170 research outputs found
Classification performance for covid patient prognosis from automatic ai segmentationâa single-center study
Background: COVID assessment can be performed using the recently developed individual risk score (prediction of severe respiratory failure in hospitalized patients with SARS-COV2 infection, PREDI-CO score) based on High Resolution Computed Tomography. In this study, we evaluated the possibility of automatizing this estimation using semi-supervised AI-based Radiomics, leveraging the possibility of performing non-supervised segmentation of ground-glass areas. Methods: We collected 92 from patients treated in the IRCCS SantâOrsola-Malpighi Policlinic and public databases; each lung was segmented using a pre-trained AI method; ground-glass opacity was identified using a novel, non-supervised approach; radiomic measurements were collected and used to predict clinically relevant scores, with particular focus on mortality and the PREDI-CO score. We compared the prediction obtained through different machine learning approaches. Results: All the methods obtained a well-balanced accuracy (70%) on the PREDI-CO score but did not obtain satisfying results on other clinical characteristics due to unbalance between the classes. Conclusions: Semi-supervised segmentation, implemented using a combination of non-supervised segmentation and feature extraction, seems to be a viable approach for patient stratification and could be leveraged to train more complex models. This would be useful in a high-demand situation similar to the current pandemic to support gold-standard segmentation for AI training
Internal alignment and position resolution of the silicon tracker of DAMPE determined with orbit data
The DArk Matter Particle Explorer (DAMPE) is a space-borne particle detector
designed to probe electrons and gamma-rays in the few GeV to 10 TeV energy
range, as well as cosmic-ray proton and nuclei components between 10 GeV and
100 TeV. The silicon-tungsten tracker-converter is a crucial component of
DAMPE. It allows the direction of incoming photons converting into
electron-positron pairs to be estimated, and the trajectory and charge (Z) of
cosmic-ray particles to be identified. It consists of 768 silicon micro-strip
sensors assembled in 6 double layers with a total active area of 6.6 m.
Silicon planes are interleaved with three layers of tungsten plates, resulting
in about one radiation length of material in the tracker. Internal alignment
parameters of the tracker have been determined on orbit, with non-showering
protons and helium nuclei. We describe the alignment procedure and present the
position resolution and alignment stability measurements
Unraveling the complexity of tyrosine kinase inhibitor-resistant populations by ultra-deep sequencing of the BCR-ABL kinase domain
In chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia, tyrosine kinase inhibitor (TKI) therapy may select for drug-resistant BCR-ABL mutants. We used an ultra-deep sequencing (UDS) approach to resolve qualitatively and quantitatively the complexity of mutated populations surviving TKIs and to investigate their clonal structure and evolution over time in relation to therapeutic intervention. To this purpose, we performed a longitudinal analysis of 106 samples from 33 patients who had received sequential treatment with multiple TKIs and had experienced sequential relapses accompanied by selection of 1 or more TKI-resistant mutations. We found that conventional Sanger sequencing had misclassified or underestimated BCR-ABL mutation status in 55% of the samples, where mutations with 1% to 15% abundance were detected. A complex clonal texture was uncovered by clonal analysis of samples harboring multiple mutations and up to 13 different mutated populations were identified. The landscape of these mutated populations was found to be highly dynamic. The high degree of complexity uncovered by UDS indicates that conventional Sanger sequencing might be an inadequate tool to assess BCR-ABL kinase domain mutation status, which currently represents an important component of the therapeutic decision algorithms. Further evaluation of the clinical usefulness of UDS-based approaches is warranted
Foetal haemoglobin-blood cells (F-cells) as a feature of embryonic tumours (blastomas)
Tumour markers are important in the diagnosis and monitoring of many tumours. This study tested the hypothesis that an oncofoetal protein, foetal haemoglobin (HbF) is a potential tumour marker in embryonic tumours, useful for management. An immunohistochemical investigation of HbF blood cell (Fc) distribution was carried out in tumours and in bone marrow samples from 83 children and 13 adults with various embryonic tumours (blastomas), and in bone marrow samples of 24 leukaemia patients. In the three, main blastoma types, nephroblastoma (Wilms' tumour), neuroblastoma and retinoblastoma, where all the patients, except two, were children, around 80% of the tumour samples had Fc within proliferating blood vessels and spaces between tumour cells. In parallel, clusters of Fc, mostly F-erythroblasts (Feb), were distributed in the bone marrow of some of those patients and in the bone marrow of 79% of the leukaemia patients. Foetal haemoglobin, as well as being a potential prognostic cancer marker, is a potential indicator of DNA hypomethylation implicated in the development of these tumours, as well as in others previously noted for the presence of HbF
The DArk Matter Particle Explorer mission
The DArk Matter Particle Explorer (DAMPE), one of the four scientific space
science missions within the framework of the Strategic Pioneer Program on Space
Science of the Chinese Academy of Sciences, is a general purpose high energy
cosmic-ray and gamma-ray observatory, which was successfully launched on
December 17th, 2015 from the Jiuquan Satellite Launch Center. The DAMPE
scientific objectives include the study of galactic cosmic rays up to
TeV and hundreds of TeV for electrons/gammas and nuclei respectively, and the
search for dark matter signatures in their spectra. In this paper we illustrate
the layout of the DAMPE instrument, and discuss the results of beam tests and
calibrations performed on ground. Finally we present the expected performance
in space and give an overview of the mission key scientific goals.Comment: 45 pages, including 29 figures and 6 tables. Published in Astropart.
Phy
Direct detection of a break in the teraelectronvolt cosmic-ray spectrum of electrons and positrons
High energy cosmic ray electrons plus positrons (CREs), which lose energy
quickly during their propagation, provide an ideal probe of Galactic
high-energy processes and may enable the observation of phenomena such as
dark-matter particle annihilation or decay. The CRE spectrum has been directly
measured up to TeV in previous balloon- or space-borne experiments,
and indirectly up to TeV by ground-based Cherenkov -ray
telescope arrays. Evidence for a spectral break in the TeV energy range has
been provided by indirect measurements of H.E.S.S., although the results were
qualified by sizeable systematic uncertainties. Here we report a direct
measurement of CREs in the energy range by the
DArk Matter Particle Explorer (DAMPE) with unprecedentedly high energy
resolution and low background. The majority of the spectrum can be properly
fitted by a smoothly broken power-law model rather than a single power-law
model. The direct detection of a spectral break at TeV confirms the
evidence found by H.E.S.S., clarifies the behavior of the CRE spectrum at
energies above 1 TeV and sheds light on the physical origin of the sub-TeV
CREs.Comment: 18 pages, 6 figures, Nature in press, doi:10.1038/nature2447
Odontostomatologic management of patients receiving oral anticoagulant therapy: a retrospective multicentric study
Introduction: Today, we frequently find patients taking oral anticoagulant therapy (OAT), a prophylaxis against the
occurrence of thromboembolic events. An oral surgeon needs to know how to better manage such patients, in
order to avoid hemorrhagic and thromboembolic complications.
Materials and methods: A group of 193 patients (119 men aged between 46 and 82 and 74 women aged
between 54 and 76) undergoing OAT for more than 5 years were managed with a standardized management
protocol and a 2-months follow-up. The aim of the present study was to apply a protocol, which could provide a
safe intra- and postoperative management of patients on OAT.
Results: Among the 193 patients, only 2 had postoperative complications.
Conclusions: We think that the protocol used in the present study can be used for complete safety in the
treatment of this type of patients.
Keywords: Oral Anticoagulant Therapy (OAT), Tranexamic Acid, Oral Surger
Study protocol for a pragmatic randomised controlled trial in general practice investigating the effectiveness of acupuncture against migraine
<p>Abstract</p> <p>Background</p> <p>Migraine is a chronic neurologic disease that can severely affect the patient's quality of life. Although in recent years many randomised studies have been carried out to investigate the effectiveness of acupuncture as a treatment for migraine, it remains a controversial issue. Our aim is to determine whether acupuncture, applied under real conditions of clinical practice in the area of primary healthcare, is more effective than conventional treatment.</p> <p>Methods/Design</p> <p>The design consists of a pragmatic multi-centre, three-armed randomised controlled trial, complemented with an economic evaluation of the results achieved, comparing the effectiveness of verum acupuncture with sham acupuncture, and with a control group receiving normal care only.</p> <p>Patients eligible for inclusion will be those presenting in general practice with migraine and for whom their General Practitioner (GP) is considering referral for acupuncture. Sampling will be by consecutive selection, and by randomised allocation to the three branches of the study, in a centralised way following a 1:1:1 distribution (verum acupuncture; sham acupuncture; conventional treatment). Secondly, one patient in three will be randomly selected from each of the acupuncture (verum or sham) groups for a brain perfusion study (by single photon emission tomography). The treatment with verum acupuncture will consist of 8 treatment sessions, once a week, at points selected individually by the acupuncturist. The sham acupuncture group will receive 8 sessions, one per week, with treatment being applied at non-acupuncture points in the dorsal and lumbar regions, using the minimal puncture technique. The control group will be given conventional treatment, as will the other two groups.</p> <p>Discussion</p> <p>This trial will contribute to available evidence on acupuncture for the treatment of migraine. The primary endpoint is the difference in the number of days with migraine among the three groups, between the baseline period (the 4 weeks prior to the start of treatment) and the period from weeks 9 to 12. As a secondary aspect, we shall record the index of laterality and the percentage of change in the mean count per pixel in each region of interest measured by the brain perfusion tomography, performed on a subsample of the patients within the real and sham acupuncture groups.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN98703707.</p
Particle Astrophysics in Space with an Antimatter Large Acceptance Detector in Orbit (ALADINO)
The note describes a proposal for a large acceptance magnetic spectrometer based on a novel superconducting magnet technology, equipped with a silicon tracker and a 3D isotropic calorimeter. ALADINO (Antimatter Large Acceptance Detector IN Orbit) is conceived to study antimatter components of the cosmic radiation in an unexplored energy window which can shed light on new phenomena related to the origin and evolution of the Universe, as well as on the origin and propagation of cosmic rays in our galaxy. The main science themes addressed by this mission are therefore the origin and composition of the Universe (by means of direct search for primordial anti-nuclei in the Cosmic Ray (CR) flux and indirect search for Dark Matter signals in the CR anti-particle fluxes) as well as the origin and propagation of CR in the Galaxy (by means of precise measurements of the energy spectra and chemical composition of the CR)
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