Validation of an AI-based algorithm for measurement of the thoracic aortic diameter in low-dose chest CT

OBJECTIVES: To evaluate the performance of artificial intelligence (AI) software for automatic thoracic aortic diameter assessment in a heterogeneous cohort with low-dose, non-contrast chest computed tomography (CT).MATERIALS AND METHODS: Participants of the Imaging in Lifelines (ImaLife) study who underwent low-dose, non-contrast chest CT (August 2017-May 2022) were included using random samples of 80 participants &lt;50y, ≥80y, and with thoracic aortic diameter ≥40 mm. AI-based aortic diameters at eight guideline compliant positions were compared with manual measurements. In 90 examinations (30 per group) diameters were reassessed for intra- and inter-reader variability, which was compared to discrepancy of the AI system using Bland-Altman analysis, paired samples t-testing and linear mixed models.RESULTS: We analyzed 240 participants (63 ± 16 years; 50 % men). AI evaluation failed in 11 cases due to incorrect segmentation (4.6 %), leaving 229 cases for analysis. No difference was found in aortic diameter between manual and automatic measurements (32.7 ± 6.4 mm vs 32.7 ± 6.0 mm, p = 0.70). Bland-Altman analysis yielded no systematic bias and a repeatability coefficient of 4.0 mm for AI. Mean discrepancy of AI (1.3 ± 1.6 mm) was comparable to inter-reader variability (1.4 ± 1.4 mm); only at the proximal aortic arch showed AI higher discrepancy (2.0 ± 1.8 mm vs 0.9 ± 0.9 mm, p &lt; 0.001). No difference between AI discrepancy and inter-reader variability was found for any subgroup (all: p &gt; 0.05).CONCLUSION: The AI software can accurately measure thoracic aortic diameters, with discrepancy to a human reader similar to inter-reader variability in a range from normal to dilated aortas.</p

The politics of playing along: radio and regulation in democratic Europe

The loss of localism has been a common trend in most radio markets in Europe and the United States. Deregulation of ownership led to a concentration phenomenon that has affected local radios in several western democracies. New forms of regulation have been considered as possible ways to stop the erosion of localism by applying rules to markets in the defense of diversity, pluralism, and the local dimension. This article analyses the local radio market in Portugal, by assessing the changes in the legislation and by examining the regulatory action that can, according to its remit, act preventively to avoid market forces to harm these principles.info:eu-repo/semantics/publishedVersio

Magnetic resonance imaging assessment of renal flow distribution patterns during ex vivo normothermic machine perfusion in porcine and human kidneys

Acceptance criteria of deceased donor organs have gradually been extended toward suboptimal quality, posing an urgent need for more objective pre-transplant organ assessment. Ex vivo normothermic machine perfusion (NMP) combined with magnetic resonance imaging (MRI) could assist clinicians in deciding whether a donor kidney is suitable for transplantation. Aim of this study was to characterize the regional distribution of perfusate flow during NMP, to better understand how ex vivo kidney assessment protocols should eventually be designed. Nine porcine and 4 human discarded kidneys underwent 3 h of NMP in an MRI-compatible perfusion setup. Arterial spin labeling scans were performed every 15 min, resulting in perfusion-weighted images that visualize intrarenal flow distribution. At the start of NMP, all kidneys were mainly centrally perfused and it took time for the outer cortex to reach its physiological dominant perfusion state. Calculated corticomedullary ratios based on the perfusion maps reached a physiological range comparable to in vivo observations, but only after 1 to 2 h after the start of NMP. Before that, the functionally important renal cortex appeared severely underperfused. Our findings suggest that early functional NMP quality assessment markers may not reflect actual physiology and should therefore be interpreted with caution

Risk measures for direct real estate investments with non-normal or unknown return distributions

The volatility of returns is probably the most widely used risk measure for real estate. This is rather surprising since a number of studies have cast doubts on the view that volatility can capture the manifold risks attached to properties and corresponds to the risk attitude of investors. A central issue in this discussion is the statistical properties of real estate returns—in contrast to neoclassical capital market theory they are mostly non-normal and often unknown, which render many statistical measures useless. Based on a literature review and an analysis of data from Germany we provide evidence that volatility alone is inappropriate for measuring the risk of direct real estate. We use a unique data sample by IPD, which includes the total returns of 939 properties across different usage types (56% office, 20% retail, 8% others and 16% residential properties) from 1996 to 2009, the German IPD Index, and the German Property Index. The analysis of the distributional characteristics shows that German real estate returns in this period were not normally distributed and that a logistic distribution would have been a better fit. This is in line with most of the current literature on this subject and leads to the question which indicators are more appropriate to measure real estate risks. We suggest that a combination of quantitative and qualitative risk measures more adequately captures real estate risks and conforms better with investor attitudes to risk. Furthermore, we present criteria for the purpose of risk classification

Apprehending public relations as a promotional industry

This special issue examines the growing social and political importance of promotional activities and public relations. For decades, promotional tools have been deployed to foster the aims of various societal agencies, be they corporations, political actors, public institutions, non-governmental organisations (NGOs) or citizen movements. In today’s turbulent political and media environments, promotional practices have become more inventive, coordinated and ubiquitous, crossing transnational borders and circulating across business, politics and social institutions. Public relations is an essential tool in the promotional mix and is increasingly a stand-alone strategy for organisations of all kinds to manage their visibility, legitimacy and relationships with stakeholders. However, its influence and power in the context of an increasingly promotional culture are under-researched. In this introduction, we set out the landscape of promotional culture in which public relations activity takes place and consider how existing research on promotional work may illuminate our knowledge of contemporary public relations work

PACAP centrally mediates emotional stress-induced corticosterone responses in mice

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a pleiotropic neuropeptide widely distributed in the nervous system. Recently, PACAP was shown to be involved in restraint stress-induced corticosterone release and concomitant expression of the genes involved in hypothalamic–pituitary–adrenal (HPA) axis activation. Therefore, in this study, we have addressed the types of stressors and the levels of the HPA axis in which PACAP signaling is involved using mice lacking PACAP (PACAP−/−). Among four different types of stressors, open-field exposure, cold exposure, ether inhalation, and restraint, the corticosterone response to open-field exposure and restraint, which are categorized as emotional stressors, but not the other two, was markedly attenuated in PACAP−/− mice. Peripheral administration of corticotropin releasing factor (CRF) or adrenocorticotropic hormone induced corticosterone increase similarly in PACAP and wild-type mice. In addition, the restraint stress-induced c-Fos expression was significantly decreased in the paraventricular nucleus (PVN) and medial amygdala (MeA), but not the medial prefrontal cortex, in PACAP−/− mice. In the PVN of PACAP−/− mice, the stress-induced c-Fos expression was blunted in the CRF neurons. These results suggest that PACAP is critically involved in activation of the MeA and PVN CRF neurons to centrally regulate the HPA axis response to emotional stressors

Children’s rights online: challenges, dilemmas and emerging directions

In debates over internet governance, the interests of children figure unevenly, and only partial progress has been made in supporting children’s rights online globally. This chapter examines how the UN Convention on the Rights of the Child is helpful in mapping children’s rights to provision, protection and participation as they apply online as well as offline. However, challenges remain. First, opportunities and risks are positively linked, policy approaches are needed to resolve the potential conflict between protection on the one hand, and provision and participation on the other. Second, while parents may be relied on to some degree to balance their child’s rights and needs, the evidence suggests that a minority of parents are ill-equipped to manage this. Third, resolution is needed regarding the responsibility for implementing digital rights, since many governments prefer self-regulation in relation to internet governance. The chapter concludes by calling for a global governance body charged with ensuring the delivery of children’s rights