Radio-frequency tissue ablation of the liver: in vivo and ex vivo experiments with four different systems

The aim of this study was to test the efficacy of four different radio-frequency ablation (RFA) systems in normal hepatic parenchyma in large animals. The RFA was applied to pig livers in vivo and to calf livers ex vivo using the Radionics cluster needle, RITA starburst XL needle, Radiotherapeutics Le Veen 4.0 needle, and the Berchtold 14-G saline-perfused 15-mm active-tip needle based on constructor specifications. The volume of tissue coagulation from RF was calculated from measurements of the vertical diameter (Dv) and transverse diameter (Dt). Lesion shape was characterized using the ratio between Dt/Dv. Radiotherapeutics and RITA produced in vivo lesion volume of 42±10, 39±4cm3 with a reproducible spherical shape (Dt/Dv of 1.01±0.16 and 0.97±0.1, respectively). Radionics produced in vivo RF lesions volume of 29±11cm3 with an ovoid shape (Dt/Dv 0.88±0.09). The RF lesions with the Berchtold device could not be assessed in vivo as 5 of 8 animals died during treatment. Ex vivo RF lesions had similar volumes with each system; however, the Radiotherapeutics device produced more reproducible shaped lesions than the other systems. In our experimental study, we found no difference between expandable needle systems in vivo. Cooled needles produced slightly smaller and ovoid shape in vivo lesion

Interobserver Variation Study of the Rutgeerts Score to Assess Endoscopic Recurrence after Surgery for Crohn's Disease.

BACKGROUND: After resection surgery for Crohn's disease, recurrence of endoscopic lesions at the site of the anastomosis or in the neoterminal ileum is graded according to the Rutgeerts score (RS). The goal of this study was to test the interobserver variability for RS. METHODS: Thirteen trained endoscopists evaluated the RS on 39 videotapes of patients who had undergone resection for Crohn's disease with an ileocolonic anastomosis 6 months earlier. Videotapes were randomly assigned to endoscopists through a balanced incomplete block design. Each videotape was scored independently by four endoscopists, and each endoscopist evaluated 12 videotapes, making a total of 156 videotape assessments. Reproducibility levels of the RS were assessed through unweighted kappa estimates among multiple raters. The proportion of inappropriate therapeutic initiation was estimated by randomly selecting one endoscopist for each videorecording, assuming that the majority of endoscopists correctly classified endoscopic recurrence. RESULTS: The kappa estimates were 0.43 (95% confidence interval: 0.33-0.52) for the RS on a 5-grade scale, 0.47 (0.28-0.66) for RS /= i2, and 0.64 (0.42-0.85) for RS i2. The percentages of inappropriate therapeutic initiation were 12.8% (3.8-21.9) when initiation was triggered by a RS >/= i2 and 8.3% (1.1-15.6) when initiation was triggered by a RS > i2 (p = 0.41). CONCLUSION: The reproducibility of the RS was moderate, especially when differentiating /=i2, which may lead to incorrect therapeutic decisions in >10% of patients

The ARIA-MASK-air® approach

Funding Information: The authors thank Ms Véronique Pretschner for submitting the paper. MASK‐air has been supported by Charité Universitätsmedizin Berlin, EU grants (EU Structural and Development Funds Languedoc Roussillon and Region PACA; POLLAR: EIT Health; Twinning: EIP on AHA; Twinning DHE: H2020; Catalyse: Horizon Europe) and educational grants from Mylan‐Viatris, ALK, GSK, Novartis, Stallergènes‐Greer and Uriach. None for the study. ® Publisher Copyright: © 2023 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.MASK-air®, a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.publishersversionpublishe

ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.Peer reviewe

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed

APPORT DE L'ANGIOSCANNER SPIRALE POUR LE DIAGNOSTIC D'EMBOLIE PULMONAIRE (DES RADIODIAGNOSTIC ET IMAGERIE MEDICALE)

NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

APPORT DE L'ANGIOSCANNER SPIRALE POUR LE DIAGNOSTIC D'EMBOLIE PULMONAIRE

NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

IMPROVEMENT OF AUV-BORNE SEABED MAPPING WITH QUALITY MAPS USING STATISTICAL ANALYSIS

International audienceSonar data is commonly affected by noise due to the processing of scatter signals and interference of acoustic waves scattered from the seabed. To overcome this problem and to limit the noise in sonar images, the sonar operator can change the sonar settings (e.g. range, pulse length, modulation, inter-track distance, etc.) to acquire the best possible acoustic data. On board autonomous underwater vehicles (AUV), due to the low bandwidth of the communication with the robot, the real time definition of the best settings by an operator is nearly unfeasible. For these reasons, we have developed an analysis method for automatically assessing the quality of the data. The results of this process are then sent to the AUV planning module which can change the sonar settings (e.g. inter-track distance).The classical approach is based on the correction of the artefacts related to the wave propagation in water column and the characteristics of the sonar system. This approach requires strong a priori knowledge of the system and the conditions of acquisition of the sonar data.The main objective of this paper is to propose a statistical measure of quality of the sonar data acquired using AUVs. This statistical measure would be representing a quality map for the input sonar data. As no prior measurement of similarity or dissimilarity of sonar images is given, the decision to whether accept the quality of data as noisy/non-noisy will be based upon statistical hypothesis testing. To accomplish the quality mapping, spectral domain filtering is performed to extract the residual image representing the speckle. Based on Maximum Likelihood (ML) method, parameters are estimated from the data for Rayleigh distribution and its fit is evaluated using Goodness-of-fit (Gof) test. Experimental results show the viability of the proposed approach while mapping the data into quality matrix representing the acceptable regions on sonar data acquired using DAURADE

The fusion of digital terrain models measured from multiple acoustic sensors – Application to the DAURADE autonomous underwater vehicle

International audienceBuilding an accurate digital terrain model (DTM) of the seabed is a key issue for various military and civilian hydrographers applications.In the past decades, the emergence of autonomous underwater vehicles (AUV) offers new methodologies to collect the bathymetric data used in the estimation of the DTM. In our study, we use the DAURADE AUV platform which is capable of acquiring bathymetry with two acoustic sensors: A multibeam echo sounder (MBES) and an interferometric sidescan sonar (ISSS). The two sensors (MBES and ISSS) are synchronized to operate concurrently. In fact, the final DTM can be improved by performing a fusion of the data; the two systems acquire the bathymetry with different resolutions, geometries and error models; these parameters are introduced in the fusion process to improve the estimation of the DTM and to increase its accuracy.The aim of this paper is to describe the fusion method and discuss our simulated results. First, the modeling of two acoustic sensors (MBES and ISSS) will be briefly described. The input data sets are simulated by applying the sensor models on simplified seabed models. The use of seabed models provides ground truth and, therefore, allows for quantifying the accuracy of the fusion process

Swath bathymetric data fusion Application to autonomous underwater vehicles

International audienceThe autonomous underwater vehicle (AUV) DAURADEplatform can acquire bathymetry with two acoustic sensors:a multibeam echo sounder (MBES) and an interferometricsidescan sonar (ISSS). The two sensors (MBES and ISSS) aresynchronized and they can simultaneously operate and acquirethe bathymetry with different resolutions, geometries and errormodels. This complementarily allows us to improve the accuracyand the coverage of the collected bathymetric data by fusing bothof them. We applied the fusion process on actual data from thetwo bathymetric sensors of DAURADE (Reson 7125 MBES andKlein 5000 Interferometric); the obtained results are presentedand discussed