Pericardial Effusion Predicts Clinical Outcomes in Patients with COVID-19: A Nationwide Multicenter Study.

RATIONALE AND OBJECTIVES: The prognostic role of pericardial effusion (PE) in Covid 19 is unclear. The aim of the present study was to estimate the prognostic role of PE in patients with Covid 19 in a large multicentre setting. MATERIALS AND METHODS: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the Covid 19 pandemic). The acquired sample comprises 1197 patients, 363 (30.3%) women and 834 (69.7%) men. In every case, chest computed tomography was analyzed for PE. Data about 30-day mortality, need for mechanical ventilation and need for intensive care unit (ICU) admission were collected. Data were evaluated by means of descriptive statistics. Group differences were calculated with Mann-Whitney test and Fisher exact test. Uni-and multivariable regression analyses were performed. RESULTS: Overall, 46.4% of the patients were admitted to ICU, mechanical lung ventilation was performed in 26.6% and 30-day mortality was 24%. PE was identified in 159 patients (13.3%). The presence of PE was associated with 30-day mortality: HR= 1.54, CI 95% (1.05; 2.23), p = 0.02 (univariable analysis), and HR= 1.60, CI 95% (1.03; 2.48), p = 0.03 (multivariable analysis). Furthermore, density of PE was associated with the need for intubation (OR=1.02, CI 95% (1.003; 1.05), p = 0.03) and the need for ICU admission (OR=1.03, CI 95% (1.005; 1.05), p = 0.01) in univariable regression analysis. The presence of PE was associated with 30-day mortality in male patients, HR= 1.56, CI 95%(1.01-2.43), p = 0.04 (multivariable analysis). In female patients, none of PE values predicted clinical outcomes. CONCLUSION: The prevalence of PE in Covid 19 is 13.3%. PE is an independent predictor of 30-day mortality in male patients with Covid 19. In female patients, PE plays no predictive role.

Proximate Content Monitoring of Black Soldier Fly Larval (Hermetia illucens) Dry Matter for Feed Material using Short-Wave Infrared Hyperspectral Imaging.

Edible insects are gaining popularity as a potential future food source because of their high protein content and efficient use of space. Black soldier fly larvae (BSFL) are noteworthy because they can be used as feed for various animals including reptiles, dogs, fish, chickens, and pigs. However, if the edible insect industry is to advance, we should use automation to reduce labor and increase production. Consequently, there is a growing demand for sensing technologies that can automate the evaluation of insect quality. This study used short-wave infrared (SWIR) hyperspectral imaging to predict the proximate composition of dried BSFL, including moisture, crude protein, crude fat, crude fiber, and crude ash content. The larvae were dried at various temperatures and times, and images were captured using an SWIR camera. A partial least-squares regression (PLSR) model was developed to predict the proximate content. The SWIR-based hyperspectral camera accurately predicted the proximate composition of BSFL from the best preprocessing model; moisture, crude protein, crude fat, crude fiber, and crude ash content were predicted with high accuracy, with R2 values of 0.89 or more, and root mean square error of prediction values were within 2%. Among preprocessing methods, mean normalization and max normalization methods were effective in proximate prediction models. Therefore, SWIR-based hyperspectral cameras can be used to create automated quality management systems for BSFL.

Deep Learning-Based Quantitative Assessment of Melamine and Cyanuric Acid in Pet Food Using Fourier Transform Infrared Spectroscopy.

Melamine and its derivative, cyanuric acid, are occasionally added to pet meals because of their nitrogen-rich qualities, leading to the development of several health-related issues. A nondestructive sensing technique that offers effective detection must be developed to address this problem. In conjunction with machine learning and deep learning technique, Fourier transform infrared (FT-IR) spectroscopy was employed in this investigation for the nondestructive quantitative measurement of eight different concentrations of melamine and cyanuric acid added to pet food. The effectiveness of the one-dimensional convolutional neural network (1D CNN) technique was compared with that of partial least squares regression (PLSR), principal component regression (PCR), and a net analyte signal (NAS)-based methodology, called hybrid linear analysis (HLA/GO). The 1D CNN model developed for the FT-IR spectra attained correlation coefficients of 0.995 and 0.994 and root mean square error of prediction values of 0.090% and 0.110% for the prediction datasets on the melamine- and cyanuric acid-contaminated pet food samples, respectively, which were superior to those of the PLSR and PCR models. Therefore, when FT-IR spectroscopy is employed in conjunction with a 1D CNN model, it serves as a potentially rapid and nondestructive method for identifying toxic chemicals added to pet food.

Low bone mineral density is a prognostic factor for elderly patients with HCC undergoing TACE: results from a multicenter study.

