Search results for: hepatic lesion segmentation

Authors: Hossein Rassi, Marjan Moradi fard, Masoud Houshmand

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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human Papillomavirus (HPV) infection is the leading risk factor for Cervical Intraepithelial Neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33, and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, miR-146a rs2910164 polymorphism, p53 polymorphism, intraepithelial, neoplasia, HPV

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Authors: Sarah K. Hagi, Majdi Alnowaimi

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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Tarek Abdelkader, Suresh Selvaraj, Prasad Iyer, Yong Mun Hin, Hajmath Begum, P. Gopalakrishnakone

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Nowadays, more and more educational institutes, as well as students, rely on 3D anatomy programs as an important tool that helps students correlate the actual locations of anatomical structures in a 3D dimension. Lately, virtual reality (VR) is gaining more favor from the younger generations due to its higher interactive mode. As a result, using virtual reality as a gamified learning platform for anatomy became the current goal. We present a model where a Virtual Human Anatomy Program (VHAP) was developed to assist with the anatomy learning experience of students. The anatomy module has been built, mostly, from real patient CT scans. Segmentation and surface rendering were used to create the 3D model by direct segmentation of CT scans for each organ individually and exporting that model as a 3D file. After acquiring the 3D files for all needed organs, all the files were introduced into a Virtual Reality environment as a complete body anatomy model. In this ongoing experiment, students from different Allied Health orientations are testing the VHAP. Specifically, the cardiovascular system has been selected as the focus system of study since all of our students finished learning about it in the 1st trimester. The initial results suggest that the VHAP system is adding value to the learning process of our students, encouraging them to get more involved and to ask more questions. Involved students comments show that they are excited about the VHAP system with comments about its interactivity as well as the ability to use it solo as a self-learning aid in combination with the lectures. Some students also experienced minor side effects like dizziness.

Keywords: 3D construction, health sciences, teaching pedagogy, virtual reality

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Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina

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Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.

Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle

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Authors: Catalina Albornoz, Giacomo Barbieri

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Crop monitoring has shown to reduce vulnerability to spreading plagues and pathologies in crops. Remote sensing with Unmanned Aerial Vehicles (UAVs) has made crop monitoring more precise, cost-efficient and accessible. Nowadays, remote monitoring involves calculating maps of vegetation indices by using different software that takes either Truecolor (RGB) or multispectral images as an input. These maps are then used to segment the crop into management zones. Finally, knowing the spectral signature of a crop (the reflected radiation as a function of wavelength) can be used as an input for decision-making and crop characterization. The calculation of vegetation indices using software such as Pix4D has high precision for monoculture plantations. However, this paper shows that using this software on mixed crops may lead to errors resulting in an incorrect segmentation of the field. Within this work, authors propose to filter all the elements different from the main crop before the calculation of vegetation indices and the spectral signature. A filter based on the Sobel method for border detection is used for filtering a coffee crop. Results show that segmentation into management zones changes with respect to the traditional situation in which a filter is not applied. In particular, it is shown how the values of the spectral signature change in up to 17% per spectral band. Future work will quantify the benefits of filtering through the comparison between in situ measurements and the calculated vegetation indices obtained through remote sensing.

Keywords: coffee, filtering, mixed crop, precision agriculture, remote sensing, spectral signature

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Authors: T. Delval, C. Sauvage, Q. Jullien, R. Viano, T. Diallo, B. Collignan, G. Picinbono

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In the context of the international spread of COVID-19, the Centre Scientifique et Technique du Bâtiment (CSTB) has led a joint research with the French government authorities Hauts-de-Seine department, to analyse the risk in school spaces according to their configuration, ventilation system and spatial segmentation strategy. This paper describes the main results of this joint research. A multidisciplinary team involving experts in indoor air quality/ventilation, pedestrian movements and IT domains was established to develop a COVID risk analysis tool based on Building Information Model. The work started with specific analysis on two pilot schools in order to provide for the local administration specifications to minimize the spread of the virus. Different recommendations were published to optimize/validate the use of ventilation systems and the strategy of student occupancy and student flow segmentation within the building. This COVID expertise has been digitized in order to manage a quick risk analysis on the entire building that could be used by the public administration through an easy user interface implemented in a free BIM Management software. One of the most interesting results is to enable a dynamic comparison of different ventilation system scenarios and space occupation strategy inside the BIM model. This concurrent engineering approach provides users with the optimal solution according to both ventilation and pedestrian flow expertise.

