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Efficient multi-modal image fusion plays an important role in the non-destructive evaluation (NDE) of infrastructures, where an essential challenge is the precise visualizing of defects. While automatic defect detection represents a significant advancement, the determination of the precise location of both surface and subsurface defects simultaneously is crucial. Hence, visible and infrared data fusion strategies are essential for acquiring comprehensive and complementary information to detect defects across vast structures. This paper proposes an infrared and visible image registration method based on Euclidean evaluation together with a trade-off between key-point threshold and non-maximum suppression. Moreover, we employ a multi-modal fusion strategy to investigate the robustness of our image registration results.

Efficient image stitching plays a vital role in the Non-Destructive Evaluation (NDE) of infrastructures. An essential challenge in the NDE of infrastructures is precisely visualizing defects within large structures. The existing literature predominantly relies on high-resolution close-distance images to detect surface or subsurface defects. While the automatic detection of all defect types represents a significant advancement, understanding the location and continuity of defects is imperative. It is worth noting that some defects may be too small to capture from a considerable distance. Consequently, multiple image sequences are captured and processed using image stitching techniques. Additionally, visible and infrared data fusion strategies prove essential for acquiring comprehensive information to detect defects across vast structures. Hence, there is a need for an effective image stitching method appropriate for infrared and visible images of structures and industrial assets, facilitating enhanced visualization and automated inspection for structural maintenance. This paper proposes an advanced image stitching method appropriate for dual-sensor inspections. The proposed image stitching technique employs self-supervised feature detection to enhance the quality and quantity of feature detection. Subsequently, a graph neural network is employed for robust feature matching. Ultimately, the proposed method results in image stitching that effectively eliminates perspective distortion in both infrared and visible images, a prerequisite for subsequent multi-modal fusion strategies. Our results substantially enhance the visualization capabilities for infrastructure inspection. Comparative analysis with popular state-of-the-art methods confirms the effectiveness of the proposed approach.

Background: Although patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain., Aims: To determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+)., Methods: We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Our protocol was registered with the International Prospective Register of Systematic Reviews (CRD42020211977). Systematic searches were last performed on June 3, 2021 in EMBASE, PubMed, Web-of-Science, Scopus, and CINAHL Databases., Inclusion Criteria: (1) studies reporting outcomes on AIS-COVID+; (2) original articles published in 2020 or later; (3) study participants aged ≥18 years., Exclusion Criteria: (1) case reports with <5 patients, abstracts, review articles; (2) studies analyzing novel interventions. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Random-effects models estimated the pooled OR and 95% confidence intervals (95% CI) for mortality, modified Rankin Scale (mRS) score, length of stay (LOS), and discharge disposition., Results: Of the 43 selected studies, 46.5% (20/43) reported patients with AIS without COVID-19 (AIS-COVID-) for comparison. Random-effects model included 7294 AIS-COVID+ and 158 401 AIS-COVID-. Compared with AIS-COVID-, AIS-COVID+ patients had higher in-hospital mortality (OR=3.87 (95% CI 2.75 to 5.45), P<0.001), less mRS scores 0-2 (OR=0.53 (95% CI 0.46 to 0.62), P<0.001), longer LOS (mean difference=4.21 days (95% CI 1.96 to 6.47), P<0.001), and less home discharge (OR=0.31 (95% CI 0.21 to 0.47), P<0.001)., Conclusions: Patients with AIS-COVID had worse outcomes, with almost fourfold increased mortality, half the odds of mRS scores 0-2, and one-third the odds of home discharge. These findings confirm the significant impact of COVID-19 on early stroke outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Spinal fusion is a common method by which surgeons decrease instability and deformity of the spinal segment targeted. Pedicle screws are vital tools in fusion surgeries and advancements in technology have introduced several modalities of screw placement. Our objective was to evaluate the accuracy of pedicle screw placement in robot-assisted (RA) versus fluoroscopic-guided (FG) techniques. The PubMed and Cochrane Library databases were systematically reviewed from January 2007 through to August 8, 2022, to identify relevant studies. The accuracy of pedicle screw placement was determined using the Gertzbein-Robbins (GR) classification system. Facet joint violation (FJV), total case radiation dosage, total case radiation time, total operating room (OR) time, and total case blood loss were collected. Twenty-one articles fulfilled the inclusion criteria. Successful screw accuracy (GR Grade A or B) was found to be 1.02 (95% confidence interval: 1.01 - 1.04) times more likely with the RA technique. In defining accuracy solely based on the GR Grade A criteria, screws placed with RA were 1.10 (95% confidence interval: 1.06 - 1.15) times more likely to be accurate. There was no significant difference between the two techniques with respect to blood loss (Hedges' g: 1.16, 95% confidence interval: -0.75 to 3.06) or case radiation time (Hedges' g: -0.34, 95% CI: -1.22 to 0.53). FG techniques were associated with shorter operating room times (Hedges' g: -1.03, 95% confidence interval: -1.76 to -0.31), and higher case radiation dosage (Hedges' g: 1.61, 95% confidence interval: 1.11 to 2.10). This review suggests that RA may slightly increase pedicle screw accuracy and decrease per-case radiation dosage compared to FG techniques. However, total operating times for RA cases are greater than those for FG cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Jung et al.)

