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OBJECTIVES The objective of the study was to establish the repeatability of baseline diagnostic images of the dorsum of the hands acquired using a high resolution Laser Doppler imager in patients with Raynaud's phenomenon secondary to Systemic Sclerosis (SSc). METHODS The dorsal side of the hands of 22 patients (8 male 14 female) , age range 29-73, median 62, with SSc and secondary Raynaud's phenomenon were imaged over two consecutive days at approximately the same time using a Moor Instruments High Resolution Laser Doppler imaging unit. The images were analysed by taking regions of interest at discrete locations in the images to calculate dimensionless values of flux(PU). Repeatability of the diagnostic investigation was assessed by using methods described by Bland and Altman and by also plotting the results from visit 1 against visit 2 and calculating the line of best fit. RESULTS AND CONCLUSIONS Based on the criteria that 95% of all measurement differences should be within a factor of 1.96 of the standard deviations of the mean values, then high resolution Laser Doppler Imaging technique is probably repeatable when acquiring and analysing baseline images of patients with Raynaud's phenomenon secondary to SSc. However a larger study with more patients is required to prove this conclusively - as only data from 19 patients was analysed [3 patients were not included due to technical issues] - and was therefore susceptible to marked clinical variations in patients presenting on different days for the investigations.

Diabetic Retinopathy (DR) is the condition caused due to uncontrolled diabetes that can lead to vision impairment. It greatly affects the retinal blood vessels and diminishes the fundus light-sensitive inner coating. Early diagnosis and regular screening of this disease are essential for prompt processing through artificial intelligence techniques. This paper targets assessing the latest techniques for screening and diagnosing DR, including 94 articles based on the Detection and grading of DR. For every analyzed approach, tables are summarized detailing imaging procedure used, datasets, performance metrics used. The research gaps are also highlighted in this paper. Despite the consistent progression and methods actualized in this field, a couple of issues actually should be centered on. The noise and contrast of the image in Image enhancement are still in the infancy stage for high resolution. This study covers a review of existing image techniques, the gold standard and private datasets available, performance measures used for detection and grading of DR. Now the future research focuses on the amalgamation of the dataset as well as techniques to make the generalized technique for detecting the lesion in DR through an automated system. Moreover, various research gaps have also been taken into account for further research. This review is beneficial to the researchers working in the field of medical imaging to screen and diagnose diseases.

BACKGROUND Additional benefit of cryoballoon left atrial roof line ablation (CB-RA) beyond cryoballoon pulmonary vein isolation (CB-PVI) is suggested in patients with persistent atrial fibrillation (PsAF). We sought to investigate the feasibility of CB-RA for PsAF and to determine the ablation area. METHODS AND RESULTS Fifty-three PsAF patients (67[58.5-75.5] years, 36 men, 11 longstanding PsAF) underwent CB-PVI. Subsequently, 44(83.0%) out of 53 patients underwent additional CB-RA. Voltage maps were created in all patients with a high-resolution mapping system. The total number and duration of CB-RAs were 3.9±0.7 and 468±84 seconds. LA roof areas were complete low voltage areas (LVAs) /scar in 37/44(84.1%) patients ("complete roof modification"). The normal LA posterior wall (LAPW) voltage area was 6.1(4.1-8.4)cm2, and the %LAPW isolation area was 61.0(47.2-71.7)%. The %LAPW isolation area was significantly greater in CB-RA patients than those without (64.0[54.2-73.2] vs. 45.0[39.5-50.5]%, p = 0.041) despite significantly larger LAs in the former group. The %LAPW isolation area was significantly greater in patients with transverse LA diameters

Small-bowel atresias are among the most common causes of intestinal obstruction in newborns, and they often require urgent surgical treatment. Imaging techniques play a very important role in their diagnosis, which is often suspected on prenatal obstetric ultrasound and confirmed on postnatal plain-film X-rays. Abdominal ultrasound's lack of ionizing radiation, wide availability, low cost, and high resolution is making this technique increasingly important in confirming atresias and in detecting possible complications in newborns. This review analyzes a series of cases seen at our center. It summarizes the different types of small-bowel atresias, focusing on the clinical presentation, imaging findings on different modalities, presence of associated disease, management, clinical course, and outcomes.

In vivo studies on association between wall shear stress (WSS) and intracranial plaque are deficient. Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging (3DT1 HR-MRI) data of patients with low-grade stenotic (

У статті показані особливості стану слизової оболонки стравоходу, шлунка та дванадцятипалої кишки у хворих на гастроезофагеальну рефлюксну хворобу. Показано, що застосування вузькоспектрального дослідження та збільшення дозволяє виявляти метаплазований циліндричний епітелій у стравоході, атрофію та кишкову метаплазію слизової оболонки шлунка, тобто використання ендоскопії зі збільшенням, хромоскопії та вузькоспектральної ендоскопії значно покращує якість огляду, скорочує час дослідження й число виконуваних біопсій.

Objectives Carbamylation is a non-enzymatic post-translational reaction of a primary amino group of a protein with isocyanate. The albumin carbamylation is a negative prognostic factor in chronic kidney disease (CKD) patients and induce charge difference implying an observed shift in electrophoretic mobility that can be measured through a symmetry factor (SF). Methods The Helena V8 and the Sebia Capillarys 2 systems were used for all experiments. The effect of in vitro carbamylation on the SF by spiking increasing concentrations of potassium isocyanate (KCNO) in serum of three healthy volunteers was investigated. Theoretical plate numbers (N) as a surrogate of separation efficiency were also calculated and correlations between SF and renal function biomarkers were performed on 284 patients. Results A dose-dependent impact of KCNO on the SF was observed for both methods with the Helena V8 being more sensitive. The mean N was significantly higher on the Helena V8 as compared to the Sebia Capillarys 2 (2,972 vs. 444.1, p Conclusions Thanks to a higher mean N, the Helena V8 might offer new possibilities, including detection of carbamylated albumin through SF calculation. Further studies are still needed to confirm the interest of using this type of assays in clinical routine.

BACKGROUND AND PURPOSE: Chronic carotid artery occlusion remains a poorly understood risk factor for subsequent stroke, and potential revascularization is dependent on understanding the anatomy and nature of the occlusion. Luminal imaging cannot assess the nature of an occlusion, so the internal structure of the occlusion must be inferred. The present study examines the signal characteristics of symptomatic and asymptomatic carotid occlusion that may point to management differentiation. MATERIALS AND METHODS: We prospectively recruited patients who were diagnosed with chronic carotid artery occlusion defined as longer than 4 weeks and confirmed by DSA. All patients underwent high-resolution MR vessel wall imaging examinations after enrollment. Baseline characteristics, vessel wall imaging features, and DSA features were collected and evaluated. The vessel wall imaging features included segment involvement, signal intensity, contrast enhancement, and vessel wall thickness. The symptomatic and asymptomatic chronic carotid artery occlusions were compared. RESULTS: A total of 44 patients with 48 lesions were included in this study from February 2020 to December 2020. Of the 48 lesions, 35 (72.9%) were symptomatic and 13 (27.1%) were asymptomatic. There was no difference in baseline and DSA features. On vessel wall imaging, C1 and C2 were the most commonly involved segments (91.7% and 68.8%, respectively). Compared with symptomatic lesions, asymptomatic lesions were more often isointense (69.2%) in the distal segment (P = .03). Both groups had diffuse wall thickening (80% and 100%). CONCLUSIONS: Signal characteristics between those with symptomatic and asymptomatic carotid artery occlusions differ in a statistically significant fashion, indicating a different structure of the occlusion.