Keywords: BIM, knowledge management, system expert, risk management, indoor ventilation, pedestrian movement, integrated design

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Authors: Gunnar Oskarsson, Irena Georgsdottir

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Tourism has been growing incredibly fast during the past years, including the cruise industry, which is gaining increasing popularity among various groups of travelers. It is a challenging task for companies serving cruise ship passengers with local products and services at the point of destination to reach them in due time with information about their offerings, as well learning how to adapt their offerings and messages to the type of customers arriving on each particular occasion. Although some research has been conducted in this sphere, there is still limited knowledge about many specifics within this sector of the tourist industry. The objective of this research is to examine one of these, with the main goal of studying the segmentation of cruise passengers and to learn about marketing practices directed towards them. A qualitative research method, based on in-depth interviews, was used, as this provides an opportunity to gain insight into the participants’ perspectives. Interviews were conducted with 10 respondents from different companies in the tourist industry in Iceland, who interact with cruise passengers on a regular basis in their work environment. The main objective was to gain an understanding of what distinguishes different customer groups, or segments, in this industry, and of the marketing approaches directed towards them. The main findings reveal that participants note the strongest difference between cruise passengers of different nationalities, passengers coming on different ships (size and type), and passengers arriving at different times of the year. A drastic difference was noticed between nationalities in four main segments, American, British, Other European, and Asian customers, although some of these segments could be divided into even further sub-segments. Other important differencing factors were size and type of ships, quality or number of stars on the ship, and travelling time of the year. Companies serving cruise ship passengers, as well as the customers themselves, could benefit if the offerings of services were designed specifically for particular segments within the industry. Concerning marketing towards cruise passengers, the results indicate that it is carried out almost exclusively through the Internet using; a reliable website and, search engine optimization. Marketing is also by word-of-mouth. This research can assist practitioners by offering a deeper understanding of the approaches that may be effective in marketing local products and services to cruise ship passengers, based on their segmentation and by identifying effective ways to reach them. The research, furthermore, provides a valuable contribution to marketing knowledge for the benefit of an increasingly important market segment in a fast growing tourist industry.

Keywords: capabilities, global integration, internationalisation, SMEs

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Authors: Asma Rashid, Shazia Iram, Iftikhar Ahmad

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Mango sudden death is an emerging problem in Pakistan. As its prevalence is observed in almost all mango growing areas and severity varied from 2-5% in Punjab and 5-10% in Sindh. Symptoms on affected trees include bark splitting, discoloration of the vascular tissue, wilting, gummosis and at the end rapid death. Total of n= 45 isolates were isolated from different mango growing areas of Punjab and Sindh. Pathogenicity of these fungal isolates was tested through artificial inoculation method on different hosts (potato tubers, detached mango leaves, detached mango twigs and mango plants) under controlled conditions and all were proved pathogenic with varying degree of aggressiveness in reference to control. The findings of the present study proved that out of these four methods, potato tubers inoculation method was the most ideal as this fix the inoculums on the target site. Increased fungal growth and spore numbers may be due to soft tissues of potato tubers from which Ceratocystis isolates can easily pass. Lesion area on potato tubers was in the range of 7.09-0.14 cm2 followed by detached mango twigs which were ranged from 0.48-0.09 cm2). All pathological results were proved highly significant at P<0.05 through ANOVA but isolate to isolate showed non-significant behaviour but they have the positive effect on lesion area. Re-isolation of respective fungi was achieved with 100 percent success which results in the verification of Koch’s postulates. DNA of fungal pathogens was successfully extracted through phenol chloroform method. Amplification was done through ITS, b-tubulin gene, and Transcription Elongation Factor (EF1-a) gene primers and the amplified amplicons were sequenced and compared from NCBI which showed 99-100 % similarity with Ceratocystis manginecans. Fungus Ceratocystis manginecans formed one of strongly supported sub-clades through phylogenetic tree. Results obtained through this work would be supportive in establishment of relation of isolates with their region and will give information about pathogenicity level of isolates that would be useful to develop the management policies to reduce the afflictions in orchards caused by mango sudden death.

Keywords: artificial inoculation, mango, Ceratocystis manginecans, phylogenetic, screening

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Authors: Eun-Young Kwon, Myung-Sook Choi, Su-Jung Cho, Ji-Young Choi, So Young Kim, Youngji Han

