Search results for: rocking curve imaging

Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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Authors: Bojana Horvat, Barbara Karleusa, Goran Volf, Nevenka Ozanic, Ivica Kisic

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Forest fire is a major threat in many regions in Croatia, especially in coastal areas. Although they are often caused by natural processes, the most common cause is the human factor, intentional or unintentional. Forest fires drastically transform landscapes and influence natural processes. The main goal of the presented research is to analyse and quantify the impact of the forest fire on hydrological processes and propose the model that best describes changes in hydrological patterns in the analysed catchments. Keeping in mind the spatial component of the processes, geospatial analysis is performed to gain better insight into the spatial variability of the hydrological response to disastrous events. In that respect, two catchments that experienced severe forest fire were delineated, and various hydrological and meteorological data were collected both attribute and spatial. The major drawback is certainly the lack of hydrological data, common in small torrential karstic streams; hence modelling results should be validated with the data collected in the catchment that has similar characteristics and established hydrological monitoring. The event chosen for the modelling is the forest fire that occurred in July 2019 and burned nearly 10% of the analysed area. Surface (land use/land cover) conditions before and after the event were derived from the two Sentinel-2 images. The mapping of the burnt area is based on a comparison of the Normalized Burn Index (NBR) computed from both images. To estimate and compare hydrological behaviour before and after the event, curve number (CN) values are assigned to the land use/land cover classes derived from the satellite images. Hydrological modelling resulted in surface runoff generation and hence prediction of hydrological responses in the catchments to a forest fire event. The research was supported by the Croatian Science Foundation through the project 'Influence of Open Fires on Water and Soil Quality' (IP-2018-01-1645).

Keywords: Croatia, forest fire, geospatial analysis, hydrological response

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Authors: Mona Hassan Aburahma, Alaa Hamed Salama

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Ufasomes “unsaturated fatty acids liposomes” are unique nano-sized self-assembled bilayered vesicles that can be easily created from the readily available unsaturated fatty acid. Ufasomes are formed due to weak associative interaction of the fully ionized and unionized fatty acids into bilayers structures. In the ufasomes constructs, the fatty acid molecules are oriented with their hydrocarbon tails directed toward the membrane interior and the carboxyl groups are in contact with water. Although ufasomes can be employed as a safe vesicular carrier for drugs, the extreme instability of their aqueous dispersions hinders their effective use in drug delivery field. Accordingly, in our study, lyophilized gels containing ufasomes were prepared using a simple assembling technique form the readily available oleic acid to overcome the colloidal instability of the ufasomes dispersions and convert them into accurate unit dosage forms. The influence of changing cholesterol percentage relative to oleic acid on the ufasomes vesicles were investigated using factorial design. The optimized oleic acid ufasomes comprised nanoscaled spherical vesicles. Scanning electron micrographs of the lyophilized gels revealed that the included ufasomes were intact, non-aggregating, and preserved their spherical morphology. Rheological characterization (viscosity and shear stress versus shear rate) of reconstituted ufasomal lyophilized gel ensured the ease of application. The capability of the ufasomes, included in the gel, to penetrate deep through the mucosa layers was illustrated using ex-vivo confocal laser imaging, thereby, highlighting the feasibility of stabilizing ufasomes using lyophilized gel platforms.

Keywords: ufasomes, lyophilized gel, confocal scanning microscopy, rheological characterization, oleic acid

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Authors: Abinash Tripathy, Girish Muralidharan, Amitava Pramanik, Prosenjit Sen

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Superhydrophobic surfaces are abundant in nature. Several surfaces such as wings of butterfly, legs of water strider, feet of gecko and the lotus leaf show extreme water repellence behaviour. Self-cleaning, stain-free fabrics, spill-resistant protective wears, drag reduction in micro-fluidic devices etc. are few applications of superhydrophobic surfaces. In order to design robust superhydrophobic surface, it is important to understand the interaction of water with superhydrophobic surface textures. In this work, we report a simple coating method for creating large-scale flexible superhydrophobic paper surface. The surface consists of multiple layers of silanized zirconia microparticles decorated with zirconia nanoparticles. Water contact angle as high as 159±10 and contact angle hysteresis less than 80 was observed. Drop impact studies on superhydrophobic paper surface were carried out by impinging water droplet and capturing its dynamics through high speed imaging. During the drop impact, the Weber number was varied from 20 to 80 by altering the impact velocity of the drop and the parameters such as contact time, normalized spread diameter were obtained. In contrast to earlier literature reports, we observed contact time to be dependent on impact velocity on superhydrophobic surface. Total contact time was split into two components as spread time and recoil time. The recoil time was found to be dependent on the impact velocity while the spread time on the surface did not show much variation with the impact velocity. Further, normalized spreading parameter was found to increase with increase in impact velocity.

