Search

• Vaccine coverage and timeliness were low among children in Matiari, Pakistan. • 48.4 % of the children were fully vaccinated with all EPI antigens. • Majority of the doses were delayed, only 21.2 % received all doses on time. • Parents' education and study year were protective against missed vaccination. • Geographical road distance was predictive of untimely vaccination. Pakistan has a well-established Expanded Program on Immunization (EPI) however vaccine-preventable diseases still account for high infant and child mortality rates. This study describes the differential vaccine coverage and determinants of vaccine uptake in rural Pakistan. From October 2014 to September 2018, we enrolled children younger than 2 years of age from the Matiari Demographic Surveillance System in Sindh, Pakistan. Socio-demographic and vaccination history were collected from all participants. Vaccine coverage rates and timeliness were reported. Socio-demographic variables for missed and untimely vaccination were studied in multivariable logistic regression. Of the 3140 enrolled children, 48.4 % received all EPI recommended vaccines. Only 21.2 % of these were age appropriate. Around 45.4 % of the children were partially vaccinated, and 6.2 % were unvaccinated. Highest coverage was seen for the first dose of pentavalent (72.8 %), 10-valent Pneumococcal Conjugate Vaccine (PCV10) (70.4 %) and Oral Polio Vaccine (OPV) (69.2 %) and the lowest coverage was for measles (29.3 %) and rotavirus (1.8 %) vaccines. Primary caretakers and wage earners with a higher level of education were protective against missed and untimely vaccination. Enrollment in the 2nd, 3rd and 4th study year was negatively associated with being unvaccinated whereas distance from a major road was positively associated with non-adherence to schedule. Vaccine coverage was low among children in Matiari, Pakistan, and majority received delayed doses. Parents' education status and year of study enrollment was protective against vaccine dropout and delayed vaccination whereas geographical distance from a major road was a predictor. Vaccine promotion and outreach efforts may have had a beneficial impact on vaccine coverage and timeliness. [ABSTRACT FROM AUTHOR]

The underperformance of oral vaccines in children of low- and middle-income countries is partly attributable to underlying environmental enteric dysfunction (EED). We conducted a longitudinal, community-based study to evaluate the association of oral rotavirus vaccine (Rotarix®) seroconversion with growth anthropometrics, EED biomarkers and intestinal enteropathogens in Pakistani infants. Children were enrolled between three to six months of their age based on their nutritional status. We measured serum anti-rotavirus immunoglobulin A (IgA) at enrollment and nine months of age with EED biomarkers and intestinal enteropathogens. A total of 391 infants received two doses of rotavirus (RV) vaccine. 331/391 provided paired blood samples. Of these 331 children, 45% seroconverted at 9 months of age, 35% did not seroconvert and 20% were seropositive at baseline. Non-seroconverted children were more likely to be stunted, wasted and underweight at enrollment. In univariate analysis, insulin-like growth factor (IGF) concentration at 6 months were higher in seroconverters, median (25th, 75th percentile): 26.3 (16.5, 43.5) ng/ml vs. 22.5 (13.6, 36.3) ng/ml for non-seroconverters, p-value = 0.024. At nine months, fecal myeloperoxidase (MPO) concentrations were significantly lower in seroconverters, 3050(1250, 7587) ng/ml vs. 4623.3 (2189, 11650) ng/ml in non-seroconverted children, p-value = 0.017. In multivariable logistic regression analysis, alpha-1 acid glycoprotein (AGP) and IGF-1 concentrations were positively associated with seroconversion at six months. The presence of sapovirus and rotavirus in fecal samples at the time of rotavirus administration, was associated with non-seroconversion and seroconversion, respectively. We detected high baseline RV seropositivity and impaired RV vaccine immunogenicity in this high-risk group of children. Healthy growth, serum IGF-1 and AGP, and fecal shedding of rotavirus were positively associated with RV IgA seroconversion following immunization, whereas the presence of sapovirus was more common in non-seroconverters. Trial registration : Clinical Trials ID: NCT03588013. [ABSTRACT FROM AUTHOR]