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Overweight and obesity have been linked to a low-grade chronic inflammatory response and an increased risk of developing metabolic syndrome including insulin resistance, type 2 diabetes mellitus and certain types of cancers. Luteolin is a dietary flavonoid with anti-inflammatory, anti-oxidant, anti-cancer and anti-diabetic properties. However, little is known about the detailed mechanism associated with the effect of luteolin on inflammation-related obesity and its complications. The aim of the present study was to reveal the anti-diabetic effect of luteolin in diet-induced obesity mice using “transcriptomics” tool. Thirty-nine male C57BL/6J mice (4-week-old) were randomly divided into 3 groups and were fed normal diet, high-fat diet (HFD, 20% fat) and HFD+0.005% (w/w) luteolin for 16 weeks. Luteolin improved insulin resistance, as measured by HOMA-IR and glucose tolerance, along with preservation action of pancreatic β-cells, compared to the HFD group. Luteoiln was significantly decreased the levels of leptin and ghrelin that play a pivotal role in energy balance, and the macrophage low-grade inflammation marker sCD163 (soluble Cd antigen 163) in plasma. Activities of hepatic anti-oxidant enzymes (catalase and glutathione peroxidase) were increased, while the levels of plasma transaminase (GOT and GPT) and oxidative damage markers (hepatic mitochondria H2O2 and TBARS) were markedly decreased by luteolin supplementation. In addition, luteolin increased oxidative capacity and fatty acid utilization by presenting decrease in enzyme activities of citrate synthase, cytochrome C oxidase and β-hydroxyacyl CoA dehydrogenase and UCP3 gene expression compared to high-fat diet. Moreover, our microarray results of muscle also revealed down-regulated gene expressions associated with TCA cycle by HFD were reversed to normal level by luteolin treatment. Taken together, our results indicate that luteolin is one of bioactive components for improving insulin resistance by increasing oxidative capacity, modulating anti-oxidant metabolism and suppressing inflammatory signaling cascades in diet-induced obese mice. These results provide possible therapeutic targets for prevention and treatment of diet-induced obesity and its complications.

Keywords: anti-oxidant metabolism, diabetes, luteolin, oxidative capacity

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Mekdes Getu Chekol, Biniam Tedros Kahsay, Rahwa Berihu Haile

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The main objective of this study is to investigate the marketing strategy practice in the Case of St. George Brewery Factory in Addis Ababa. One of the core activities in a Business Company to stay in business is having a well-developed marketing strategy. It assessed how the marketing strategies were practiced in the company to achieve its goals aligned with segmentation, target market, positioning, and the marketing mix elements to satisfy customer requirements. Using primary and secondary data, the study is conducted by using both qualitative and quantitative approaches. The primary data was collected through open and closed-ended questionnaires. Considering the size of the population is small, the selection of the respondents was carried out by using a census. The finding shows that the company used all the 4 Ps of the marketing mix elements in its marketing strategies and provided quality products at affordable prices by promoting its products by using high and effective advertising mechanisms. The product availability and accessibility are admirable with the practices of both direct and indirect distribution channels. On the other hand, the company has identified its target customers, and the company’s market segmentation practice is geographical location. Communication effectiveness between the marketing department and other departments is very good. The adjusted R2 model explains 61.6% of the marketing strategy practice variance by product, price, promotion, and place. The remaining 38.4% of variation in the dependent variable was explained by other factors not included in this study. The result reveals that all four independent variables, product, price, promotion, and place, have a positive beta sign, proving that predictor variables have a positive effect on that of the predicting dependent variable marketing strategy practice. Even though the marketing strategies of the company are effectively practiced, there are some problems that the company faces while implementing them. These are infrastructure problems, economic problems, intensive competition in the market, shortage of raw materials, seasonality of consumption, socio-cultural problems, and the time and cost of awareness creation for the customers. Finally, the authors suggest that the company better develop a long-range view and try to implement a more structured approach to attain information about potential customers, competitor’s actions, and market intelligence within the industry. In addition, we recommend conducting the study by increasing the sample size and including different marketing factors.

Keywords: marketing strategy, market segmentation, target marketing, market positioning, marketing mix

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Authors: Pranav Ajmera, Amit Kharat, Tanveer Gupte, Richa Pant, Viraj Kulkarni, Vinay Duddalwar, Purnachandra Lamghare

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The cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR, that is, a value greater than 0.55, is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR from chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. We propose a deep learning-based model for automatic CTR calculation that can assist the radiologist with the diagnosis of cardiomegaly and optimize the radiology flow. The study population included 1012 posteroanterior (PA) CXRs from a single institution. The Attention U-Net deep learning (DL) architecture was used for the automatic calculation of CTR. A CTR of 0.55 was used as a cut-off to categorize the condition as cardiomegaly present or absent. An observer performance test was conducted to assess the radiologist's performance in diagnosing cardiomegaly with and without artificial intelligence (AI) assistance. The Attention U-Net model was highly specific in calculating the CTR. The model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. During the analysis, we observed that 51 out of 1012 samples were misclassified by the model when compared to annotations made by the expert radiologist. We further observed that the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR. Our segmentation-based AI model demonstrated high specificity and sensitivity for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinical workflows.

