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The combination of visual assessment of whole body [18F]FDG PET images and evaluation of bone marrow samples by Multiparameter Flow Cytometry (MFC) or Next-Generation Sequencing (NGS) is currently the most common clinical practice for the detection of Measurable Residual Disease (MRD) in Multiple Myeloma (MM) patients. In this study, radiomic features extracted from the bone marrow biopsy locations are analyzed and compared to those extracted from the whole bone marrow in order to study the representativeness of these biopsy locations in the image-based MRD assessment. Whole body [18F]FDG PET of 39 patients with newly diagnosed MM were included in the database, and visually evaluated by experts in nuclear medicine. A methodology for the segmentation of biopsy sites from PET images, including sternum and posterior iliac crest, and their subsequent quantification is proposed. First, starting from the bone marrow segmentation, a segmentation of the biopsy sites is performed. Then, segmentations are quantified extracting SUV metrics and radiomic features from the [18F]FDG PET images and are evaluated by Mann–Whitney U-tests as valuable features differentiating PET+/PET− and MFC+ /MFC− groups. Moreover, correlation between whole bone marrow and biopsy sites is studied by Spearman ρ rank. Classification performance of the radiomics features is evaluated applying seven machine learning algorithms. Statistical analyses reveal that some images features are significant in PET+/PET− differentiation, such as SUVmax, Gray Level Non-Uniformity or Entropy, especially with a balanced database where 16 of the features show a p value 18F]FDG PET images in MRD assessment in MM patients.

La investigación tiene objetivo de analizar actividades de marketing en redes sociales de marcas más reconocidas de entidades financieras ecuatorianas, siendo importante el estudio de la relación que existe entre el entorno de marketing online, la propuesta de valor, la imagen de marca y cómo estas influyen sobre lealtad a la marca. Se utiliza el enfoque cuantitativo para la metodología, mediante la aplicación de una encuesta digital a 245 clientes de bancos, para el análisis de datos obtenidos de la muestra extraída se utilizó software estadístico: SPSS y Smart PLS 3.0, los resultados demuestran que el marketing online tiene influencia directa de manera positiva en la lealtad del cliente de bancos. Insumo importante para los gestores bancarios y para la academia.

Purpose Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [18F]FDG PET/CT has demonstrated the ability to improve diagnostic accuracy compared with the conventional modified Duke criteria in patients with suspected IE, especially those with prosthetic valve infective endocarditis (PVIE). The aim of this study is to provide an adjunctive diagnostic tool to improve the diagnostic accuracy in cardiovascular infections, specifically PVIE. Methods A segmentation tool to extract quantitative measures of [18F]FDG PET/CT image studies of prosthetic heart valve regions was developed and validated in 20 cases of suspected PVIE, of which 9 were confirmed. For that, Valvular Heterogeneity Index (VHI) and Ring-to-Center Ratio (RCR) were defined. Results Results show an overall increase in the metabolic uptake of the prosthetic valve ring in the studies with confirmed PVIE diagnosis (SUVmax from 1.70 to 3.20; SUVmean from 0.86 to 1.50). The VHI and RCR showed areas under the curve of 0.727 and 0.808 in the receiver operating characteristics curve analyses, respectively, for PVIE diagnosis. Mann–Whitney U tests showed statistically significant differences between groups for RCR (p = 0.02). Visual analyses and clinical reports were concordant with the extracted quantitative metrics. Conclusion The proposed new method and presented software solution (CASSIA) provide the capability to assess quantitatively myocardial metabolism along the prosthetic valve region in routine [18F]FDG PET/CT scans for evaluating heart valve infectious processes. VHI and RCR are proposed as new potential adjunctive measures for PVIE diagnosis.

Neurodegenerative parkinsonisms affect mainly cognitive and motor functions and are syndromes of overlapping symptoms and clinical manifestations such as tremor, rigidness, and bradykinesia. These include idiopathic Parkinson’s disease (PD) and the atypical parkinsonisms, namely progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA) and dementia with Lewy body (DLB). Differences in the striatal metabolism among these syndromes are evaluated using [18F]FDG PET, caused by alterations to the dopaminergic activity and neuronal loss. A study cohort of three patients with PD, 29 with atypical parkinsonism (10 PSP, 6 CBD, 2 MSA, 7 DLB, and 4 non-classifiable), and a control group of 25 patients with normal striatal metabolism is available. Standardized uptake value ratios (SUVR) are extracted from the striatum, and the caudate and the putamen separately. SUVRs are compared among the study groups. In addition, hemispherical and caudate-putamen differences are evaluated in atypical parkinsonisms. Striatal hypermetabolism is detected in patients with PD, while atypical parkinsonisms show hypometabolism, compared to the control group. Hemispherical differences are observed in CBD, MSA and DLB, with the latter also showing statistically significant caudate–putamen asymmetry (p = 0.018). These results indicate disease-specific metabolic uptake patterns in the striatum that can support the differential diagnosis.

Automatic surgical workflow analysis (SWA) plays an important role in the modelling of surgical processes. Current automatic approaches for SWA use videos (with accuracies varying from 0.8 and 0.9), but they do not incorporate speech (inherently linked to the ongoing cognitive process). The approach followed in this study uses both video and speech to classify the phases of laparoscopic cholecystectomy, based on neural networks and machine learning. The automatic application implemented in this study uses this information to calculate the total time spent in surgery, the time spent in each phase, the number of occurrences, the minimal, maximal and average time whenever there is more than one occurrence, the timeline of the surgery and the transition probability between phases. This information can be used as an assessment method for surgical procedural skills.

