An automatic deep learning approach for coronary artery calcium segmentation

Coronary artery calcium (CAC) is a significant marker of atherosclerosis and cardiovascular events. In this work we present a system for the automatic quantification of calcium score in ECG-triggered non-contrast enhanced cardiac computed tomography (CT) images. The proposed system uses a supervised deep learning algorithm, i.e. convolutional neural network (CNN) for the segmentation and classification of candidate lesions as coronary or not, previously extracted in the region of the heart using a cardiac atlas. We trained our network with 45 CT volumes; 18 volumes were used to validate the model and 56 to test it. Individual lesions were detected with a sensitivity of 91.24%, a specificity of 95.37% and a positive predicted value (PPV) of 90.5%; comparing calcium score obtained by the system and calcium score manually evaluated by an expert operator, a Pearson coefficient of 0.983 was obtained. A high agreement (Cohen's k = 0.879) between manual and automatic risk prediction was also observed. These results demonstrated that convolutional neural networks can be effectively applied for the automatic segmentation and classification of coronary calcifications

The Cozzo Disi mine (Casteltermini, Sicily, Italy) a multi-disciplinary approach to record, study, preserve and develop the mining heritage in Sicily

Cozzo Disi was one of the main sulphur mines in Italy, but after the closure and more than 10 years of desertion, urgent works are now necessary to save it from vandalism and flooding. This big mine contains geological and mineralogical peculiarities, so uncommon to be sometimes unique: this is the case of the \u201cGrandi Garbere\u201d at 3rd level, majestic karst cavities, containing magnificent selenite crystals documented by old miners. The possibility to have a \u201cSicilian Naica\u201d attracted a multi-disciplinary underground task-force, now exploring the mine underground, in order to inspect old works and their good-safety conditions, and to achieve the rooms/caves of \u201cGrandi Garbere\u201d. This extraordinary discovery should be relevant for the future of this territory. In the past, the mine was characterized by huge safety problems: hydrogen sulfide, carbon dioxide and explosive atmospheres; so, the team involved in actual and future explorations has to move with caution, using adequate equipment and - if necessary - waiting for acceptable environmental conditions created by artificial tools (ventilation, pumping, etc.)

Il metodo deposimetrico per la misura della dispersione di fibre di asbesto dalle coperture in cemento amianto : revisione e perfezionamento

Background: The present article is a follow-up of previous research, in which a sedimentation method was proposed to measure the dispersion of fibre bundles (primary pollution) from asbestos-cement roofs.Objectives: The aim of this study was to improve and standardize a screening method to evaluate asbestos bundle release from asbestos-containing materials. Methods: An appropriate instrument (deposimetro) was used to passively sample asbestos on microscope slides by direct sedimentation. The microscopic analysis of samples was improved by the dispersion staining method, combined with the calculation of weight concentrations of asbestos per surface and time unit. The sampling efficiency was improved by introducing a new adhesive treatment of the microscope slides (85% stearyl alcohol, 15% octyldodecan) and a size cut-off restricting the counting method only to fibre bundles with diameters larger than 2 \u3bcm. Results: The optimal sampling time was defined as 25-30 days without rain, extending the sampling time established in the previous investigation, and the optimal instrument position was defined at distances of 50 cm (vertical) and 0 cm (horizontal) from the roof edge. The effect of wind direction and velocity on asbestos release was also assessed, showing that wind gusts with a velocity of more than 10 m/s are mostly associated with dispersion peaks. Conclusions: A simple algorithm was proposed on the basis of field data (n=32) and 5 hazard classes were defined as a function of weight concentrations and asbestos type. The passive sampler is low in cost and is intended for use in large-scale surveys to identify removal priorities

Patient Perceptions and Knowledge of Ionizing Radiation from Medical Imaging

Importance: Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures. Objective: To assess patients' knowledge about medical radiation and related risks. Design, Setting, and Participants: A survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020. Main Outcomes and Measures: Survey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues. Results: Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866). Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P =.03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P =.004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71; 95% CI, 1.43-2.03; P <.001) and having a higher educational level (intermediate vs low: OR, 1.48; 95% CI, 1.17-1.88; P <.001; high vs low: OR, 2.68; 95% CI, 2.09-3.43; P <.001). Conclusions and Relevance: The results of this survey suggest that patients undergoing medical imaging procedures have overall limited knowledge about medical radiation. Intervention to achieve better patient awareness of radiation risks related to medical exposures may be beneficial

The calculation of the cardiac troponin T 99th percentile of the reference population is affected by age, gender, and population selection: A multicenter study in Italy.

