread for drug-target interaction prediction, network-centric methods are also evolving. In this chapter, we focus on the process of the drug-target interaction prediction from the perspective of using machine learning algorithms and the various stages involved for developing an accurate predictor., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: This study was designed to investigate clinical differences between pediatric patients who presented with chest pain, tachycardia, and/or tachypnea who subsequently were or were not diagnosed with myocarditis. The results were used to develop a decision tree to aid in rapid diagnosis of pediatric myocarditis., Methods: A retrospective case-control study was performed using the electronic medical records of children aged 0 to 18 years between the years 2003 and 2020 with a complaint of chest pain, tachycardia, and/or tachypnea. Patients included in the study were those diagnosed with myocarditis and those with suspected myocarditis, which was ultimately ruled out. Demographic and clinical differences between the research groups were analyzed. A decision tree was rendered using the rpart (Recursive Partitioning and Regression Trees) package., Results: Four thousand one hundred twenty-five patients were screened for eligibility. Seventy-three myocarditis patients and 292 nonmyocarditis patients were included. Compared with the control group, the study group was found to have a higher mean respiratory rate (37 ± 23 vs 23 ± 7 breaths per minute) and mean heart rate (121 ± 44 vs 97 ± 25 beats per minute) and lower mean systolic and diastolic blood pressure (102 ± 27/56 ± 17 mm Hg vs 114 ± 14/67 ± 10 mm Hg). The mean white blood cell count was greater in the case group (13 ± 6 vs 10 ± 5 × 10 3 /μL). A decision tree was rendered using simple demographic and clinical variables. The accuracy of the algorithm was 85.2%, with 100% accuracy in patients aged 0 to 2.5 years and 69% in patients aged 2.5 to 18 years., Conclusion: The clinical and laboratory characteristics described in this study were similar to what is described in the literature. The decision tree may aid in the diagnosis of myocarditis in patients 2.5 years and younger. In the population aged 2.5 to 18 years, the decision tree did not constitute an adequate tool for detecting myocarditis., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: It has been reported that the estimate of ultrasound attenuation coefficient (AC) is affected by depth of measurement, with linear decrease of values with depth. It is unknown whether backscatter coefficient (BSC) has similar behavior., Methods: This retrospective study was performed with Sequoia US system equipped with ultrasound derived fat fraction (UDFF) algorithm (Siemens Healthineers, Issaquah, WA, USA) that combines BSC with AC. UDFF was obtained positioning upper edge of the region of interest at 1.5,2,3,4,5 cm below liver capsule. BSC data were extracted from UDFF offline. A fractional polynomial regression, which selects the best model considering the polynomial development of the variables of interest, was used. Covariates included were age, sex, skin-to-liver-capsule distance, stiffness. Distance was included as linear factor or with a power ranging from - 2 to 3, and the best fitting model was chosen according to partial F test. Body mass index (BMI) was not included because of collinearity with skin-to-liver capsule distance., Results: 104 individuals (56 females; age: 57.9 ± 13.0 years; BMI: 29.0 ± 6.5 kg/m 2 ; skin-to-liver-capsule distance: 2.3 ± 0.7 cm; liver stiffness: 7.5 ± 5.5 kiloPascal) were studied. Best fitting model for BSC included a combination of depth as linear factor and square root. BSC showed a decrease of - 13.98 dB/cm-steradian for each logarithmic increase of 1 cm depth (coefficient: - 13.98; 95% CI: - 21.016; - 5.379; p = .001). Skin-to-liver-capsule distance and stiffness also were independent predictors of BSC., Conclusions: The estimation of the BSC in the liver exhibits a depth dependence that significantly affects results. A standardized acquisition protocol is needed to compare results and reliably assess changes over time., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: MR-STAT is a relatively new multiparametric quantitative MRI technique in which quantitative paramater maps are obtained by solving a large-scale nonlinear optimization problem. Managing reconstruction times is one of the main challenges of MR-STAT. In this work we leverage GPU hardware to reduce MR-STAT reconstruction times. A highly optimized, GPU-compatible Bloch simulation toolbox is developed as part of this work that can be utilized for other quantitative MRI techniques as well., Methods: The Julia programming language was used to develop a flexible yet highly performant and GPU-compatible Bloch simulation toolbox called BlochSimulators.jl. The runtime performance of the toolbox is benchmarked against other Bloch simulation toolboxes. Furthermore, a (partially matrix-free) modification of a previously presented (matrix-free) MR-STAT reconstruction algorithm is proposed and implemented using the Julia language on GPU hardware. The proposed algorithm is combined with BlochSimulators.jl and the resulting MR-STAT reconstruction times on GPU hardware are compared to previously presented MR-STAT reconstruction times., Results: The BlochSimulators.jl package demonstrates superior runtime performance on both CPU and GPU hardware when compared to other existing Bloch simulation toolboxes. The GPU-accelerated partially matrix-free MR-STAT reconstruction algorithm, which relies on BlochSimulators.jl, allows for reconstructions of 68 seconds per two-dimensional (2D slice)., Conclusion: By combining the proposed Bloch simulation toolbox and the partially matrix-free reconstruction algorithm, 2D MR-STAT reconstructions can be performed in the order of one minute on a modern GPU card. The Bloch simulation toolbox can be utilized for other quantitative MRI techniques as well, for example for online dictionary generation for MR Fingerprinting., (© 2024 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Cox models with time-dependent coefficients and covariates are widely used in survival analysis. In high-dimensional settings, sparse regularization techniques are employed for variable selection, but existing methods for time-dependent Cox models lack flexibility in enforcing specific sparsity patterns (ie, covariate structures). We propose a flexible framework for variable selection in time-dependent Cox models, accommodating complex selection rules. Our method can adapt to arbitrary grouping structures, including interaction selection, temporal, spatial, tree, and directed acyclic graph structures. It achieves accurate estimation with low false alarm rates. We develop the sox package, implementing a network flow algorithm for efficiently solving models with complex covariate structures. sox offers a user-friendly interface for specifying grouping structures and delivers fast computation. Through examples, including a case study on identifying predictors of time to all-cause death in atrial fibrillation patients, we demonstrate the practical application of our method with specific selection rules., (© 2024 John Wiley & Sons Ltd.)

Estimating causal effects from large experimental and observational data has become increasingly prevalent in both industry and research. The bootstrap is an intuitive and powerful technique used to construct standard errors and confidence intervals of estimators. Its application however can be prohibitively demanding in settings involving large data. In addition, modern causal inference estimators based on machine learning and optimization techniques exacerbate the computational burden of the bootstrap. The bag of little bootstraps has been proposed in non-causal settings for large data but has not yet been applied to evaluate the properties of estimators of causal effects. In this article, we introduce a new bootstrap algorithm called causal bag of little bootstraps for causal inference with large data. The new algorithm significantly improves the computational efficiency of the traditional bootstrap while providing consistent estimates and desirable confidence interval coverage. We describe its properties, provide practical considerations, and evaluate the performance of the proposed algorithm in terms of bias, coverage of the true 95% confidence intervals, and computational time in a simulation study. We apply it in the evaluation of the effect of hormone therapy on the average time to coronary heart disease using a large observational data set from the Women's Health Initiative., (© 2024 John Wiley & Sons Ltd.)