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The paper presents an anti-lock braking system (ABS) control logic based on the measurement of the longitudinal forces at the hub bearings. The availability of force information allows to design a logic that does not rely on the estimation of the tyre–road friction coefficient, since it continuously tries to exploit the maximum longitudinal tyre force. The logic is designed by means of computer simulation and then tested on a specific hardware in the loop test bench: the experimental results confirm that measured wheel force can lead to a significant improvement of the ABS performances in terms of stopping distance also in the presence of road with variable friction coefficient. [ABSTRACT FROM AUTHOR]

Introduction: Breast arterial calcifications (BAC) are common incidental findings on routine mammograms, which have been suggested as a sex-specific biomarker of cardiovascular disease (CVD) risk. Previous work showed the efficacy of a pretrained convolutional network (CNN), VCG16, for automatic BAC detection. In this study, we further tested the method by a comparative analysis with other ten CNNs., Material and Methods: Four-view standard mammography exams from 1,493 women were included in this retrospective study and labeled as BAC or non-BAC by experts. The comparative study was conducted using eleven pretrained convolutional networks (CNNs) with varying depths from five architectures including Xception, VGG, ResNetV2, MobileNet, and DenseNet, fine-tuned for the binary BAC classification task. Performance evaluation involved area under the receiver operating characteristics curve (AUC-ROC) analysis, F 1 -score (harmonic mean of precision and recall), and generalized gradient-weighted class activation mapping (Grad-CAM++) for visual explanations., Results: The dataset exhibited a BAC prevalence of 194/1,493 women (13.0%) and 581/5,972 images (9.7%). Among the retrained models, VGG, MobileNet, and DenseNet demonstrated the most promising results, achieving AUC-ROCs > 0.70 in both training and independent testing subsets. In terms of testing F 1 -score, VGG16 ranked first, higher than MobileNet (0.51) and VGG19 (0.46). Qualitative analysis showed that the Grad-CAM++ heatmaps generated by VGG16 consistently outperformed those produced by others, offering a finer-grained and discriminative localization of calcified regions within images., Conclusion: Deep transfer learning showed promise in automated BAC detection on mammograms, where relatively shallow networks demonstrated superior performances requiring shorter training times and reduced resources., Relevance Statement: Deep transfer learning is a promising approach to enhance reporting BAC on mammograms and facilitate developing efficient tools for cardiovascular risk stratification in women, leveraging large-scale mammographic screening programs., Key Points: • We tested different pretrained convolutional networks (CNNs) for BAC detection on mammograms. • VGG and MobileNet demonstrated promising performances, outperforming their deeper, more complex counterparts. • Visual explanations using Grad-CAM++ highlighted VGG16's superior performance in localizing BAC., (© 2024. The Author(s).)

Bone Strain Index (BSI), based on dual-energy X-ray absorptiometry (DXA), is a densitometric index of bone strength of the femur and lumbar spine. Higher BSI values indicate a higher strain applied to bone, predisposing to higher fracture risk. This retrospective, multicentric study on Italian women reports the BSI normative age-specific reference curves. A cohort of Caucasian Italian women aged 20 to 90 years was selected from three different clinical centres. Bone mineral density (BMD) and BSI measurements were obtained for the lumbar spine vertebrae (L1-L4) and for the femur (neck, trochanter and intertrochanter) using Hologic densitometers scans. The data were compared with BMD normative values provided by the densitometer manufacturer. Then, the age-specific BSI curve for the femur and lumbar spine was generated. No significant difference was found between the BMD of the subjects in this study and BMD reference data provided by Hologic ( p = 0.68 for femur and p = 0.90 for lumbar spine). Spine BSI values (L1-L4) increase by 84% between 20 and 90 years of age. The mean BSI of the total femur increases about 38% in the same age range. The BSI age-specific reference curve could help clinicians improve osteoporosis patient management, allowing an appropriate patient classification according to the bone resistance to the applied loads and fragility fracture risk assessment.

Objectives: MRI-derived extracellular volume (ECV) allows characterization of myocardial changes before the onset of overt pathology, which may be caused by cancer therapy cardiotoxicity. Our purpose was to review studies exploring the role of MRI-derived ECV as an early cardiotoxicity biomarker to guide timely intervention., Materials and Methods: In April 2022, we performed a systematic search on EMBASE and PubMed for articles on MRI-derived ECV as a biomarker of cancer therapy cardiotoxicity. Two blinded researchers screened the retrieved articles, including those reporting ECV values at least 3 months from cardiotoxic treatment. Data extraction was performed for each article, including clinical and technical data, and ECV values. Pooled ECV was calculated using the random effects model and compared among different treatment regimens and among those who did or did not experience overt cardiac dysfunction. Meta-regression analyses were conducted to appraise which clinical or technical variables yielded a significant impact on ECV., Results: Overall, 19 studies were included. Study populations ranged from 9 to 236 patients, for a total of 1123 individuals, with an average age ranging from 12.5 to 74 years. Most studies included patients with breast or esophageal cancer, treated with anthracyclines and chest radiotherapy. Pooled ECV was 28.44% (95% confidence interval, CI, 26.85-30.03%) among subjects who had undergone cardiotoxic cancer therapy, versus 25.23% (95%CI 23.31-27.14%) among those who had not (p = .003)., Conclusion: A higher ECV in patients who underwent cardiotoxic treatment could imply subclinical changes in the myocardium, present even before overt cardiac pathology is detectable., Clinical Relevance Statement: The ability to detect subclinical changes in the myocardium displayed by ECV suggests its use as an early biomarker of cancer therapy-related cardiotoxicity., Key Points: • Cardiotoxicity is a common adverse effect of cancer therapy; therefore, its prompt detection could improve patient outcomes. • Pooled MRI-derived myocardial extracellular volume was higher in patients who underwent cardiotoxic cancer therapy than in those who did not (28.44% versus 25.23%, p = .003). • MRI-derived myocardial extracellular volume represents a potential early biomarker of cancer therapy cardiotoxicity., (© 2023. The Author(s).)