Background Context: Prior studies have suggested that muscle strength and quality may be associated with low back pain. Recently, a novel magnetic resonance imaging (MRI)-based lumbar muscle health grade was shown to correlate with health-related quality of life scores after spine surgery. However, the potential association between history of lumbar spine surgery and paralumbar muscle health requires further investigation., Purpose: To compare MRI-based paralumbar muscle health parameters between patients with versus without a history of surgery for degenerative lumbar spinal disease., Study Design/setting: Retrospective cohort study., Patient Sample: Consecutive series of patients who presented to the spine surgery clinic of a single surgeon., Outcome Measures: MRI-based measurements of paralumbar cross-sectional area (PL-CSA), Goutallier grade, lumbar indentation value (LIV)., Methods: A retrospective analysis was performed on a consecutive series of patients of a single surgeon, and patients were included based on availability of lumbar MRI. Axial T2-weighted lumbar MRIs were analyzed for PL-CSA, Goutallier classification, and LIV. Measurements were performed at the center of disc spaces from L1 to L5. Patients with and without history of spine surgery were matched based on age, sex, race, ethnicity, and body mass index (BMI) via propensity score matching. Normality of each muscle health variable was assessed using Kolmogorov-Smirnov test. Mann-Whitney U test or independent t-test performed to compare the matched cohorts, as appropriate., Results: A total of 615 patients were assessed. For final analysis, 89 patients with a history of previous spine surgery were matched with 89 patients without a history of spine surgery. There were no statistically significant differences in age, sex, race, ethnicity, or BMI between the matched cohorts. History of spine surgery was generally associated with worse lumbar muscle health. At all 4 intervertebral levels between L1-L5, PL-CSA was significantly smaller among patients with history of spine surgery. At L4-L5, patients with prior spine surgery had significantly smaller PL-CSA/BMI. Patients with prior spine surgery were found to have greater fatty infiltration of the muscles, with higher average Goutallier grades at levels L1-L2, L2-L3, and L4-L5. In addition, history of spine surgery was associated with smaller LIV at L1-L2, L3-L4, and L4-L5., Conclusions: The current study demonstrates that history of lumbar spine surgery is associated with worse paralumbar muscle health based on quantitative and qualitative measurements on MRI. On average, patients with history of spine surgery were found to have smaller cross-sectional areas of the paralumbar muscles, greater amounts of fatty infiltration based on Goutallier classification, and smaller lumbar indentation values., Competing Interests: Declaration of Competing Interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Published by Elsevier Inc.)

Although resting-state functional magnetic resonance imaging (fMRI) studies have observed dynamically changing brain-wide networks of correlated activity, fMRI's dependence on hemodynamic signals makes results challenging to interpret. Meanwhile, emerging techniques for real-time recording of large populations of neurons have revealed compelling fluctuations in neuronal activity across the brain that are obscured by traditional trial averaging. To reconcile these observations, we use wide-field optical mapping to simultaneously record pan-cortical neuronal and hemodynamic activity in awake, spontaneously behaving mice. Some components of observed neuronal activity clearly represent sensory and motor function. However, particularly during quiet rest, strongly fluctuating patterns of activity across diverse brain regions contribute greatly to interregional correlations. Dynamic changes in these correlations coincide with changes in arousal state. Simultaneously acquired hemodynamics depict similar brain-state-dependent correlation shifts. These results support a neural basis for dynamic resting-state fMRI, while highlighting the importance of brain-wide neuronal fluctuations in the study of brain state., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Speech-in-noise (SiN) recognition difficulties are often reported in patients with tinnitus. Although brain structural changes such as reduced gray matter (GM) volume in auditory and cognitive processing regions have been reported in the tinnitus population, it remains unclear how such changes influence speech understanding, such as SiN performance. In this study, pure-tone audiometry and Quick Speech-in-Noise test were conducted on individuals with tinnitus and normal hearing and hearing-matched controls. T1-weighted structural MRI images were obtained from all participants. After preprocessing, GM volumes were compared between tinnitus and control groups using whole-brain and region-of-interest analyses. Further, regression analyses were performed to examine the correlation between regional GM volume and SiN scores in each group. The results showed decreased GM volume in the right inferior frontal gyrus in the tinnitus group relative to the control group. In the tinnitus group, SiN performance showed a negative correlation with GM volume in the left cerebellum (Crus I/II) and the left superior temporal gyrus; no significant correlation between SiN performance and regional GM volume was found in the control group. Even with clinically defined normal hearing and comparable SiN performance relative to controls, tinnitus appears to change the association between SiN recognition and regional GM volume. This change may reflect compensatory mechanisms utilized by individuals with tinnitus who maintain behavioral performance., (© 2023. The Author(s) under exclusive licence to Association for Research in Otolaryngology.)