Neurodegenerative parkinsonisms affect mainly cognitive and motor functions and are syndromes of overlapping symptoms and clinical manifestations such as tremor, rigidness, and bradykinesia. These include idiopathic Parkinson's disease (PD) and the atypical parkinsonisms, namely progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA) and dementia with Lewy body (DLB). Differences in the striatal metabolism among these syndromes are evaluated using [

Aim: The aim was to develop and implement a virtual reality tool based on eye-tracking technologies that allow to evaluate the characteristics of the gaze patterns of glaucoma patients in order to have a better understanding of the limitations that these patients experience in their daily life. Setting: This study took place on the Ophthalmology department of Hospital Clínico San Carlos, Madrid, Spain. Methods: In total, 56 participants collaborated in the study. They were divided in two groups, a group composed of 33 glaucoma patients selected by the Ophthalmology department and a control group composed of 23 healthy individuals. Both groups completed two virtual tasks while their gaze was being monitored. The first task, defined as “static” consisted in two exercises based on the observation of images. The second task, defined as “dynamic,” consisted in a virtual driving simulator. Number of fixations, fixations duration, saccades amplitude and velocity, fixations/saccades ratio, total execution time, and other specific metrics were measured. These are the total search time for the second exercise of the first task and the number of collisions for the dynamic task. In addition, the dispersion of fixations was also discussed. Results: For the two exercises of the static task, patients exhibited significative differences in terms of number of fixations ( p = 0.012 in free observation exercise), mean saccadic velocity ( p = 0.023 and 0.017), fixations/saccades ratio ( p = 0.035 and 0.04), and also the search and total execution times of the visual search exercise ( p = 0.004 and 0.027, respectively). For the dynamic task, significative differences were found on average saccades amplitude ( p = 0.02), average saccades velocity ( p = 0.03), and the number of collisions ( p = 0.02). Conclusion: The results show that eye-tracking technologies can be used as a tool for evaluating the gaze patterns of glaucoma patients and differentiate them of healthy individuals. However, further studies with a larger cohort of participants and additional tasks are needed.

Introduction: Effectiveness of e-learning diminishes without the support of a pedagogical model to guide its use. In minimally invasive surgery (MIS), this has been reported as a limitation when technology is used to deliver contents without a sound pedagogical background. Material and methods: We describe how a generic pedagogical model, the 3D pedagogy framework, can be used for setting learning outcomes and activities in e-learning platforms focused on MIS cognitive skills. A demonstrator course on Nissen fundoplication was developed following the model step-by-step in the MISTELA learning platform. Course design was informed by Kolb’s Experiential learning model. Content validation was performed by 13 MIS experts. Results: Ten experts agreed on the suitability of content structuring done according to the pedagogical model. All experts agreed that the course provides means to assess the intended learning outcomes. Conclusions: This work showcases how a general-purpose e-learning framework can be accommodated to the needs of MIS training without limiting the course designers’ pedagogical approach. Key advances for its success include: (1) proving the validity of the model in the wider scope of MIS skills and (2) raising awareness amongst stakeholders on the need of developing training plans with explicit, rather than assumed, pedagogical foundations. Abbreviations: MIS: minimally invasive surgery; TEL: technology enhanced learning.

The Objective Structured Clinical Exam (OSCE) is an assessment tool used as a reliable method for clinical competence evaluation of students. This paper presents an investigation focused on the chain of survival, its related exploration, management, and technical skills, and how Virtual Reality (VR) can be used for the creation of immersive environments capable of evaluating students’ performance while applying the correct protocols. In particular, the Cardiopulmonary Resuscitation (CPR) procedure is studied as an essential step in the development of the chain of survival. The paper also aims to highlight the limitations of traditional methods using mechanical mannequins and the benefits of the new approaches that involve the students in virtual, immersive, and dynamic environments. Furthermore, an immersive VR station is presented as a new technique for assessing CPR performance through objective data collection and posterior evaluation. A usability test was carried out with 33 clinicians and OSCE evaluators to test the viability of the presented scenario, reproducing conditions of a real examination. Results suggest that the environment is intuitive, quick, and easy to learn and could be used in clinical practice to improve CPR performance and OSCE evaluation.

The last few years have been crucial in defining the most appropriate way to quantitatively assess [Whole body [Quantitative analysis for PET+/PET- differentiating demonstrated to be significant for most of the variables assessed with Mann-Whitney U-test such as Variance, Energy, and Entropy (p-value = 0.001). Moreover, the quantitative analysis with a balanced database evaluated by Mann-Whitney U-test revealed in even better results with 19 features with p-values0.001. On the other hand, radiomics analysis for MFC+/MFC- differentiating demonstrated the necessity of combining MFC evaluation with [A proof-of-concept for the extraction and evaluation of bone marrow radiomics features of [

Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [A segmentation tool to extract quantitative measures of [Results show an overall increase in the metabolic uptake of the prosthetic valve ring in the studies with confirmed PVIE diagnosis (SUVThe proposed new method and presented software solution (CASSIA) provide the capability to assess quantitatively myocardial metabolism along the prosthetic valve region in routine [

Background The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance. Methods A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682). Results Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance. Conclusions The impact of stress responses presents an important factor in surgical environments, affecting residents’ training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons’ stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.

This chapter will analyse personalization within the context of technological innovation. It will first of all clarify the conceptual terms used in the debate, in particular patient, person-centered and people-centered care and their various uses and limitations. It will then focus on specific issues of personalization and technology in emerging areas, notably in interprofessional practices and in medical training. This will allow greater understanding of both the possibilities and emerging tensions in the integration of personalization and technological innovation in healthcare systems from the training stage to its integration in various professional cadres.

Objective The aim of the study was to assess the impact of clinical and metabolic parameters derived from 18F-FDG PET/CT (positron emission tomography–computed tomography) in patients with locally advanced cervical cancer (LACC) on prognosis. Methods Patients with LACC of stage IB2-IVA treated by primary radiochemotherapy followed by brachytherapy were enrolled in this retrospective study. Indexes derived from standardized uptake value (SUV), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and textural features of the primary tumor were measured for each patient. Overall survival (OS) and recurrence-free survival (RFS) rates were calculated according to Kaplan–Meier and survival curves were compared using the log-rank test. Uni- and multivariate analyses were performed using the Cox regression model. Results A total of 116 patients were included. Median follow-up was 58 months (range: 1–129). A total of 36 (31%) patients died. Five-year OS and RFS rates were 69 and 60%, respectively. Univariate analyses indicated that FIGO stage, the presence of hydronephrosis, high CYFRA 21.1 levels, and textural features had a significant impact on OS and RFS. MTV as well as SCC-Ag concentration were also significantly associated with OS. On multivariate analysis, the presence of hydronephrosis, CYFRA 21.1, and sphericity were independent prognostics factors for OS and RFS. Also, SCC-Ag level, MTV, and GLZLM (gray-level zone length matrix) ZLNU (zone length non-uniformity) were significantly associated with OS. Conclusion Classical prognostic factors and tumor heterogeneity on pretreatment PET/CT were significantly associated with prognosis in patients with LACC.