Keywords: contact angle, contact angle hysteresis, contact time, superhydrophobic

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Authors: Mitchell Stanton

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Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of the living tissues to the mechanical loads is necessary for a wide range of developing fields such as, designing of prosthetics and optimized surgery operations. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically growth and remodeling is one of the main sources. Extracting body organs from medical imaging, does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is the gravity since an organ grows under its influence from its birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. In this paper, we have implemented a computational framework based on fixed-point iteration to determine the residual stresses due to growth. Using nonlinear continuum mechanics and the concept of fictitious configuration we find the unknown stress-free reference configuration which is necessary for mechanical analysis. To illustrate the method, we apply it to a finite element model of healthy human face whose geometry has been extracted from medical images. We have computed the distribution of residual stress in facial tissues, which can overcome the effect of gravity and cause that tissues remain firm. Tissue wrinkles caused by aging could be a consequence of decreasing residual stress and not counteracting the gravity. Considering these stresses has important application in maxillofacial surgery. It helps the surgeons to predict the changes after surgical operations and their consequences.

Keywords: growth, soft tissue, residual stress, finite element method

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Authors: Joo-Heon Lee, Seo-Yeon Park, Chanyang Sur, Ho-Won Jang

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Satellite-based remote sensing technique has been widely used in the area of drought and environmental monitoring to overcome the weakness of in-situ based monitoring. There are many advantages of remote sensing for drought watch in terms of data accessibility, monitoring resolution and types of available hydro-meteorological data including environmental areas. This study was focused on the applicability of drought monitoring based on satellite imageries by applying to the historical drought events, which had a huge impact on meteorological, agricultural, and hydrological drought. Satellite-based drought indices, the Standardized Precipitation Index (SPI) using Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Mission (GPM); Vegetation Health Index (VHI) using MODIS based Land Surface Temperature (LST), and Normalized Difference Vegetation Index (NDVI); and Scaled Drought Condition Index (SDCI) were evaluated to assess its capability to analyze the complex topography of the Korean peninsula. While the VHI was accurate when capturing moderate drought conditions in agricultural drought-damaged areas, the SDCI was relatively well monitored in hydrological drought-damaged areas. In addition, this study found correlations among various drought indices and applicability using Receiver Operating Characteristic (ROC) method, which will expand our understanding of the relationships between hydro-meteorological variables and drought events at global scale. The results of this research are expected to assist decision makers in taking timely and appropriate action in order to save millions of lives in drought-damaged areas.

Keywords: drought monitoring, moderate resolution imaging spectroradiometer (MODIS), remote sensing, receiver operating characteristic (ROC)

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Rahele Mesbah, Nic Van Der Wee, Manja Koenders, Erik Giltay, Albert Van Hemert, Max De Leeuw

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Introduction: Patients with bipolar disorder (BD), characterized by depressive and manic episodes, often suffer from cognitive dysfunction. An up-to-date meta-analysis of functional Magnetic Resonance Imaging (fMRI) studies examining cognitive function in BD is lacking. Objective: The aim of the current fMRI meta-analysis is to investigate brain functioning of bipolar patients compared with healthy subjects within three domains of emotion processing, reward processing, and working memory. Method: Differences in brain regions activation were tested within whole-brain analysis using the activation likelihood estimation (ALE) method. Separate analyses were performed for each cognitive domain. Results: A total of 50 fMRI studies were included: 20 studies used an emotion processing (316 BD and 369 HC) task, 9 studies a reward processing task (215 BD and 213 HC), and 21 studies used a working memory task (503 BD and 445 HC). During emotion processing, BD patients hyperactivated parts of the left amygdala and hippocampus as compared to HC’s, but showed hypoactivation in the inferior frontal gyrus (IFG). Regarding reward processing, BD patients showed hyperactivation in part of the orbitofrontal cortex (OFC). During working memory, BD patients showed increased activity in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC). Conclusions: This meta-analysis revealed evidence for activity disturbances in several brain areas involved in the cognitive functioning of BD patients. Furthermore, most of the found regions are part of the so-called fronto-limbic network which is hypothesized to be affected as a result of BD candidate genes' expression.