Objective: Breast arterial calcifications (BAC) are a sex-specific cardiovascular disease biomarker that might improve cardiovascular risk stratification in women. We implemented a deep convolutional neural network for automatic BAC detection and quantification., Methods: In this retrospective study, four readers labelled four-view mammograms as BAC positive (BAC+) or BAC negative (BAC-) at image level. Starting from a pretrained VGG16 model, we trained a convolutional neural network to discriminate BAC+ and BAC- mammograms. Accuracy, F1 score, and area under the receiver operating characteristic curve (AUC-ROC) were used to assess the diagnostic performance. Predictions of calcified areas were generated using the generalized gradient-weighted class activation mapping (Grad-CAM++) method, and their correlation with manual measurement of BAC length in a subset of cases was assessed using Spearman ρ., Results: A total 1493 women (198 BAC+) with a median age of 59 years (interquartile range 52-68) were included and partitioned in a training set of 410 cases (1640 views, 398 BAC+), validation set of 222 cases (888 views, 89 BAC+), and test set of 229 cases (916 views, 94 BAC+). The accuracy, F1 score, and AUC-ROC were 0.94, 0.86, and 0.98 in the training set; 0.96, 0.74, and 0.96 in the validation set; and 0.97, 0.80, and 0.95 in the test set, respectively. In 112 analyzed views, the Grad-CAM++ predictions displayed a strong correlation with BAC measured length (ρ = 0.88, p < 0.001)., Conclusion: Our model showed promising performances in BAC detection and in quantification of BAC burden, showing a strong correlation with manual measurements., Clinical Relevance Statement: Integrating our model to clinical practice could improve BAC reporting without increasing clinical workload, facilitating large-scale studies on the impact of BAC as a biomarker of cardiovascular risk, raising awareness on women's cardiovascular health, and leveraging mammographic screening., Key Points: • We implemented a deep convolutional neural network (CNN) for BAC detection and quantification. • Our CNN had an area under the receiving operator curve of 0.95 for BAC detection in the test set composed of 916 views, 94 of which were BAC+ . • Furthermore, our CNN showed a strong correlation with manual BAC measurements (ρ = 0.88) in a set of 112 views., (© 2023. The Author(s).)

Zika virus (ZIKV) is a strongly neurotropic flavivirus whose infection has been associated with microcephaly in neonates. However, clinical and experimental evidence indicate that ZIKV also affects the adult nervous system. In this regard, in vitro and in vivo studies have shown the ability of ZIKV to infect glial cells. In the central nervous system (CNS), glial cells are represented by astrocytes, microglia, and oligodendrocytes. In contrast, the peripheral nervous system (PNS) constitutes a highly heterogeneous group of cells (Schwann cells, satellite glial cells, and enteric glial cells) spread through the body. These cells are critical in both physiological and pathological conditions; as such, ZIKV-induced glial dysfunctions can be associated with the development and progression of neurological complications, including those related to the adult and aging brain. This review will address the effects of ZIKV infection on CNS and PNS glial cells, focusing on cellular and molecular mechanisms, including changes in the inflammatory response, oxidative stress, mitochondrial dysfunction, Ca 2+ and glutamate homeostasis, neural metabolism, and neuron-glia communication. Of note, preventive and therapeutic strategies that focus on glial cells may emerge to delay and/or prevent the development of ZIKV-induced neurodegeneration and its consequences., (© 2023 Wiley Periodicals LLC.)

We aimed to explore the feasibility of 4D flow magnetic resonance imaging (MRI) for patients undergoing thoracic aorta endovascular repair (TEVAR). We retrospectively evaluated ten patients (two female), with a mean (±standard deviation) age of 61 ± 20 years, undergoing MRI for a follow-up after TEVAR. All 4D flow examinations were performed using a 1.5-T system (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany). In addition to the standard examination protocol, a 4D flow-sensitive 3D spatial-encoding, time-resolved, phase-contrast prototype sequence was acquired. Among our cases, flow evaluation was feasible in all patients, although we observed some artifacts in 3 out of 10 patients. Three individuals displayed a reduced signal within the vessel lumen where the endograft was placed, while others presented with turbulent or increased flow. An aortic endograft did not necessarily hinder the visualization of blood flow through 4D flow sequences, although the graft could generate flow artifacts in some cases. A 4D Flow MRI may represent the ideal tool to follow up on both healthy subjects deemed to be at an increased risk based on their anatomical characteristics or patients submitted to TEVAR for whom a surveillance protocol with computed tomography angiography would be cumbersome and unjustified.

Purpose: To evaluate myocardial status through the assessment of extracellular volume (ECV) calculated at computed tomography (CT) in patients hospitalized for novel coronavirus disease (COVID-19), with regards to the presence of pulmonary embolism (PE) as a risk factor for cardiac dysfunction., Method: Hospitalized patients with COVID-19 who underwent contrast-enhanced CT at our institution were retrospectively included in this study and grouped with regards to the presence of PE. Unenhanced and portal venous phase scans were used to calculate ECV by placing regions of interest in the myocardial septum and left ventricular blood pool. ECV values were compared between patients with and without PE, and correlations between ECV values and clinical or technical variables were subsequently appraised., Results: Ninety-four patients were included, 63/94 of whom males (67%), with a median age of 70 (IQR 56-76 years); 28/94 (30%) patients presented with PE. Patients with PE had a higher myocardial ECV than those without (33.5%, IQR 29.4-37.5% versus 29.8%, IQR 25.1-34.0%; p = 0.010). There were no correlations between ECV and patients' age (p = 0.870) or sex (p = 0.122), unenhanced scan voltage (p = 0.822), portal phase scan voltage (p = 0.631), overall radiation dose (p = 0.569), portal phase scan timing (p = 0.460), and contrast agent dose (p = 0.563)., Conclusions: CT-derived ECV could help identify COVID-19 patients at higher risk of cardiac dysfunction, especially when related to PE, to potentially plan a dedicated, patient-tailored clinical approach., 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 © 2023 Elsevier B.V. All rights reserved.)

The inner ear, the organ of equilibrium and hearing, has an extraordinarily complex and intricate arrangement. It contains highly specialized structures meticulously tailored to permit auditory processing. However, hearing also relies on both peripheral and central pathways responsible for the neuronal transmission of auditory information from the cochlea to the corresponding cortical regions. Understanding the anatomy and physiology of all components forming the auditory system is key to better comprehending the pathophysiology of each disease that causes hearing impairment. In this narrative review, the authors focus on the pathophysiology as well as on cellular and molecular mechanisms that lead to hearing loss in different neonatal infectious diseases. To accomplish this objective, the morphology and function of the main structures responsible for auditory processing and the immune response leading to hearing loss were explored. Altogether, this information permits the proper understanding of each infectious disease discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Capra, DosSantos, Sanz, Acosta Filha, Nunes, Heringer, Ximenes-da-Silva, Pessoa, de Mattos Coelho-Aguiar, da Fonseca, Mendes, da Rocha, Devalle, Niemeyer Soares Filho and Moura-Neto.)