Modern surgical education is focused on making use of the available technologies in order to train and assess surgical skill acquisition. Innovative technologies for the automatic, objective assessment of nontechnical skills are currently under research. The main aim of this study is to determine whether personal resourcefulness can be assessed by monitoring parameters that are related to stress and visual attention and whether there is a relation between these and psychomotor skills in surgical education. For this purpose, we implemented an application in order to monitor the electrocardiogram (ECG), galvanic skin response (GSR), gaze and performance of surgeons-in-training while performing a laparoscopic box-trainer task so as to obtain technical and personal resourcefulness’ metrics. Eight surgeons (6 nonexperts and 2 experts) completed the experiment. A total of 22 metrics were calculated (7 technical and 15 related to personal resourcefulness) per subject. The average values of these metrics in the presence of stressors were compared with those in their absence and depending on the participants’ expertise. The results show that both the mean normalized GSR signal and average surgical instrument’s acceleration change significantly when stressors are present. Additionally, the GSR and acceleration were found to be correlated, which indicates that there is a relation between psychomotor skills and personal resourcefulness.

Brain Health is defined as the development and preservation of optimal brain integrity and neural network functioning for a given age. Recent studies have related healthy habits with better maintenance of brain health across the lifespan. As a part of the Barcelona Brain Health Initiative (BBHI), a mHealth platform has been developed with the purpose of helping people to improve and monitor their healthy habits, facilitating the delivery of health coaching strategies. A decision support system (DSS), named Intelligent Coaching Assistant (ICA), has been developed to ease the work of professional brain health coaches, helping them design and monitor adherence to multidomain interventions in a more efficient manner. Personalized recommendations are based on users’ current healthy habits, individual preferences, and motivational aspects. Taking these inputs, an initial user profile is defined, and the ICA applies an algorithm for determining the most suitable personalized intervention plan. An initial validation has been done focusing on assessing the feasibility and usability of the solution, involving 20 participants for three weeks. We conclude that this kind of technology-based intervention is feasible and implementable in real-world settings. Importantly, the personalized intervention proposal generated by the DSS is feasible and its acceptability and usability are high.

Dynamic early-phase PET images acquired with radiotracers binding to fibrillar amyloid-beta (Aβ) have shown to correlate with [18F]fluorodeoxyglucose (FDG) PET images and provide perfusion-like information. Perfusion information of static PET scans acquired during the first minute after radiotracer injection (FMF, first-minute-frame) is compared to [18F]FDG PET images. FMFs of 60 patients acquired with [18F]florbetapir (FBP), [18F]flutemetamol (FMM), and [18F]florbetaben (FBB) are compared to [18F]FDG PET images. Regional standardized uptake value ratios (SUVR) are directly compared and intrapatient Pearson’s correlation coefficients are calculated to evaluate the correlation of FMFs to their corresponding [18F]FDG PET images. Additionally, regional interpatient correlations are calculated. The intensity profiles of mean SUVRs among the study cohort (r = 0.98, p &lt, 0.001) and intrapatient analyses show strong correlations between FMFs and [18F]FDG PET images (r = 0.93 ± 0.05). Regional VOI-based analyses also result in high correlation coefficients. The FMF shows similar information to the cerebral metabolic patterns obtained by [18F]FDG PET imaging. Therefore, it could be an alternative to the dynamic imaging of early phase amyloid PET and be used as an additional neurodegeneration biomarker in amyloid PET studies in routine clinical practice while being acquired at the same time as amyloid PET images.

Surgery is evolving towards a safer minimally invasive approach, driven by different technological advances. Augmented reality systems are gradually being adopted by surgeons to support their orientation and improve their accuracy, like the example of the Resection Map for the support of hepatectomies. There are also several AR prototypes, like the Endoclamp Positioning System and the ARIS*ER RFA system, with a great potential to reduce errors and increase safety in MIS heart clamping and needle ablations/biopsies respectively. The development and adoption of AR technologies is one of the main drivers in today's surgical revolution. Research efforts in this field are directed in several directions. One crucial aspect is the reduction of the technological burden in the OR, with solutions like the tracking of surgical tools based in video analysis. Another is to find the scientific and technological grounds to provide haptic and tactile feedback in robotic systems. And one of the most difficult challenges is to solve the problem of organ deformation and shift during soft tissue surgery. And last but not least, it is necessary to highlight the importance in this field of research of a fluent and coordinated multidisciplinary dialogue and effort in the R&D team. User centred design techniques, where surgeons, engineers and human factor specialists are involved in all the development phases (concept, design, implementation and testing), are strongly advised.

Purpose Chemotherapy-induced cardiotoxicity is one of the main complications during and after cancer treatment. While echocardiography is the most used technique in clinical practice to evaluate left ventricular (LV) dysfunction, a multimodal approach is preferred for the early detection of anthracycline-induced cardiotoxicity. In this paper, an image processing tool allowing the qualitative and quantitative analysis of myocardial metabolic activity by [18F]fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) images, acquired routinely during and after cancer treatment, is presented. Methods The methodology is based on cardiac single photon emission computed tomography image processing protocols used in clinical practice. LV polar maps are created, and quantitative regional values are calculated. The tool was validated in a study group of 24 patients with Hodgkin or non-Hodgkin lymphoma (HL and NHL, respectively) treated with anthracyclines. Staging, interim and end-of-treatment [18F]FDG PET/CT images were acquired and the presented tool was used to extract the quantitative metrics of LV metabolic activity. Results Results show an overall increase of metabolic activity in the interim PET image acquired while on treatment compared to staging PET, which then decreased in the end-of-treatment scan. Positive correlation coefficients between staging and interim scans, and negative correlation coefficients between interim and end-of-treatment scans also support this finding. Metabolic changes occur predominantly in the septal region. Conclusion The proposed methodology and presented software solution provides the capability to assess quantitatively myocardial metabolism acquired by routine [18F]FDG PET/CT scanning during cancer treatment for evaluating anthracycline-induced cardiotoxicity. The [18F]FDG PET/CT septal-lateral uptake ratio is proposed as a new quantitative measure of myocardial metabolism. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-021-02508-9

Manual segmentation of muscle and adipose compartments from computed tomography (CT) axial images is a potential bottleneck in early rapid detection and quantification of sarcopenia. A prototype deep learning neural network was trained on a multi-center collection of 3413 abdominal cancer surgery subjects to automatically segment truncal muscle, subcutaneous adipose tissue and visceral adipose tissue at the L3 lumbar vertebral level. Segmentations were externally tested on 233 polytrauma subjects. Although after severe trauma abdominal CT scans are quickly and robustly delivered, with often motion or scatter artefacts, incomplete vertebral bodies or arms that influence image quality, the concordance was generally very good for the body composition indices of Skeletal Muscle Radiation Attenuation (SMRA) (Concordance Correlation Coefficient (CCC) = 0.92), Visceral Adipose Tissue index (VATI) (CCC = 0.99) and Subcutaneous Adipose Tissue Index (SATI) (CCC = 0.99). In conclusion, this article showed an automated and accurate segmentation system to segment the cross-sectional muscle and adipose area L3 lumbar spine level on abdominal CT. Future perspectives will include fine-tuning the algorithm and minimizing the outliers.

Amyloid positron emission tomography (PET) brain imaging with radiotracers like [18F]florbetapir (FBP) or [18F]flutemetamol (FMM) is frequently used for the diagnosis of Alzheimer’s disease. Quantitative analysis is usually performed with standardized uptake value ratios (SUVR), which are calculated by normalizing to a reference region. However, the reference region could present high variability in longitudinal studies. Texture features based on the grey-level co-occurrence matrix, also called Haralick features (HF), are evaluated in this study to discriminate between amyloid-positive and negative cases. A retrospective study cohort of 66 patients with amyloid PET images (30 [18F]FBP and 36 [18F]FMM) was selected and SUVRs and 6 HFs were extracted from 13 cortical volumes of interest. Mann–Whitney U-tests were performed to analyze differences of the features between amyloid positive and negative cases. Receiver operating characteristic (ROC) curves were computed and their area under the curve (AUC) was calculated to study the discriminatory capability of the features. SUVR proved to be the most significant feature among all tests with AUCs between 0.692 and 0.989. All HFs except correlation also showed good performance. AUCs of up to 0.949 were obtained with the HFs. These results suggest the potential use of texture features for the classification of amyloid PET images.

Chronic thromboembolic pulmonary hypertension (CTEPH) is confirmed by visual analysis of single-photon emission computer tomography (SPECT) ventilation and perfusion (V/Q) images. Defects in the perfusion image discordant with the ventilation image indicate obstructed segments and the positive diagnosis of CTEPH. A quantitative metric and classification algorithm are proposed based on volumetric data from SPECT V/Q images. The difference in ventilation and perfusion volumes (VV-P) is defined as a quantitative metric to identify discordant defects in the SPECT images. The algorithm was validated with 22 patients grouped according to their diagnosis: (1) CTEPH and (2) respiratory pathology. Volumetric data from SPECT perfusion images was also compared before and after treatment for CTEPH. CTEPH was detected with a sensitivity of 0.67 and specificity of 0.80. The performance of volumetric data from SPECT perfusion images for the evaluation of treatment response was studied for two cases and improvement of pulmonary perfusion was observed in one case. This study uses volumetric data from SPECT V/Q images for the diagnosis of CTEPH and its differentiation from respiratory pathologies. The results indicate that the defined metric is a viable option for a quantitative analysis of SPECT V/Q images.

BACKGROUND: The increasing number of patients with acquired brain injury and the current subjectivity of the conventional upper extremity (UE) assessment tests require new objective assessment techniques. OBJECTIVE: This research proposes a novel objective motor assessment (OMA) methodology based on the Fugl-Meyer assessment (FMA). The goals are to automatically calculate the objective scores (OSs) of FMA-UE movements (as well as a global OS) and to interpret the estimated OSs. METHODS: Fifteen patients participated in the study. The OMA algorithm was designed to detect small-scale variations in UE movements. The OSs for 14 FMA-UE movements and the global OSs were automatically calculated using the algorithm and evaluated by 2 therapists. The interpretation of the global OSs was performed at 3 levels: by item, movement and globally. RESULTS: The global OSs calculated by our algorithm had a significant correlation with the therapists' scores (0.783 and 0.938

Healthy daily activities have a positive influence on many aspects of our lives. Habits have a deep impact on our health, they help to prevent the appearance of chronic and neurodegenerative diseases and will provide a healthy and active aging. This research work is aiming to analyze the need of new approaches on monitoring daily life activities, investigating new technologies and user modelling methods for healthy habits monitoring. mHealth platforms allow to perform a multivariable monitoring for allowing effective and personalized interventions. Data analytics, data mining and gamification methodologies are being applied to investigate user experience models. This user adaptation is commonly focused on personality and mood monitoring. Furthermore, new user models are built based on monitoring data, personality of user and the daily activity patterns extracted from intelligent and personalized monitoring. The final goal is contributing to improve user´s adherence to interventions, quality of life and quality of care in mHealth applications.

Depression is a mental disorder which can become a serious health problem. This research line is focused on creating a depression detection service from text analysis. Sentiment Analysis and Natural Language Processing methods will be used to develop this service. The service will classify text in positive or negative depending on the emotions inferred from user’s input texts. In this study, five classifiers have been evaluated to determine which one fits better for this purpose. Naive Bayes, Decision Tree, Naive Bayes based on Bernoulli model and Maximum Entropy are the classifiers analyzed. A specific corpus which includes sentences that fit research needs was designed for testing purposes, whereas Sentiment140’s corpus was used with training purposes. An evaluation methodology formed by three tests was designed. Results show a promising starting point, but further analysis will be needed. Future related works will focus on expanding classification to get user’s mood and not only a binary classification. It will allow to include this service as input for developing personalized intervention and education mHealth systems.