Keywords: cognitive functioning, fMRI analysis, bipolar disorder, fronto-limbic network

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Authors: Hasan Ziari, Hassan Fazaeli, Seyed Javad Vaziri Kang Olyaei, Asma Sadat Dabiri

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The presence of cracks in concrete pavements is a place for the ingression of corrosive substances, acids, oils, and water into the pavement and reduces its long-term durability and level of service. One of the causes of early cracks in concrete pavements is the plastic shrinkage. This shrinkage occurs due to the formation of negative capillary pressures after the equilibrium of the bleeding and evaporation rates at the pavement surface. These cracks form if the tensile stresses caused by the restrained shrinkage exceed the tensile strength of the concrete. Different climate conditions change the rate of evaporation and thus change the balance time of the bleeding and evaporation, which changes the severity of cracking in concrete. The present study examined the relationship between the balance time of bleeding and evaporation and the area of cracking in the concrete slabs using the standard method ASTM C1579 in 27 different environmental conditions by using continuous video recording and digital image analyzing. The results showed that as the evaporation rate increased and the balance time decreased, the crack severity significantly increased so that by reducing the balance time from the maximum value to its minimum value, the cracking area increased more than four times. It was also observed that the cracking area- balance time curve could be interpreted in three sections. An examination of these three parts showed that the combination of climate conditions has a significant effect on increasing or decreasing these two variables. The criticality of a single factor cannot cause the critical conditions of plastic cracking. By combining two mild environmental factors with a severe climate factor (in terms of surface evaporation rate), a considerable reduction in balance time and a sharp increase in cracking severity can be prevented. The results of this study showed that balance time could be an essential factor in controlling and predicting plastic shrinkage cracking in concrete pavements. It is necessary to control this factor in the case of constructing concrete pavements in different climate conditions.

Keywords: bleeding and cracking severity, concrete pavements, climate conditions, plastic shrinkage

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Authors: Lan Luo, Jingjing Huang, Huafang Li

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Introduction: Distressing low sexual desire is common in China, while the lack of reliable and valid instruments to evaluate symptoms of hypoactive sexual desire disorder (HSDD) impedes related research and clinical services. Aim: This study aimed to validate the reliability and validity of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) in Chinese female HSDD patients. Methods: We administered FSFI and FSDS-DAO in a convenient sample of Chinese adult women. Participants were diagnosed by a psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Results: We had a valid analysis sample of 279 Chinese women, of which 107 were HSDD patients. The Cronbach's α of FSFI and FSDS-DAO were 0.947 and 0.956, respectively, and the intraclass correlation coefficients of which were 0.86 and 0.89, respectively (the interval was 13-15 days). The correlation coefficient between the Revised Adult Attachment Scale (RAAS) and FSFI (or FSDS-DAO) did not exceed 0.4; the area under the receiver operating characteristic (ROC) curve was 0. 83 when combined FSFI-d (the desire domain of FSFI) and FSDS-DAO to diagnose HSDD, which was significantly different from that of using these scales individually. FSFI-d of less than 2.7 (1.2-6) and FSDS-DAO of no less than 15 (0-60) (Sensitivity 65%, Specificity 83%), or FSFI-d of no more than 3.0 (1.2-6) and FSDS-DAO of no less than 14 (0-60) (Sensitivity 74%, Specificity 77%) can be used as cutoff scores in clinical research or outpatient screening. Clinical implications: FSFI (including FSFI-d) and FSDS-DAO are suitable for the screening and evaluation of Chinese female HSDD patients of childbearing age. Strengths and limitations: Strengths include a thorough validation of FSFI and FSDS-DAO and the exploration of the cutoff score combing FSFI-d and FSDS-DAO. Limitations include a small convenience sample and the requirement of being sexually active for HSDD patients. Conclusion: FSFI (including FSFI-d) and FSDS-DAO have good internal consistency, test-retest reliability, construct validity, and criterion validity in Chinese female HSDD patients of childbearing age.