Keywords: cardiomegaly, deep learning, chest radiograph, artificial intelligence, cardiothoracic ratio

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Authors: Saba Fahham, Supak Ngamsom, Suchaya Damrongsri

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Objective: The objective is to determine the optimal threshold of Romexis software for the airway volume and minimum cross-section area (MCA) analysis using Image J as a gold standard. Materials and Methods: A total of ten cone-beam computed tomography (CBCT) images were collected. The airway volume and MCA of each patient were analyzed using the automatic airway segmentation function in the CBCT DICOM viewer (Romexis). Airway volume and MCA measurements were conducted on each CBCT sagittal view with fifteen different threshold values from the Romexis software, Ranging from 300 to 1000. Duplicate DICOM files, in axial view, were imported into Image J for concurrent airway volume and MCA analysis as the gold standard. The airway volume and MCA measured from Romexis and Image J were compared using a t-test with Bonferroni correction, and statistical significance was set at p<0.003. Results: Concerning airway volume, thresholds of 600 to 850 as well as 1000, exhibited results that were not significantly distinct from those obtained through Image J. Regarding MCA, employing thresholds from 400 to 850 within Romexis Viewer showed no variance from Image J. Notably, within the threshold range of 600 to 850, there were no statistically significant differences observed in both airway volume and MCA analyses, in comparison to Image J. Conclusion: This study demonstrated that the utilization of Planmeca Romexis Viewer 6.4.3.3 within threshold range of 600 to 850 yields airway volume and MCA measurements that exhibit no statistically significant variance in comparison to measurements obtained through Image J. This outcome holds implications for diagnosing upper airway obstructions and post-orthodontic surgical monitoring.

Keywords: airway analysis, airway segmentation, cone beam computed tomography, threshold

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Authors: Tareg Belali, Mosleh Abomughaid, Muhanad Alhujaily

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HNF4a is one of the steroid hormone receptor family of transcription factors with roles in the development of the liver and the regulation of several critical metabolic pathways, such as glycolysis, drug metabolism, and apolipoproteins and blood coagulation. The transcriptional potency of HNF4a is well known due to its involvement in diabetes and other metabolic diseases. However, recently HNF4a has been discovered to be closely associated with several haematological disorders, mainly because of genetic mutations, drugs, and hepatic disorders. We review HNF4a structure and function and its role in haematological disorders. We discuss possible good therapies that are based on targeting HNF4a.

Keywords: hepatocyte nuclear factor 4 alpha, HNF4a nuclear receptor, steroid hormone receptor family of transcription factors, hematological disorders

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Authors: Dongqi Li, Yunjia Huang, Tomo Inoue, Kohei Inoue

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With urbanization, urban cultural heritage is facing the impact and destruction of modernization and urbanization. Many historical areas are losing their historical information and regional cultural characteristics, so it is necessary to carry out systematic color planning for historical areas in conservation. As an early focus on urban color planning, Japan has a systematic approach to urban color planning. Hence, this paper selects five merchant towns from the category of important traditional building preservation areas in Japan as the subject of this study to explore the color structure and emotion of this type of historic area. First, the image semantic segmentation method identifies the buildings, roads, and landscape environments. Their color data were extracted for color composition and emotion analysis to summarize their common features. Second, the obtained Internet evaluations were extracted by natural language processing for keyword extraction. The correlation analysis of the color structure and keywords provides a valuable reference for conservation decisions for this historic area in the town. This paper also combines the color structure and Internet evaluation results with generative adversarial networks to generate predicted images of color structure improvements and color improvement schemes. The methods and conclusions of this paper can provide new ideas for the digital management of environmental colors in historic districts and provide a valuable reference for the inheritance of local traditional culture.

Keywords: historic districts, color planning, semantic segmentation, natural language processing

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Authors: Osama M. Ahmed, Walaa G. Hozayen, Haidy Tamer Abo Sree

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The effect of doxorubicin (4 mg/kg b.w.week) without or with oral administration of ethanolic purslane (Portulaca oleracea) shoot (leaves and stems) extract (50 mg/kg b.w.day) or ethanolic purslane seeds extract (50 mg/kg b.w.day) co-treatments for 6 weeks was evaluated in adult male rats. There was an increase in serum levels of ALT, AST, ALP, GGT and total bilirubin. In addition, hepatic glutathine, glutathione transferase, peroxidase, SOD, CAT activities were decreased while lipid peroxidation in the liver was increased. Co-administration of ethanolic purslane and seed extracts successfully improved the adverse changes in the liver functions with an increase in antioxidants activities and reduction of lipid peroxidation.