Background: Knee osteo-arthritis is widely prevalent in the elderly population in our society and associated with significant morbidity and poor quality of life. Early diagnosis of the condition can enable timely and proper care for the patients. Magnetic Resonance Imaging, CT Scan, Ultrasonography and plain radiography are the different modalities of imaging that are commonly used for detection and diagnosis of knee osteo-arthritis. Aims and Objectives: To find out the early osteoarthritic changes of knee by Magnetic Resonance Imaging and compare those findings with conventional radiography, high frequency USG and CT scan findings. Materials and Methods: Patients suffering from knee osteoarthritis (OA) as per American College of Rheumatology guideline criteria (n=56) underwent imaging of the knee using plain radiography, ultrasonography, CT scan and MRI. The imaging findings studied in the patients were joint space narrowing (JSN), meniscal abnormality, Baker’s cyst, cruciate ligament abnormality, knee effusion, subchondral cyst, and loose bodies. A comparison between radiography, CT scan and USG was done for the imaging findings with MRI as the reference standard. Z-test of proportionality was used to find statistically significant difference for the three imaging modalities. A P

The targeted cancer therapies that have been introduced in recent years are directed against cancer-specific molecules and signaling pathways, and thus, they have limited nonspecific toxicities. However, major vascular events, including stroke, are common in patients receiving tyrosine kinase inhibitors (TKIs). Inhibition of vascular endothelial growth factor receptor by some TKIs probably explains such events. Moreover, venous and arterial thromboses, atherosclerosis, and bleeding have been reported. Ischemic lesions can also occur due to impaired angiogenesis or endothelial dysfunction. However, the exact mechanisms of arterial stroke in patients with cancer receiving TKIs are unknown. Here, we have report two cases of non-thrombotic ischemic cerebrovascular events related to TKIs and described the high-resolution magnetic resonance imaging findings.

BackgroundNon-invasive oxygen saturation (SpO2) measurement is a central vital sign that supports the management of COVID-19 patients. However, reports on SpO2 characteristics (patterns and dynamics) are scarce and none, to our knowledge, has analysed high resolution continuous SpO2 in COVID-19. MethodsSpO2 signal sampled at 1Hz and clinical data were collected from COVID-19 departments at the Rambam Health Care Campus (Haifa, Israel) between May 1st, 2020 and February 1st, 2021. Data from a total of 367 COVID-19 patients, totalling 27K hours of continuous SpO2 recording, could be retrieved, including 205 non-critical and 162 critical cases. Desaturations based on different SpO2 threshold definitions and oximetry derived digital biomarkers (OBMs) were extracted and compared across severity and support levels. FindingsAn absolute SpO2 threshold at 93% was the most efficient in discriminating between critical and non-critical patients without support or under oxygen support. Under no support, the non-critical group depicted a fold change (FC) of 1 {middle dot}8 times more frequent desaturations compared to the critical group. However, the hypoxic burden was 1 {middle dot}6 times more important in critical versus non-critical patients. Other OBMs depicted significant differences, notably the percentage of time below 93% SpO2 (CT93) was the most discriminating OBM. Mechanical ventilation depicted a strong effect on SpO2 by significantly reducing the frequency (1 {middle dot}85 FC) and depth (1 {middle dot}21 FC) of desaturations. OBMs related to periodicity and hypoxic burden were markedly affected up to several hours before the initiation of the mechanical ventilation. InterpretationThis is the first report investigating continuous SpO2 measurements in hospitalized patients affected with COVID-19. SpO2 characteristics differ between critical and non-critical patients and are impacted by the level of support. OBMs from high resolution SpO2 signal may enable to anticipate clinically relevant events, monitoring of treatment response and may be indicative of future deterioration. FundingThe Milner Foundation, The Placide Nicod fundation and the Technion Machine Learning and Intelligent Systems center (MLIS).

Progress in development of prognostic and therapeutic options for the rare cholestatic liver diseases, primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC), is hampered by limited knowledge of their pathogeneses. In particular, the potential role of hepatotoxic and/or metabolism-altering environmental chemicals in the pathogenesis of these diseases remains relatively unstudied. Moreover, the extent to which metabolic pathways are altered due to ongoing cholestasis and subsequent liver damage or possibly influenced by hepatotoxic chemicals is poorly understood. In this study, we applied a comprehensive exposomics-metabolomics approach to uncover potential pathogenic contributors to PSC and PBC. We used untargeted high-resolution mass spectrometry to characterize a wide range of exogenous chemicals and endogenous metabolites in plasma and tested them for association with disease. Exposome-wide association studies (EWAS) identified environmental chemicals, including pesticides, additives and persistent pollutants, that were associated with PSC and/or PBC, suggesting potential roles for these compounds in disease pathogenesis. Metabolome-wide association studies (MWAS) found disease-associated alterations to amino acid, eicosanoid, lipid, co-factor, nucleotide, mitochondrial and microbial metabolic pathways, many of which were shared between PSC and PBC. Notably, this analysis implicates a potential role of the 5-lipoxygenase pathway in the pathogenesis of these diseases. Finally, EWAS × MWAS network analysis uncovered linkages between environmental agents and disrupted metabolic pathways that provide insight into potential mechanisms for PSC and PBC. Conclusion: This study establishes combined exposomics-metabolomics as a generalizable approach to identify potentially pathogenic environmental agents and enumerate metabolic alterations that may impact PSC and PBC, providing a foundation for diagnostic and therapeutic strategies.