Background: Our purpose was to evaluate the correlations between right ventricular (RV) late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) in patients with tetralogy of Fallot (ToF) scheduled for pulmonary valve replacement (PVR) and post-PVR functional data., Methods: We retrospectively reviewed ToF patients scheduled for PVR who underwent two CMR examinations at our institution, one before the procedure (CMR-0), including contrast-enhanced sequences, and one after the procedure (CMR-1). Functional left and RV data were obtained by segmenting short-axis stacks on both CMR examinations, and normalised variations were calculated by dividing differences between CMR-1 and CMR-0 by the intercurring time interval, whereas the RV scar burden was assessed on CMR-0 LGE sequences both semiquantitatively and quantitatively. Data were reported as median and interquartile range, differences were appraised with the Mann-Whitney U test, while correlations were assessed with Spearman's ρ., Results: Fifteen patients with a median age of 25 years (16-29), including 9 (60%) males, with a median time interval between CMR-0 and CMR-1 of 17 months (12-23), were retrospectively reviewed. The semiquantitative LGE score at CMR-0 was 7 (6-9), and LGE volume was 4.49 mL (3.70-5.78), covering 5.63% (4.92-7.00) of the RV. RV LGE score showed a moderate positive correlation with the normalised variation of RV stroke volume (ρ = 0.662, p = 0.007) and a borderline moderate positive correlation with the normalised variation of RV end-diastolic indexed volume (ρ = 0.513, p = 0.050)., Conclusions: The assessment of RV LGE before PVR may provide insights on post-PVR functional data, potentially facilitating a patient-tailored treatment pathway., (© 2023. The Author(s).)

Breast density (BD) and breast arterial calcifications (BAC) can expand the role of mammography. In premenopause, BD is related to body fat composition: breast adipose tissue and total volume are potential indicators of fat storage in visceral depots, associated with higher risk of cardiovascular disease (CVD). Women with fatty breast have an increased likelihood of hypercholesterolemia. Women without cardiometabolic diseases with higher BD have a lower risk of diabetes mellitus, hypertension, chest pain, and peripheral vascular disease, while those with lower BD are at increased risk of cardiometabolic diseases. BAC, the expression of Monckeberg sclerosis, are associated with CVD risk. Their prevalence, 13 % overall, rises after menopause and is reduced in women aged over 65 receiving hormonal replacement therapy. Due to their distinct pathogenesis, BAC are associated with hypertension but not with other cardiovascular risk factors. Women with BAC have an increased risk of acute myocardial infarction, ischemic stroke, and CVD death; furthermore, moderate to severe BAC load is associated with coronary artery disease. The clinical use of BAC assessment is limited by their time-consuming manual/visual quantification, an issue possibly solved by artificial intelligence-based approaches addressing BAC complex topology as well as their large spectrum of extent and x-ray attenuations. A link between BD, BAC, and osteoporosis has been reported, but data are still inconclusive. Systematic, standardised reporting of BD and BAC should be encouraged., Competing Interests: V. Magni, D. Capra, A. Cozzi, C. B. Monti, N. Mobini, and A. Colarieti all declare that they have no competing interest. F. Sardanelli has received research grants from and is a member of the speakers' bureau and of the advisory group for General Electric, Bayer and Bracco; he is also a member of the scientific advisory board of DeepTrace Technologies S.R.L., (Copyright © 2022 Elsevier B.V. All rights reserved.)

We aimed to investigate whether unenhanced magnetic resonance imaging (MRI) could represent a safe and highly sensitive tool for endoleak screening in patients treated with endovascular aneurysm repair (EVAR) using computed tomography angiography (CTA) as a reference standard. Patients who underwent CTA for EVAR follow-up at our institution were prospectively enrolled. All MRI examinations were performed with a 1.5 T unit. The true-FISP and HASTE sequences of the MRI scans were assessed for the presence of hyperintensity within the aneurysm sac outside the graft, whereas phase-contrast through-plane sequences were used for blood flow quantification. We included 45 patients, 5 (11%) of whom were female. The median age was 73 years (IQR 68−78 years). Among our patients, 19 (42%) were positive for endoleaks at CTA, of whom 13 (68%) had type II endoleaks and 6 (32%) had type I endoleaks. There were no significant differences in age, sex, aneurysm type, prosthesis type, or contrast-to-noise ratio between hyperintensity and thrombus between patients with and without endoleaks (p > 0.300). The combined evaluation of true-FISP and HASTE yielded 100% sensitivity (95% CI: 79−100%) and 19% specificity (95% CI: 7−40%). Patients with a positive CTA had a median thrombus flow of 0.06 L/min (IQR 0.03−0.23 L/min), significantly greater than that of patients with a negative CTA (p = 0.007). Setting a threshold at 0.01 L/min, our MRI protocol yielded 100% sensitivity, 56% specificity, and an AUC of 0.76 (95% CI 0.60−0.91). In conclusion, unenhanced MRI has perfect sensitivity for endoleak detection, although with subpar specificity that could be improved with phase-contrast flow analysis., Competing Interests: Caterina B. Monti has received travel support from Bracco. F. Sardanelli has received research grants from and is a member of the speakers&rsquo; bureau and of the advisory group for General Electric, Bayer, and Bracco. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Sarcopenia has been associated with an increased incidence of adverse outcomes, including higher mortality, after endovascular aortic repair (EVAR). We aim to use computed tomography (CT) to quantify changes in total psoas muscles area (PMA) and psoas muscle density (PMD) after EVAR, and to evaluate the reproducibility of both measurements. PMA and PMD were assessed via manual segmentation of the psoas muscle on pre- and post-operative CT scans belonging to consecutive patients who underwent EVAR. Wilcoxon test was used to compare PMA and PMD before and after EVAR, and inter- and intra-reader agreements of both methods were evaluated through Bland−Altman analysis. A total of 50 patients, 42 of them males (84%), were included in the study. PMA changes from 1243 mm2 (1006−1445 mm2) to 1102 mm2 (IQR 937−1331 mm2), after EVAR (p < 0.001). PMD did not vary between pre-EVAR (33 HU, IQR 26.5−38.7 HU) and post-EVAR (32 HU, IQR 26−37 HU, p = 0.630). At inter-reader Bland−Altman analysis, PMA showed a bias of 64.0 mm2 and a coefficient of repeatability (CoR) of 359.2 mm2, whereas PMD showed a bias of −2.43 HU and a CoR of 6.19 HU. At intra-reader Bland−Altman analysis, PMA showed a bias of −81.1 mm2 and a CoR of 394.6 mm2, whereas PMD showed a bias of 1.41 HU and a CoR of 6.36 HU. In conclusion, PMA decreases after EVAR. A good intra and inter-reader reproducibility was observed for both PMA and PMD. We thus propose to use PMA during the follow-up of patients who underwent EVAR to monitor muscle depletion after surgery.

The inner ear is composed by tiny and complex structures that, together with peripheral and central auditory pathways, are responsible for hearing processing. However, not only the anatomy of the cochlea, its compartments and related structures are complex. The mechanisms involved in the regulation of homeostasis in the inner ear fluid, which determines the ionic gradient necessary for hearing and balancing sensory excitability, is an intricate phenomenon that involves several molecules. Among them, Aquaporins (AQP) play a significant role in this process. AQP are part of a family of small, integral membrane proteins that regulate different processes, including bidirectional water and ionic flow in the inner ear. Changes in the expression of these proteins are essential to auditory physiology and several pathophysiological processes in the inner ear. This review focuses on the role of AQP in health and disease of the auditory system., (Copyright © 2022 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Background: Our aim was to evaluate the reproducibility of epicardial adipose tissue (EAT) volume, measured on scans performed using an open-bore magnetic resonance scanner., Methods: Consecutive patients referred for bariatric surgery, aged between 18 and 65 years who agreed to undergo cardiac imaging (MRI), were prospectively enrolled. All those with cardiac pathology or contraindications to MRI were excluded. MRI was performed on a 1.0-T open-bore scanner, and EAT was segmented on all scans at both systolic and diastolic phase by two independent readers (R1 with four years of experience and R2 with one year). Data were reported as median and interquartile range; agreement and differences were appraised with Bland-Altman analyses and Wilcoxon tests, respectively., Results: Fourteen patients, 11 females (79%) aged 44 (41-50) years, underwent cardiac MRI. For the first and second readings, respectively, EAT volume was 86 (78-95) cm 3 and 85 (79-91) cm 3 at systole and 82 (74-95) cm 3 and 81 (75-94) cm 3 at diastole for R1, and 89 (79-99) cm 3 and 93 (84-98) cm 3 at systole and 92 (85-103) cm 3 and 93 (82-94) cm 3 at diastole for R2. R1 had the best reproducibility at diastole (bias 0.3 cm 3 , standard deviation of the differences (SD) 3.3 cm 3 ). R2 had the worst reproducibility at diastole (bias 3.9 cm 3 , SD 12.1 cm 3 ). The only significant difference between systole and diastole was at the first reading by R1 (p = 0.016). The greatest bias was that of inter-reader reproducibility at diastole (-9.4 cm 3 )., Conclusions: Reproducibility was within clinically acceptable limits in most instances., (© 2022. The Author(s) under exclusive licence to European Society of Radiology.)

Purpose: To compare real-time compressed sensing (CS) and standard balanced steady-state free precession (bSSFP) cardiac cine imaging in children., Materials and Methods: Twenty children (mean age, 15 years ± 5 [SD], range, 7-21 years; 10 male participants) with biventricular congenital heart disease ( n = 11) or cardiomyopathy ( n = 9) were prospectively included. Examinations were performed with 1.5-T imagers by using both bSSFP and CS sequences in all participants. Quantification of ventricular volumes and function was performed for all images by two readers blinded to patient diagnosis and type of sequence. Values were correlated with phase-contrast flow measurements by one reader. Intra- and interreader agreement were analyzed., Results: There were no significant differences between ventricular parameters measured on CS compared with those of bSSFP ( P > .05) for reader 1. Only ejection fraction showed a significant difference ( P = .02) for reader 2. Intrareader agreement was considerable for both sequences (bSSFP: mean difference range, +1 to -2.6; maximum CI, +7.9, -13; bias range, 0.1%-4.1%; intraclass correlation coefficient [ICC] range, 0.931-0.997. CS: mean difference range, +7.4 to -5.6; maximum CI, +37.2, -48.8; bias range, 0.5%-7.5%; ICC range, 0.717-0.997). Interreader agreement was acceptable but less robust, especially for CS (bSSFP: mean difference range, +2.6 to -5.6; maximum CI, +60.7, -65.3; bias range, 1.6%-6.2%; ICC range, 0.726-0.951. CS: mean difference range, +10.7 to -9.1; maximum CI, +87.5, -84.6; bias range, 1.1%-17.3%; ICC range, 0.509-0.849). The mean acquisition time was shorter for CS (20 seconds; range, 17-25 seconds) compared with that for bSSFP (160 seconds; range, 130-190 seconds) ( P < .001)., Conclusion: CS cardiac cine imaging provided equivalent ventricular volume and function measurements with shorter acquisition times compared with those of bSSFP and may prove suitable for the pediatric population. Keywords: Compressed Sensing, Balanced Steady-State Free Precession, Cine Imaging, Cardiovascular MRI, Pediatrics, Cardiac, Heart, Cardiomyopathies, Congenital, Segmentation© RSNA, 2022., Competing Interests: Disclosures of conflicts of interest: D. Curione No relevant relationships. P. Ciliberti No relevant relationships. C.B.M. No relevant relationships. D. Capra No relevant relationships. V.B. No relevant relationships. P. Ciancarella No relevant relationships. T.P.S. No relevant relationships. C.N. No relevant relationships. D.F. No relevant relationships. M.A.P. No relevant relationships. F.S. No relevant relationships. A.S. No relevant relationships., (© 2022 by the Radiological Society of North America, Inc.)

In this study, we aimed to quantify LGE and edema at short-tau inversion recovery sequences on cardiac magnetic resonance (CMR) in patients with myocarditis. We retrospectively evaluated CMR examinations performed during the acute phase and at follow-up. Forty-seven patients were eligible for retrospective LGE assessment, and, among them, twenty-five patients were eligible for edema evaluation. Both groups were paired with age- and sex-matched controls. The median left ventricle LGE was 6.4% (interquartile range 5.0−9.2%) at the acute phase, 4.4% (3.3−7.2%) at follow-up, and 4.3% (3.0−5.3%) in controls, the acute phase being higher than both follow-up and controls (p < 0.001 for both), while follow-up and controls did not differ (p = 0.139). An optimal threshold of 5.0% was obtained for LGE with 87% sensitivity and 48% specificity; the positive likelihood ratio (LR) was 1.67, and the negative LR was 0.27. Edema was 12.8% (9.4−18.1%) at the acute phase, 7.3% (5.5−8.8%) at follow-up, and 6.7% (5.6−8.6%) in controls, the acute phase being higher than both follow-up and controls (both p < 0.001), while follow-up and controls did not differ (p = 0.900). An optimal threshold of 9.5% was obtained for edema with a sensitivity of 76% and a specificity of 88%; the positive LR was 6.33, and the negative LR was 0.27. LGE and edema thresholds are useful in cases of suspected mild myocarditis.