Pakistan introduced Ten-valent pneumococcal-conjugate-vaccine PCV10 in 2012 as a 3 + 0 schedule without catch-up. Children <2 years old in Matiari, Sindh provided nasopharyngeal swabs between 2014 and 2018, which were cultured for pneumococcus and serotyped through multiplex PCR at the Aga Khan University Hospital. Carriage rates over time for Vaccine-Type (VT) and Non-VT (NVT) serotypes were used to estimate direct, indirect, total and overall effects of vaccination. Regression analysis was used to determine factors associated with VT carriage. Pneumococcus was detected in 2370/3140 (75%). VT carriage decreased overall, 16.1–9.6% (p-trend <0.001); vaccinated (all 3 doses of PCV10 received) 11.3–8.1% (p-trend 0.031) and unvaccinated (no PCV10 dose received) 17.4–10.3% (p-trend 0.003) with a decline in serotypes 6B, 9V/9A and 19F. Immunization increased from 41.0% to 68.4% (p-trend 0.001). Direct effect of vaccine was 32.8% (95% CI 14.7–47.0%) and indirect effect 44.6%(95% CI 40.6–48.6%). Factors associated with decreased VT colonization were education 1–5 years (aOR 0.7, 95%CI 0.6–1.0), history of difficulty breathing (aOR 0.7, 95%CI 0.5–1.0), exposure to smoke (aOR 0.8, 95% CI 0.6–1.0), child fully immunized (aOR 0.7, 95%CI 0.5–1.0) and enrolled in 3rd (aOR 0.6, 95%CI 0.4–0.8) and 4th (aOR 0.6, 95%CI 0.5–0.9) year of the study whereas history of runny nose (aOR 1.5, 95% CI 1.2–1.9) was positively associated. Decrease in VT pneumococcal carriage in vaccinated and unvaccinated children indicates herd immunity. Sustained increase in vaccine coverage and close long-term surveillance is warranted. [ABSTRACT FROM AUTHOR]

Thermocatalytic conversion of CO 2 into liquid fuels and chemicals is a promising approach to mitigate global warming. Although, the CO 2 conversion and long-chain hydrocarbon selectivity are highly dependent on the choice of metal-oxide promoter, but role of the promoter remains unclear. Herein, the role of MgO as a promoter for an Fe-based catalyst was investigated. Bimetallic Na-FeMgO x catalyst exhibited a high C 5+ yield of 25.1% with a CO 2 conversion of 49.1% at the early stage of the reaction. The presence of MgO facilitates the reduction of Fe oxides and formation of oxygen vacancies by transferring electrons to Fe-based phases. In addition, at the early stage of reaction, the decoration of the Mg oxide surface with nanosized χ-Fe 5 C 2 enhances the C 5+ yield. However, the progressive transformation of MgO to MgCO 3 during CO 2 conversion deactivates the Na-FeMgO x catalyst. A detailed deactivation mechanism is also discussed. [Display omitted] • MgO-promoted Fe 3 O 4 produced a C 5+ yield of 25.1% at a CO 2 conversion of 49.1%. • MgO performed its role as an electronic promoter on Fe 3 O 4 and Fe 5 C 2. • The formation of MgCO 3 suppressed the promotional effect of MgO. • Re-oxidation of Fe 5 C 2 to Fe 3 O 4 during CO 2 conversion was main deactivation mechanism. [ABSTRACT FROM AUTHOR]