Background PET imaging has been widely used in diagnosis of neurological disorders; however, its application to pediatric population is limited due to lacking pediatric age–specific PET template. This study aims to develop a pediatric age–specific PET template (PAPT) and conduct a pilot study of epileptogenic focus localization in pediatric epilepsy. Methods We recruited 130 pediatric patients with epilepsy and 102 age-matched controls who underwent 18F-FDG PET examination. High-resolution PAPT was developed by an iterative nonlinear registration-averaging optimization approach for two age ranges: 6–10 years (n = 17) and 11–18 years (n = 50), respectively. Spatial normalization to the PAPT was evaluated by registration similarities of 35 validation controls, followed by estimation of potential registration biases. In a pilot study, epileptogenic focus was localized by PAPT-based voxel-wise statistical analysis, compared with multi-disciplinary team (MDT) diagnosis, and validated by follow-up of patients who underwent epilepsy surgery. Furthermore, epileptogenic focus localization results were compared among three templates (PAPT, conventional adult template, and a previously reported pediatric linear template). Results Spatial normalization to the PAPT significantly improved registration similarities (P P n = 40), the PAPT-based localization also achieved a substantial agreement with resection areas (Kappa = 0.743), and the highest detection rate (95%) and accuracy (80.0%). Conclusion The PAPT can significantly improve spatial normalization and epileptogenic focus localization in pediatric epilepsy. Future pediatric neuroimaging studies can also benefit from the unbiased spatial normalization by PAPT. Trial registration. NCT04725162: https://clinicaltrials.gov/ct2/show/NCT04725162

Purpose The purpose of this study was to describe 2 cases of biopsy-proven conjunctival myxomas and present their optical signs on high-resolution optical coherence tomography (HR-OCT) with clinical and histopathological correlations. Methods Two middle-aged female patients with a clinical diagnosis of conjunctival cysts were referred for surgical treatment. Clinical assessment, photographs, ultrasound biomicroscopy, and HR-OCT images were obtained. Excisional biopsies were performed, and specimens were sent for histopathological and immunohistochemical analyses. Results Clinically, these patients presented with a well-circumscribed, semitranslucent, yellow-pinkish mass. Ultrasound biomicroscopy showed a dome-shaped epibulbar mass with medium-to-high internal reflectivity. No compromise of the underlying sclera was noted. HR-OCT showed a normal conjunctival epithelium, a subepithelial nonhomogeneous mass with hyperreflective and hyporeflective areas lined by a highly hyperreflective band, and mild posterior shadowing. Histopathological findings and immunoreactivity for CD34 and vimentin confirmed the diagnosis of conjunctival myxoma. Conclusions The HR-OCT optical signs found in our 2 cases strongly correlated with the microscopic findings. Disclosing the optical signs observed on HR-OCT can help clinicians diagnose and differentiate this lesion, guiding its management. However, more studies with a larger number of patients comparing conjunctival myxoma and other ocular surface tumors are needed to enlighten readers about the unique pattern observed by HR-OCT.

Objectives Functional gastrointestinal disorders (FGD) are common during early childhood. In severe defecation disorders, anorectal manometry (AM) is done to exclude aganglionosis. High-resolution anorectal manometry (HRAM) can probably improve diagnostics but normative data in infants are scarce. This study aims to provide HRAM data in healthy infants overall and in subgroups of infants with FGD, defined as functional constipation (FC), infant colic (IC) and infant dyschezia (ID) (ROME 3 criteria). Methods This prospective observational cohort study enrolled healthy term infants, having HRAM at 2 and 6 months, using a water-perfused pediatric anorectal silicone catheter. Data was provided for presence of anorectal waves and recto anal inhibitory reflex (RAIR), volume needed to elicit RAIR and anal resting pressure (ARP). Questionnaires at 2 and 6 months identified subjects with FC, IC and ID. Results A total of 187 HRAM investigations were done in 107 infants, without any complications. Normal RAIR was found in all, at least at one occasion. Mean ARP increased between 2- and 6-month investigations in infants without FGD. No other differences in HRAM data could be seen between infants with or without an FGD. At 2 months FC, IC and ID were seen (2%, 4% and 17%), whereas at 6-months only FC and ID were seen (7% and 1%). Conclusion We can provide data on HRAM in infants at 2 and 6 months of age. When performing repeated HRAM in healthy infants, RAIR was found in all subjects. HRAM is safe, easy tolerable and can be recommended in infants with or without FGD. An infographic is available for this article at:http://links.lww.com/MPG/C583.

BACKGROUND: To validate the feasibility of generating high-resolution intravascular 3.0 Tesla (T) magnetic resonance imaging of the coronary artery wall to further plaque imaging. METHODS: A receive-only 0.014-inch diameter magnetic resonance imaging guidewire (MRIG) was manufactured for intravascular imaging within a phantom experiment and the coronary artery wall of the swine. For coronary artery wall imaging, both high-resolution images and conventional resolution images were acquired. A 16-channel commercial surface coil for magnetic resonance imaging was employed for the control group. RESULTS: For the phantom experiment, the MRIG showed a higher signal-to-noise ratio than the surface coil. The peak signal-to-noise ratio of the MRIG and the surface coil-generated imaging were 213.6 and 19.8, respectively. The signal-to-noise ratio decreased rapidly as the distance from the MRIG increased. For the coronary artery wall experiment, the vessel wall imaging by the MRIG could be identified clearly, whereas the vessel wall imaging by the surface coil was blurred. The average signal-to-noise ratio of the artery wall was 21.1±5.40 by the MRIG compared to 8.4±2.19 by the surface coil, where the resolution was set at 0.2 mm × 0.2 mm × 2 mm. As expected, the high-resolution sequence clearly showed more details than the conventional resolution sequence set at 0.7 mm × 0.7 mm × 2.0 mm. Histological examination showed no evidence of mechanical injuries in the target vessel walls. CONCLUSIONS: The study validated the feasibility of generating magnetic resonance imaging (MRI) at 0.2 mm × 0.2 mm × 2 mm for the coronary artery wall using a 0.014 inch MRIG.

PURPOSE OF REVIEW: To provide an overview of recent developments in the field of osteoarthritis research with a focus on insights gleaned from the application of different -omic technologies. RECENT FINDINGS: We searched for osteoarthritis-relevant studies focusing on transcriptomics, epigenomics, proteomics and metabolomics, published since November of 2019. Study designs showed a trend towards characterizing the genomic profile of osteoarthritis-relevant tissues with high resolution, for example either by using single-cell technologies or by considering several -omic levels and disease stages. SUMMARY: Multitissue interactions (cartilage-subchondral bone; cartilage-synovium) are prevalent in the pathophysiology of osteoarthritis, which is characterized by substantial matrix remodelling in an inflammatory milieu. Subtyping approaches using -omic technologies have contributed to the identification of at least two osteoarthritis endotypes. Studies using data integration approaches have provided molecular maps that are tissue-specific for osteoarthritis and pave the way for expanding these data integration approaches towards a more comprehensive view of disease aetiopathogenesis.

A change detection analysis utilizing Very High-resolution (V.H.R.) satellite imagery was performed to evaluate the changes in coastal vegetation in La Parguera, southwestern Puerto Rico, attributa...