Positron emission tomography (PET) with amyloid binding tracers and 18F-fluordesoxyglucose (FDG) is used in the diagnosis of Alzheimer’s disease and other dementias. The dual-phase amyloid PET protocol acquires an early perfusion image immediately after the radiotracer injection that resembles FDG images. We studied the correlation of early phase 18F-florbetapir (eFBP) and FDG PET images by the quantitation of regional radiotracer uptake. Subjects with a neurodegenerative disease and eFBP and FDG PET scans were retrospectively selected. The PET images were normalized to the Montreal Neurological Institute template using Statistical Parametric Mapping version 12. Regional standardized uptake value ratios (SUVR) were extracted with the cerebellum serving as the reference region. Pearson’s correlation tests were performed to evaluate the regional correlation between eFBP and FDG PET images based on the quantitative measurements. Overall high correlation coefficients of up to r = 0.95 were observed in cortical regions that are in line with other studies or exceed previous results.

Cooperative relationships between groups are difficult because of the high human capability to differentiate between in-group vs. out-group members. This obstacle exists even when the groups can obtain benefits for themselves from cooperation with other groups (rational cooperation). Based on an interactionist approach, the authors propose that personal (individual differences) and situational (conflicts) factors contribute to rational intergroup cooperation. The authors conducted a preliminary correlational study (Study 1) and an experimental investigation (Study 2). In Study 1, the authors examined, with 105 participants, the psychometric properties of the Spanish version of the Rational–Experiential Inventory (REI), measuring individual differences in information processing. In Study 2, the authors conducted an experimental investigation with 141 participants, testing the role of individual differences and conflict in intergroup rational cooperation. Findings of Study 1 showed that the scale ha...

In this article, we described a new mobile-Health (mHealth) supported clinical pathway of care for people living with medically stable HIV in terms of platform acceptability, usability and technical feasibility. The EmERGE mHealth platform was codesigned with clinicians and the community, developed using Scrum agile methodology, integrated with hospital information systems and validated in a large prospective cohort study of 2251 participants. The evaluation of this new paradigm of care was conducted using a tailored Health Technology Assessment: the Model for Assessment of Telemedicine Applications. Usability and acceptability were assessed through the System Usability Score and a Patient Reported Experience Measure. The EmERGE platform was successfully deployed across diverse care settings in five European countries and used by 2251 patients and more than 20 clinicians for up to 30 months. Results from the formal evaluation demonstrated that the EmERGE platform is feasible and acceptable, with a high level of usability (median System Usability Score (SUS) 85.0%) and very positive patient-reported experiences (94.2% would recommend to a friend). The EmERGE platform is a secure and General Data Protection Regulation (GDPR)-compliant system with a complete set of functionalities that could be easily adapted to other clinical conditions, clinical sites and health systems thanks to its modular technical architecture.

Surgeons’ procedural skills and intraoperative decision making are key elements of clinical practice. However, the objective assessment of these skills remains a challenge to this day. Surgical workflow analysis (SWA) is emerging as a powerful tool to solve this issue in surgical educational environments in real time. Typically, SWA makes use of video signals to automatically identify the surgical phase. We hypothesize that the analysis of surgeons’ speech using natural language processing (NLP) can provide deeper insight into the surgical decision-making processes. As a preliminary step, this study proposes to use audio signals registered in the educational operating room (OR) to classify the phases of a laparoscopic cholecystectomy (LC). To do this, we firstly created a database with the transcriptions of audio recorded in surgical educational environments and their corresponding phase. Secondly, we compared the performance of four feature extraction techniques and four machine learning models to find the most appropriate model for phase recognition. The best resulting model was a support vector machine (SVM) coupled to a hidden-Markov model (HMM), trained with features obtained with Word2Vec (82.95% average accuracy). The analysis of this model’s confusion matrix shows that some phrases are misplaced due to the similarity in the words used. The study of the model’s temporal component suggests that further attention should be paid to accurately detect surgeons’ normal conversation. This study proves that speech-based classification of LC phases can be effectively achieved. This lays the foundation for the use of audio signals for SWA, to create a framework of LC to be used in surgical training, especially for the training and assessment of procedural and decision-making skills (e.g., to assess residents’ procedural knowledge and their ability to react to adverse situations).

VR P300-based BCI has proven to be a suitable method for training social attention skills in youngsters with autism spectrum disorder (ASD). In this study, we present a method that could be used in such an application to identify which object the user is paying attention to in a virtual environment by means of EEG recordings only. Temporal and time-frequency features were explored. Furthermore, the prediction accuracy of linear and nonlinear classification methods was assessed and compared, along with their computational times and complexity, and linear discriminant analysis (LDA) yielded the best overall performance (82%). The successful predictions and low computational times demonstrate the feasibility of the proposed solution for a VR-BCI neurorehabilitation tool.

Introducción: El análisis del movimiento es una valiosa herramienta para la evaluación de las habilidades psicomotrices en la laparoscopia. Sin embargo, requiere tecnologías para el seguimiento de la actividad de los instrumentos laparoscópicos durante el entrenamiento. En este artículo presentamos una técnica sin sensores para realizar el seguimiento de los movimientos de los instrumentos laparoscópicos basado en un sistema de cámara ortogonal y procesamiento de imágenes de video. Método: Los movimientos de los instrumentos laparoscópicos son capturados con dos cámaras web colocadas en configuración ortogonal. La posición y la orientación en el espacio de trabajo tridimensional se obtienen utilizando marcadores de color colocados en la punta de los instrumentos. Resultados: Las pruebas de precisión mostraron una resolución de 0.14 mm para el desplazamiento, con 1694 cm3 de espacio de trabajo total y 0.54° en los movimientos angulares. Los errores relativos medios del sistema de seguimiento fueron