Degenerative cervical myelopathy (DCM) is the most frequent cause of spinal cord dysfunction and injury in the adult population and leads to significant loss of quality of life and economic impact from its associated medical care expenditures and loss of work. Surgical intervention is recommended for patients manifesting progressing neurological signs and symptoms of myelopathy, but the optimal management in individuals who have mild and clinically stable disease manifestations is controversial. Understanding the natural history of DCM is, thus, important in assessing patients and identifying those most appropriately indicated for surgical management. Despite the attempts to rigorously perform studies of the natural history of these patients, most published investigations suffer from methodological weaknesses or are underpowered to provide definitive answers. Investigations of particular patient subsets, however, provide some clinical guidance as to which patients stand most to benefit from surgery, and these may include those with lower baseline mJOA scores, evidence of segmental hypermobility, cord signal changes on MRI, abnormal somatosensory or motor-evoked potentials, or the presence of certain inflammatory markers. Clinicians should assess patients with mild myelopathy and those harboring asymptomatic cervical spinal cord compression individually when making treatment decisions and an understanding of the various factors that may influence natural history may aid in identifying those best indicated for surgery. Further investigations will likely identify how variables that affect natural history can be used in devising more precise treatment algorithms., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: In this exploratory, open-label study, we used behavioral and brain imaging measures to assess the effectiveness of a smartphone application (ReSound Relief app), which aims to help reduce tinnitus-related distress., Method: Fourteen participants with a wide range of tinnitus-related symptoms and who were not currently undergoing any external treatment participated. They completed the 6-month study and reported different levels of engagement with the app., Results: Across a range of tinnitus questionnaires, most participants showed either no change or decrease in tinnitus handicap. Resting-state and task-based functional magnetic resonance imaging (fMRI) data were collected at baseline and the end of the study. Resting-state fMRI of 12 participants revealed alterations in interregional connectivity of default mode, salience, emotion, auditory, and visual processing networks at the end of the intervention period compared to baseline. Ratings of affective sounds (as pleasant, neutral, or unpleasant) were assessed using fMRI, and comparison after 6 months of app usage revealed reduced activity in the left superior temporal gyrus (secondary auditory cortex), right superior occipital gyrus, and left posterior cingulate cortex. Our findings were not significant at a false discovery rate level of p < .05., Conclusions: The reported changes were not significant, possibly due to the small sample size, heterogeneity of the tinnitus handicap among subjects at the start of the project, and the length of the intervention period. Nevertheless, this study underscores the ease of usage of the app and the potential use of brain imaging to assess changes due to a passive, self-administered intervention for individuals with varying levels of tinnitus severity.