Keywords: sexual desire, sexual distress, hypoactive sexual desire disorder, scale

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Authors: Nion Sirimongkonlertkun, Vivard Phonekeo

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This research focused on open burning occurrence in Greater Mekong Sub-Region countries that influences the increase of PM10concentrations. Thailand, Myanmar, and Laos were chosen as a case study, and 2009, 2010, and 2012 were chosen as the year for case study. Hotspot detected by MODIS (Moderate Resolution Imaging Specto radiometer) sensor on board of Terra/Aqua satellites and provided by Rapid Response System was used to represent open burning location in the region. Hotspot was selected through fire confidence with confidence levels of 80-100%. The spatial analysis by GIS was used as the main tool for analyzing and defining the location of open burning at study sites as hotspot with the pixel size of 1 km by 1 km. The total hotspot counts in the study period of four years (2007, 2009, 2010, and January-April 2012) at the regional level, including Thailand, Laos, and Myanmar were 255,177 hotspots or a very high yearly average of 63,795 hotspots. The highest amount was seen in Myanmar (50%), followed by Laos (36%), and Thailand (14%). For Thailand, the majority of burning or 64% occurred in the northern region with the density of 5 hotspots per 100 km2. According to statistics of the 4 years, the increasing rate of hotspot from January to February was 10 times and from February to March was 4 times. After that period, the hotspot started to decline by 2 times from March to April. Therefore, in order to develop a policy which aims to lessen open burning conduction, the government should seriously focus on this problem during the peak period—February to March in every year when hotspot and open burning area is significantly increased.

Keywords: PM10, hotspot, greater mekong sub-region, open burning

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Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

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Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: Farha Mizana Shamsudin, Shahidan Radiman, Yusof Abdullah, Nasri Abdul Hamid

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Oxide dispersion strengthened (ODS) ferritic steels are amongst the most promising candidates for large scale structural materials to be applied in next generation fission and fusion nuclear power reactors. This kind of material is relatively stable at high temperature, possess remarkable mechanical properties and comparatively good resistance from neutron radiation damage. The superior performance of ODS ferritic steels over their conventional properties is attributed to the high number density of nano-sized dispersoids that act as nucleation sites and stable sinks for many small helium bubbles resulting from irradiation, and also as pinning points to dislocation movement and grain growth. ODS ferritic steels are usually produced by powder metallurgical routes involving mechanical alloying (MA) process of Y2O3 and pre-alloyed or elemental metallic powders, and then consolidated by hot isostatic pressing (HIP) or hot extrusion (HE) techniques. In this study, Fe-14Cr-3W-0.5Ti-0.3Y₂O₃ (designated as 14YWT) was produced by mechanical alloying process and followed by hot isostatic pressing (HIP) technique. Crystal structure and morphology of this sample were identified and characterized by using X-ray Diffraction (XRD) and field emission scanning electron microscope (FESEM) respectively. The magnetic measurement of this sample at room temperature was carried out by using a vibrating sample magnetometer (VSM). FESEM micrograph revealed a homogeneous microstructure constituted by fine grains of less than 650 nm in size. The ultra-fine dispersoids of size between 5 nm to 19 nm were observed homogeneously distributed within the BCC matrix. The EDS mapping reveals that the dispersoids contain Y-Ti-O nanoclusters and from the magnetization curve plotted by VSM, this sample approaches the behavior of soft ferromagnetic materials. In conclusion, ODS Fe-14Cr-3W-0.5Ti-0.3Y₂O₃ (14YWT) ferritic steel was successfully produced by HIP technique in this present study.

Keywords: hot isostatic pressing, magnetization, microstructure, ODS ferritic steel

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Authors: Anthony D. Rhodes, Manan Goel

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We provide a high fidelity deep learning algorithm (HyperSeg) for interactive video segmentation tasks using a dense convolutional network with context-aware skip connections and compressed, 'hypercolumn' image features combined with a convolutional tessellation procedure. In order to maintain high output fidelity, our model crucially processes and renders all image features in high resolution, without utilizing downsampling or pooling procedures. We maintain this consistent, high grade fidelity efficiently in our model chiefly through two means: (1) we use a statistically-principled, tensor decomposition procedure to modulate the number of hypercolumn features and (2) we render these features in their native resolution using a convolutional tessellation technique. For improved pixel-level segmentation results, we introduce a boundary loss function; for improved temporal coherence in video data, we include temporal image information in our model. Through experiments, we demonstrate the improved accuracy of our model against baseline models for interactive segmentation tasks using high resolution video data. We also introduce a benchmark video segmentation dataset, the VFX Segmentation Dataset, which contains over 27,046 high resolution video frames, including green screen and various composited scenes with corresponding, hand-crafted, pixel-level segmentations. Our work presents a improves state of the art segmentation fidelity with high resolution data and can be used across a broad range of application domains, including VFX pipelines and medical imaging disciplines.

