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Color correction is an important methodology where a digital image's colors undergo a transformation to more accurately represent their appearance using a predefined set of illumination conditions. Colorimetric measurements in diagnostics are sensitive to very small changes in colors and therefore require consistent, reproducible illumination conditions to produce accurate results, making color correction a necessity. This paper presents an image color correction pipeline developed by HueDx, Inc., using transfer algorithms that improve upon existing methodologies and demonstrates real-world applications of this pipeline in colorimetric clinical chemistry using a smartphone enabled, paper-based total protein diagnostic assay. Our pipeline is able to compensate for a variety of illumination conditions to provide consistent imaging for quantitative colorimetric measurements using white-balancing, multivariate gaussian distributions and histogram regression via dynamic, non-linear interpolating lookup tables. We empirically demonstrate that each point in the color correction pipeline provides a theoretical basis for achieving consistent and precise color correction. To show this, we measure color difference with deltaE (ΔE00), alongside quantifying performance of the HueDx color correction system, including the phone hardware, color sticker manufacturing quality and software correction capabilities. The results show that the HueDx color correction system is capable of restoring images to near-imperceptible levels of difference independent of their original illumination conditions including brightness and color temperature. Comparisons drawn from the paper-based total protein assay calibrated and quantified with and without using the HueDx color correction pipeline show that the coefficient of variation in precision testing is almost twice as high without color-correcting. Limits of blank, detection and quantitation were also higher without color-correction. Overall, we were able to demonstrate the HueDx platform improves reading and outcome of the total protein diagnostic assay and is useful for the development of smartphone-based quantitative colorimetric diagnostic assays for point-of-care testing., Competing Interests: Financial support for the development of this product was provided by HueDx,Inc., an early-stage venture-capital-backed company. All authors are employees of the company. The HueDx system, consisting of the color correction pipeline, HueCard(with custom sticker) and HueTools are commercially marketed products. Code for the color correction pipeline cannot be made available publicly due to legal restrictions., (Copyright: © 2024 Menon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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

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

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

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

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

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

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

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

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

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

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

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

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

Many ranking algorithms and metrics have been proposed to identify high-impact papers. Both the direct citation counts and the network-based PageRank-like algorithms are commonly used. Ideally, the more complete the data on the citation network, the more informative the ranking. However, obtaining more data on citation relations is often costly and challenging. In some cases, obtaining the citation counts can be relatively simple. In this paper, we look into using the additional citation counts but without additional citation relations to form more informative metrics for identifying high-impact papers. As an example, we propose enhancing the original PageRank algorithm by combining the local citation network with the additional citation counts from a more complete data source. We apply this enhanced method to American Physical Society (APS) papers to verify its effectiveness. The results indicate that the proposed ranking algorithm is robust against missing data and can improve the identification of high-quality papers. This shows that it is possible to enhance the effectiveness of a network-based metric calculated on a relatively small citation network by including only the additional data of the citation counts, without the additional citation relations. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

We study the effects of ambient air humidity on the dynamics of imbibition in a paper. We observed that a quick increase of ambient air humidity leads to depinning and non-Washburn motion of wetting fronts. Specifically, we found that after depinning the wetting front moves with decreasing velocity v[proportionality](h(p)/h(D))(γ), where h(D) is the front elevation with respect to its pinned position at lower humidity h(p), while γ=/~1/3. The spatiotemporal maps of depinned front activity are established. The front motion is controlled by the dynamics of local avalanches directed at 30° to the balk flow direction. Although the roughness of the pinned wetting front is self-affine and the avalanche size distribution displays a power-law asymptotic, the roughness of the moving front becomes multiaffine a few minutes after depinning.

Good cross-directional control of sheet variables in a paper machine depends on a number of factors. One such factor is the correct alignment of actuators with their corresponding responses. The alignment changes with time either locally or across the whole paper sheet due to a variety of reasons. In this paper, we provide an online mapping technique based on estimating the cross-correlation between actuator movement and the measurements. This procedure involves two steps-in the first step (called alignment monitoring) we determine if the current mapping is wrong at any CD position, and in the second step (called re-mapping), the alignment of actuators is corrected. The main advantage of this method is in its ability to re-align under closed loop conditions with minimal operational disruption.

We explore the application of terahertz spectroscopic techniques for the remote determination of the water content of paper. The aim is the development of a rapid diagnostic imaging tool applicable in paper fabrication processes. THz radiation offers a high sensitivity for water, a good spatial resolution, and insensitivity to scattering at the paper surface. The advent of THz cameras makes fast large-area image detectors feasible. In this paper, we show for the case of a 0.6-THz fixed-frequency system, that the water content of paper can be determined with high accuracy. We demonstrate a quantitative (calibrated) method for determining the moisture content in paper based on extinction and phase measurements in the lower THz range with a spatial resolution in the mm-range and scanning times below two minutes.