Background Motion analysis parameters (MAPs) have been extensively validated for assessment of minimally invasive surgical skills. However, there are discrepancies on how specific MAPs, tasks, and skills match with each other, reflecting that motion analysis cannot be generalized independently of the learning outcomes of a task. Additionally, there is a lack of knowledge on the meaning of motion analysis in terms of surgical skills, making difficult the provision of meaningful, didactic feedback. In this study, new higher significance MAPs (HSMAPs) are proposed, validated, and discussed for the assessment of technical skills in box trainers, based on principal component analysis (PCA). Methods Motion analysis data were collected from 25 volunteers performing three box trainer tasks (peg grasping/PG, pattern cutting/PC, knot suturing/KS) using the EVA tracking system. PCA was applied on 10 MAPs for each task and hand. Principal components were trimmed to those accounting for an explained variance >80% to define the HSMAPs. Individual contributions of MAPs to HSMAPs were obtained by loading analysis and varimax rotation. Construct validity of the new HSMAPs was carried out at two levels of experience based on number of surgeries. Results Three new HSMAPs per hand were defined for PG and PC tasks, and two per hand for KS task. PG presented validity for HSMAPs related to insecurity and economy of space. PC showed validity for HSMAPs related to cutting efficacy, peripheral unawareness, and confidence. Finally, KS presented validity for HSMAPs related with economy of space and knotting security. Conclusions PCA-defined HSMAPs can be used for technical skills’ assessment. Construct validation and expert knowledge can be combined to infer how competences are acquired in box trainer tasks. These findings can be exploited to provide residents with meaningful feedback on performance. Future works will compare the new HSMAPs with valid scoring systems such as GOALS.

This research presents a novel low-cost pedagogical environment oriented to ease the use experiential learning methods for training on image-guided robotic surgery technologies. The environment proposes a simplified surgical simulation use case: the movement of insertion and extraction of a needle, similar to an image-guided biopsy situation. The training environment is composed of a 3D-printed phantom, a CT scan of the phantom, a virtual reality environment that includes haptic information, an ad-hoc 1 degree of freedom (DOF) robotic system for insertion/extraction and a Novint Falcon, a low cost 3 DOF manipulator that allows achieving haptic feedback. A first pilot experience has been carried out in the ?Surgical Simulation and Planning? course of the Bachelor of Biomedical Engineering at Universidad Politécnica de Madrid (UPM). Results of the surveys carried out (by teachers and learners) show that the new project-based methodology improves in all cases the values of student?s satisfaction obtained using the classical methodology based on master classes and practices.

This manuexamines whether the effect of anchoring bias is greater when citizens evaluate the quality of a publicservice after receiving negative initial information about service performance than after receiving positive information.It also tests whether there are differences in this anchoring bias by comparing formal (report) vs. informal (rumor)communication. Two field experiments were conducted with the participation of passengers of a commuter public traintransportation organization (Experiment 1, N = 105) and users of a public university administrative service (Experiment 2,N = 172). The first experiment confirmed the bias produced by the negative initial information, whereas this bias does notexist for the positive information. The second experiment showed that the bias produced by the initial information hasthe same magnitude for both formal and informal communication. This paper concludes with a discussion of theoreticaland practical implications for managing reputation in public services. Este manuscrito examina si el efecto del sesgo de anclaje es mayor cuando los ciudadanos evalúan la calidad de un serviciopúblico después de recibir información inicial negativa sobre la calidad del servicio, que después de recibir informaciónpositiva. También pone a prueba si hay diferencias en este sesgo de anclaje al comparar la comunicación formal (informe)con la comunicación informal (rumor). Se realizaron dos experimentos de campo con la participación de pasajerosde una compañía pública de trenes de cercanías (experimento 1, N = 105) y usuarios del servicio administrativo de unauniversidad pública (experimento 2, N = 172). El primer experimento confirmó el sesgo producido por la informacióninicial negativa, mientras que este sesgo no existe para la información positiva. El segundo experimento mostró que elsesgo producido por la información inicial tiene la misma magnitud tanto para la comunicación formal como para lainformal. El trabajo concluye con una discusión de las implicaciones teóricas y prácticas para la gestión de la reputaciónde los servicios públicos.

We propose a fully automated methodology for hexahedral meshing of patient-specific structures of the human knee obtained from magnetic resonance images, i.e. femoral/tibial cartilages and menisci. We select eight patients from the Osteoarthritis Initiative and validate our methodology using MATLAB on a laptop computer. We obtain the patient-specific meshes in an average of three minutes, while faithfully representing the geometries with well-shaped elements. We hope to provide a fundamentally different means to test hypotheses on the mechanisms of disease progression by integrating our patient-specific FE meshes with data from individual patients. Download both our meshes and software at http://im.engr.uconn.edu/downloads.php.

Background Diffuse Large B cell lymphoma (DLBCL) is usually diagnosed between the 5th-6th decade of life. Its incidence increases with age. Chemotherapy (CT) with R-CHOP is the standard treatment for any age. However, in the clinical practice, alternative treatments with less toxicities are offered to elderly patients. This group of patients is usually not well represented in clinical trials. Our aim is to asses the benefit of standard treatment in this population, as well as discontinuation of treatment and its impact on overall survival (OS). As secondary endpoint, we have analyzed the survival rate in the subgroup of patients older than 75 years of age treated with CT. Methods A retrospective review was performed in patients ≥65 years who were diagnosed with DLBCL during the years 2013-2015 in the Hospital of Leon. Patients with histological confirmation of the primary diagnosis and who received treatment were included. Results 65 patients were analyzed. The average age was 75 years. 64% were male and 30% had stage 4 disease at the time of diagnosis. The CT schemes were: R-CHOP (N = 28), R-CEOP (N = 11) and R-miniCHOP (N = 8). 10 patients had grade 4 AEs. One death ocurred after receiving the first cicle. 70% completed at least 4 cicles of CT. Median OS was 51 months versus (vs) 11 months in favor of R-CHOP group (HR = 0,59, p = 0,112 IC 95%=0,30-1,13). Results were not statistically significant likely because of the small sample size. 45% of patients had a complete response, 20% had a partial response and 10% had no response to treatment.The main cause of death was disease progression. Median OS was 15 months in both groups, in patients older than 75 treated with CT vs Conclusions In clinical practice, age is an important variable to account for when deciding on the management approach for heamatological malignancies such as DLBCL. Although our results show a non-statistically significant benefit in OS of R-CHOP vs other schemes, this could be due to the small sample size. Given the prevalence of elderly population in our country, and the proved benefit of standard chemotherapy in the approach of DLBCL, more studies are needed. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Introduction: E-learning web environments, including the new TELMA platform, are increasingly being used to provide cognitive training in minimally invasive surgery (MIS) to surgeons. A complete validation of this MIS elearning platform has been performed to determine whether it complies with the three web quality dimensions: usability, content and functionality. Methods: 21 Surgeons participated in the validation trials. They performed a set of tasks in the TELMA platform, where an e-MIS validity approach was followed. Subjective (questionnaires and checklists) and objective (web analytics) metrics were analysed to achieve the complete validation of usability, content and functionality. Results: The TELMA platform allowed access to didactic content with easy and intuitive navigation. Surgeons performed all tasks with a close-to-ideal number of clicks and amount of time. They considered the design of the website to be consistent (95.24%), organised (90.48%) and attractive (85.71%). Moreover, they gave the content a high score (4.06 out of 5) and considered it adequate for teaching purposes. The surgeons scored the professional language and content (4.35), logo (4.24) and recommendations (4.20) the highest. Regarding functionality, the TELMA platform received an acceptance of 95.24% for navigation and 90.48% for interactivity. Conclusions: According to the study, it seems that TELMA had an attractive design, innovative content and interactive navigation, which are three key features of an e-learning platform. TELMA successfully met the three criteria necessary for consideration as a website of quality by achieving more than 70% of agreements regarding all usability, content and functionality items validated; this constitutes a preliminary requirement for an effective e-learning platform. However, the content completeness, authoring tool and registration process required improvement. Finally, the e-MIS validity methodology used to measure the three dimensions of web quality in this work can be applied to other clinical areas or training fields.