Mammographic breast density (BD) is commonly visually assessed using the Breast Imaging Reporting and Data System (BI-RADS) four-category scale. To overcome inter- and intraobserver variability of visual assessment, the authors retrospectively developed and externally validated a software for BD classification based on convolutional neural networks from mammograms obtained between 2017 and 2020. The tool was trained using the majority BD category determined by seven board-certified radiologists who independently visually assessed 760 mediolateral oblique (MLO) images in 380 women (mean age, 57 years ± 6 [SD]) from center 1; this process mimicked training from a consensus of several human readers. External validation of the model was performed by the three radiologists whose BD assessment was closest to the majority (consensus) of the initial seven on a dataset of 384 MLO images in 197 women (mean age, 56 years ± 13) obtained from center 2. The model achieved an accuracy of 89.3% in distinguishing BI-RADS a or b (nondense breasts) versus c or d (dense breasts) categories, with an agreement of 90.4% (178 of 197 mammograms) and a reliability of 0.807 (Cohen κ) compared with the mode of the three readers. This study demonstrates accuracy and reliability of a fully automated software for BD classification. Keywords: Mammography, Breast, Convolutional Neural Network (CNN), Deep Learning Algorithms, Machine Learning Algorithms Supplemental material is available for this article. © RSNA, 2022., Competing Interests: Disclosures of conflicts of interest: V.M. No relevant relationships. M.I. CTO and employee of DeepTrace Technologies. DeepTrace Technologies is a spin-off of Scuola Universitaria Superiore IUSS, Pavia, Italy; shareholder in DeepTrace Technologies. A.C. No relevant relationships. M.A. Scientific advisor for Bracco Imaging. C.S. CEO of DeepTrace Technologies. DeepTrace Technologies is a spin-off of Scuola Universitaria Superiore IUSS, Pavia, Italy; shareholder in DeepTrace Technologies. A.A.A. No relevant relationships. D.C. No relevant relationships. S.C. No relevant relationships. G.D.P. No relevant relationships. D.F. No relevant relationships. G.G. No relevant relationships. C.B.M. No relevant relationships. G.M. No relevant relationships. G.P. No relevant relationships. S.S. Honoraria for lectures from GE Healthcare; support for attending meetings/travel from GE Healthcare. I.C. Shareholder in DeepTrace Technologies. S.P. No relevant relationships. F.S. Member of Scientific Advisory Board for DeepTrace Technologies., (2022 by the Radiological Society of North America, Inc.)

Background: We investigated the radiodensity of epicardial (EAT), subcutaneous (SAT), and visceral adipose tissue (VAT) before and after treatment with anthracyclines in a population of breast cancer (BC) patients, and in controls not treated with anthracyclines, to detect a potential role of EAT density as a biomarker of changes related to chemotherapy cardiotoxicity., Methods: We reviewed BC patients treated with anthracyclines who underwent CT before (CT-t 0 ) and after (CT-t 1 ) chemotherapy, and age- and sex-matched controls who underwent two CT examinations at comparable intervals. On non-contrast scans, EAT was segmented contouring the pericardium and thresholding between -190 and -30 Hounsfield units (HU), and SAT and VAT were segmented with two 15-mm diameter regions of interest thresholded between -195 and -45 HU., Results: Thirty-two female patients and 32 controls were included. There were no differences in age (p = 0.439) and follow-up duration (p = 0.162) between patients and controls. Between CT-t 0 and CT-t 1 , EAT density decreased in BC patients (-66 HU, interquartile range [IQR] -71 to -63 HU, to -71 HU, IQR -75 to -66 HU, p = 0.003), while it did not vary in controls (p = 0.955). SAT density increased from CT-t 0 to CT-t 1 in BC patients (-107 HU, IQR -111 to -105 HU, to -105 HU, IQR -110 to -100 HU, p = 0.014), whereas it did not change in controls (p = 0.477). VAT density did not vary in either BC patients (p = 0.911) or controls (p = 0.627)., Conclusions: EAT density appears to be influenced by anthracycline treatment for BC, well known for its cardiotoxicity, shifting towards lower values indicative of a less active metabolism., (© 2021. The Author(s).)

Background: We applied an artificial intelligence-based model to predict fragility fractures in postmenopausal women, using different dual-energy x-ray absorptiometry (DXA) parameters., Methods: One hundred seventy-four postmenopausal women without vertebral fractures (VFs) at baseline (mean age 66.3 ± 9.8) were retrospectively evaluated. Data has been collected from September 2010 to August 2018. All subjects performed a spine x-ray to assess VFs, together with lumbar and femoral DXA for bone mineral density (BMD) and the bone strain index (BSI) evaluation. Follow-up exams were performed after 3.34 ± 1.91 years. Considering the occurrence of new VFs at follow-up, two groups were created: fractured versus not-fractured. We applied an artificial neural network (ANN) analysis with a predictive tool (TWIST system) to select relevant input data from a list of 13 variables including BMD and BSI. A semantic connectivity map was built to analyse the connections among variables within the groups. For group comparisons, an independent-samples t-test was used; variables were expressed as mean ± standard deviation., Results: For each patient, we evaluated a total of n = 6 exams. At follow-up, n = 69 (39.6%) women developed a VF. ANNs reached a predictive accuracy of 79.56% within the training testing procedure, with a sensitivity of 80.93% and a specificity of 78.18%. The semantic connectivity map showed that a low BSI at the total femur is connected to the absence of VFs., Conclusion: We found a high performance of ANN analysis in predicting the occurrence of VFs. Femoral BSI appears as a useful DXA index to identify patients at lower risk for lumbar VFs., (© 2021. The Author(s).)