We report an elliptical beam design for aberration mitigation in high-resolution optical coherence tomography (OCT). We polished a large angle on the fiber terminal facet in the sample arm to make a non-rotational symmetric beam with different numerical apertures (NA) for the two axes vertical to the optical axis. By sacrificing the resolution in the out-of-plane transverse direction, the elliptical beam mitigated the aberration introduced by the focusing optics in the OCT system. The elliptical beam with a doubled NA in the in-plane transverse direction promoted the axial field-of-view (FOV) by about 50% and increased the signal back-coupling efficiency by about 25%. We verified the feasibility of the design by imaging the USAF 1951 resolution chart, swine cornea ex vivo, and human skin in vivo. Results show that the proposed method relieves aberration-related problems in high-resolution OCT. Ministry of Education (MOE) Ministry of Health (MOH) National Medical Research Council (NMRC) Published version This work was supported in part by China Railway Siyuan Survey and Design Group Company Ltd. under Grant 2020K183, in part by National Medical Research Council under Grant MOH-OFIRG19may-0009, and in part by Ministry of Education Singapore under Grant MOE-T2EP30120-0001.

Background Cyclic motor patterns (CMP) are the predominant motor pattern in the distal colon, and are important in both health and disease. Their origin, mechanism and relation to bioelectrical slow-waves remain incompletely understood. During abdominal surgery, an increase in the CMP occurs in the distal colon. This study aimed to evaluate the feasibility of detecting propagating slow waves and spike waves in the distal human colon through intraoperative, high-resolution (HR), serosal electrical mapping. Methods HR electrical recordings were obtained from the distal colon using validated flexible PCB arrays (6 × 16 electrodes; 4 mm inter-electrode spacing; 2.4 cm2, 0.3 mm diameter) for up to 15 min. Passive unipolar signals were obtained and analysed. Results Eleven patients (33–71 years; 6 females) undergoing colorectal surgery under general anaesthesia (4 with epidurals) were recruited. After artefact removal and comprehensive manual and automated analytics, events consistent with regular propagating activity between 2 and 6 cpm were not identified in any patient. Intermittent clusters of spike-like activities lasting 10–180 s with frequencies of each cluster ranging between 24 and 42 cpm, and an average amplitude of 0.54 ± 0.37 mV were recorded. Conclusions Intraoperative colonic serosal mapping in humans is feasible, but unlike in the stomach and small bowel, revealed no regular propagating electrical activity. Although sporadic, synchronous spike-wave events were identifiable. Alternative techniques are required to characterise the mechanisms underlying the hyperactive CMP observed in the intra- and post-operative period. New findings The aim of this study was to assess the feasibility of detecting propagating electrical activity that may correlate to the cyclic motor pattern in the distal human colon through intraoperative, high-resolution, serosal electrical mapping. High-resolution electrical mapping of the human colon revealed no regular propagating activity, but does reveal sporadic spike-wave events. These findings indicate that further research into appropriate techniques is required to identify the mechanism of hyperactive cyclic motor pattern observed in the intra- and post-operative period in humans.

Résumé: Contexte: La mise en place de la sonde ventriculaire gauche dans une zone exempte de cicatrice myocardique est un facteur déterminant de la réponse au traitement de resynchronisation cardiaque. Nous avons cherché à développer et à valider une approche électrocardiographique (ECG) simple, concrète et novatrice afin de repérer de manière peropératoire la présence de tissu cicatriciel au ventricule gauche (VG). Nous avons émis l'hypothèse qu'il y aurait une diminution de l'amplitude du rythme de stimulation du ventricule gauche mesurée à la surface de la peau à l'ECG haute résolution (HR) lors de la stimulation de régions du VG présentant du tissu cicatriciel comparativement aux régions exemptes de cicatrices. Il s'agit de ce que nous appelons la méthode EASE (ECG Amplitude Signal Evaluation). Méthodologie: Des patients vus de manière consécutive qui présentaient une dysfonction systolique ischémique du VG et répondaient aux critères standard pour l'implantation de novo d'un dispositif de resynchronisation cardiaque ont été recrutés de manière prospective. Tous ont fait l'objet d'une résonance magnétique cardiaque améliorée par injection d'un produit de contraste avant l'implantation pour évaluer la présence de tissu cicatriciel. L'amplitude moyenne de l'impulsion de stimulation du VG a été échantillonnée sur l'ECG de surface HR réalisé pendant l'intervention, puis comparée aux résultats de la résonance magnétique cardiaque. Résultats: En tout, 38 points de stimulation du VG ont été évalués chez 13 receveurs. Le voltage médian mesuré sur l'ECG de surface HR dans les régions présentant du tissu cicatriciel était réduit de 41 % (intervalle interquartile : 17 % à 63 %), tandis qu'il n'y avait pas de changement mesurable du voltage (intervalle interquartile : 0 à 0 %) dans les régions exemptes de cicatrices par rapport à l'amplitude maximale (test de Wilcoxon, p < 0,0001). Conclusion: La méthode EASE semble avoir une utilité potentielle en tant que nouvel outil peropératoire pour guider la mise en place de la sonde ventriculaire gauche dans les régions exemptes de cicatrices. Il faudra réaliser d'autres travaux pour valider l'utilité de cette méthode dans une cohorte de patients plus importante. Abstract: Background: The placement of the left ventricular (LV) lead in an area free of myocardial scar is an important determinant of cardiac resynchronization therapy response. We sought to develop and validate a simple, practical, and novel electrocardiographic (ECG)-based approach to intraoperatively identify the presence of LV scar. We hypothesized that there would be a reduction in the measured amplitude of the LV pacing stimulus on the skin surface using a high-resolution (HR) ECG when pacing from LV regions with scar compared with regions without scar. We term this the ECG Amplitude Signal Evaluation (EASE) method. Methods: Consecutive patients with ischemic LV systolic dysfunction and standard criteria for de novo cardiac resynchronization therapy implantation were prospectively enrolled. All underwent a preimplant contrast-enhanced cardiac magnetic resonance study to assess for scar. The average amplitude of the LV pacing impulse was sampled on HR surface ECG intraprocedurally and then compared with the cardiac magnetic resonance results. Results: A total of 38 LV pacing sites were assessed among 13 recipients. The median voltage measured on the surface HR ECG in regions with scar was reduced by 41% (interquartile range, 17% to 63%), whereas there was no measurable change in voltage (interquartile range, 0 to 0%) in regions without scar compared with the maximal amplitude (Wilcoxon P < 0.0001). Conclusion: The EASE method appears to be of potential value as a novel intraoperative tool to guide LV lead placement to regions free of scar. Future work is required to validate the utility of this method in a larger patient cohort.