Keywords: antioxidants, doxorubicin, hepatotoxicity, purslane

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Authors: Rafael do Amaral Teodoro, Leandro Augusto da Silva

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Originated from graphite, graphene is a two-dimensional (2D) material that promises to revolutionize technology in many different areas, such as energy, telecommunications, civil construction, aviation, textile, and medicine. This is possible because its structure, formed by carbon bonds, provides desirable optical, thermal, and mechanical characteristics that are interesting to multiple areas of the market. Thus, several research and development centers are studying different manufacturing methods and material applications of graphene, which are often compromised by the scarcity of more agile and accurate methodologies to characterize the material – that is to determine its composition, shape, size, and the number of layers and crystals. To engage in this search, this study proposes a computational methodology that applies deep learning to identify graphene oxide crystals in order to characterize samples by crystal sizes. To achieve this, a fully convolutional neural network called U-net has been trained to segment SEM graphene oxide images. The segmentation generated by the U-net is fine-tuned with a standard deviation technique by classes, which allows crystals to be distinguished with different labels through an object delimitation algorithm. As a next step, the characteristics of the position, area, perimeter, and lateral measures of each detected crystal are extracted from the images. This information generates a database with the dimensions of the crystals that compose the samples. Finally, graphs are automatically created showing the frequency distributions by area size and perimeter of the crystals. This methodological process resulted in a high capacity of segmentation of graphene oxide crystals, presenting accuracy and F-score equal to 95% and 94%, respectively, over the test set. Such performance demonstrates a high generalization capacity of the method in crystal segmentation, since its performance considers significant changes in image extraction quality. The measurement of non-overlapping crystals presented an average error of 6% for the different measurement metrics, thus suggesting that the model provides a high-performance measurement for non-overlapping segmentations. For overlapping crystals, however, a limitation of the model was identified. To overcome this limitation, it is important to ensure that the samples to be analyzed are properly prepared. This will minimize crystal overlap in the SEM image acquisition and guarantee a lower error in the measurements without greater efforts for data handling. All in all, the method developed is a time optimizer with a high measurement value, considering that it is capable of measuring hundreds of graphene oxide crystals in seconds, saving weeks of manual work.

Keywords: characterization, graphene oxide, nanomaterials, U-net, deep learning

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Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

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Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

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Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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Authors: Michael R. Shurin, Galina Shurin, Vladimir A. Kirichenko

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Background. Visibility of hepatic malignancies is poor on non-contrast imaging for daily verification of liver malignancies prior to radiation therapy on MRI-guided Linear Accelerators (MR-Linac). Ferumoxytol® (Feraheme, AMAG Pharmaceuticals, Waltham, MA) is a SPION agent that is increasingly utilized off-label as hepatic MRI contrast. This agent has the advantage of providing a functional assessment of the liver based upon its uptake by hepatic Kupffer cells proportionate to vascular perfusion, resulting in strong T1, T2 and T2* relaxation effects and enhanced contrast of malignant tumors, which lack Kupffer cells. The latter characteristic has been recently utilized for MRI-guided radiotherapy planning with precision targeting of liver malignancies. However potential radiotoxicity of SPION has never been addressed for its safe use as an MRI-contrast agent during liver radiotherapy on MRI-Linac. This study defines the radiomodulating properties of SPIONs in vitro on human monocyte and macrophage cell lines exposed to 60Go gamma-rays within clinical radiotherapy dose range. Methods. Human monocyte and macrophages cell line in cultures were loaded with a clinically relevant concentration of Ferumoxytol (30µg/ml) for 2 and 24 h and irradiated to 3Gy, 5Gy and 10Gy. Cells were washed and cultured for additional 24 and 48 h prior to assessing their phenotypic activation by flow cytometry and function, including viability (Annexin V/PI assay), proliferation (MTT assay) and cytokine expression (Luminex assay). Results. Our results reveled that SPION affected both human monocytes and macrophages in vitro. Specifically, iron oxide nanoparticles decreased radiation-induced apoptosis and prevented radiation-induced inhibition of human monocyte proliferative activity. Furthermore, Ferumoxytol protected monocytes from radiation-induced modulation of phenotype. For instance, while irradiation decreased polarization of monocytes to CD11b+CD14+ and CD11bnegCD14neg phenotype, Ferumoxytol prevented these effects. In macrophages, Ferumoxytol counteracted the ability of radiation to up-regulate cell polarization to CD11b+CD14+ phenotype and prevented radiation-induced down-regulation of expression of HLA-DR and CD86 molecules. Finally, Ferumoxytol uptake by human monocytes down-regulated expression of pro-inflammatory chemokines MIP-1α (Macrophage inflammatory protein 1α), MIP-1β (CCL4) and RANTES (CCL5). In macrophages, Ferumoxytol reversed the expression of IL-1RA, IL-8, IP-10 (CXCL10) and TNF-α, and up-regulates expression of MCP-1 (CCL2) and MIP-1α in irradiated macrophages. Conclusion. SPION agent Ferumoxytol increases resistance of human monocytes to radiation-induced cell death in vitro and supports anti-inflammatory phenotype of human macrophages under radiation. The effect is radiation dose-dependent and depends on the duration of Feraheme uptake. This study also finds strong evidence that SPIONs reversed the effect of radiation on the expression of pro-inflammatory cytokines involved in initiation and development of radiation-induced liver damage. Correlative translational work at our institution will directly assess the cyto-protective effects of Ferumoxytol on human Kupfer cells in vitro and ex vivo analysis of explanted liver specimens in a subset of patients receiving Feraheme-enhanced MRI-guided radiotherapy to the primary liver tumors as a bridge to liver transplant.