Purpose: The aim of our work was to systematically review and meta-analyze epicardial adipose tissue (EAT) density values reported in literature, assessing potential correlations of EAT density with segmentation thresholds and other technical and clinical variables., Method: A systematic search was performed, aiming for papers reporting global EAT density values in Hounsfield Units (HU) in patients undergoing chest CT for any clinical indication. After screening titles, abstract and full text of each retrieved work, studies reporting mean and standard deviation for EAT density were ultimately included. Technical, clinical and EAT data were extracted, and divided into subgroups according to clinical conditions of reported subjects. Pooled density analyses were performed both overall and for subgroups according to clinical conditions. Metaregression analyses were done to appraise the impact of clinical and technical variables on EAT volume., Results: Out of 152 initially retrieved works, 13 were ultimately included, totaling for 7683 subjects. EAT density showed an overall pooled value of -85.86 HU (95% confidence interval [95% CI] -91.84, -79.89 HU), being -86.40 HU (95% CI -112.69, -60.12 HU) in healthy subjects and -80.71 HU (95% CI -87.43, -73.99 HU) in patients with coronary artery disease. EAT volume and lower and higher segmentation thresholds were found to be significantly correlated with EAT density (p = 0.044, p < 0.001 and p< 0.001 respectively)., Conclusions: Patients with coronary artery disease appear to present with higher EAT density values, while the correlations observed at metaregression highlight the need for well-established, shared thresholds for EAT segmentation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The purpose of this study was to evaluate the level of agreement between flow/velocity data obtained from 2D-phase-contrast (PC) and 4D-flow in patients scheduled for treatment of carotid artery stenosis. Image acquisition was performed using a 1.5 T scanner. We compared mean flow rates, vessel areas, and peak velocities obtained during the acquisition with both techniques in 20 consecutive patients, 15 males and 5 females aged 69 ± 5 years (mean ± standard deviation). There was a good correlation between both techniques for the CCA flow ( r = 0.65, p < 0.001), whereas for the ICA flow and ECA flow the correlation was only moderate ( r = 0.4, p = 0.011 and r = 0.45, p = 0.003, respectively). Correlations of peak velocities between methods were good for CCA ( r = 0.56, p < 0.001) and moderate for ECA ( r = 0.41, p = 0.008). There was no correlation for ICA ( r = 0.04, p = 0.805). Cross-sectional area values between methods showed no significant correlations for CCA ( r = 0.18, p = 0.269), ICA ( r = 0.1, p = 0.543), and ECA ( r = 0.05, p = 0.767). Conclusion: the 4D-flow imaging provided a good correlation of CCA and a moderate correlation of ICA flow rates against 2D-PC, underestimating peak velocities and overestimating cross-sectional areas in all carotid segments.

Objectives: To assess changes in working patterns and education experienced by radiology residents in Northwest Italy during the COVID-19 pandemic., Methods: An online questionnaire was sent to residents of 9 postgraduate schools in Lombardy and Piedmont, investigating demographics, changes in radiological workload, involvement in COVID-19-related activities, research, distance learning, COVID-19 contacts and infection, changes in training profile, and impact on psychological wellbeing. Descriptive and χ 2 statistics were used., Results: Among 373 residents invited, 300 (80%) participated. Between March and April 2020, 44% (133/300) of respondents dedicated their full time to radiology; 41% (124/300) engaged in COVID-19-related activities, 73% (90/124) of whom working in COVID-19 wards; 40% (121/300) dedicated > 25% of time to distance learning; and 66% (199/300) were more involved in research activities than before the pandemic. Over half of residents (57%, 171/300) had contacts with COVID-19-positive subjects, 5% (14/300) were infected, and 8% (23/300) lost a loved one due to COVID-19. Only 1% (3/300) of residents stated that, given the implications of this pandemic scenario, they would not have chosen radiology as their specialty, whereas 7% (22/300) would change their subspecialty. The most common concerns were spreading the infection to their loved ones (30%, 91/300), and becoming sick (7%, 21/300). Positive changes were also noted, such as being more willing to cooperate with other colleagues (36%, 109/300)., Conclusions: The COVID-19 pandemic changed radiology residents' training programmes, with distance learning, engaging in COVID-19-related activities, and a greater involvement in research becoming part of their everyday practice., Key Points: • Of 300 participants, 44% were fully dedicated to radiological activity and 41% devoted time to COVID-19-related activities, 73% of whom to COVID-19 wards. • Distance learning was substantial for 40% of residents, and 66% were involved in research activities more than before the COVID-19 pandemic. • Over half of residents were exposed to COVID-19 contacts and less than one in twenty was infected., (© 2021. The Author(s).)

Background: Breast arterial calcifications (BAC), representing Mönckeberg's sclerosis of the tunica media of breast arteries, are an imaging biomarker for cardiovascular risk stratification in the female population. Our aim was to estimate the intra- and inter-reader reproducibility of a semiquantitative score for BAC assessment (BAC-SS)., Methods: Consecutive women who underwent screening mammography at our center from January 1 st to January 31 st , 2018 were retrieved and included according to BAC presence. Two readers (R1 and R2) independently applied the BAC-SS to medio-lateral oblique views, obtaining a BAC score by summing: (I) number of calcified vessels (from 0 to n); (II) vessel opacification, i.e., the degree of artery coverage by calcium bright pixels (0 or 1); and (III) length class of calcified vessels (from 0 to 4). R1 repeated the assessment 2 weeks later. Scoring time was recorded. Cohen's κ statistics and Bland-Altman analysis were used., Results: Among 408 women, 57 (14%) had BAC; 114 medio-lateral oblique views were assessed. Median BAC score was 4 [interquartile range (IQR): 3-6] for R1 and 4 (IQR: 2-6) for R2 (P=0.417) while median scoring time was 156 s (IQR: 99-314 s) for R1 and 191 s (IQR: 137-292 s) for R2 (P=0.743). Bland-Altman analysis showed a 77% intra-reader reproducibility [bias: 0.193, coefficient of repeatability (CoR): 0.955] and a 64% inter-reader reproducibility (bias: 0.211, CoR: 1.516). Cohen's κ for BAC presence was 0.968 for intra-reader agreement and 0.937 for inter-reader agreement., Conclusions: Our BAC-SS has a good intra- and inter-reader reproducibility, within acceptable scoring times. A large-scale study is warranted to test its ability to stratify cardiovascular risk in women., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-560). FS has received research grants from and is member of speakers’ bureau and of advisory group for General Electric, Bayer, and Bracco. The other authors have no conflicts of interest to declare., (2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

We assessed the role of artificial intelligence applied to chest X-rays (CXRs) in supporting the diagnosis of COVID-19. We trained and cross-validated a model with an ensemble of 10 convolutional neural networks with CXRs of 98 COVID-19 patients, 88 community-acquired pneumonia (CAP) patients, and 98 subjects without either COVID-19 or CAP, collected in two Italian hospitals. The system was tested on two independent cohorts, namely, 148 patients (COVID-19, CAP, or negative) collected by one of the two hospitals (independent testing I) and 820 COVID-19 patients collected by a multicenter study (independent testing II). On the training and cross-validation dataset, sensitivity, specificity, and area under the curve (AUC) were 0.91, 0.87, and 0.93 for COVID-19 versus negative subjects, 0.85, 0.82, and 0.94 for COVID-19 versus CAP. On the independent testing I, sensitivity, specificity, and AUC were 0.98, 0.88, and 0.98 for COVID-19 versus negative subjects, 0.97, 0.96, and 0.98 for COVID-19 versus CAP. On the independent testing II, the system correctly diagnosed 652 COVID-19 patients versus negative subjects (0.80 sensitivity) and correctly differentiated 674 COVID-19 versus CAP patients (0.82 sensitivity). This system appears promising for the diagnosis and differential diagnosis of COVID-19, showing its potential as a second opinion tool in conditions of the variable prevalence of different types of infectious pneumonia.

Purpose: The aim of this study is to review the literature concerning myocardial late gadolinium enhancement (LGE) with cardiac magnetic resonance in patients with Tetralogy of Fallot (ToF), with regards to its prevalence, characteristics and clinical relevance., Methods: We performed a systematic search, aiming to retrieve original articles that evaluated LGE in ToF, running a search string on MEDLINE and EMBASE in November 2019 and November 2020. Papers were then selected by two independent, blinded readers based on title and abstract, and then on full-text reading, and articles which did not include LGE evaluation were excluded. From each included paper two readers extracted descriptive data concerning technical parameters of LGE acquisition, LGE description and clinical significance., Results: 18 articles were eventually included in our review. The included studies observed that a higher amount of right ventricular LGE relates with higher right ventricular volumes, lower ejection fraction and a higher pulmonary regurgitant fraction, thus acting as a marker of progressive impairment of myocardial function. Moreover, LGE in ToF patients correlated with the onset of arrhythmias, and with serum biomarkers indicative of myocardial stress and fibrosis., Conclusions: LGE could be used in the follow-up repaired ToF patients as its appraisal can provide information concerning cardiac dysfunction. Moreover, it may be ideal to aim towards a common framework for standardizing assessment and quantification of LGE in ToF patients., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Adipose tissue, in particular epicardial adipose tissue, has been identified as a potential biomarker of cardiovascular pathologies such as coronary artery disease (CAD) in the light of its metabolic activity and close anatomic and pathophysiologic relationship to the heart. Our purpose was to evaluate epicardial adipose tissue density at both unenhanced and contrast-enhanced computed tomography (CT), along with CT densities of paracardiac and subcutaneous adipose tissue, as well as the relations of such densities with CAD. We retrospectively reviewed patients who underwent cardiac CT at our institution for CAD assessment. We segmented regions of interest on epicardial, paracardiac, and subcutaneous adipose tissue on unenhanced and contrast-enhanced scans. A total of 480 patients were included, 164 of them presenting with CAD. Median epicardial adipose tissue density measured on contrast-enhanced scans (-81.5 HU; interquartile range -84.9 to -78.0) was higher than that measured on unenhanced scans (-73.4 HU; -76.9 to -69.4) ( p < 0.001), whereas paracardiac and subcutaneous adipose tissue densities were not ( p ≥ 0.055). Patients with or without CAD, did not show significant differences in density of epicardial, paracardiac, and subcutaneous adipose tissue either on unenhanced or contrast-enhanced scans ( p ≥ 0.092). CAD patients may experience different phenomena (inflammation, fibrosis, increase in adipose depots) leading to rises or drops in epicardial adipose tissue density, resulting in variations that are difficult to detect.

Objectives: To investigate the knowledge of radiologists on breast arterial calcifications (BAC) and attitude about BAC reporting, communication to women, and subsequent action., Methods: An online survey was offered to EUSOBI members, with 17 questions focused on demographics, level of experience, clinical setting, awareness of BAC association with cardiovascular risk, mammographic reporting, modality of BAC assessment, and action habits. Descriptive statistics were used., Results: Among 1084 EUSOBI members, 378 (34.9%) responded to the survey, 361/378 (95.5%) radiologists, 263 females (69.6%), 112 males (29.6%), and 3 (0.8%) who did not specify their gender. Of 378 respondents, 305 (80.7%) declared to be aware of BAC meaning in terms of cardiovascular risk and 234 (61.9%) to routinely include BAC in mammogram reports, when detected. Excluding one inconsistent answer, simple annotation of BAC presence was declared by 151/233 (64.8%), distinction between low versus extensive BAC burden by 59/233 (25.3%), and usage of an ordinal scale by 22/233 (9.5%) and of a cardinal scale by 1/233 (0.4%). Among these 233 radiologists reporting BAC, 106 (45.5%) declared to orally inform the woman and, in case of severe BAC burden, 103 (44.2%) to investigate cardiovascular history, and 92 (39.5%) to refer the woman to a cardiologist., Conclusion: Among EUSOBI respondents, over 80% declared to be aware of BAC cardiovascular meaning and over 60% to include BAC in the report. Qualitative BAC assessment predominates. About 40% of respondents who report on BAC, in the case of severe BAC burden, investigate cardiovascular history and/or refer the woman to a cardiologist., Key Points: • Of 1084 EUSOBI members, 378 (35%) participated: 81% of respondents are aware of breast arterial calcification (BAC) cardiovascular meaning and 62% include BAC in the mammogram report. • Of those reporting BAC, description of presence was declared by 65%, low versus extensive burden distinction by 25%, usage of an ordinal scale by 10%, and of a cardinal scale by 0.4%; 46% inform the woman and, in case of severe BAC burden, 44% examine cardiovascular history, and 40% refer her to a cardiologist. • European breast radiologists may be ready for large-scale studies to ascertain the role of BAC assessment in the comprehensive framework of female cardiovascular disease prevention.

