Kidney and Kidney Tumour Segmentation in CT Images

Automatic segmentation of kidney and kidney tumour in Computed Tomography (CT) images is essential, as it uses less time as compared to the current gold standard of manual segmentation. However, many hospitals are still reliant on manual study and segmentation of CT images by medical practitioners because of its higher accuracy. Thus, this study focuses on the development of an approach for automatic kidney and kidney tumour segmentation in contrast-enhanced CT images. A method based on Convolutional Neural Network (CNN) was proposed, where a 3D U-Net segmentation model was developed and trained to delineate the kidney and kidney tumour from CT scans. Each CT image was pre-processed before inputting to the CNN, and the effect of down-sampled and patch-wise input images on the model performance was analysed. The proposed method was evaluated on the publicly available 2021 Kidney and Kidney Tumour Segmentation Challenge (KiTS21) dataset. The method with the best performing model recorded an average training Dice score of 0.6129, with the kidney and kidney tumour Dice scores of 0.7923 and 0.4344, respectively. For testing, the model obtained a kidney Dice score of 0.8034, and a kidney tumour Dice score of 0.4713, with an average Dice score of 0.6374

Diagnosis of COVID-19 based on Chest Radiography

The Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, in early December 2019 and now becoming a pandemic. When COVID-19 patients undergo radiography examination, radiologists can observe the present of radiographic abnormalities from their chest X-ray (CXR) images. In this study, a deep convolutional neural network (CNN) model was proposed to aid radiologists in diagnosing COVID-19 patients. First, this work conducted a comparative study on the performance of modified VGG-16, ResNet-50 and DenseNet-121 to classify CXR images into normal, COVID-19 and viral pneumonia. Then, the impact of image augmentation on the classification results was evaluated. The publicly available COVID-19 Radiography Database was used throughout this study. After comparison, ResNet-50 achieved the highest accuracy with 95.88%. Next, after training ResNet-50 with rotation, translation, horizontal flip, intensity shift and zoom augmented dataset, the accuracy dropped to 80.95%. Furthermore, an ablation study on the effect of image augmentation on the classification results found that the combinations of rotation and intensity shift augmentation methods obtained an accuracy higher than baseline, which is 96.14%. Finally, ResNet-50 with rotation and intensity shift augmentations performed the best and was proposed as the final classification model in this work. These findings demonstrated that the proposed classification model can provide a promising result for COVID-19 diagnosis

In vitro evaluation of finger's hemodynamics for vein graft surveillance using electrical bio-impedance method

Electrical bio-impedance measurement has great potential in many biomedical applications including vein graft surveillance. Studies have shown that thrombosis was the major cause of the vein graft failure. The meticulous skills of the surgeon and effective postoperative surveillance of vein graft remain the cornerstones of clinical success in the current surgical management of vein graft survival. Vascular blood flow is the key clinical indicators for the evaluation of patency of the vein graft and ensuring the patient's quality of life. In this work, electrical bio-impedance method has been proposed as an alternative to the existing surveillance method as it is non-invasive, portable, easy applicable in practice, fast response, radiation free, and required only low-cost instrumentation. It was employed to measure pulsatile changes in longitudinal bio-impedance to quantify arterial blood flow and blood volume. We expect that by measuring the changes in tissue bio-impedance which can be used to evaluate important peripheral hemodynamic, it allows the detection of early stage stenosis within vascular and vein graft as well as estimate its severity with predetermined normative data provided

A cross-sectional study on level of knowledge and level of attitude towards asthma among the sampled population aged 13 years and above of Rumah Uming and Rumah Cherida, Meradong, from 20th November 2006 to 26th January 2007

Introduction: Asthma is a chronic inflammatory disorder of the airways characterized by wheezing, breathlessness, chest tightness and cough. Asthma affects people of all ages. In Malaysia, asthma was among the commonest conditions that accounted for outpatient department attendance. Asthma is not curable, yet an asthmatic patient can live a normal life ifit is well-controlled. Objectives: The objective of this study is to study the level of knowledge and level of attitude towards asthma among the sampled population aged 13 years and above in Rumah Uming and Rumah Cherida from 20th November 2006 to 26th January 2007. Methodology: A cross-sectional study on level of knowledge and level of attitude towards asthma was carried out. The sample size of 90 respondents was chosen using a simple random sampling method. Data collection was done by means of interview-guided questionnaire, and all collected data was entered and analysed using SPSS software version 13. The statistical tests that were used include Pearson correlation test, chi-square test, independent sample t-test, ANOV A test, Spearman rho test, Mann-Whitney U test and Kruskal-Wallis test. Results: The main source of information regarding asthma was obtained from mass media. The study showed more than half of the respondents had poor level of knowledge in terms of general knowledge and signs and symptoms (62.2%), risk factor and triggering factor (55.6%), and treatment and prevention of asthma (60.0%). However, 56.7% of respondents had good knowledge about complications of asthma. There was a significant relationship between total level of knowledge with gender (p = 0.034), household income (p = 0.018), and personal and family history of asthma (p = 0.008). Females, higher income group and respondents with personal and family history of asthma showed better score of knowledge. Most of the respondents had good attitude in terms of seeking knowledge (65.6%) and prevention of asthma (53.3%), however 55.6% showed poor attitude in terms of the treatment of asthma. Significant association was found between total level of attitude and level of education (p = 0.042). There was also a positive relationship between the total level of knowledge and the total level of attitude towards asthma among the respondents (p = 0.023). Conclusion: The study revealed a significantly higher level of knowledge among the respondents who were female, with higher household income and with personal and family history of asthma

