Artificial Intelligence Educational & Research Initiatives and Leadership Positions in Academic Radiology Departments.

PURPOSE: Rapid advances in artificial intelligence (AI) have generated significant interest in the radiology community. However, formal AI initiatives and leadership roles in academic radiology has not been formally evaluated. The purpose of this study was to assess the prevalence of formal AI initiatives and leadership roles in academic radiology departments. METHODS: Radiology departments with National Institutes of Health funding in fiscal year 2019 were identified. AI educational and research initiatives, leadership roles, and industry partnerships were assessed by searching department websites for AI-related keywords. Correlations between NIH funding and the presence of AI initiatives were evaluated with linear regression. RESULTS: Sixty-two radiology departments with NIH funding were included in this study. Educational initiatives on AI were offered by 29 (47%) departments. Fifty-five (89%) departments had at least 1 AI researcher and 34 (55%) departments were affiliated with an AI research laboratory, center, or cluster. AI-specific leadership roles and industry partnerships were identified in 3 (5%) and 23 (37%) departments, respectively. The amount of NIH funding did not have a significant linear correlation with educational initiatives (P = 0.08) but there was a significant linear correlation between funding and presence of research initiatives (P = 0.003). CONCLUSIONS: AI educational initiatives were offered by almost half of radiology departments. Most departments had AI researchers and affiliated labs, but the majority were not led by the radiology department, and few had formal AI leadership roles. In the new AI era, these findings provide a benchmark for departments considering implementing formal AI initiatives.

Estimating Catchment Populations of Global Health Radiology Outreach Using Geographic Information Systems Analysis.

PURPOSE: The purpose of this study was to design, develop, and test geographic information systems (GIS) analytic methods for quantifying and characterizing catchment populations across all sites served by a radiology global health organization. METHODS: The analysis included populations served by 78 low-resource medical facilities in 32 countries partnered with radiology nonprofit organization, RAD-AID International. Three constraints were used to approximate patient catchment areas: (1) 1-hour driving time, (2) 1-hour walking time, and (3) 10-mile circular radius. GIS calculated populations within each constraint using publicly available geospatial input databases, including a global digital elevation model, population and land cover data, and road locations from OpenStreetMap. Demographic and health data from the World Health Organization were incorporated to provide further characteristics of covered populations. RESULTS: The total populations served by all RAD-AID sites as measured by driving time, walking time, and 10-mile radius were 189,241,193 (47.8% female), 26,190,117 (48.7% female), and 110,884,095 (48.1% female), respectively. For individual locations, median population within 1-hour driving time was 1,795,977 (range: 8,742-30,630,800), with an average life expectancy of 68.4 ± 5.8 years. Median child mortality before age 5 was 3.8% (range: 0.9%-8.3%), and median prevalence of human immunodeficiency virus infection was 3.1% (range: 0.7%-10.9%). CONCLUSION: In this study, GIS provided a robust multisite analysis for estimating the potential global population reached by an international radiology outreach organization with targeted individual site measurements. Given heightened needs to accurately characterize global outreach populations, this GIS-based approach may be useful for analysis, outreach planning, and resource allocation among global health organizations.

Narrative review of vascular iatrogenic trauma and endovascular treatment.

Iatrogenic injury is unfortunately a leading cause of morbidity and mortality for patients worldwide. The etiology of iatrogenic injury is broad, and can be seen with both diagnostic and therapeutic interventions. While steps can be taken to reduce the occurrence of iatrogenic injury, it is often not completely avoidable. Once iatrogenic injury has occurred, prompt recognition and appropriate management can help reduce further harm. The objective of this narrative review it to help reader better understand the risk factors associated with, and treatment options for a broad range of potential iatrogenic injuries by presenting a series of iatrogenic injury cases. This review also discusses rates, risk factors, as well as imaging and clinical signs of iatrogenic injury with an emphasis on endovascular and minimally invasive treatments. While iatrogenic vascular injury once required surgical intervention, now minimally invasive endovascular treatment is a potential option for certain patients. Further research is needed to help identify patients that are at the highest risk for iatrogenic injury, allowing patients and providers to reconsider or avoid interventions where the risk of iatrogenic injury may outweigh the benefit. Further research is also needed to better define outcomes for patients with iatrogenic vascular injury treated with minimally invasive endovascular techniques verses conservative management or surgical intervention.

Primary Care Provider Awareness of IR: A Single-Center Analysis.

PURPOSE: To evaluate primary care provider awareness of interventional radiology (IR) services at a tertiary care academic medical center to identify areas of IR practice that require additional education and awareness initiatives. MATERIAL AND METHODS: An internet-based survey was distributed via email to primary care providers, including internal medicine (IM), family medicine (FM), obstetrics and gynecology (OBGYN), and hospital medicine (HM) physicians in the region. The survey consisted of 17 questions regarding provider demographics, experiences with IR in their practice, awareness of IR training, and awareness of IR procedures and services. RESULTS: A total of 234 of 533 invited physicians completed the survey (40% IM, 22% FM, 22% HM, and 16% OBGYN). Providers rated their knowledge of IR as poor (49, 20.3%), adequate (137, 56.9%), good (49, 20.3%), and excellent (6, 2.5%). Although 235 (97.5%) had consulted IR previously, only 141 (58.5%) had referred a patient directly to IR for an elective procedure. IR was offered as an alternative to surgical procedures never (42, 17.6%), a quarter of the time (101, 42.3%), half of the time (61, 25.5%), three-quarters of the time (27, 11.3%), and every time (8, 3.35%). Most respondents (161, 67.4%) learned the most about IR procedures during residency. Most (180, 75.3%) indicated that they would like to learn more about IR. CONCLUSIONS: These findings indicate that more can be done to educate providers about the potential role of IR in patient care. Provider awareness is limited regarding procedures that are increasingly popular in the IR community. This study helps to identify specific areas of IR in which awareness of can be increased.