Objectives: We aimed to assess extracellular volume (ECV) through non-gated, contrast-enhanced computed tomography (CT) before and after radiation therapy (RT) in patients with esophageal cancer (EC)., Materials and Methods: EC patients who had undergone CT before and after RT were retrospectively assessed. Patients with preexisting cardiovascular disease or with heavily artifacted CT were excluded. ECV was calculated using density values for the myocardial septum and blood pool. Data were reported as mean and standard deviation or median and interquartile range according to their distribution; t test or Wilcoxon and Pearson r or Spearman ρ were subsequently used., Results: Twenty-one patients with stage ≥ IB EC, aged 64 ± 18 years, were included. Mean and maximum RT doses were 21.2 Gy (16.9-24.1) and 42.5 Gy (41.8-49.2), respectively. At baseline (n = 21), hematocrit was 39% ± 4%, ECV 27.9% ± 3.5%; 35 days (30-38) after RT (n = 20), hematocrit was 36% ± 4%, lower than at baseline (p = 0.002), ECV 30.3% ± 8.3%, higher than at baseline (p = 0.081); at follow-up 420 days (244-624) after RT (n = 13), hematocrit was 36% ± 5%, lower than at baseline (p = 0.030), ECV 31.4% ± 4.5%, higher than at baseline (p = 0.011). No patients showed signs of overt cardiotoxicity. ECV early after RT was moderately positively correlated with maximum RT dose (ρ = 0.50, p = 0.036)., Conclusions: In EC patients, CT-derived myocardial ECV was increased after RT and may thus appear as a potential early biomarker of cardiotoxicity.

Aims: Carotid intima-media thickness (CIMT) is used increasingly as an imaging biomarker of cardiovascular risk (CVR). Our aim was to compare semiautomatic CIMT (sCIMT) versus manual CIMT (mCIMT) for reproducibility and prediction of CVR., Materials and Methods: Two independent readers measured sCIMT and mCIMT on previously acquired images of the right common carotid artery of 200 consecutive patients. Measurements were performed twice, four weeks apart; sCIMT was reported along with an image quality index (IQI) provided by the software. CVR stratification was compared for thresholds established by mCIMT studies, adapted for sCIMT according to a regression model., Results: sCIMT (median 0.67 mm, interquartile range [IQR] 0.57‒0.76 mm) was significantly lower (p<0.001) than mCIMT (median 0.76 mm, IQR 0.63‒0.84 mm; ρ=0.832, p<0.001, slope 0.714, intercept 0.124). Overall, intra-reader reproducibility was 76% for sCIMT and 83% for mCIMT (p=0.002), inter-reader reproducibility 75% and 76%, respectively (p=0.316). In 129 cases with IQI≥0.65, reproducibility was significantly higher (p≤0.004) for sCIMT than for mCIMT (intra-reader 85% versus 83%, inter-reader 80% versus 77%,). The agreement between sCIMT and mCIMT for CVR stratification was fair both overall (κ=0.270) and for IQI≥0.65 (κ=0.345), crude concordance being 79% and 88%, respectively., Conclusions: Reproducibility of sCIMT was not higher than mCIMT overall but sCIMT was significantly more reproducible than mCIMT for high-IQI cases. sCIMT cannot be used for CVR stratification due to fair concordance with mCIMT, even for high IQI. More research is required to improve image quality and define sCIMT-based thresholds for stratification of CVR.

Purpose: To assess right ventricular (RV) myocardial strain both globally and segmentally through feature-tracking cardiac magnetic resonance (CMR) in patients with Tetralogy of Fallot (ToF), with regards to pulmonary valve replacement (PVR)., Methods: After Ethics Committee approval, we retrospectively included 46 consecutive ToF patients who had two CMR examinations performed at our institution between March 2014 and June 2019. We divided patients into those who had not undergone PVR between the two CMR examinations (Group-0), and those who had (Group-1). Ventricular volumes were quantified on cine sequences, and strain was calculated through feature-tracking, using the previously traced segmentations. RV longitudinal and radial strain were assessed both globally and separately for the septum and free wall. Variations were normalized for intercurrent years, differences were appraised with t-tests or Mann-Whitney U., Results: 30 patients belonged to Group-0 and 16 to Group-1. Median age was 22 years (interquartile range [IQR] 17-29 years) in Group-0, and 21 years (IQR 16-29 years) in Group-1. No significant differences were reported in RV strain between groups (p ≥ 0.254) except for RV septal radial strain, significantly higher (p = 0.010) in Group-0 (24.2 %, IQR 10.1-52.4 %) than in Group-1 (6.0 %, IQR -3.3-23.3 %) at the second CMR. Both global and segmental RV strains decreased over time in both groups, and yearly variations did not differ significantly (p ≥ 0.081) between groups., Conclusions: While PVR performed at the appropriate timing eases the burden on the RV allowing for a reduction in volumes, RV strain seems to continuously deteriorate as in patients who do not undergo PVR., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Recent studies have suggested the neuroinvasive potential of severe acute respiratory coronavirus 2 (SARS-CoV-2). Notably, neuroinvasiveness might be involved in the pathophysiology of coronavirus disease 2019 (COVID-19). Some studies have demonstrated that synapse-connected routes may enable coronaviruses to access the central nervous system (CNS). However, evidence related to the presence of SARS-CoV-2 in the CNS, its direct impact on the CNS, and the contribution to symptoms suffered, remain sparse. Here, we review the current literature that indicates that SARS-CoV-2 can invade the nervous system. We also describe the neural circuits that are potentially affected by the virus and their possible role in the progress of COVID-19. In addition, we propose several strategies to understand, diagnose, and treat the neurological symptoms of COVID-19., (Copyright © 2020 DosSantos, Devalle, Aran, Capra, Roque, Coelho-Aguiar, Spohr, Subilhaga, Pereira, D'Andrea Meira, Niemeyer Soares Filho and Moura-Neto.)

In this paper the authors present the results of a dosimetric analysis related to the exposure of live-line workers to the magnetic fields generated by high voltage overhead lines and substations. The study extends the work published by Dawson et al. in 2002, considering more evolved anatomical models nowadays available, the new reference limits given by the 2013/35/EU Directive, and a new methodology, based on the intercomparison of two alternative solvers and the use of data filtering. Moreover, additional exposure scenarios are here considered with respect to the studies already available in literature. The results show that for the exposure scenario of high voltage live line works with bare hand method, in any analyzed position, the exposure limits for the tissues of the central nervous system, as well as for all other tissues, are never exceeded, despite in some cases the action levels are exceeded. For the exposure of workers in substations near 220 kV and 380 kV line trap coils exposure is compliant with the regulatory limits if the current flowing through the line trap does not exceed the value of 1000 A. Finally, for the exposure of workers in substations near cable connections, electric field values induced in the body are always lower than regulatory limits with a phase current value equal to 1600 A r.m.s.