Introduction: The management of spinal neoplasia consists of surgical, radiation, and systemic options. Little data exist to guide management based on overall health status, which is particularly challenging when patients who could benefit from surgery may be too frail for it. This study's objective was to evaluate the 5-Item Modified Frailty Index (mFI-5) as a predictor of 30-day morbidity in patients undergoing instrumented resection for metastatic extradural spinal tumors., Methods: Adults undergoing extradural tumor resection from the 2011 to 2019 National Surgical Quality Improvement Program datasets were identified by Current Procedural Terminology codes 63275-63278 with an adjunct instrumentation code (22840-22843). Patients were classified into frailty levels 0, 1, or 2+ based on mFI-5 scores of 0, 1, or 2-5, respectively. The primary outcome was morbidity. Secondary outcomes were readmission and reoperation. Multivariate modeling was utilized to analyze mFI-5 as a predictor of outcomes. The Akaike information criterion (AIC) was used to compare relative-model-fit based on frailty versus individual comorbidity variables to determine the optimal model. Chi-squared and Fisher's exact tests were used to establish significance between individual complications and frailty., Results: There were 874 patients. Readmission, reoperation, and morbidity rates were 19.5%, 5.0%, 52.3%, respectively. In multivariate analyses, mFI-5=1 (OR: 1.45, SE: 0.31, p=0.036), mFI-5=2+ (OR: 1.41, SE: 0.40, p=0.036), operative time (OR: 1.18, SE: 0.03, p≤0.001), and chronic steroid use (OR: 1.56, SE: 0.42, p=0.037) independently predicted morbidity. Elective surgery (OR: 0.61) was protective. Frailty did not predict readmission or reoperation. Frailty was found to be significantly associated with respiratory complications, urinary tract infections, cardiac events, and sepsis/septic shock specifically., Conclusions: mFI-5=1 independently predicted 45% increased odds of morbidity. mFI-5=2+ independently predicted 41% increased odds of morbidity. Further, every 30 additional minutes of operative time predicted 18% increased odds of morbidity, suggesting an increased risk of site-related complication events. Taken together, the mFI-5 serves as a valid predictor of morbidity in patients with extradural tumor undergoing instrumented excision., Competing Interests: Conflicts of Interest: Dr. Jeff Silber receives teaching fees for Stryker., (Copyright © 2023 The Japanese Society for Spine Surgery and Related Research.)

Brain imaging studies have revealed neural changes in chronic tinnitus patients that are not restricted to auditory brain areas; rather, the engagement of limbic system structures, attention and memory networks are has been noted. Hearing aids (HA) provide compensation for comorbid hearing loss and may decrease tinnitus-related perception and annoyance. Using resting state positron emission tomography our goal was to analyze metabolic and functional brain changes after six months of effective HA use by patients with chronic tinnitus and associated sensorineural hearing loss. 33 age and hearing loss matched participants with mild/moderate hearing loss were enrolled in this study: 19 with tinnitus, and 14 without tinnitus. Participants with tinnitus of more than 6 months with moderate/severe Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores composed the tinnitus group. A full factorial 2X2 ANOVA was conducted for imaging analysis, with group (tinnitus and controls) and time point (pre-intervention and post-intervention) as factors. Six months after HA fitting, tinnitus scores reduced statistically and clinically. Analysis revealed increased glycolytic metabolism in the left orbitofrontal cortex, right temporal lobe and right hippocampus, and reduced glycolytic metabolism in the left cerebellum and inferior parietal lobe within the tinnitus group. The hearing loss control group showed no significant metabolic changes in the analysis. Parsing out the contribution of tinnitus independent of hearing loss, allowed us to identify areas implicated in declines in tinnitus handicap as a result of the intervention. Brain regions implicated in the present study may be part of chronic tinnitus-specific network., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Subjective, chronic tinnitus, the perception of sound in the absence of an external source, commonly occurs with many comorbidities, making it a difficult condition to study. Hearing loss, often believed to be the driver for tinnitus, is perhaps one of the most significant comorbidities. In the present study, white matter correlates of tinnitus and hearing loss were examined. Diffusion imaging data were collected from 96 participants-43 with tinnitus and hearing loss (TIN HL ), 17 with tinnitus and normal hearing thresholds (TIN NH ), 17 controls with hearing loss (CON HL ) and 19 controls with normal hearing (CON NH ). Fractional anisotropy (FA), mean diffusivity and probabilistic tractography analyses were conducted on the diffusion imaging data. Analyses revealed differences in FA and structural connectivity specific to tinnitus, hearing loss, and both conditions when comorbid, suggesting the existence of tinnitus-specific neural networks. These findings also suggest that age plays an important role in neural plasticity, and thus may account for some of the variability of results in the literature. However, this effect is not seen in tractography results, where a sensitivity analysis revealed that age did not impact measures of network integration or segregation. Based on these results and previously reported findings, we propose an updated model of tinnitus, wherein the internal capsule and corpus callosum play important roles in the evaluation of, and neural plasticity in response to tinnitus., (© 2021. The Author(s).)