Purpose: High-resolution vessel wall-magnetic resonance imaging (VW-MRI) has been used to detect regional vessel wall pathology, significantly contributing to the diagnosis of primary angiitis of the central nervous system (PACNS) from other arteriopathies. In this study, we aimed to describe three cases of PACNS initially presenting as acute ischemic stroke, diagnosed and followed up with VW-MRI. Methods: The medical records of three patients diagnosed with PACNS were retrospectively reviewed. We also reviewed the clinical application of VW-MRI in published articles for the pediatric cases since 2016. Results: The initial presenting symptoms were headache, diplopia, confused mentality, hemiplegia, dysarthria, and dizziness. All patients had acute infarction on brain MRI, with suspicion of vasculopathy on magnetic resonance angiography. VW-MRI revealed narrowing of vessels with concentric wall thickening and diffuse enhancement in the anterior cerebral artery (n=1), middle cerebral artery (n=1), posterior cerebral artery (n=2), lenticulostriate artery (n=1), anterior inferior cerebellar artery (n=1), and vertebral artery (n=1), suggestive of vascular wall pathology. After excluding the possible etiologies of vasculitis, the clinical diagnosis of PACNS was established. Three patients received high-dose steroid and cyclophosphamide therapy. Two patients were treated with long-term azathioprine based upon the findings of persistent vessel enhancement on VW-MRI. All patients were regularly followed up with VW-MRI for more than 1 year. We summarized the clinical and radiological features of the published pediatric cases using VW-MRI to date. Conclusion: High-resolution VW-MRI plays an important role in diagnosing childhood PACNS, as results correlate with disease activity.

Thalamic nuclei play critical roles in regulation of neurological functions like sleep and wakefulness. They are increasingly implicated in neurodegenerative and neurological diseases such as multiple sclerosis and essential tremor. However, segmentation of thalamic nuclei is difficult due to their poor visibility in conventional MRI scans. Sophisticated methods have been proposed which require specialized MRI acquisitions and complex post processing. There are few high spatial resolution (1 mm3 or higher) in vivo MRI thalamic atlases available currently. The goal of this work is the development of an in vivo MRI-based structural thalamic atlas at 0.7 × 0.7 × 0.5 mm resolution based on manual segmentation of 9 healthy subjects using the Morel atlas as a guide. Using data analysis from healthy subjects as well as patients with multiple-sclerosis and essential tremor and at 3T and 7T MRI, we demonstrate the utility of this atlas to provide fast and accurate segmentation of thalamic nuclei when only conventional T1 weighted images are available., Measurement(s)thalamic nucleiTechnology Type(s)multi-atlas segmentationSample Characteristic - OrganismHomo sapiens Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.16601045

Background: Gastro-esophageal reflux disease (GERD) has a prevalence of 10-20% in the Western countries while its prevalence amongst the Pakistani population is between 22 to 24%. Esophageal manometry is currently the gold standard for diagnosing esophageal motility disorders. Aims and Objectives: To determine the frequency of esophageal motility disorder in patients with GERD. Materials and Methods: This cross-sectional study was conducted at the department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Patients diagnosed with GERD (defined as having typical reflux symptoms with more than 2 episodes per were) were included in this study. These patients were subjected to upper GI endoscopy followed by esophageal manometry. Esophageal motility disorders were then classificated by using the Chicago classification 3.0. Results: A total of 76 patients were included in our study, out of which 41 (53.9%) were females. A mean age of 46.1 years ± 12 years and a mean body mass index (BMI) of 23.7kg/m2 was noted. The most common comorbid condition seen in our patients was diabetes mellitus, which was seen in 13 patients (17%). A normal EGD was noted in 48 patients (63%). Liquid perfusion esophageal manometer catheter was mainly used in our study that is in 70 patients (92.1%). Weak esophageal peristalsis was the most common esophageal motor abnormality seen in 16 patients (21.1%). Conclusion: A significant proportion of patients with GERD have the presence of a motility disorders, the early identification and treatment of which can lead to improvement GERD symptoms.

Purpose The prevalence of dysphagia in patients with neurodegenerative diseases (ND) is alarmingly high and frequently results in morbidity and accelerated mortality due to subsequent adverse events (e.g., aspiration pneumonia). Swallowing in patients with ND should be continuously monitored due to the progressive disease nature. Access to instrumental swallow evaluations can be challenging, and limited studies have quantified changes in temporal/spatial swallow kinematic measures in patients with ND. High-resolution cervical auscultation (HRCA), a dysphagia screening method, has accurately differentiated between safe and unsafe swallows, identified swallow kinematic events (e.g., laryngeal vestibule closure [LVC]), and classified swallows between healthy adults and patients with ND. This study aimed to (a) compare temporal/spatial swallow kinematic measures between patients with ND and healthy adults and (b) investigate HRCA's ability to annotate swallow kinematic events in patients with ND. We hypothesized there would be significant differences in temporal/spatial swallow measurements between groups and that HRCA would accurately annotate swallow kinematic events in patients with ND. Method Participants underwent videofluoroscopic swallowing studies with concurrent HRCA. We used linear mixed models to compare temporal/spatial swallow measurements ( n = 170 ND patient swallows, n = 171 healthy adult swallows) and deep learning machine-learning algorithms to annotate specific temporal and spatial kinematic events in swallows from patients with ND. Results Differences ( p < .05) were found between groups for several temporal and spatial swallow kinematic measures. HRCA signal features were used as input to machine-learning algorithms and annotated upper esophageal sphincter (UES) opening, UES closure, LVC, laryngeal vestibule reopening, and hyoid bone displacement with 66.25%, 85%, 68.18%, 70.45%, and 44.6% accuracy, respectively, compared to human judges' measurements. Conclusion This study demonstrates HRCA's potential in characterizing swallow function in patients with ND and other patient populations.

Uncertainties concerning anatomy and function of cortico-subcortical projections have arisen during the recent years. A clear distinction between cortico-subthalamic (hyperdirect) and cortico-tegmental projections (superolateral medial forebrain bundle, slMFB) so far is elusive. Deep Brain Stimulation (DBS) of the slMFB (for major depression, MD and obsessive compulsive disorders, OCD) has on the one hand been interpreted as actually involving limbic (prefrontal) hyperdirect pathways. On the other hand slMFB’s stimulation region in the mesencephalic ventral tegmentum is said to impact on other structures too, going beyond the antidepressant (or anti OCD) efficacy of sole modulation of the cortico-tegmental reward-associated pathways. We have here used a normative diffusion MRT template (HCP, n = 80) for long-range tractography and augmented this dataset with ex-vivo high resolution data (n = 1) in a stochastic brain space. We compared this data with histological information and used the high resolution ex-vivo data set to scrutinize the mesencephalic tegmentum for small fiber pathways present. Our work resolves an existing ambiguity between slMFB and prefrontal hyperdirect pathways which—for the first time—are described as co-existent. DBS of the slMFB does not appear to modulate prefrontal hyperdirect cortico-subthalamic but rather cortico-tegmental projections. Smaller fiber structures in the target region—as far as they can be discerned—appear not to be involved in slMFB DBS. Our work enfeebles previous anatomical criticism and strengthens the position of the slMFB DBS target for its use in MD and OCD.

There is growing enthusiasm to develop inexpensive, non-invasive, and portable methods that accurately assess swallowing and provide biofeedback during dysphagia treatment. High-resolution cervical auscultation (HRCA), which uses acoustic and vibratory signals from non-invasive sensors attached to the anterior laryngeal framework during swallowing, is a novel method for quantifying swallowing physiology via advanced signal processing and machine learning techniques. HRCA has demonstrated potential as a dysphagia screening method and diagnostic adjunct to VFSSs by determining swallowing safety, annotating swallow kinematic events, and classifying swallows between healthy participants and patients with a high degree of accuracy. However, its feasibility as a non-invasive biofeedback system has not been explored. This study investigated 1. Whether HRCA can accurately differentiate between non-effortful and effortful swallows; 2. Whether differences exist in Modified Barium Swallow Impairment Profile (MBSImP) scores (#9, #11, #14) between non-effortful and effortful swallows. We hypothesized that HRCA would accurately classify non-effortful and effortful swallows and that differences in MBSImP scores would exist between the types of swallows. We analyzed 247 thin liquid 3 mL command swallows (71 effortful) to minimize variation from 36 healthy adults who underwent standardized VFSSs with concurrent HRCA. Results revealed differences (p

OBJECTIVE The objective of this study was to evaluate the clinical feasibility of high-resolution contrast-enhanced dynamic T1-weighted imaging (T1WI) using compressed sensing (CS) in magnetic resonance imaging. METHODS This study retrospectively included 35 patients who underwent dynamic T1WI using volumetric interpolated breath-hold examination (VIBE) with CS reconstruction (CS-VIBE) and 35 patients with conventional VIBE for comparison. Two observers assessed the liver and pancreas edges, hepatic artery, motion artifacts, and overall image quality. Quantitative analysis was performed by measuring signal intensity and image noise. RESULTS The results showed that CS-VIBE achieved significantly better anatomic delineation of the liver and pancreas edges and hepatic artery clarity than VIBE (P < 0.001). There were no significant differences in motion artifacts in dynamic phases and overall image quality. The signal intensities and INs of CS-VIBE were higher than VIBE. CONCLUSIONS High-resolution dynamic T1WI using CS provides better anatomic delineation with comparable or better overall image quality than conventional VIBE.

Transcatheter therapies are a common way to treat cardiovascular diseases. These therapies are complicated by significant anatomical patient-to-patient variations that exist in terms of transcatheter vascular pathways. Adding to the complexity of transcatheter procedures, the training tools used for physician education often overlook vast patient-to-patient variations and utilize idealized models of patient anatomy that may be unrealistic. In this study, anatomically accurate models were created from high-resolution images of real patient vasculatures. Using fourteen human cadavers donated for research, we collected high-resolution images to generate 3D computational renderings of various patient anatomies. These models make up the “Transcatheter Pathways Vasculature Database” that can be used for physician education and training, as well as improving transcatheter delivery system design. We performed multiple studies that emphasize the anatomical differences that exist in patient vasculatures. Using 3D printing and virtual reality, we developed educational materials and benchtop models to train physicians using true patient anatomies. These tools can also provide device designers with data to improve their products based on real patient vessels. The “Transcatheter Pathways Vasculature Database” highlights differences between patient vasculatures. By educating and training physicians with patient anatomies that accurately represent significant patient-to-patient variations, learning is more translatable to what is seen in the clinic.

Introduction: We aimed to provide a practical and evidence-based guide on the indications, performance and reporting of high-resolution oesophageal manometry (HRM) and ambulatory pH monitoring (PHM) in adult patients in Singapore. Methods: The guideline committee comprised local gastroenterologists from public and private sectors with particular expertise in aspects of HRM and PHM, and it was tasked to produce evidence-based statements on the indications, performance and reporting of these tests. Each committee member performed literature searches to retrieve relevant articles within the context of domains to which they were assigned. Results: Twelve recommendation statements were created and summarised. Conclusion: Standardising key aspects of HRM and PHM is imperative to ensure the delivery of high-quality care. We reported the development of recommendations for the performance and interpretation of HRM and ambulatory reflux monitoring in Singapore. Keywords: Gastro-oesophageal reflux disease, GERD, high-resolution oesophageal manometry, oesophagus, pH testing

Introduction: Anorectal manometry (ARM) provides comprehensive assessment of pressure activity in the rectum and anal canal. Absolute pressure values might depend on the catheter used. Objective: Our aim was to compare the results obtained by different anorectal catheters in children with functional anorectal disorders. Methods: Children diagnosed with functional defecation disorders based on the Rome IV criteria were prospectively enrolled. ARM was performed in the supine position successively using 2 different probes in each patient in random order. Resting, squeeze pressures, and bear-down maneuver variables obtained by high-resolution (2-dimensional [2D]) and high-definition (3-dimensional [3D]) catheters were compared. Results: We prospectively included 100 children {mean age 7.5 [standard deviation (SD) ± 4.3] years; 62 boys}. Mean resting pressures were significantly higher when measured with the 3D than with the 2D catheter (71 [SD ± 19.4] vs. 65 [SD ± 20.1] mm Hg, respectively; p = 0.000). Intrarectal pressure measured by 3D and 2D catheters was similar (35 vs. 39 mm Hg, respectively; p = 0.761), but the percent of anal relaxation appeared to be higher for the 3D than for the 2D probe (12 vs. 5%, respectively; p = 0.002). Dyssynergic defecation (DD) was diagnosed in 41/71 patients (57.7%) using the 3D probe and in 51/71 children (71.8%) using the 2D probe (p = 0.044). Cohen’s kappa showed only fair agreement between the catheters (κ = 0.40) in diagnosis of DD. Conclusions: Our study demonstrated significantly different values of pressures obtained with different types of catheters. Normal ranges for conventional manometry cannot be applied to high-resolution systems, and results obtained by different types of manometry cannot be compared without adjustments (NCT02812823).

Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. The study aimed to evaluate the utility of high resolution mapping (HRM) with small and closely spaced electrodes for guiding ablation of VA from the SOV. Seventeen patients with LVOT VA underwent HRM in the SOV with either PentaRay (13) or Orion (4) catheters. Ablation was guided by low amplitude high frequency potentials that were identified with HRM and tagged on the electroanatomic map. High frequency low amplitude potentials during sinus rhythm (late) or VA (early) were demonstrated with HRM in all 17 consecutive patients; while these potentials were either absent or usually had a far-field appearance in the recordings obtained at the same sites with a 3.5-mm standard ablation catheter. On intracardiac echocardiogram, sites with these potentials corresponded to the bases of the sinuses adjacent to the LV ostium. Ablation was acutely successful in 16 out of 17 patients. Significant reduction in VA burden (≥ 90%) was noted in 15 patients. High frequency low amplitude potentials during sinus rhythm (late) and VA (early) are consistently recorded using HRM in the SOV in patients with VA arising from the aortic sinuses of Valsalva. Standard ablation catheters have limited resolution for detecting these potentials. HRM may potentially improve outcomes of ablation of VA originating from the aortic SOV.