Keywords: computer vision, object segmentation, interactive segmentation, model compression

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Ningning Liu, Gaoding Jia, Yinshan Wang, Haimei Li, Xinian Zuo, Yufeng Wang, Lu Liu, Qiujin Qian

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Background: There has been speculation that a high IQ may not necessarily provide protection against attention deficit hyperactivity disorder (ADHD), and there may be a U-shaped correlation between IQ and ADHD symptoms. However, this speculation has not been validated in the ADHD population in any study so far. Method: We conducted a study with 5,138 children who have been professionally diagnosed with ADHD and have a wide range of IQ levels. General Linear Models were used to determine the optimal model between IQ and ADHD core symptoms with sex and age as covariates. The ADHD symptoms we looked at included the total scores (TO), inattention (IA) and hyperactivity/impulsivity (HI). Wechsler Intelligence scale were used to assess IQ [Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ)]. Furthermore, we examined the correlation between IQ and the execution function [Behavior Rating Inventory of Executive Function (BRIEF)], as well as between IQ and brain surface area, to determine if the associations between IQ and ADHD symptoms are reflected in executive functions and brain structure. Results: Consistent with previous research, the results indicated that FSIQ and VIQ both showed a linear negative correlation with the TO and IA scores of ADHD. However, PIQ showed an inverted U-shaped relationship with the TO and HI scores of ADHD, with 103 as the peak point. These findings were also partially reflected in the relationship between IQ and executive functions, as well as IQ and brain surface area. Conclusion: To sum up, the relationship between IQ and ADHD symptoms is not straightforward. Our study confirms long-standing academic hypotheses and finds that PIQ exhibits an inverted U-shaped relationship with ADHD symptoms. This study enhances our understanding of symptoms and behaviors of ADHD with varying IQ characteristics and provides some evidence for targeted clinical intervention.

Keywords: ADHD, IQ, execution function, brain imaging

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Authors: Mohamed El Horri, Amine Mouden, Reda Messaoudi, Mohamed Chekkal, Driss Benlaldj, Malika Baghdadi, Lahcene Benmahdi, Fatima Seghier

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Background/aim: Recently, the Von Willebrand factor antigen (vWF-Ag)has been identified as a new marker of portal hypertension (PH) and its complications. Few studies talked about its role in the prediction of esophageal varices. VWF-Ag is considered a non-invasive approach, In order to avoid the endoscopic burden, cost, drawbacks, unpleasant and repeated examinations to the patients. In our study, we aimed to evaluate the ability of this marker in the prediction of another complication of portal hypertension, which is portal hypertensive gastropathy (PHG), the one that is diagnosed also by endoscopic tools. Patients and methods: It is about a prospective study, which include 124 cirrhotic patients with no history of bleeding who underwent screening endoscopy for PH-related complications like esophageal varices (EVs) and PHG. Routine biological tests were performed as well as the VWF-Ag testing by both ELFA and Immunoturbidimetric techniques. The diagnostic performance of our marker was assessed using sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic curves. Results: 124 patients were enrolled in this study, with a mean age of 58 years [CI: 55 – 60 years] and a sex ratio of 1.17. Viral etiologies were found in 50% of patients. Screening endoscopy revealed the presence of PHG in 20.2% of cases, while for EVsthey were found in 83.1% of cases. VWF-Ag levels, were significantly increased in patients with PHG compared to those who have not: 441% [CI: 375 – 506], versus 279% [CI: 253 – 304], respectively (p <0.0001). Using the area under the receiver operating characteristic curve (AUC), vWF-Ag was a good predictor for the presence of PHG. With a value higher than 320% and an AUC of 0.824, VWF-Ag had an 84% sensitivity, 74% specificity, 44.7% positive predictive value, 94.8% negative predictive value, and 75.8% diagnostic accuracy. Conclusion: VWF-Ag is a good non-invasive low coast marker for excluding the presence of PHG in patients with liver cirrhosis. Using this marker as part of a selective screening strategy might reduce the need for endoscopic screening and the coast of the management of these kinds of patients.