Efficient production of indigoidine in Escherichia coli.

Indigoidine is a bacterial natural product with antioxidant and antimicrobial activities. Its bright blue color resembles the industrial dye indigo, thus representing a new natural blue dye that may find uses in industry. In our previous study, an indigoidine synthetase Sc-IndC and an associated helper protein Sc-IndB were identified from Streptomyces chromofuscus ATCC 49982 and successfully expressed in Escherichia coli BAP1 to produce the blue pigment at 3.93 g/l. To further improve the production of indigoidine, in this work, the direct biosynthetic precursor L-glutamine was fed into the fermentation broth of the engineered E. coli strain harboring Sc-IndC and Sc-IndB. The highest titer of indigoidine reached 8.81 ± 0.21 g/l at 1.46 g/l L-glutamine. Given the relatively high price of L-glutamine, a metabolic engineering technique was used to directly enhance the in situ supply of this precursor. A glutamine synthetase gene (glnA) was amplified from E. coli and co-expressed with Sc-indC and Sc-indB in E. coli BAP1, leading to the production of indigoidine at 5.75 ± 0.09 g/l. Because a nitrogen source is required for amino acid biosynthesis, we then tested the effect of different nitrogen-containing salts on the supply of L-glutamine and subsequent indigoidine production. Among the four tested salts including (NH4)2SO4, NH4Cl, (NH4)2HPO4 and KNO3, (NH4)2HPO4 showed the best effect on improving the titer of indigoidine. Different concentrations of (NH4)2HPO4 were added to the fermentation broths of E. coli BAP1/Sc-IndC+Sc-IndB+GlnA, and the titer reached the highest (7.08 ± 0.11 g/l) at 2.5 mM (NH4)2HPO4. This work provides two efficient methods for the production of this promising blue pigment in E. coli.

Functional dissection and module swapping of fungal cyclooligomer depsipeptide synthetases.

BbBSLS and BbBEAS were dissected and reconstituted in Saccharomyces cerevisiae. The intermodular linker is essential for the reconstitution of the separate modules. Module 1 can be swapped between BbBEAS and BbBSLS, while modules 2 and 3 control the product profiles. BbBSLS is a flexible enzyme that also synthesizes beauvericins.

Engineered production of fungal anticancer cyclooligomer depsipeptides in Saccharomyces cerevisiae.

Two fungal cyclooligomer depsipeptide synthetases(CODSs), BbBEAS (352 kDa) and BbBSLS (348 kDa) from Beauveria bassiana ATCC7159, were reconstituted in Saccharomyces cerevisiae BJ5464-NpgA, leading to the production of the corresponding anticancer natural products, beauvericins and bassianolide, respectively. The titers of beauvericins (33.8 ± 1.4 mg/l) and bassianolide (21.7± 0.1 mg/l) in the engineered S. cerevisiae BJ5464-NpgA strains were comparable to those in the native producer B. bassiana. Feeding D-hydroxyisovaleric acid (D-Hiv) and the corresponding L-amino acid precursors improved the production of beauvericins and bassianolide. However, the high price of D-Hiv limits its application in large-scale production of these cyclooligomer depsipeptides. Alternatively, we engineered another enzyme, ketoisovalerate reductase (KIVR) from B. bassiana, into S. cerevisiae BJ5464-NpgA for enhanced in situ synthesis of this expensive substrate. Co-expression of BbBEAS and KIVR in the yeast led to significant improvement of the production of beauvericins.The total titer of beauvericin and its congeners (beauvericins A-C) was increased to 61.7 ± 3.0 mg/l and reached 2.6-fold of that in the native producer B. bassiana ATCC7159. Supplement of L-Val at 10 mM improved the supply of ketoisovalerate, the substrate of KIVR, which consequently further increased the total titer of beauvericins to 105.8 ± 2.1 mg/l. Using this yeast system,we functionally characterized an unknown CODS from Fusarium venenatum NRRL 26139 as a beauvericin synthetase, which was named as FvBEAS. Our work thus provides a useful approach for functional reconstitution and engineering of fungal CODSs for efficient production of this family of anticancer molecules.

Specific chlorination of isoquinolines by a fungal flavin-dependent halogenase.

Rdc2 is the first flavin-dependent halogenase identified from fungi. Based on the reported structure of the bacterial halogenase CmlS, we have built a homology model for Rdc2. The model suggests an open substrate binding site that is capable of binding the natural substrate, monocillin II, and possibly other molecules such as 4-hydroxyisoquinoline (1) and 6-hydroxyisoquinoline (2). In vitro and in vivo halogenation experiments confirmed that 1 and 2 can be halogenated at the position ortho to the hydroxyl group, leading to the synthesis of the chlorinated isoquinolines 1a and 2a, respectively, which further expands the spectrum of identified substrates of Rdc2. This work revealed that Rdc2 is a useful biocatalyst for the synthesis of various halogenated compounds.

Production of a new pyridine N-oxide by bioconversion with Cunninghamella echinulata var. elegans.

A new N-oxide was produced from 3-(N-Boc-aminomethyl)-5-bromopyridine by bioconversion with Cunninghamella echinulata var. elegans ATCC 9245, and its structure was established based on the spectral data. The microbial N-oxidation is efficient and highly selective. The substrate was transformed into the product in 7 days.