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

Background Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.Methods In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186.Findings Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78 center dot 6%] female patients and 4922 [21 center dot 4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1 center dot 4 [IQR 0 center dot 6-3 center dot 4]) compared with the prepandemic phase (2 center dot 0 [0 center dot 9-3 center dot 7]; p<0 center dot 0001) and pandemic decrease phase (2 center dot 3 [1 center dot 0-5 center dot 0]; p<0 center dot 0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69 center dot 0%] of 3704 vs 1515 [71 center dot 5%] of 2119; OR 1 center dot 1 [95% CI 1 center dot 0-1 center dot 3]; p=0 center dot 042), lymph node metastases (343 [9 center dot 3%] vs 264 [12 center dot 5%]; OR 1 center dot 4 [1 center dot 2-1 center dot 7]; p=0 center dot 0001), and tumours at high risk of structural disease recurrence (203 [5 center dot 7%] of 3584 vs 155 [7 center dot 7%] of 2006; OR 1 center dot 4 [1 center dot 1-1 center dot 7]; p=0 center dot 0039).Interpretation Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation.Funding None.Copyright (c) 2023 Published by Elsevier Ltd. All rights reserved

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Technologies for Assessment of Motor Disorders in Parkinson’s Disease: A Review

Parkinson’s Disease (PD) is characterized as the commonest neurodegenerative illness that gradually degenerates the central nervous system. The goal of this review is to come out with a summary of the recent progress of numerous forms of sensors and systems that are related to diagnosis of PD in the past decades. The paper reviews the substantial researches on the application of technological tools (objective techniques) in the PD field applying different types of sensors proposed by previous researchers. In addition, this also includes the use of clinical tools (subjective techniques) for PD assessments, for instance, patient self-reports, patient diaries and the international gold standard reference scale, Unified Parkinson Disease Rating Scale (UPDRS). Comparative studies and critical descriptions of these approaches have been highlighted in this paper, giving an insight on the current state of the art. It is followed by explaining the merits of the multiple sensor fusion platform compared to single sensor platform for better monitoring progression of PD, and ends with thoughts about the future direction towards the need of multimodal sensor integration platform for the assessment of PD

Whole-exome sequencing identifies MST1R as a genetic susceptibility gene in nasopharyngeal carcinoma

Multiple factors, including host genetics, environmental factors, and Epstein-Barr virus (EBV) infection, contribute to nasopharyngeal carcinoma (NPC) development. To identify genetic susceptibility genes for NPC, a whole-exome sequencing (WES) study was performed in 161 NPC cases and 895 controls of Southern Chinese descent. The gene-based burden test discovered an association between macrophage- stimulating 1 receptor (MST1R) and NPC. We identified 13 independent cases carrying the MST1R pathogenic heterozygous germ-line variants, and 53.8% of these cases were diagnosed with NPC aged at or even younger than 20 y, indicating that MST1R germline variants are relevant to disease early-age onset (EAO) (age of ≤20 y). In total, five MST1R missense variants were found in EAO cases but were rare in controls (EAO vs. control, 17.9% vs. 1.2%, P = 7.94 × 10 -12 ). The validation study, including 2,160 cases and 2,433 controls, showed that the MST1R variant c.G917A:p.R306H is highly associated with NPC (odds ratio of 9.0). MST1R is predominantly expressed in the tissue-residentmacrophages and is critical for innate immunity that protects organs from tissue damage and inflammation. Importantly, MST1R expression is detected in the ciliated epithelial cells in normal nasopharyngeal mucosa and plays a role in the cilia motility important for host defense. Although no somatic mutation of MST1R was identified in the sporadic NPC tumors, copy number alterations and promoter hypermethylation at MST1R were often observed. Our findings provide new insights into the pathogenesis of NPC by highlighting the involvement of the MST1R-mediated signaling pathways.Link_to_subscribed_fulltex

Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study.

There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3-4.8) versus 26.4 h (IQR 21.4-31.4, p < 0.001), with 32 (21.5%) positive and 117 (78.5%) negative. Cohen's κ correlation between tests is 0.96 (95% CI 0.91-1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0-28.8), p = 0.02. Mean length of stay on COVID-19 "holding" wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems