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• The application of machine learning to brain computed tomography (CTB) data shows promise for improving diagnostic accuracy and triage. • Most existing CTB machine learning models lack clinical comprehensiveness and sufficient external validation. • There is an opportunity to develop comprehensive, low-bias CTB classification systems that demonstrate greater clinical utility. • Comprehensive systems promise to improve diagnosis, decision making, treatment timeliness, clinical audits, and education at scale. Brain computed tomography (CTB) scans are widely used to evaluate intracranial pathology. The implementation and adoption of CTB has led to clinical improvements. However, interpretation errors occur and may have substantial morbidity and mortality implications for patients. Deep learning has shown promise for facilitating improved diagnostic accuracy and triage. This research charts the potential of deep learning applied to the analysis of CTB scans. It draws on the experience of practicing clinicians and technologists involved in development and implementation of deep learning-based clinical decision support systems. We consider the past, present and future of the CTB, along with limitations of existing systems as well as untapped beneficial use cases. Implementing deep learning CTB interpretation systems and effectively navigating development and implementation risks can deliver many benefits to clinicians and patients, ultimately improving efficiency and safety in healthcare. [ABSTRACT FROM AUTHOR]

Our previously published health economic modelling studies of DNA screening for HBOC, Lynch syndrome20 and familial hypercholesterolaemia21 provide a platform for the consideration of DNA screening in Australia. Our model on DNA screening for familial hypercholesterolaemia genes found similar results.21 Our future modelling will assess the combined benefits and costs of screening for familial cancer genes and familial hypercholesterolaemia genes concurrently in the same test. At $200 per test, savings in prevented cancer treatment outweighed DNA screening costs, projecting DNA screening to be cost-saving for the Australian public health system (for cancer genes alone). Keywords: Genetic counselling; Mass screening; Population health EN Genetic counselling Mass screening Population health 278 280 3 04/05/22 20220401 NES 220401 Australia will take a world-first step towards offering preventive DNA screening through the public health care system In adult-onset genomic conditions, such as hereditary breast and ovarian cancer (HBOC), Lynch syndrome and familial hypercholesterolaemia, certain DNA variants confer high risk of developing future disease.1 DNA screening for these conditions could thereby identify medically actionable genetic risk factors, prompting timely risk management and informed decision making from early adulthood to facilitate early detection or prevention.2 Despite this opportunity, diagnostic rates for these conditions remain low,2-4 limited by restricted access to genetic testing and lack of awareness. [Extracted from the article]

Abstract: Long-term treatment for Parkinson''s disease (PD) with the dopamine-precursor levodopa (l-DOPA) results in the development of motor fluctuations, including involuntary movements, termed l-DOPA-induced dyskinesia (LID). Currently, effective treatments for LID are limited. The neurodegenerative processes underlying PD result in loss of serotonin (5-HT) input from the dorsal raphe nucleus (DRN) to the striatum, but to a lesser extent than loss of dopamine input. l-DOPA may be converted to dopamine in remaining serotonergic neurons and the non-physiological release of dopamine may lead to abnormal dopamine receptor stimulation in the striatopallidal pathways and result in the generation of LID. Suppressing the activity of these 5-HT inputs to the striatum via presynaptic 5-HT1A agonists may reduce LID. However, to date, studies with 5-HT1A agonists have suggested a reduction in LID, but with worsening PD disability. Postsynaptic 5-HT2A and 5-HT2C receptors in the striatum may modulate dopamine to reduce LID and the atypical antipsychotic, clozapine is effective at reducing LID without worsening PD. Alternatively, postsynaptic 5-HT1A, presynaptic 5-HT1B/1D receptors and 5-HT2C receptors may modulate GABA and glutamate release within other basal ganglia nuclei to reduce LID. Thus, 5-HT ligands can modulate basal ganglia function and hence motor function through several receptor subtypes and locations, with potential therapeutic benefit to the motor complications induced by long-term l-DOPA therapy in PD. Future studies are needed to develop 5-HT selective drugs that can reduce LID without affecting the anti-parkinsonian action of l-DOPA. [Copyright &y& Elsevier]

Abstract: Whilst bilateral internal cerebral vein thrombosis has been well documented in the literature, unilateral cerebral vein thrombosis is a rare entity, most likely underdiagnosed. It is important to recognise imaging features for prompt diagnosis, as timely treatment may prevent a debilitating or potentially fatal outcome. We have reviewed all 14 cases of unilateral internal cerebral vein thrombosis in the literature, and present the salient and specific findings using our case as an illustration. Noteworthy, the predominance of left sided disease (13/15 cases), which raises the possibility of asymmetric venous drainage though could be due to chance alone. [ABSTRACT FROM AUTHOR]