Background: The aim of this study is to determine the 99th upper-reference limit (URL) for cardiac troponin T (cTnT) in Italian apparently healthy subjects. Methods: The reference population was selected from 5 cities: Bolzano (n = 290), Milano (CAMELIA-Study, n = 287), Montignoso (MEHLP-Study, n = 306), Pisa (n = 182), and Reggio Calabria (MAREA-Study, n = 535). Subjects having cardiac/systemic acute/chronic diseases were excluded. Participants to MEHLP project underwent cardiac imaging investigation. High-sensitive cTnT was measured with Cobas-e411 (Roche Diagnostics). Results: We enrolled 1600 healthy subjects [54.6%males; age range 10–90 years; mean (SD): 36.4 (21.2) years], including 34.6% aged b20 years, 54.5% between 20 and 64 years, and 10.9% over 65 years. In the youngest the 99th URL was 10.9 ng/L in males and 6.8 ng/L in females; in adults 23.2 ng/L and 10.2 ng/L; and in elderly 36.8 ng/L and 28.6 ng/L. After the exclusion of outliers the 99th URL values were significantly decreased (P b 0.05) in particular those of the oldest (13.8 ng/L and 14 ng/L). MEHLP participants were divided in healthy and asymptomatic, according to known cardiovascular risk factors (HDL, LDL, glucose, C-reactive protein): the 99th URL of cTnT values of these subgroups was significantly different (19.5 vs. 22.7, P b 0.05). Conclusions: 99th URL of cTnT valueswas strongly affected by age, gender, selection of subjects and the statistical evaluation of outliers

From transformation to chronification of migraine: Pathophysiological and clinical aspects

Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identify factors associated with migraine transformation fr

From transformation to chronification of migraine : pathophysiological and clinical aspects

Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identify factors associated with migraine transformation from different perspectives. Understanding CM as a pathological brain state with trigeminovascular participation where biological changes occur, we have completed a comprehensive review on the clinical, epidemiological, genetic, molecular, structural, functional, physiological and preclinical evidence available

In vivo migration of labeled autologous natural killer cells to liver metastases in patients with colon carcinoma

BACKGROUND: Besides being the effectors of native anti-tumor cytotoxicity, NK cells participate in T-lymphocyte responses by promoting the maturation of dendritic cells (DC). Adherent NK (A-NK) cells constitute a subset of IL-2-stimulated NK cells which show increased expression of integrins and the ability to adhere to solid surface and to migrate, infiltrate, and destroy cancer. A critical issue in therapy of metastatic disease is the optimization of NK cell migration to tumor tissues and their persistence therein. This study compares localization to liver metastases of autologous A-NK cells administered via the systemic (intravenous, i.v.) versus locoregional (intraarterial, i.a.) routes. PATIENTS AND METHODS: A-NK cells expanded ex-vivo with IL-2 and labeled with (111)In-oxine were injected i.a. in the liver of three colon carcinoma patients. After 30 days, each patient had a new preparation of (111)In-A-NK cells injected i.v. Migration of these cells to various organs was evaluated by SPET and their differential localization to normal and neoplastic liver was demonstrated after i.v. injection of (99m)Tc-phytate. RESULTS: A-NK cells expressed a donor-dependent CD56(+)CD16(+)CD3(- )(NK) or CD56(+)CD16(+)CD3(+ )(NKT) phenotype. When injected i.v., these cells localized to the lung before being visible in the spleen and liver. By contrast, localization of i.a. injected A-NK cells was virtually confined to the spleen and liver. Binding of A-NK cells to liver neoplastic tissues was observed only after i.a. injections. CONCLUSION: This unique study design demonstrates that A-NK cells adoptively transferred to the liver via the intraarterial route have preferential access and substantial accumulation to the tumor site

Asbestos risk in the textile industry : braking systems on machinery used until the 1990's

BACKGROUND: We recently described asbestos risk in the non-asbestos textile industry as the result of fibre dispersion from ceilings, pipe insulation and machines. OBJECTIVES: The widespread use of brakes with asbestos linings on the machines as well as other functional details were considered for a proper evaluation of their role in producing atmospheric pollution METHODS: All the information was collected on the basis of the personal technical experience of two of the Authors and by direct observation of the machines. RESULTS: All the textile machines (ring spinning, twisting, warping, winding, looms) used until the 1990's were without exception equipped with asbestos-lined mechanical brakes. The heavy action required produced relatively rapid wear of the linings and the dust produced was spread into the atmosphere by the continuous action of the "travelling blowing cleaners" and by the daily cleaning of the machines using compressed air at the end of the shift: violent air blowing undoubtedly caused redispersion of the fine dust from the brakes and also acted as a mechanical grinder on the bundles that sedimented on the machines from the ceilings and pipes, producing more ultrathin respirable fibres. CONCLUSIONS: the contribution of textile machinery to atmospheric pollution by asbestos fibres was significant and due both to the widespread use of brakes with asbestos-containing materials and to the continuous action on the machines of compressed air blowers. Asbestos pollution was certainly high in all the factories so that in the near future still further mesothelioma cases among ex-workers are to be expected