Laparoscopic surgery is commonly used in many surgical procedures but requires a learning process to develop the necessary skills. Virtual reality simulators play an essential role within the training curricula. This paper aims to determine whether training in SINERGIA VR simulator allows novice surgeons to improve their basic psychomotor laparoscopic skills.Forty-two people participated in this study, including 28 unexperience medical students and 14 expert surgeons who developed previously more than 100 laparoscopic procedures. Medical students made a pre-training test in LapMentor II; then, they trained in SINERGIA and they finally accomplished a post-training test in LapMentor II. Experts just made one trial in LapMentor II. A statistical analysis was carried out and results of pre- and post-training tests of novices were compared with Wilcoxon signed-rank test. Pre- and post-training tests of novices were also compared with results of experts with Mann-Whitney U test.Most metrics provided by LapMentor II and included in this study show significant differences when comparing pre- and post-training tests of novices. Analysis of pre-training test of novices and experts results show significant differences in all analyzed metrics for all studied tasks. On the other hand, LapMentor was not able to distinguish between experts and novices after training in SINERGIA for any metric in the camera manipulation task and for some metrics of the other tasks.Training in SINERGIA VR simulator allows improvement of basic psychomotor laparoscpic skills and transferring them to another virtual simulator. Therefore, it could be used in laparoscopic surgery training programs.

One of the most important revolutions in the past few decades in clinical practice has been motivated by the introduction of Minimally Invasive Surgery (MIS) techniques, which have spread amongst almost all surgical specialities. MIS training is a principal component of the education of new surgical residents, with an increasing demand for knowledge and skills for medical students and surgeons. Technology enhanced learning (TEL) solutions can deal with the growing need for MIS learning. This research work aims to develop a MIS learning environment based on web technologies, named TELMA, which will respond to the growing amount of information and multimedia surgical contents available (mainly intervention’s video recording libraries), in compliance with specific learning needs of surgical students and professionals, enhancing their competence on MIS cognitive skills. Furthermore, TELMA will support knowledge capturing, sharing and reuse, and effective management of didactic contents through personalised and collaborative services.

In this paper, the development of an assisting system for laparoscopic surgical training is presented. With this system, we expect to facilitate the training process at the first stages of training in laparoscopic surgery and to contribute to an objective evaluation of surgical skills. To achieve this, we propose the insertion of multimedia contents and outlines of work adapted to the level of experience of trainees and the detection of the movements of the laparoscopic instrument into the monitored image. A module to track the instrument is implemented focusing on the tip of the laparoscopic tool. This tracking method does not need the presence of artificial marks or special colours to distinguish the instruments. Similarly, the system has another method based on visual tracking to localize support multimedia content in a stable position of the field of vision. Therefore, this position of the support content is adapted to the movements of the camera or the working area. Experimental results are presented to show the feasibility of the proposed system for assisting in laparoscopic surgical training.

Motion analysis is employed to assess minimally invasive surgical psychomotor skills in box trainers. Tracking of laparoscopic instruments requires sensor-based systems that can be expensive, limit movements and modify their ergonomic properties. We evaluate the feasibility of using Leap Motion as a cheap, unobtrusive alternative. Four experiments were performed to determine its precision while tracking a laparoscopic instrument inside and outside a box trainer. Static long and short term precision of the Leap Motion was

Due to limitations in conventional medical imaging and the restrictions imposed by both the anatomy and the surgical approach in pancreatic cancer, there is a need for methods to support intraoperative imaging in order to improve their accurate anatomical localization and the characterization of their nature. Laparoscopic ultrasounds (LUS) images and endoscopic videos can be used to extract useful information during the surgical procedures. A fast approach for acquiring an estimation of the tumor positioning and size through laparoscopic ultrasounds images has been developed. Based on the surgical video, endoscope 3D tracking is achieved by means of a Shape-from-Motion technique. Intraoperative imaging algorithms’ validation has been carried out in an ex vivo porcine model and results have shown the viability of exploiting them for structures characterization and their 3D reconstruction.

La necesidad de desarrollar nuevos implantes basados en materiales bioactivos que sean capaces de soportar grandes cargas mecánicas ha llevado a la producción de sustratos metálicos recubiertos con cerámicas bioactivas. Recientemente se ha propuesto un dispositivo alternativo que consiste en un sustrato de carburo de silicio (SiC) biomórfico recubierto con vidrio bioactivo, mediante la técnica de Depósito por Láser Pulsado (PLD), y que dispone de la resistencia mecánica adecuada, además de gran ligereza y una porosidad intrínseca muy favorable de cara a la implantación. En este trabajo se presenta un estudio interdisciplinar de este nuevo material centrado en la morfología y porosidad de sustratos de SiC provenientes de diferentes maderas, la bioactividad de los recubrimientos producidos por PLD y en la evaluación in vitro con células de osteosarcoma MG-63 con la que se ha determinado la citotoxicidad de estos materiales y se ha estudiado la influencia de los mismos en la adhesión y la proliferación celular. In the past years there was a need to develop new tough bioactive materials capable to resist high loads when implanted in the body, that led to the production of bioactive coatings on metallic substrates. A new approach, which consists of biomorphic silicon carbide (SiC) coated with bioactive glass by Pulsed Laser Deposition (PLD), was recently presented. This new material joins the high mechanical strength, lightness and porosity of biomorphic SiC and the bioactive properties of PLD glass films. In this work, a multiple evaluation of this new material is presented starting from the biomorphic SiC morphology and porosity, following with the bioactivity in simulated body fluid of the coatings, and ending with a deep in vitro study with MG-63 cells. The citotoxicity of the SiC coated and uncoated and the cell proliferation and attachment were studied.