[Display omitted] • Highly porous carbon network was derived from zeolitic-imidazole frameworks. • Co-deposition on porous carbon enhanced the catalytic activity. • Co on carbon was electrochemically stable as cathode material during 520 h cycling. Porous carbon wrapped on cobalt catalyst is one of the promising candidates to replace noble metal-based catalysts for ORR. Herein, a porous carbon network (PCN) was obtained by synthesis of zeolitic-imidazole frameworks (ZIF-8) followed by pyrolysis at 1050 ℃ under a nitrogenous atmosphere and the cobalt (Co) was deposited on PCN to obtain Co-PCN by sequential reduction method. The PCN showed a relatively high specific surface area of 806.43 m2/g and decreases to 329.4 m2/g with the introduction of Co contents in PCN. The Co-PCN reveals excellent performance having a current density of 350 mA cm−2 for the ORR at 0.5 V after 20th cycles as a cathode material in rechargeable zinc-air batteries. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fabrication of nickel-cobalt nanocage for oxygen evolution reactions. • Excellent oxygen evolution reaction performance with overpotential of 350 mV. • Synergic effect of cobalt-nickel catalyst improves the conductivity and charge transfer. The development of efficient, eco-friendly, and inexpensive electrocatalysts has become crucial and significant in water-splitting applications. Herein, we developed a nickel-cobalt nanocage (Ni/Co-NC) electrocatalyst via the solvothermal method which can boost the performances towards oxygen evolution reactions (OER) and hydrogen evolution reactions (HER). The Ni/Co-NC reveals significant performance at an onset potential of 350 mV for the OER at a delivered current density of 10 mA cm−2. The significant amount of oxygen vacancies generated by the addition of nickel in cobalt has been verified by XPS and the nanocage structure revealed by TEM and SEM images helps in effective performance for OER/HER. Furthermore, the synergistic effect between various Ni3+/Ni2+ and Co2+ could optimize the performance resulting in a smaller Tafel slope of 70 mV dec−1 for Ni/Co-NC. [ABSTRACT FROM AUTHOR]

[Display omitted] • Polyvinyl alcohol (PVA) based nanofibers were prepared via centrifugal spinning. • Scanning electron microscopy images reveled the diameter of nanofibers. • PVA based nanofibers were antibacterial against S. aureus and E. coli. In this study, three types of nanofibers, i.e. polyvinyl alcohol (PVA), alginate di-aldehyde (ADA)/PVA, and ADA-gelatin (GEL)/PVA, were fabricated via centrifugal spinning. The spinability of ADA was improved by mixing with PVA. Furthermore, GEL and sesame oil were added in the ADA solution to control the degradation kinetics and to improve the viscosity of the solution, respectively. Later, the solution was fed to a rotating spinneret (3000 rpm at 250 °C) which led to the fabrication of nanofibers. The developed nanofibers were loaded with copper-silver (Cu-Ag) doped mesoporous bioactive glass nanoparticles (MBGNs) to provide therapeutic effects (antibacterial effect). Scanning electron microscopy images showed that the nanofiber diameters were 139 ± 62 nm, 258 ± 42 nm, and 281 ± 34 nm, for PVA, ADA/PVA, and ADA-GEL/PVA respectively, with web-like morphology. Fourier transform infrared spectroscopy confirmed the presence of chemical bonds attributed to the ADA, GEL, and PVA components. The results of the inhibition halo test confirmed that the nanofibers (ADA-GEL/PVA & ADA/PVA) exhibit potent antibacterial effect against Staphylococcus aureus and Escherichia coli. [ABSTRACT FROM AUTHOR]

Highlights: [•] Interface for sketch based retrieval from large floor plan repositories. [•] Sketch recognition and graph matching for floor plans retrieval. [•] Integrated system for automatic analysis of Architectural floor plans. [•] Novel pre- and postprocessing methods for the analysis are proposed. [•] Improved overall detection rate and recognition accuracy over SotA systems. [ABSTRACT FROM AUTHOR]

[Display omitted] • Nanosized Ag@Co 3 O 4 nanoflower were synthesized by chemical deposition. • Small crystallite size and silver deposition enhanced electrochemical performance. • Highly stability upto 500 h with lower overpotential. The studies of core–shell nanoparticles have gained significant interests due to the high stability and probable template to form a core–shell complex by coating on them with organic or inorganic substances. The silica nanoparticle covered with cobalt is especially important because it has a chemically stable core. Co 3 O 4 -NF was synthesized by the calcination of Co(OH) 2 @SiO 2 under atmospheric air for oxygen reduction and evolution reactions. After calcination, Ag deposition was performed to produce Ag@Co 3 O 4 -NF and their surface area reduces from 125.68 to 108.12 m2/g. The crystallanity and morphological features were observed by the X-ray diffraction (XRD) and scanning electron microscopy (SEM). Furthermore, Ag@Co 3 O 4 -NF catalysts exhibited superior electrochemical performance as a cathode material for Zinc-air batteries. The cyclic test for charging and discharging was performed for 500 h revealing Ag@Co 3 O 4 -NF a potential catalyst, having splendid stability for the OER and ORR. [ABSTRACT FROM AUTHOR]