Keywords: superparamagnetic iron oxide nanoparticles, radioprotection, magnetic resonance imaging, liver

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Authors: Rabab Makki, Deputy Chief Dietitian

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Malnutrition is commonly seen in Liver Disease patients. Prevalence of malnutrition in cirrhosis, is as high as 65-90%. Protein depletion and reduced muscle function are common. There are many mechanisms of malnutrition in liver cirrhosis e.g. insulin resistance, low respiratory quotient, increased glucogenesis etc. Nutrition support improves outcome in patients unable to maintain an intake of 35-40 Kcal/kg and 1.2-1.5 gm/kg/day. Simple methods of assessment such as subjective global assessment, calorie counting, MMC are useful. The value of BCAAs remains uncertain despite a considerable number of studies. Normal protein diets have been given safely to patients with hepatic encephalopathy. Restriction of protein not more than 48 hours pre- and pro-biotic, glutamine, fish oil etc are all part of the latest advanced techniques used.

Keywords: liver cirrhosis, omega 3 for liver disease, nutrition management, malnutrition

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Authors: Marcela De Oliveira, Marina P. Da Silva, Fernando C. G. Da Rocha, Jorge M. Santos, Jaime S. Cardoso, Paulo N. Lisboa-Filho

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Multiple Sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by neurodegeneration, inflammation, demyelination, and axonal loss. Magnetic resonance imaging (MRI), due to the richness in the information details provided, is the gold standard exam for diagnosis and follow-up of neurodegenerative diseases, such as MS. Brain atrophy, the gradual loss of brain volume, is quite extensive in multiple sclerosis, nearly 0.5-1.35% per year, far off the limits of normal aging. Thus, the brain volume quantification becomes an essential task for future analysis of the occurrence atrophy. The analysis of MRI has become a tedious and complex task for clinicians, who have to manually extract important information. This manual analysis is prone to errors and is time consuming due to various intra- and inter-operator variability. Nowadays, computerized methods for MRI segmentation have been extensively used to assist doctors in quantitative analyzes for disease diagnosis and monitoring. Thus, the purpose of this work was to evaluate the brain volume in MRI of MS patients. We used MRI scans with 30 slices of the five patients diagnosed with multiple sclerosis according to the McDonald criteria. The computational methods for the analysis of images were carried out in two steps: segmentation of the brain and brain volume quantification. The first image processing step was to perform brain extraction by skull stripping from the original image. In the skull stripper for MRI images of the brain, the algorithm registers a grayscale atlas image to the grayscale patient image. The associated brain mask is propagated using the registration transformation. Then this mask is eroded and used for a refined brain extraction based on level-sets (edge of the brain-skull border with dedicated expansion, curvature, and advection terms). In the second step, the brain volume quantification was performed by counting the voxels belonging to the segmentation mask and converted in cc. We observed an average brain volume of 1469.5 cc. We concluded that the automatic method applied in this work can be used for the brain extraction process and brain volume quantification in MRI. The development and use of computer programs can contribute to assist health professionals in the diagnosis and monitoring of patients with neurodegenerative diseases. In future works, we expect to implement more automated methods for the assessment of cerebral atrophy and brain lesions quantification, including machine-learning approaches. Acknowledgements: This work was supported by a grant from Brazilian agency Fundação de Amparo à Pesquisa do Estado de São Paulo (number 2019/16362-5).

Keywords: brain volume, magnetic resonance imaging, multiple sclerosis, skull stripper

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Authors: Ainouna Bouziane

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The ability of Electron Tomography to recover the 3D structure of catalysts, with spatial resolution in the subnanometer scale, has been widely explored and reviewed in the last decades. A variety of experimental techniques, based either on Transmission Electron Microscopy (TEM) or Scanning Transmission Electron Microscopy (STEM) have been used to reveal different features of nanostructured catalysts in 3D, but High Angle Annular Dark Field imaging in STEM mode (HAADF-STEM) stands out as the most frequently used, given its chemical sensitivity and avoidance of imaging artifacts related to diffraction phenomena when dealing with crystalline materials. In this regard, our group has developed a methodology that combines image denoising by undecimated wavelet transforms (UWT) with automated, advanced segmentation procedures and parameter selection methods using CS-TVM (Compressed Sensing-total variation minimization) algorithms to reveal more reliable quantitative information out of the 3D characterization studies. However, evaluating the accuracy of the magnitudes estimated from the segmented volumes is also an important issue that has not been properly addressed yet, because a perfectly known reference is needed. The problem particularly complicates in the case of multicomponent material systems. To tackle this key question, we have developed a methodology that incorporates volume reconstruction/segmentation methods. In particular, we have established an approach to evaluate, in quantitative terms, the accuracy of TVM reconstructions, which considers the influence of relevant experimental parameters like the range of tilt angles, image noise level or object orientation. The approach is based on the analysis of material-realistic, 3D phantoms, which include the most relevant features of the system under analysis.

