Interpretable simultaneous localization of MRI corpus callosum and classification of atypical Parkinsonian disorders using YOLOv5

Structural MRI(S-MRI) is one of the most versatile imaging modality that revolutionized the anatomical study of brain in past decades. The corpus callosum (CC) is the principal white matter fibre tract, enabling all kinds of inter-hemispheric communication. Thus, subtle changes in CC might be associated with various neurological disorders. The present work proposes the potential of YOLOv5-based CC detection framework to differentiate atypical Parkinsonian disorders (PD) from healthy controls (HC). With 3 rounds of hold-out validation, mean classification accuracy of 92% is obtained using the proposed method on a proprietary dataset consisting of 20 healthy subjects and 20 cases of APDs, with an improvement of 5% over SOTA methods (CC morphometry and visual texture analysis) that used the same dataset. Subsequently, in order to incorporate the explainability of YOLO predictions, Eigen CAM based heatmap is generated for identifying the most important sub-region in CC that leads to the classification. The result of Eigen CAM showed CC mid-body as the most distinguishable sub-region in classifying APDs and HC, which is in-line with SOTA methodologies and the current prevalent understanding in medicine

Design and characteristics of the prophylactic intra-operative ventricular arrhythmia ablation in high-risk LVAD candidates (PIVATAL) trial

BACKGROUND: The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra-operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant. METHODS: We designed a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra-operative VTA ablation (n = 50) versus conventional medical management (n = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life. CONCLUSION: The primary aim of this first-ever randomized trial is to assess the efficacy of intra-operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA

Modeling Deep Neural Networks For Drone Identification

In the beginning, only the military used drones. The drones can be simply transformed into lethal weapons by adding explosives. Terrorists have reportedly attempted attacks using drones. Drones are challenging for traditional RADAR to detect because of their small size and weak electromagnetic signals. Both the business sector and the academic community evaluate a counter mechanism. Early kinds of drones were far more visible than they are now, but as time went on, they shrank and grew more intelligent. More people are in danger at public events now than ever before, thanks to developments in drone technology and capacity. Concertgoers, sports enthusiasts, and others may feel more secure thanks to actions taken to lessen the impact of these threats. Business meetings, sporting events, and concerts are all vulnerable to disruptions from drone technology for different reasons. High-quality photographs and videos taken by drones might be used to eavesdrop on or profit from exclusive events. Drones might make it easier for criminals to take audio or video from a concert or sports event, as well as sensitive company data. As a result, keeping an eye out for drones in restricted areas and nabbing them before them because trouble is essential to keeping the peace

First in human: the effects of biventricular pacing on cardiac output in severe pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) carries high morbidity and mortality despite available treatment options. In severe PAH, right ventricular (RV) diastolic pressure overload leads to interventricular septal bowing, hindering of left ventricular diastolic filling and reduced cardiac output (CO). Some animal studies suggest that pacing may mitigate this effect. We hypothesized that eliminating late diastole via ventricular pacing could improve CO in human subjects with severe PAH. Using minimal to no sedation, we performed transvenous acute biventricular (BiV) pacing and right heart catheterization in six patients with symptomatic PAH. Hemodynamic measurements were taken at baseline and during BiV pacing at various 20-ms intervals of V-V timing. We compared baseline CO to (1) CO while pacing the RV first by 80\ua0ms (mimicking RV-only pacing), and then to (2) CO during pacing at the V-V timing that resulted in the highest CO. All participants were female, PASP 74 ± 14\ua0mmHg, QRS duration 104 ± 20\ua0ms. Compared with baseline, the CO decreased when the RV was paced first by 80\ua0ms (7.2 ± 1.0 vs. 6.2 ± 1.1 L/min, p = 0.028). Pacing with optimal V-V timing produced CO similar to baseline (7.2 ± 1.0 vs. 7.4 ± 1.4, p = 0.92). Two patients (33%) met the predefined endpoint of a 15% increase in CO during pacing at the optimal V-V timing. In symptomatic PAH, V-V optimized acute BiV pacing does not consistently improve CO. However, acute BiV pacing did improve CO in a subset of this cohort. Further research is needed to identify predictors of response to cardiac resynchronization therapy in this population

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Background Over the next few years, atrial fibrillation (AF)–related morbidity and costs will increase significantly. Thus, it is prudent to examine the impact of AF treatment on health care resource use. This study examined the impact of AF ablation on hospitalization, length of stay, and resource use for patients undergoing AF ablation in a multihospital system. Methods and Results In an observational analysis, outcomes of total, cardiovascular, and AF hospitalizations, emergency department visits, and length of stay were compared for 3417 patients between 12 months before and 24 months following AF ablation. Use of electrical cardioversions and antiarrhythmic use were also compared 1 year before to 2 years after AF ablation. There were fewer total (0.7±1.3 versus 0.3±0.7; P<0.001), cardiovascular (0.7±1.2 versus 0.2±0.6; P<0.001), and AF (0.6±1.1 versus 0.1±0.3; P<0.001) hospitalizations and emergency department visits (0.8±2.1 versus 0.4±0.9; P<0.001) per patient‐year for the 2 years following AF ablation compared with 1 year before. Average length of stay per patient‐year (1.4±7.9 versus 3.6±5.3 days; P<0.0001), the percentage of patients on antiarrhythmic therapy (21.2% versus 58.5%; P<0.0001), and those undergoing electrical cardioversions (16.1% versus 28.1%; P<0.0001) were lower 2 years following AF ablation versus 1 year before. Conclusions We noted a decrease in total, cardiovascular, and AF hospitalizations and health care resource use during the 2‐year period after index AF ablation, compared with the 1 year before. AF ablation may portend a decline in patient morbidity and health care costs