The wide structural versatility of the Metal-Organic Framework (MOF) is considered to be potential catalysts. In this work, [Mn (BDC). nDMF] n was synthesized by the reaction of 1,4-benzene dicarboxylic acid (1,4-BDC) with Manganese (II) nitrate using a solvothermal method. The [Mn (BDC). nDMF] n crystals were calcined for 2 h to produce Mn-MOF derived catalysts (C@MnO catalysts). The formation of MnO crystals was investigated by the X-ray diffraction (XRD) and the Raman Spectroscopy analyzed the graphitization. The resulting catalysts, C@MnO are highly porous with a high specific surface area of 291.62 m2/g at 700 °C. After calcination, Ni deposition was performed, to produce Ni@C@MnO on which Ni-atoms are deposited on the surface of MnO. The surface area reduces to 214.09 m2/g at 700 °C and the structure is distorted due to deposition. Numerous characterization techniques, including XRD, SEM, EDS, TGA, and Raman, strongly support the effective incorporation of Mn and Ni into the material frameworks. When applied as a cathode for Zinc-air battery, the Ni@C@MnO electrode delivered a high current density of 0.206 Acm−2 for the OER. The cyclic test for charging-discharging was performed for 152 cycles revealing a potential catalyst, having splendid stability for the OER and ORR. Unlabelled Image • Fabrication of carbon-coated manganese (C@MnO) catalysts by solvothermal method • Nickel deposition on C@MnO catalysts • Improved catalytic performance for the oxygen reduction and evolution reactions [ABSTRACT FROM AUTHOR]

• Fabrication of efficient bimetallic catalysts for OER. • Nickel decoration was performed on bimetallic CNT/CoNi. • Ni/CNT/CoNi exhibited excellent electrochemical performance and cycling stability. The fabrication of efficient catalysts for the oxygen evolution reactions (OER) that are required to accelerate the sluggish kinetics of metal-air batteries has attracted significant attention for application in energy conversion devices. Metal-organic frameworks (MOFs) have been recognized as potential candidates for the formation of promising catalysts. In this study, we report the formation of Ni/CNT/CoNi using bimetallic-ZIF (CoNi-ZIF) as a precursor. Bimetallic CoNi encapsulated in carbon nanotubes (CNTs) was obtained by calcinating CoNi-ZIF-67 to yield CNT/CoNi. The resulting CNT/CoNi was highly porous with a significant specific surface area of 242 m2/g. After calcination, Ni deposition on the CNT was performed and the surface area was reduced to 168.7 m2/g. Ni/CNT/CoNi was applied as a cathode material in zinc-air batteries, exhibiting excellent electrochemical performance and cycling stability. [ABSTRACT FROM AUTHOR]

• Nickel deposited catalysts using Zeolitic-Imidazolate Frameworks-67 as a precursor were synthesized. • The catalysts exhibited higher catalytic activities for oxygen reduction and evolution reactions. • The catalysts show low overpotential and high stability. Zeolitic imidazolate framework containing cobalt and nickel (Co- and Ni-ZIF-67) were used as a precursor to perform Ni deposition, in order to obtain enhanced catalytic activity and nanocatalysts. Co or Ni embedded in the carbon nanotubes (CNTs) were obtained by the heat treatment of Co- or Ni-ZIF-67. On Co or Ni embedded CNTs, Ni-deposition was performed to obtain the Ni-deposited catalysts, Ni-CNT-(Co or Ni), which have a higher surface area of 136.7 and 259 m2/g, respectively. These catalysts exhibit superior performance, low overpotential, and high stability for both oxygen reduction and evolution reactions. The superior performance is attributed to metal deposition, which creates highly active catalytic sites and has potential application as a catalyst for the rechargeable zinc-air battery. [ABSTRACT FROM AUTHOR]

• Synthesis and characterization of Co 3 O 4 -NFs by the calcination of Co(OH) 2 @SiO 2. • Fabrication of Ni@Co 3 O 4 -NFs by chemical deposition of nickel nanoparticles. • Higher catalytic activity for the OER and ORR. • Higher stability and longer life cycles. Co 3 O 4 nanoflowers (NFs) were obtained from cobalt hydroxide coated on silica, Co(OH) 2 @SiO 2 , prepared from a homogenous mixture of urea and cobalt nitrate in an aqueous solution. The Co 3 O 4 @SiO 2 was obtained by calcining Co(OH) 2 @SiO 2 under atmospheric air for 3 h and then immersing in sodium hydroxide to yield Co 3 O 4 -NFs. The Ni-deposited Co 3 O 4 NFs (Ni@Co 3 O 4 -NFs) were synthesized by chemical deposition of nickel nanoparticles onto Co 3 O 4 -NF by a reducing agent, NaBH 4. The physical characterization of Co 3 O 4 -NFs and Ni@Co 3 O 4 -NFs was performed by Brunauer-Emmett-Teller analysis, scanning electron microscopy and X-ray diffraction. The electrochemical properties of Co 3 O 4 -NFs and Ni@Co 3 O 4 -NFs for the oxygen reduction and evolution reaction were determined in an 8 M KOH solution. Ni@Co 3 O 4 -NF showed a better cell performance than that of Co 3 O 4 -NF. Moreover, Ni@Co 3 O 4 -NF exhibited a higher stability and longer life cycles at 20 mA cm−2 at a 2 h charging and discharging rate as compared to Co 3 O 4 -NF. Therefore, Co 3 O 4 -NF and Ni@Co 3 O 4 -NF could be used as a cathode material for Zn-air rechargeable batteries. [ABSTRACT FROM AUTHOR]

[Display omitted] • Thermocatalytic decomposition of ammonia is presented. • Ammonia as a hydrogen carrier for green hydrogen production is discussed. • Ruthenium and non-ruthenium-based catalysts for ammonia conversion are reviewed. • Techno-economic analysis of ammonia and hydrogen economy is discussed. • Hydrogen source, production pathways, and energy efficiency are presented. Sustainable societal growth relies on the efficient storage, transportation, and use of renewable energies. Considerable progress has been made in sustainable hydrogen production via water electrolysis and biomass conversion, but hydrogen storage and transportation remain major challenges for commercial-scale applications. Owing to its high hydrogen content and energy density, ammonia is a promising zero-carbon energy carrier for large-scale energy storage. Therefore, the transformation of renewable hydrogen into ammonia is a promising strategy for effective hydrogen transportation and storage. Unlike the direct combustion of ammonia, which can produce NO x , catalytic cracking into nitrogen and hydrogen provides an environmentally friendly method for hydrogen regeneration. Herein, recent advances in effective ammonia decomposition via various processes, including electrochemical, photochemical, and, particularly, thermochemical routes, are summarized. In addition, hydrogen separation techniques and techno-economic analyses of the ammonia and hydrogen economy are discussed. The main objective of this review is to provide a conceptual framework for effective ammonia cracking to yield pure hydrogen as a clean fuel for developing futuristic and sustainable energy solutions. [ABSTRACT FROM AUTHOR]

This study aim to investigate the diagnostic potential of Raman spectroscopy in comparison with rapid urease test and histopathology in diagnosis of H. pylori infection. A comparative study was conducted at Pathology Laboratory and a total of 94 samples were collected from patients based on Rome IV criteria. Sensitivity, specificity and accuracy of histopathology, rapid urease test and for Raman spectroscopy were investigated. Rapid urease test showed 23 false negative results of H. pylori as compared to Raman spectroscopy and histopathology. We concluded that Raman spectroscopy showed sensitivity (94.5%), accuracy (94.0%) and specificity of (87.5%) in the diagnosis of H. pylori infection. However rapid urease test showed specificity of 92.5% while low sensitivity 75%, and 78% accuracy as compared to Raman spectroscopy and histopathology. This study illustrates the applicability of Raman spectroscopy as a potent innovative detection tool for the molecular detection of H. pylori infection in gastritis. [ABSTRACT FROM AUTHOR]

Background: Intestinal inflammation and malabsorption in environmental enteric dysfunction (EED) are associated with early childhood growth faltering in impoverished settings worldwide.Objectives: The goal of this study was to identify candidate biomarkers associated with inflammation, EED histology, and as predictors of later growth outcomes by focusing on the liver-gut axis by investigating the bile acid metabolome.Methods: Undernourished rural Pakistani infants (n = 365) with weight-for-height Z score (WHZ) < -2 were followed up to the age of 24 mo and monitored for growth, infections, and EED. Well-nourished local children (n = 51) were controls, based on consistent WHZ > 0 and height-for-age Z score (HAZ) > -1 on 2 consecutive visits at 3 and 6 mo. Serum bile acid (sBA) profiles were measured by tandem MS at the ages of 3-6 and 9 mo and before nutritional intervention. Biopsies and duodenal aspirates were obtained following upper gastrointestinal endoscopy from a subset of children (n = 63) that responded poorly to nutritional intervention. BA composition in paired plasma and duodenal aspirates was compared based on the severity of EED histopathological scores and correlated to clinical and growth outcomes.Results: Remarkably, >70% of undernourished Pakistani infants displayed elevated sBA concentrations consistent with subclinical cholestasis. Serum glycocholic acid (GCA) correlated with linear growth faltering (HAZ, r = -0.252 and -0.295 at the age of 3-6 and 9 mo, respectively, P <0.001) and biomarkers of inflammation. The proportion of GCA positively correlated with EED severity for both plasma (rs = 0.324 P = 0.02) and duodenal aspirates (rs = 0.307 P = 0.06) in children with refractory wasting that underwent endoscopy, and the proportion of secondary BA was low in both undernourished and EED children.Conclusions: Dysregulated bile acid metabolism is associated with growth faltering and EED severity in undernourished children. Restoration of intestinal BA homeostasis may offer a novel therapeutic target for undernutrition in children with EED. This trial was registered at clinicaltrials.gov as NCT03588013. [ABSTRACT FROM AUTHOR]

• Online handwriting classification dataset. • Feature set. • A comparative analysis with existing feature sets. • Feature impact evaluation and contributions. • A combination of feature set based on evaluation. This paper has a threefold contribution. First, it presents a novel online handwriting database captured using a digital/sensor pen (Apple pencil) and digital/sensor screen (iPad). The captured data are continuous streams of multi-dimensional points, analyzed and processed to classify handwritten sequences into plain text, mathematical expressions, and plots/graphs. Second, a new feature set for online handwritten sequence classification is proposed. The said feature set is used to establish a benchmark for the proposed dataset using various machine-learning classifiers. Third, an ablation study is performed to look into the performance of the proposed feature set compared to the existing feature sets. Here, the proposed feature set has outperformed all the existing feature sets in various evaluation metrics. Furthermore, the proposed dataset and the feature set have been made publicly available along with the benchmark evaluation to enable further research in the field. [ABSTRACT FROM AUTHOR]

In this study, we examine the average and extreme dependence between Exchange Traded Funds ETFs (both energy & commodity) and WTI crude oil prices by using EGARCH-copula models. We use both static (Normal, Student-t, Gumbel and Clayton) and time-varying (Normal and SJC) copulas to explore both average and extreme dependence. Based on the Akaike information criterion (AIC), our results show that time-varying copulas outperform the static copulas. Further, we have found strong enough positive correlations of energy and commodity ETFs with oil prices to suggest that they could be used as a tool for managing oil price risk. Also, contrasting results of time-varying copulas with each other provide useful information regarding the hedge or safe-haven properties of energy and commodity ETFs. • We explore dynamic dependence between ETFs and WTI crude oil prices. • Both static and dynamic copulas are used to measure average and extreme dependence. • Our results show that time-varying copulas outperform the static copulas. • Positive correlations of energy and commodity ETFs with oil prices is found. [ABSTRACT FROM AUTHOR]