Keywords: electron tomography, supported catalysts, nanometrology, error assessment

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Authors: Wi-Sun Ryu, Eun-Kee Bae

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Prior studies have shown that patients with right hemispheric stroke are likely to seek medical service compared with those with left hemispheric stroke. However, the underlying mechanism for this phenomenon is unknown. In the present study, we generated lesion probability maps in a patient with right and left middle cerebral artery infarct and statistically compared. We found that precentral gyrus-Brodmann area 44, a language area in the left hemisphere - involvement was significantly higher in patients with left hemispheric stroke. This finding suggests that a language dysfunction was more noticeable, thereby taking more patients to hospitals.

Keywords: cerebral infarct, brain MRI, statistical parametric mapping, middle cerebral infarct

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Authors: Safaa S. Hassan, Mohammed H. Elbakry, Safwat A. Mangoura, Zainab M. Omar

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Background: Liver fibrosis is the main reason for increased mortality in chronic liver disease. It has no standard treatment. Antioxidants from a variety of sources are capable of slowing or preventing oxidation of other molecules. Aim: to evaluate the hepatoprotective effect of vit. C, vit. E and gallic acid in comparison to silymarin in the rat model of carbon tetrachloride induced liver fibrosis and their possible mechanisms of action. Material& Methods: A total number of 60 adult male albino rats 160-200gm were divided into six equal groups; received subcutaneous (s.c) injection for 8 weeks. Group I: as control. Group II: received 1.5 mL/kg of CCL4 .Group III: CCL4 and co- treatment with silymarin 100mg/kg p.o. daily. Group IV: CCL4 and co-treatment with vit. C 50mg/kg p.o. daily. Group V: CCL4 and co-treatment with vit. E 200mg/kg. p.o. Group VI: CCL4 and co-treatment with Gallic acid 100mg/kg. p.o. daily. Liver was processed for histological and immunohistochemical examination. Levels of AST, ALT, ALP, reduced GSH, MDA, SOD and hydroxyproline concentration were measured and evaluated statistically. Results: Light and electron microscopic examination of liver of group II exhibited foci of altered cells with dense nuclei and vacuolated, granular cytoplasm, mononuclear cell infiltration in portal areas, profuse collagen fiber deposits were found around portal tract, more intense staining α-SMA-positive cells occupied most of the liver fibrosis tissue, electron lucent areas in the cytoplasm of the hepatocytes, margination of nuclear chromatin. Treatment by any of the antioxidants variably reduced the hepatic structural changes induced by CCL4. Biochemical analysis showed that carbon tetrachloride significantly increased the levels of serum AST, ALT, ALP, hepatic malondialdehyde and hydroxyproline content. Moreover, it decreased the activities of superoxide dismutase and glutathione. Treatment with silymarin, gallic acid, vit. C and vit. E decreased significantly the AST, ALT, and ALP levels in plasma, MDA and hydroxyproline and increased the activities of SOD and glutathione in liver tissue. The effect of administration of CCl4 was improved with the used antioxidants in variable degrees. The most efficient antioxidant was silymarin followed by gallic acid and vit. C then vit. E. It is possibly due to their antioxidant effect, free radical scavenging properties and the reduction of oxidant dependent activation and proliferation of HSCs. Conclusion: So these antioxidants can be a promising drugs candidate for ameliorating liver fibrosis better than the use of the drugs and their side effects.

Keywords: antioxidant, ccl4, gallic acid, liver fibrosis

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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Authors: Xiang Zhang, Daohong Yang, Ziyuan Wu, Lei Li, Wanting Zhou

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Visual Simultaneous Localization and Mapping (VSLAM) uses cameras to collect information in unknown environments to realize simultaneous localization and environment map construction, which has a wide range of applications in autonomous driving, virtual reality and other related fields. At present, the related research achievements about VSLAM can maintain high accuracy in static environment. But in dynamic environment, due to the presence of moving objects in the scene, the movement of these objects will reduce the stability of VSLAM system, resulting in inaccurate localization and mapping, or even failure. In this paper, a robust VSLAM method was proposed to effectively deal with the problem in dynamic environment. We proposed a dynamic region removal scheme based on semantic segmentation neural networks and geometric constraints. Firstly, semantic extraction neural network is used to extract prior active motion region, prior static region and prior passive motion region in the environment. Then, the light weight frame tracking module initializes the transform pose between the previous frame and the current frame on the prior static region. A motion consistency detection module based on multi-view geometry and scene flow is used to divide the environment into static region and dynamic region. Thus, the dynamic object region was successfully eliminated. Finally, only the static region is used for tracking thread. Our research is based on the ORBSLAM3 system, which is one of the most effective VSLAM systems available. We evaluated our method on the TUM RGB-D benchmark and the results demonstrate that the proposed VSLAM method improves the accuracy of the original ORBSLAM3 by 70%˜98.5% under high dynamic environment.