Objective: Magnetic resonance imaging (MRI) has been established as the gold standard imaging technique for assessing knee joint pathologies. However, high-resolution sonography (HRS) is affordable, easily available, cost-effective, and can be used for knee joint assessment. This study was conducted to assess the diagnostic yield of HRS in the evaluation of knee joint pathologies compared with MRI. Materials and Methods: In the study, 103 patients, with symptomatic knee pain, were included. HRS was performed followed by MRI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Kappa values were calculated to assess the performance of HRS compared with MRI. Results: The most frequent pathologies observed on HRS were knee joint effusion (84%) followed by medial meniscal (43%) and lateral meniscal (26%) tear. Conclusion: HRS demonstrated good diagnostic accuracy in diagnosis of knee joint pathologies as compared with MRI. Therefore, HRS could be utilized as a screening tool for detection of knee joint pathologies.

The palatine tonsils form an important part of the human immune system. Together with the other lymphoid tonsils of Waldeyer's tonsillar ring, they act as the first line of defense against ingested or inhaled pathogens. Although histologically stained sections of the palatine tonsil are widely available, they represent the tissue only in two dimensions and do not provide reference to three‐dimensional space. Such a representation of a tonsillar specimen based on imaging data as a 3D anatomical reconstruction is lacking both in scientific publications and especially in textbooks. As a first step in this direction, the objective of the present work was to image a resected tonsil specimen with high spatial resolution in a 9.4 T small‐bore pre‐clinical MRI and to combine these data with data from the completely sectioned and H&E stained same palatine tonsil. Based on the information from both image modalities, a 3D anatomical sketch was drawn by a scientific graphic artist. In perspective, such studies could help to overcome the difficulty of capturing the spatial extent and arrangement of anatomical structures from 2D images and to establish a link between three‐dimensional anatomical preparations and two‐dimensional sections or illustrations, as they have been found so far in common textbooks and anatomical atlases., A resected human tonsil was imaged with high spatial resolution in a 9.4 T small‐bore pre‐clinical MRI. Data were combined and co‐registered with data from the completely sectioned and H&E stained same palatine tonsil. Based on the information from both image modalities, a 3D anatomical sketch was drawn by a scientific graphic artist.

As research continues to demonstrate successes in the use of percutaneous trans-vascular techniques in structural heart intervention, both the subspecialty trained and non-subspecialty trained cardiac imager find themselves performing and reporting larger amounts of information regarding cardiovascular findings. It is therefore imperative that the imager gains understanding and appreciation for how these various measurements are obtained, as well as their implication in a patient's care. Cardiac gated computed tomography (CT) has solidified its role and ability at providing high resolution images that can be used to obtain the key measurements used in structural heart intervention planning. This manuscript aims to provide an overview of what measurements are necessary to report when interpreting CT examinations purposed for structural heart intervention. This includes a review on indications and brief discussion on complications related to these procedures.

Interstitial fibrosis and tubular atrophy (IFTA) on a renal biopsy are strong indicators of disease chronicity and prognosis. Techniques that are typically used for IFTA grading remain manual, leading to variability among pathologists. Accurate IFTA estimation using computational techniques can reduce this variability and provide quantitative assessment. Using trichrome-stained whole-slide images (WSIs) processed from human renal biopsies, we developed a deep-learning framework that captured finer pathologic structures at high resolution and overall context at the WSI level to predict IFTA grade. WSIs (n = 67) were obtained from The Ohio State University Wexner Medical Center. Five nephropathologists independently reviewed them and provided fibrosis scores that were converted to IFTA grades: ≤10% (none or minimal), 11% to 25% (mild), 26% to 50% (moderate), and >50% (severe). The model was developed by associating the WSIs with the IFTA grade determined by majority voting (reference estimate). Model performance was evaluated on WSIs (n = 28) obtained from the Kidney Precision Medicine Project. There was good agreement on the IFTA grading between the pathologists and the reference estimate (κ = 0.622 ± 0.071). The accuracy of the deep-learning model was 71.8% ± 5.3% on The Ohio State University Wexner Medical Center and 65.0% ± 4.2% on Kidney Precision Medicine Project data sets. Our approach to analyzing microscopic- and WSI-level changes in renal biopsies attempts to mimic the pathologist and provides a regional and contextual estimation of IFTA. Such methods can assist clinicopathologic diagnosis.

This study investigates the risk from oil spills along the main shipping lane in the Red Sea based upon oil spill model trajectories forced by the outputs of validated high resolution regional met-ocean data. Following the intra-annual variations in the met-ocean conditions, the results are presented by classifying the basin into three regions: northern, central and southern Red Sea. The maximum distance traveled by the slick is presented for 1, 2, 5, 10, 14 and 20 days after the commencement of a spill. Different measures of hazard assessment in terms of the concentration of beached oil alongside the corresponding probability maps are also analyzed. The volume fractions of beached, dispersed and evaporated oil, 20 days after the commencement of a spill are quantified. The Red Sea general circulation is characterized by rich mesoscale eddies, which appear to be the most prevailing dynamics in oil transport in the basin. Two case events are analyzed to closely examine the effects of the mesoscale circulations on the fate of spilled oil. The results of this study provide a comprehensive assessment of oil spill hazards in the Red Sea, stemming its main shipping lane and identifies the areas at high risk that require timely mitigation strategies.

MRI has been used to image rectal cancer for over two decades and there is extensive research on this imaging technique. The 1999 seminal paper by Brown et al. [1] demonstrated the accuracy of thin-slice MRI in identifying the depth of extramural tumor in 28 patients with rectal cancer. MRI has also been shown to predict involvement of the circumferential resection margin in total mesorectal excision surgery, which is extremely useful to surgeons who may otherwise have produced an R2 resection [2,3]. MRI has enabled the stratification of patients into high- and low-risk and the selection of appropriate patients for neoadjuvant chemoradiotherapy. It has previously been demonstrated that the thin section, or high-resolution (HR) T2 imaging provided promising results in the assessment of lymph nodes, detection of extramural venous invasion, and differentiation of tumors from fibrosis on post-treatment imaging, which continue to be extensively studied [4,5,6]. The majority of publications assessing MRI in rectal cancer describe the use of HR T2 sequences, and the term ‘HR T2’ has been generally accepted to represent HR imaging. There have been a variety of results regarding the accuracy of rectal MRI, particularly the T2 sequence alone, and it has been regularly assessed against other techniques including diffusion, post-contrast, and radiomics. On more in-depth methodological assessment, there is significant heterogeneity in the resolution of the HR T2 sequences across many publications, and this may have an impact on the results.