Food safety is a current challenge that needs to be addressed globally to overcome burden of foodborne diseases. In this study, food samples collected from Pakistan Institute of Medical Sciences, Islamabad, were analyzed for microbial quality. Parameters to measure the presence or absence of Salmonella, Staphylococcus, coliform, fungi, enteropathogenic Escherichia coli, and total viable counts in foods were studied. Enumeration of aerobic mesophilic bacteria and coliform bacteria was carried out to check the quality of water. The results showed that there was microbial contamination in the foods served at hospital under investigation for this study. Most of the contamination existed because of nonhygienic practices by individuals and serving places. Salmonella, fecal coliforms, and fungal cross-contamination was reported. A hazard analysis and critical control point system was implemented to study what areas are at greater risk and are a reason of contamination in the hospital. The study concluded that high prevalence of the microbial contamination was observed in facilities of the Pakistan Institute of Medical Sciences hospital, requiring strict preventive and precautionary measures to be taken to ensure the safety and health of patients and attendants in the hospital. [ABSTRACT FROM AUTHOR]

• AI is crucial for deployment of computer-aided diagnosis systems. • Framework for multimodal justification for decisions in medical image analysis. • Concept-based xAI assures comprehensible explanation and knowledge discovery. • Dermoscopy as a prime use-case for ExAID framework. Background and objectives: One principal impediment in the successful deployment of Artificial Intelligence (AI) based Computer-Aided Diagnosis (CAD) systems in everyday clinical workflows is their lack of transparent decision-making. Although commonly used eXplainable AI (XAI) methods provide insights into these largely opaque algorithms, such explanations are usually convoluted and not readily comprehensible. The explanation of decisions regarding the malignancy of skin lesions from dermoscopic images demands particular clarity, as the underlying medical problem definition is ambiguous in itself. This work presents ExAID (Explainable AI for Dermatology), a novel XAI framework for biomedical image analysis that provides multi-modal concept-based explanations, consisting of easy-to-understand textual explanations and visual maps, to justify the predictions. Methods: Our framework relies on Concept Activation Vectors to map human-understandable concepts to those learned by an arbitrary Deep Learning (DL) based algorithm, and Concept Localisation Maps to highlight those concepts in the input space. This identification of relevant concepts is then used to construct fine-grained textual explanations supplemented by concept-wise location information to provide comprehensive and coherent multi-modal explanations. All decision-related information is presented in a diagnostic interface for use in clinical routines. Moreover, the framework includes an educational mode providing dataset-level explanation statistics as well as tools for data and model exploration to aid medical research and education processes. Results: Through rigorous quantitative and qualitative evaluation of our framework on a range of publicly available dermoscopic image datasets, we show the utility of multi-modal explanations for CAD-assisted scenarios even in case of wrong disease predictions. We demonstrate that concept detectors for the explanation of pre-trained networks reach accuracies of up to 81.46%, which is comparable to supervised networks trained end-to-end. Conclusions: We present a new end-to-end framework for the multi-modal explanation of DL-based biomedical image analysis in Melanoma classification and evaluate its utility on an array of datasets. Since perspicuous explanation is one of the cornerstones of any CAD system, we believe that ExAID will accelerate the transition from AI research to practice by providing dermatologists and researchers with an effective tool that they can both understand and trust. ExAID can also serve as the basis for similar applications in other biomedical fields. [ABSTRACT FROM AUTHOR]

• Proving that CNNs have the potential to capture "micro deformations". • Learning the discrimination from a two-phase CNN based feature extractor. • Achieving state of the art on four benchmark datasets of different languages. For signature verification systems, micro deformations can be defined as the small differences in the same strokes of signatures or special writing habits of different signers. These micro deformations can reveal the core distinction between the genuine signatures and skilled forgeries. In this paper, we prove that Convolutional Neural Networks (CNNs) have the potential to extract those micro deformations by max-pooling. More specifically, the micro deformations can be determined by watching the location coordinates of the maximum values in pooling windows of max-pooling. Extensive analysis and experiments demonstrate that it is possible to achieve state-of-the-art performance by using this location information as a new feature for capturing micro deformations, along with convolutional features. The proposed method outperforms the state-of-the-art systems on four publicly available datasets of different languages, i.e., English (GPDSsynthetic, CEDAR), Persian (UTSig), and Hindi (BHSig260). [ABSTRACT FROM AUTHOR]