Functional magnetic resonance imaging has been increasingly used to understand the mechanisms involved in subjective tinnitus; however, researchers have struggled to reach a consensus about a primary mechanistic model to explain tinnitus. While many studies have used functional connectivity of the BOLD signal to understand how patterns of activity change with tinnitus severity, there is much less research on whether there are differences in more fundamental physiology, including cerebral blood flow, which may help inform the BOLD measures. Here, arterial spin labeling was used to measure perfusion in four regions-of-interest, guided by current models of tinnitus, in a sample of 60 tinnitus patients and 31 control subjects. We found global reductions in cerebral perfusion in tinnitus compared with controls. Additionally, we observed a significant negative correlation between tinnitus severity and perfusion. These results demonstrate that examining perfusion from the whole brain may present a complementary tool for studying tinnitus. More research will help better understand the physiology underlying these differences in perfusion., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

In the present study, we used an innovative music-rest interleaved fMRI paradigm to investigate the neural correlates of tinnitus distress. Tinnitus is a poorly-understood hearing disorder where individuals perceive sounds, in the absence of an external source. Although the great majority of individuals habituate to chronic tinnitus and report few symptoms, a minority report debilitating distress and annoyance. Prior research suggests that a diverse set of brain regions, including the attention, the salience, and the limbic networks, play key roles in mediating both the perception of tinnitus and its impact on the individual; however, evidence of the degree and extent of their involvement has been inconsistent. Here, we minimally modified the conventional resting state fMRI by interleaving it with segments of jazz music. We found that the functional connectivity between a set of brain regions-including cerebellum, precuneus, superior/middle frontal gyrus, and primary visual cortex-and seeds in the dorsal attention network, the salience network, and the amygdala, were effective in fractionating the tinnitus patients into two subgroups, characterized by the severity of tinnitus-related distress. Further, our findings revealed cross-modal modulation of the attention and salience networks by the visual modality during the music segments. On average, the more bothersome the reported tinnitus, the stronger was the exhibited inter-network functional connectivity. This study substantiates the essential role of the attention, salience, and limbic networks in tinnitus habituation, and suggests modulation of the attention and salience networks across the auditory and visual modalities as a possible compensatory mechanism for bothersome tinnitus., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The resting state fMRI time series appears to have cyclic patterns, which indicates presence of cyclic interactions between different brain regions. Such interactions are not easily captured by pre-established resting state functional connectivity methods including zero-lag correlation, lagged correlation, and dynamic time warping distance. These methods formulate the functional interaction between different brain regions as similar temporal patterns within the time series. To use information related to temporal ordering, cyclicity analysis has been introduced to capture pairwise interactions between multiple time series. In this study, we compared the efficacy of cyclicity analysis with aforementioned similarity-based techniques in representing individual-level and group-level information. Additionally, we investigated how filtering and global signal regression interacted with these techniques. We obtained and analyzed fMRI data from patients with tinnitus and neurotypical controls at two different days, a week apart. For both patient and control groups, we found that the features generated by cyclicity and correlation (zero-lag and lagged) analyses were more reliable than the features generated by dynamic time warping distance in identifying individuals across visits. The reliability of all features, except those generated by dynamic time warping, improved as the global signal was regressed. Nevertheless, removing fluctuations >0.1 Hz deteriorated the reliability of all features. These observations underscore the importance of choosing appropriate preprocessing steps while evaluating different analytical methods in describing resting state functional interactivity. Further, using different machine learning techniques including support vector machines, discriminant analyses, and convolutional neural networks, our results revealed that the manifestation of the group-level information within all features was not sufficient enough to dissociate tinnitus patients from controls with high sensitivity and specificity. This necessitates further investigation regarding the representation of group-level information within different features to better identify tinnitus-related alternation in the functional organization of the brain. Our study adds to the growing body of research on developing diagnostic tools to identify neurological disorders, such as tinnitus, using resting state fMRI data., (Copyright © 2020 Shahsavarani, Abraham, Zimmerman, Baryshnikov and Husain.)

Study Design: Prospective study., Purpose: We compared the effects of two methods of epidural steroid injection in patients with recurrent disc herniation., Overview of Literature: To our knowledge, there is no previous report of such a comparison in these patients., Methods: The study was performed with 30 patients with relapsed lumbar disc herniation whose pain was not relieved by conservative remedies. The patients were divided into two groups, each of 15 patients, and entered the study for caudal or transforaminal injections. The degree of pain, ability to stand and walk, and the Prolo function score were evaluated in both groups before the injection and 2 months and 6 months after the injection., Results: The degrees of pain reduction in the caudal injection group in the second and sixth months were 0.6 and 1.63, respectively, and in the transforaminal injection group were 1.33 and 1.56, respectively. The difference between the two methods was not statistically significant. Similarly, no other evaluated criterion showed a significant difference between the methods., Conclusions: In the current study, the caudal and transforaminal steroid injection methods showed similar outcomes in the treatment of relapsed lumbar disc herniation. However, more detailed patient categorizing may help in finding possible subgroups with differences.