Single-cell Hi-C (scHi-C) analysis has been increasingly used to map chromatin architecture in diverse tissue contexts, but computational tools to define chromatin loops at high resolution from scHi-C data are still lacking. Here, we describe Single-Nucleus Analysis Pipeline for Hi-C (SnapHiC), a method that can identify chromatin loops at high resolution and accuracy from scHi-C data. Using scHi-C data from 742 mouse embryonic stem cells, we benchmark SnapHiC against a number of computational tools developed for mapping chromatin loops and interactions from bulk Hi-C. We further demonstrate its use by analyzing single-nucleus methyl-3C-seq data from 2,869 human prefrontal cortical cells, which uncovers cell type-specific chromatin loops and predicts putative target genes for noncoding sequence variants associated with neuropsychiatric disorders. Our results indicate that SnapHiC could facilitate the analysis of cell type-specific chromatin architecture and gene regulatory programs in complex tissues., SnapHiC offers a computational tool for improving detection of chromatin loops from single-cell Hi-C data.

Purpose: The purpose of this study is to investigate how RT-PCR (real time–polymerase-chain-reaction) and chest High-Resolution Computed Tomography (HRCT) can detect COVID-19 (Coronavirus Disease 2019) disease in the early, progressive and severe stages, as well as patient’s outcome. Method: We perform a prospective study with chest HRCT on 206 patients with positive RT-PCR test. The patients were divided into three groups; early stage (100 patients), progressive stage (70 patients) and severe stage (36 patients). Results: The early stage involved typical category (COVID-19 Reporting and Data System, CO-RADS 5, 34 cases - 34%), indeterminate category (CORADS 3, six cases - 6%), atypical category (CO-RADS 4, ten cases - 10%) and normal chest HRCT imaging (CO-RADS 1, 50 cases - 50%). The progressive stage involved a typical category (CO-RADS 5, 70 cases, 100%), The severe stage involved a typical category (CO-RADS 5, 36 cases, 100%). Conclusion: RT-PCR is the gold standard and specific tool for confirming COVID-19 infection. Combination of RT-PCR and chest HRCT is used for the early diagnosis of COVID-19 pneumonia. Chest HRCT is positive in 50% of patients in the early stage of COVID-19. Chest HRCT is not only detecting pulmonary parenchymal changes but also determining patient’s outcome in the progressive and severe stages of COVID-19 (CO-RADS 5). Patients with progressive stage will not need ventilator and patients with severe stage should receive ventilator.

High-resolution esophageal manometry (HRM) is frequently used in the outpatient setting, but its role in the inpatient setting is unknown. We conducted a retrospective study of patients who underwent inpatient or outpatient HRM. Few differences were noted between groups and 28% of inpatients had an additional intervention. Tolerance of oral diet and diabetes were associated with a lower likelihood of additional intervention. Ultimately, the inpatient HRM group had unique characteristics and few subsequent interventions.

IMAGENS DE VEÍCULO AÉREO NÃO TRIPULADO APLICADAS NA OBTENÇÃO DO ÍNDICE DE VEGETAÇÃO POR DIFERENÇA NORMALIZADA FELIPE DE SOUZA NOGUEIRA TAGLIARINI1, MIKAEL TIMÓTEO RODRIGUES2-3, BRUNO TIMÓTEO RODRIGUES1; YARA MANFRIN GARCIA1 E SÉRGIO CAMPOS1 1 Departamento de Engenharia Rural, Faculdade de Ciências Agronômicas (FCA) - Universidade Estadual Paulista (UNESP), Avenida Universitária, nº 3780, Altos do Paraíso, CEP: 18610-034, Botucatu, São Paulo, Brasil. E-mail: felipe_tagliarini@hotmail.com; brunogta21@hotmail.com; yaramanfrin@hotmail.com; sergio.campos@unesp.br 2 Centro Universitário Dinâmica das Cataratas (UDC), Rua Castelo Branco, nº 440, Centro, CEP: 85852-010, Foz do Iguaçu, Paraná, Brasil. E-mail: mikael.rodrigues@udc.edu.br 3 Parque Tecnológico Itaipu (PTI), Avenida Tancredo Neves, nº 6731, Jardim Itaipu, Caixa Postal: 2039, CEP: 85867-900, Foz do Iguaçu, Paraná, Brasil. E-mail: mikael.rodrigues@pti.org.br. RESUMO: O advento dos Veículos Aéreos Não Tripulados (VANT) como ferramenta no sensoriamento remoto possibilitou uma plataforma atuante em diferentes áreas para o mapeamento com elevada precisão e resolução. O objetivo deste estudo consistiu na análise do Índice de Vegetação por Diferença Normalizada (NDVI) para elaboração de mapa temático por meio de aerofotogrametria e fotointerpretação, com maior detalhamento da vegetação devido à altíssima resolução espacial alcançada com o uso de imagens coletadas por VANT em trecho do rio Lavapés, dentro dos limites da Fazenda Experimental Lageado no município de Botucatu-SP. As imagens foram obtidas por meio dos sensores MAPIR Survey3W RGB e Survey3W NIR/InfraRED, embarcados em VANT multirrotor 3DR SOLO. Para construção dos ortomosaicos RGB e NDVI, as imagens foram processadas no software Pix4Dmapper 3.0. O resultado do NDVI proporcionou transição bem nítidas entre os alvos bióticos (vegetação) e os alvos abióticos (corpo d'água, solo e edificações), e também entre a própria vegetação, possibilitando a distinção da vegetação de porte arbóreo, com maior vigor vegetativo, em relação a vegetação de porte herbáceo. As imagens com elevada resolução espacial coletadas por VANT, demonstraram flexibilidade de utilização, possuindo elevado potencial para o mapeamento de dinâmica da paisagem e a resposta espectral da vegetação. Palavras-chaves: drone, índice radiométrico, sensoriamento remoto IMAGES OF UNMANNED AERIAL VEHICLE APPLIED TO OBTAIN THE NORMALIZED DIFFERENCE VEGETATION INDEX ABSTRACT: The advent of Unmanned Aerial Vehicle (UAV) as a tool in remote sensing has enabled a platform acting in different areas for mapping with high precision and resolution. This study aimed to analyze the Normalized Difference Vegetation Index (NDVI) for the elaboration of thematic map through aerophotogrammetry and photointerpretation, with greater detail of vegetation due to high spatial resolution achieved with the use of images collected by UAV in a stretch of Lavapés river, inside the domains of Lageado Experimental Farm in the municipality of Botucatu-SP. The images were obtained through MAPIR Survey3W RGB and Survey3W NIR/InfraRED sensors, aboard a 3DR SOLO multirotor UAV. For constructing RGB and NDVI orthomosaics, the images were processed using Pix4Dmapper 3.0 software. The NDVI result provided a clear transition among biotic targets (vegetation) and abiotic targets (water, soil and buildings), and among the vegetation itself, with greater vegetative vigor, making possible the distinction of arboreal vegetation, in relation to herbaceous vegetation. The images with high spatial resolution collected by UAV demonstrated the flexibility of use, having high potential to mapping landscape dynamics and the spectral response of vegetation. Keywords: drone, radiometric index, remote sensing.