Keywords: von willebrand factor, portal hypertensive gastropathy, prediction, liver cirrhosis

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Authors: Ziwei Wang, Andrea Lucotti, Luigi Brambilla, Matteo Tommasini, Chiara Bertarelli

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Surface-enhanced Raman Spectroscopy (SERS) is a highly sensitive detection that provides abundant information on low concentration analytes from various researching areas. Based on localized surface plasmon resonance, metal nanostructures including gold, silver and copper have been investigated as SERS substrate during recent decades. There has been increasing more attention of exploring good performance, homogenous, repeatable SERS substrates. Here, we show that electrospinning, which is an inexpensive technique to fabricate large-scale, self-standing and repeatable membranes, can be effectively used for producing SERS substrates. Nanoparticles and nanorods are added to the feed electrospinning solution to collect functionalized polymer fibrous mats. We report stable electrospun membranes as SERS substrate using gold nanorods (AuNRs) and poly(vinyl alcohol). Particularly, a post-processing crosslinking step using glutaraldehyde under acetone environment was carried out to the electrospun membrane. It allows for using the membrane in any liquid environment, including water, which is of interest both for sensing of contaminant in wastewater, as well as for biosensing. This crosslinked AuNRs/PVA membrane has demonstrated excellent performance as SERS substrate for low concentration 10-6 M Rhodamine 6G (Rh6G) aqueous solution. This post-processing for fabricating SERS substrate is the first time reported and proved through Raman imaging of excellent stability and outstanding performance. Finally, SERS tests have been applied to several analytes, and the application of AuNRs/PVA membrane is broadened by removing the detected analyte by rinsing. Therefore, this crosslinked AuNRs/PVA membrane is re-usable.

Keywords: SERS spectroscopy, electrospinning, crosslinking, composite materials

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Authors: Elena Carcano, Mirzi Betasolo

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This study helps Public Water Bureaus in giving reliable answers to water concession requests. Rapidly increasing water requests can be supported provided that further uses of a river course are not totally compromised, and environmental features are protected as well. Strictly speaking, a water concession can be considered a continuous drawing from the source and causes a mean annual streamflow reduction. Therefore, deciding if a water concession is appropriate or inappropriate seems to be easily solved by comparing the generic demand to the mean annual streamflow value at disposal. Still, the immediate shortcoming for such a comparison is that streamflow data are information available only for few catchments and, most often, limited to specific sites. Subsequently, comparing the generic water demand to mean daily discharge is indeed far from being completely satisfactory since the mean daily streamflow is greater than the water withdrawal for a long period of a year. Consequently, such a comparison appears to be of little significance in order to preserve the quality and the quantity of the river. In order to overcome such a limit, this study aims to complete the information provided by flow duration curves introducing a link between Flow Duration Curves (FDCs) and recession curves and aims to show the chronological sequence of flows with a particular focus on low flow data. The analysis is carried out on 25 catchments located in North-Eastern Italy for which daily data are provided. The results identify groups of catchments as hydrologically homogeneous, having the lower part of the FDCs (corresponding streamflow interval is streamflow Q between 300 and 335, namely: Q(300), Q(335)) smoothly reproduced by a common recession curve. In conclusion, the results are useful to provide more reliable answers to water request, especially for those catchments which show similar hydrological response and can be used for a focused regionalization approach on low flow data. A mathematical link between streamflow duration curves and recession curves is herein provided, thus furnishing streamflow duration curves information upon a temporal sequence of data. In such a way, by introducing assumptions on recession curves, the chronological sequence upon low flow data can also be attributed to FDCs, which are known to lack this information by nature.

Keywords: chronological sequence of discharges, recession curves, streamflow duration curves, water concession

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: cancer, complementary and alternative medicine , ozone therapy, palliative care, PEMF therapy

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

Procedia PDF Downloads 186

Authors: Ifeoma Maryjane Iloamaeke, Kelvin Obazie, Mmesoma Offornze, Chiamaka Marysilvia Ifeaghalu, Cecilia Aduaka, Ugomma Chibuzo Onyeije, Claudine Ifunanaya Ogu, Ngozi Anastesia Okonkwo