Recently new coating technologies have been developed based on the so-called Pulsed Laser Deposition (PLD) method, which consists in the laser ablation of a target material, and as a consequence of the matter-radiation interaction, the transport of ablated species from the target to the substrate is originated. PLD is quite versatile technique, and allows the incorporation of a reactive atmosphere and electric discharges in the process so that the properties of the coatings can be modified. In this work, these new technologies were applied in the processing of bioactive ceramic thin films of hydroxyapatite and bioactive glass. The influence of processing parameters, such as temperature, voltage applied of the radiofrequency discharge and reactive atmosphere, on the coating properties have been studied. It was found that in the case of hydroxyapatite coatings, the water vapour atmosphere coupled with the radiofrequency discharge enhances the deposition rate and cristallinity of the coatings. Nevertheless, the optimum properties for bioactive glass coatings were obtained in vacuum and absence of electrical discharge conditions.En la actualidad existen nuevas tecnologías de procesamiento de recubrimientos basados en la técnica denominada depósito por láser pulsado (PLD), la cual consiste en la ablación de un blanco mediante un haz láser y como consecuencia de la interacción radiación – materia se origina el transporte del material hasta el sustrato a recubrir. Esta técnica es muy versátil ya que permite la incorporación de atmósferas reactivas en el proceso y de descargas eléctricas en la pluma de ablación las cuales pueden inducir modificaciones en las propiedades de los recubrimientos. En este trabajo se aplican estas nuevas tecnologías a la obtención de capas cerámicas bioactivas de hidroxiapatita y de vidrio bioactivo. Se ha estudiado la influencia de parámetros de proceso como temperatura, diferencia de potencial de la descarga de radiofrecuencia aplicada y atmósfera reactiva, desde el punto de vista de la composición y estructura de los recubrimientos. En el caso de la hidroxiapatita, la presencia de una atmósfera de vapor de agua y de una descarga de radiofrecuencia favorece el ritmo de depósito y la cristalinidad de los recubrimientos. Sin embargo, los recubrimientos óptimos de vidrio bioactivo se obtienen en condiciones de vacío y ausencia de descargas eléctricas.

Pulsed laser deposition (PLD) is a promising technique to produce bioactive glass coatings due to unique characteristic that allows depositing multicomponent films in stoichiometric composition. Moreover, when the ablation experiments are conducted in the presence of a reactive atmosphere (reactive pulsed laser deposition) the film composition can be enriched as compared to that of the basic target and the film properties can be tailored by varying the ambient gas pressure. In this work, the influence of different reactive atmospheres (N 2 O, H 2 O, NH 3 , Ar) and the role of the total pressure on the PLD bioactive glass film properties have been investigated. The coatings were produced by ablating a silica-based bioactive glass target with an ArF laser beam (193 nm, 4.17 J cm −2 ). Films were grown on silicon substrates at 200 °C. The bonding configuration changes were followed by Fourier transform infrared spectroscopy and the film thickness was measured by profilometry. The infrared spectra reveal that an oxidant environment (N 2 O, H 2 O) promotes the reduction of the non-bridging silicon–oxygen groups (Si O NBO) and the incorporation of carbonate groups and adsorbed water, while a NH 3 and Ar atmosphere favours the formation of Si O NBO groups. The total pressure of the atmosphere also plays an important role on the film properties. When the Ar pressure is increased, a gradual shifting of the Si O stretching vibration to higher wavenumbers, the incorporation of carbonates and the diminution of the Si O NBO groups were observed.

Bioactive glasses of different composition were ablated in vacuum with an ArF laser to investigate the transfer of the multi-component system to titanium substrates. Both the bioactive coatings and the bulk glasses were analysed by Rutherford backscattering spectrometry (RBS), particle induced X-ray emission (PIXE), nuclear reaction analysis (NRA), Fourier transform infrared (FTIR) and X-ray photoelectron spectroscopies (XPS). The composition analyses by RBS, PIXE and NRA reveal that the target stoichiometry is nearly congruent transferred to the coating. Nevertheless, along the thin film slight inhomogeneities in composition were found. On the other hand, XPS and FTIR spectra show important changes in the bonding configuration of the coatings and a diminution of the non-bridging oxygen functional groups. This new rearrangement of the coating network forming and modifying agents strongly impacts the bioactive behaviour of the films when soaked in simulated body fluids.

This paper presents an study design to assess the effectiveness of a new cognitive rehabilitation environment based on interactive video and advanced monitoring technologies.

A correct patient-specific identification of the abdominal aortic aneurysm is useful for both diagnosis and treatment stages, as it locates the disease and represents its geometry. The actual thickness and shape of the arterial wall and the intraluminal thrombus are of great importance when predicting the rupture of the abdominal aortic aneurysms. The authors describe a novel method for delineating both the internal and external contours of the aortic wall, which allows distinguishing between vessel wall and intraluminal thrombus. The method is based on active shape model and texture statistical information. The method was validated with eight MR patient studies. There was high correspondence between automatic and manual measurements for the vessel wall area. Resulting segmented images presented a mean Dice coefficient with respect to manual segmentations of 0.88 and a mean modified Hausdorff distance of 1.14 mm for the internal face and 0.86 and 1.33 mm for the external face of the arterial wall. Preliminary results of the segmentation show high correspondence between automatic and manual measurements for the vessel wall and thrombus areas. However, since the dataset is small the conclusions cannot be generalized. ispartof: Computational and Mathematical Methods in Medicine vol:2015 ispartof: location:United States status: published