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

The ACR Incidental Findings Committee presents recommendations for managing pituitary findings that are incidentally detected on CT, MRI and 18 F-fluorodeoxyglucose PET. The Pituitary Subcommittee, which included radiologists practicing neuroradiology and an endocrinologist, developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches successively categorize pituitary findings on the basis of imaging features. They terminate with an ascertainment of an indolent lesion (with sufficient confidence to discontinue follow-up) or a management recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected pituitary findings., (Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

In this paper, we propose an end-to-end approach to addressing QRS complex detection and measurement of Electrocardiograph (ECG) paper using convolutional neural networks (CNNs). Unlike conventional detection solutions that convert images to digital data, our method can directly detect QRS complex in images using Faster-RCNN, then the R-peak can be located and measured through a CNN. Validated by clinical ECG data in the St.-Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database and real ECG paper from Peking University People's Hospital, the proposed method can achieve the recall of 98.32%, the precision of 99.01% in detecting and 0.012 mv of mean absolute error in measuring. Experimental results demonstrate the superior performance of our method over conventional solutions, which would pave the way to detect and measure ECG paper using CNNs.

Quantifying the impact of a scholarly paper is of great significance, yet the effect of geographical distance of cited papers has not been explored. In this paper, we examine 30,596 papers published in Physical Review C, and identify the relationship between citations and geographical distances between author affiliations. Subsequently, a relative citation weight is applied to assess the impact of a scholarly paper. A higher-order weighted quantum PageRank algorithm is also developed to address the behavior of multiple step citation flow. Capturing the citation dynamics with higher-order dependencies reveals the actual impact of papers, including necessary self-citations that are sometimes excluded in prior studies. Quantum PageRank is utilized in this paper to help differentiating nodes whose PageRank values are identical.

Conservative activism around the purported influence of Critical Race Theory (CRT) on K-12 education has swept the country in recent years. While others have documented the sources of these messages, how school districts have responded to these critiques has not yet been investigated. Drawing on research on how social media algorithms elevate polarizing information and activate emotions, we analyze public social media posts on school/district Facebook pages mentioning the phrase "critical race" to examine how educators address the claim of teaching CRT and how the local community responds. We use sentiment analysis to examine the emotions of these posts and how they are distributed across states. We also explore the sentiment of subsequent community reactions reflected in the comments of each post, including negative emotions such as anger and fear, and positive emotions such as trust. This study has implications for how school districts can help to stop cycles of fearful rhetoric and engage with stakeholders in ways that unite a school community around shared priorities.

Extracorporeal life support systems (ECLS) are life-sustaining measures for severe cardiovascular diseases, serving as bridging treatment either until cardiovascular function is restored or alternative treatment, such as heart transplantation or the implantation of permanent ventricular assist devices is performed. Given the insufficient evidence and frequent urgency of implantation without initial patient consent, the ethical challenges and psychological burden for patients, relatives and the interprofessional intensive care team are significant. As with any treatment, an appropriate therapeutic goal for ECLS treatment based on the indications and patient informed consent is mandatory. In order to integrate the necessary ethical considerations into everyday clinical practice, a structured algorithm for handling ECLS is proposed here, which takes ethical aspects into due account. [ABSTRACT FROM AUTHOR]

Background: In naturally occurring numbers the frequencies of digits 1-9 in the leading position are counterintuitively distributed because the frequencies of occurrence are unequal. Benford-Newcomb's law describes the expected distribution of these frequencies. It was previously shown that known fraudulent articles consistently violated this law., Objective: To compare the features of 12 known fraudulent articles from a single Japanese author to the features of 13 articles in the same research field from other Japanese authors, published during the same time period and identified with a Medline database search., Results: All 25 articles were assessed to determine whether the data violated the law. Formulas provided by the law were used to determine the frequencies of occurrence for the first two leading digits in manually extracted numbers. It was found that all the known fraudulent papers violated the law and 6 of the 13 articles used for comparison followed the law. Assuming that the articles in the comparison group were not falsified or fabricated, the sensitivity of assessing articles with Benford-Newcomb's law was 100% (95% confidence interval CI: 73.54-100%) but the specificity was only 46.15% (95% CI: 19.22-74.87%) and the positive predictive value was 63.16% (95% CI: 38.36-83.71%)., Conclusion: All 12 of the known falsified articles violated Benford-Newcomb's law, which indicated that this analysis had a high sensitivity. The low specificity of the assessment may be explained by the assumptions made about the articles identified for comparison. Violations of Benford-Newcomb's law about the frequencies of the leading digits cannot serve as proof of falsification but they may provide a basis for deeper discussions between the editor and author about a submitted work.