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This work investigated the effects of pH, settling time, and coagulant dosages on the removal of color, turbidity, and heavy metals from paint industrial wastewater using the seed of Artocarpus heterophyllus (AH) by the coagulation-flocculation process. The paint effluent was physicochemically characterized, while AH coagulant was instrumentally characterized by Scanning Electron Microscope (SEM), Fourier Transform Infrared (FTIR), and X-ray diffraction (XRD). A Jar test experiment was used for the coagulation-flocculation process. The result showed that paint effluent was polluted with color, turbidity (36000 NTU), mercury (1.392 mg/L), lead (0.252 mg/L), arsenic (1.236 mg/L), TSS (63.40mg/L), and COD (121.70 mg/L). The maximum color removal efficiency was 94.33% at the dosage of 0.2 g/L, pH 2 at a constant time of 50 mins, and 74.67% at constant pH 2, coagulant dosage of 0.2 g/L and 50 mins. The highest turbidity removal efficiency was 99.94% at 0.2 g/L and 50 mins at constant pH 2 and 96.66% at pH 2 and 0.2 g/L at constant time of 50 mins. The mercury removal efficiency of 99.29% was achieved at the optimal condition of 0.8 g/L coagulant dosage, pH 8, and constant time of 50 mins and 99.57% at coagulant dosage of 0.8 g/L, time of 50 mins constant pH 8. The highest lead removal efficiency was 99.76% at a coagulant dosage of 10 g/L, time of 40 mins at constant pH 10, and 96.53% at pH 10, coagulant dosage of 10 g/L and constant time of 40 mins. For arsenic, the removal efficiency is 75.24 % at 0.8 g/L coagulant dosage, time of 40 mins, and constant pH of 8. XRD imaging before treatment showed that Artocarpus heterophyllus coagulant was crystalline and changed to amorphous after treatment. The SEM and FTIR results of the AH coagulant and sludge suggested there were changes in the surface morphology and functional groups before and after treatment. The reaction kinetics were modeled best in the second order.

Keywords: Artocarpus heterophyllus, coagulation-flocculation, coagulant dosages, setting time, paint effluent

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Authors: Yoganathan Karthik, Guhanathan Poravi

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Colorizing near-infrared (NIR) images poses unique challenges due to the absence of color information and the nuances in light absorption. In this paper, we present an approach to NIR image colorization utilizing a synthetic dataset generated from visible light images. Our method addresses two major challenges encountered in NIR image colorization: accurately colorizing objects with color variations and avoiding over/under saturation in dimly lit scenes. To tackle these challenges, we propose a Generative Adversarial Network (GAN)-based framework that learns to map NIR images to their corresponding colorized versions. The synthetic dataset ensures diverse color representations, enabling the model to effectively handle objects with varying hues and shades. Furthermore, the GAN architecture facilitates the generation of realistic colorizations while preserving the integrity of dimly lit scenes, thus mitigating issues related to over/under saturation. Experimental results on benchmark NIR image datasets demonstrate the efficacy of our approach in producing high-quality colorizations with improved color accuracy and naturalness. Quantitative evaluations and comparative studies validate the superiority of our method over existing techniques, showcasing its robustness and generalization capability across diverse NIR image scenarios. Our research not only contributes to advancing NIR image colorization but also underscores the importance of synthetic datasets and GANs in addressing domain-specific challenges in image processing tasks. The proposed framework holds promise for various applications in remote sensing, medical imaging, and surveillance where accurate color representation of NIR imagery is crucial for analysis and interpretation.

Keywords: computer vision, near-infrared images, automatic image colorization, generative adversarial networks, synthetic data

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Authors: A. Ibovi Mouondayi, S. Zaher, K. Nassar, S. Janani

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Introduction: Osteoarticular ultrasound has become an essential tool for the investigation and monitoring of osteoarticular pathologies for rheumatologists. It is performed in the clinic, cheap to access than other imaging technics. Important anatomical sites of inflammation in inflammatory diseases such as synovium, tendon sheath, and enthesis are easily identifiable on ultrasound. Objective: The objective of this study was to evaluate the importance of ultrasound for rheumatologists in the development of diagnoses of inflammatory rheumatism in cases of uncertain clinical presentation. Material and Methods: This is a retrospective study conducted in our department and carried out over a period of 30 months from January 2020 to June 2022. We included all patients with inflammatory arthralgia without clinical arthritis. Patients' data were collected through a patient operating system. Results: A total of 35 patients were identified, made up of 4 men and 31 women, with a sex ratio M/F of 0.12. The average age of the patients was 48.8 years, with extremes ranging from 17 years to 83 years. All patients had inflammatory polyarthralgia for an average of 9.3 years. Only two patients had suspicious synovitis on clinical examination. 91.43% of patients had a positive inflammatory assessment with an average CRP of 22.2 mg/L. Rheumatoid factor (RF) was present in 45.7% of patients and anti-CCP in 48.57%, with respective averages of 294.43 and 314.63 international units/mL. Radiographic lesions were found in 54% of patients. Osteoarticular ultrasound was performed in all these patients. Subclinical synovitis was found in 60% of patients, including 23% Doppler positive. Tenosynovitis was found in 11% of patients. Enthesitis was objectified in 3% of patients. Rheumatoid arthritis (RA) was retained in 40% of patients; psoriatic arthritis in 6% of patients, hydroxyapatite arthritis, and osteoarthritis in 3% each. Conclusion: Osteoarticular ultrasound has been an essential tool in the practice of rheumatology in recent years. It is for diagnostic purposes in chronic inflammatory rheumatism as well as in degenerative rheumatism and crystal induced arthropathies, but also essential in the follow-up of patients in rheumatology.