Keywords: dynamic scene, dynamic visual SLAM, semantic segmentation, scene flow, VSLAM

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Authors: Shivahari Revathi Venkateswaran

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Segmenting customers plays a significant role in churn prediction. It helps the marketing team with proactive and reactive customer retention. For the reactive retention, the retention team reaches out to customers who already showed intent to disconnect by giving some special offers. When coming to proactive retention, the marketing team uses churn prediction model, which ranks each customer from rank 1 to 100, where 1 being more risk to churn/disconnect (high ranks have high propensity to churn). The churn prediction model is built by using XGBoost model. However, with the churn rank, the marketing team can only reach out to the customers based on their individual ranks. To profile different groups of customers and to frame different marketing strategies for targeted groups of customers are not possible with the churn ranks. For this, the customers must be grouped in different segments based on their profiles, like demographics and other non-controllable attributes. This helps the marketing team to frame different offer groups for the targeted audience and prevent them from disconnecting (proactive retention). For segmentation, machine learning approaches like k-mean clustering will not form unique customer segments that have customers with same attributes. This paper finds an alternate approach to find all the combination of unique segments that can be formed from the user attributes and then finds the segments who have uplift (churn rate higher than the baseline churn rate). For this, search algorithms like fast search and recursive search are used. Further, for each segment, all customers can be targeted using individual churn ranks from the churn prediction model. Finally, a UI (User Interface) is developed for the marketing team to interactively search for the meaningful segments that are formed and target the right set of audience for future marketing campaigns and prevent them from disconnecting.

Keywords: churn prediction modeling, XGBoost model, uplift segments, proactive marketing, search algorithms, retention, k-mean clustering

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Authors: Shenlun Chen, Leonard Wee

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Tumor grading is an essential reference for colorectal cancer (CRC) staging and survival prognostication. The widely used World Health Organization (WHO) grading system defines histological grade of CRC adenocarcinoma based on the density of glandular formation on whole slide images (WSI). Tumors are classified as well-, moderately-, poorly- or un-differentiated depending on the percentage of the tumor that is gland forming; >95%, 50-95%, 5-50% and <5%, respectively. However, manually grading WSIs is a time-consuming process and can cause observer error due to subjective judgment and unnoticed regions. Furthermore, pathologists’ grading is usually coarse while a finer and continuous differentiation grade may help to stratifying CRC patients better. In this study, a deep learning based automatic differentiation grading algorithm was developed and evaluated by survival analysis. Firstly, a gland segmentation model was developed for segmenting gland structures. Gland regions of WSIs were delineated and used for differentiation annotating. Tumor regions were annotated by experienced pathologists into high-, medium-, low-differentiation and normal tissue, which correspond to tumor with clear-, unclear-, no-gland structure and non-tumor, respectively. Then a differentiation prediction model was developed on these human annotations. Finally, all enrolled WSIs were processed by gland segmentation model and differentiation prediction model. The differentiation grade can be calculated by deep learning models’ prediction of tumor regions and tumor differentiation status according to WHO’s defines. If multiple WSIs were possessed by a patient, the highest differentiation grade was chosen. Additionally, the differentiation grade was normalized into scale between 0 to 1. The Cancer Genome Atlas, project COAD (TCGA-COAD) project was enrolled into this study. For the gland segmentation model, receiver operating characteristic (ROC) reached 0.981 and accuracy reached 0.932 in validation set. For the differentiation prediction model, ROC reached 0.983, 0.963, 0.963, 0.981 and accuracy reached 0.880, 0.923, 0.668, 0.881 for groups of low-, medium-, high-differentiation and normal tissue in validation set. Four hundred and one patients were selected after removing WSIs without gland regions and patients without follow up data. The concordance index reached to 0.609. Optimized cut off point of 51% was found by “Maxstat” method which was almost the same as WHO system’s cut off point of 50%. Both WHO system’s cut off point and optimized cut off point performed impressively in Kaplan-Meier curves and both p value of logrank test were below 0.005. In this study, gland structure of WSIs and differentiation status of tumor regions were proven to be predictable through deep leaning method. A finer and continuous differentiation grade can also be automatically calculated through above models. The differentiation grade was proven to stratify CAC patients well in survival analysis, whose optimized cut off point was almost the same as WHO tumor grading system. The tool of automatically calculating differentiation grade may show potential in field of therapy decision making and personalized treatment.

Keywords: colorectal cancer, differentiation, survival analysis, tumor grading

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