Keywords: ultrasound, skeletal, rheumatoid arthritis, arthralgia

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Authors: Swathi Gopakumar, Sruthi Krishna, Shivasubramani Krishnamoorthy

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Contactless, painless and radiation-free thermal imaging technology is one of the preferred screening modalities for detection of breast cancer. However, poor signal to noise ratio and the inexorable need to preserve edges defining cancer cells and normal cells, make the segmentation process difficult and hence unsuitable for computer-aided diagnosis of breast cancer. This paper presents key findings from a research conducted on the appraisal of two promising techniques, for the detection of breast cancer: (I) marker-controlled, Level-set segmentation of anisotropic diffusion filtered preprocessed image versus (II) Segmentation using marker-controlled level-set on a Gaussian-filtered image. Gaussian-filtering processes the image uniformly, whereas anisotropic filtering processes only in specific areas of a thermographic image. The pre-processed (Gaussian-filtered and anisotropic-filtered) images of breast samples were then applied for segmentation. The segmentation of breast starts with initial level-set function. In this study, marker refers to the position of the image to which initial level-set function is applied. The markers are generally placed on the left and right side of the breast, which may vary with the breast size. The proposed method was carried out on images from an online database with samples collected from women of varying breast characteristics. It was observed that the breast was able to be segmented out from the background by adjustment of the markers. From the results, it was observed that as a pre-processing technique, anisotropic filtering with level-set segmentation, preserved the edges more effectively than Gaussian filtering. Segmented image, by application of anisotropic filtering was found to be more suitable for feature extraction, enabling automated computer-aided diagnosis of breast cancer.

Keywords: anisotropic diffusion, breast, Gaussian, level-set, thermograms

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

Procedia PDF Downloads 192

Authors: Fariba Tadayon, Elmira Hassanlou, Hasan Bagheri, Mostafa Jafarian

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Heavy metals are released into water, plants, soil, and food by natural and human activities. Lead has toxic roles in the human body and may cause serious problems even in low concentrations, since it may have several adverse effects on human. Therefore, determination of lead in different samples is an important procedure in the studies of environmental pollution. In this work, an ultrasonic assisted-ionic liquid based-liquid-liquid microextraction (UA-IL-DLLME) procedure for the determination of lead in zucchini, pomegranate, and lettuce has been established and developed by using flame atomic absorption spectrometer (FAAS). For UA-IL-DLLME procedure, 10 mL of the sample solution containing Pb2+ was adjusted to pH=5 in a glass test tube with a conical bottom; then, 120 μL of 1-Hexyl-3-methylimidazolium hexafluoro phosphate (CMIM)(PF6) was rapidly injected into the sample solution with a microsyringe. After that, the resulting cloudy mixture was treated by ultrasonic for 5 min, then the separation of two phases was obtained by centrifugation for 5 min at 3000 rpm and IL-phase diluted with 1 cc ethanol, and the analytes were determined by FAAS. The effect of different experimental parameters in the extraction step including: ionic liquid volume, sonication time and pH was studied and optimized simultaneously by using Response Surface Methodology (RSM) employing a central composite design (CCD). The optimal conditions were determined to be an ionic liquid volume of 120 μL, sonication time of 5 min, and pH=5. The linear ranges of the calibration curve for the determination by FAAS of lead were 0.1-4 ppm with R2=0.992. Under optimized conditions, the limit of detection (LOD) for lead was 0.062 μg.mL-1, the enrichment factor (EF) was 93, and the relative standard deviation (RSD) for lead was calculated as 2.29%. The levels of lead for pomegranate, zucchini, and lettuce were calculated as 2.88 μg.g-1, 1.54 μg.g-1, 2.18 μg.g-1, respectively. Therefore, this method has been successfully applied for the analysis of the content of lead in different food samples by FAAS.

Keywords: Dispersive liquid-liquid microextraction, Central composite design, Food samples, Flame atomic absorption spectrometry.

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

Procedia PDF Downloads 143