OBJECTIVES: Low bone mineral density (BMD) was recently identified as a novel risk factor for patients with hepatocellular carcinoma (HCC). In this multicenter study, we aimed to validate the role of BMD as a prognostic factor for patients with HCC undergoing transarterial chemoembolization (TACE). METHODS: This retrospective multicenter trial included 908 treatment-naïve patients with HCC who were undergoing TACE as a first-line treatment, at six tertiary care centers, between 2010 and 2020. BMD was assessed by measuring the mean Hounsfield units (HUs) in the midvertebral core of the 11th thoracic vertebra, on contrast-enhanced computer tomography performed before treatment. We assessed the influence of BMD on median overall survival (OS) and performed multivariate analysis including established estimates for survival. RESULTS: The median BMD was 145 HU (IQR, 115-175 HU). Patients with a high BMD (≥ 114 HU) had a median OS of 22.2 months, while patients with a low BMD (< 114 HU) had a lower median OS of only 16.2 months (p < .001). Besides albumin, bilirubin, tumor number, and tumor diameter, BMD remained an independent prognostic factor in multivariate analysis. CONCLUSIONS: BMD is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. The integration of BMD into novel scoring systems could potentially improve survival prediction and clinical decision-making. KEY POINTS: • Bone mineral density can be easily assessed in routinely acquired pre-interventional computed tomography scans. • Bone mineral density is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. • Thus, bone mineral density is a novel imaging biomarker for prognosis prediction in elderly patients with HCC undergoing TACE.

Identification of Early Heat and Water Stress in Strawberry Plants Using Chlorophyll-Fluorescence Indices Extracted via Hyperspectral Images.

Strawberry (Fragaria × ananassa Duch) plants are vulnerable to climatic change. The strawberry plants suffer from heat and water stress eventually, and the effects are reflected in the development and yields. In this investigation, potential chlorophyll-fluorescence-based indices were selected to detect the early heat and water stress in strawberry plants. The hyperspectral images were used to capture the fluorescence reflectance in the range of 500 nm-900 nm. From the hyperspectral cube, the region of interest (leaves) was identified, followed by the extraction of eight chlorophyll-fluorescence indices from the region of interest (leaves). These eight chlorophyll-fluorescence indices were analyzed deeply to identify the best indicators for our objective. The indices were used to develop machine-learning models to assess the performance of the indicators by accuracy assessment. The overall procedure is proposed as a new workflow for determining strawberry plants' early heat and water stress. The proposed workflow suggests that by including all eight indices, the random-forest classifier performs well, with an accuracy of 94%. With this combination of the potential indices, namely the red-edge vegetation stress index (RVSI), chlorophyll B (Chl-b), pigment-specific simple ratio for chlorophyll B (PSSRb), and the red-edge chlorophyll index (CIREDEDGE), the gradient-boosting classifier performs well, with an accuracy of 91%. The proposed workflow works well with a limited number of training samples which is an added advantage.

Deep Learning-driven classification of external DICOM studies for PACS archiving.

OBJECTIVES: Over the course of their treatment, patients often switch hospitals, requiring staff at the new hospital to import external imaging studies to their local database. In this study, the authors present MOdality Mapping and Orchestration (MOMO), a Deep Learning-based approach to automate this mapping process by combining metadata analysis and a neural network ensemble. METHODS: A set of 11,934 imaging series with existing anatomical labels was retrieved from the PACS database of the local hospital to train an ensemble of neural networks (DenseNet-161 and ResNet-152), which process radiological images and predict the type of study they belong to. We developed an algorithm that automatically extracts relevant metadata from imaging studies, regardless of their structure, and combines it with the neural network ensemble, forming a powerful classifier. A set of 843 anonymized external studies from 321 hospitals was hand-labeled to assess performance. We tested several variations of this algorithm. RESULTS: MOMO achieves 92.71% accuracy and 2.63% minor errors (at 99.29% predictive power) on the external study classification task, outperforming both a commercial product (82.86% accuracy, 1.36% minor errors, 96.20% predictive power) and a pure neural network ensemble (72.69% accuracy, 10.3% minor errors, 99.05% predictive power) performing the same task. We find that the highest performance is achieved by an algorithm that combines all information into one vote-based classifier. CONCLUSION: Deep Learning combined with metadata matching is a promising and flexible approach for the automated classification of external DICOM studies for PACS archiving. KEY POINTS: • The algorithm can successfully identify 76 medical study types across seven modalities (CT, X-ray angiography, radiographs, MRI, PET (+CT/MRI), ultrasound, and mammograms). • The algorithm outperforms a commercial product performing the same task by a significant margin (> 9% accuracy gain). • The performance of the algorithm increases through the application of Deep Learning techniques.

Artificial intelligence guided enhancement of digital PET: scans as fast as CT?

PURPOSE: Both digital positron emission tomography (PET) detector technologies and artificial intelligence based image post-reconstruction methods allow to reduce the PET acquisition time while maintaining diagnostic quality. The aim of this study was to acquire ultra-low-count fluorodeoxyglucose (FDG) ExtremePET images on a digital PET/computed tomography (CT) scanner at an acquisition time comparable to a CT scan and to generate synthetic full-dose PET images using an artificial neural network. METHODS: This is a prospective, single-arm, single-center phase I/II imaging study. A total of 587 patients were included. For each patient, a standard and an ultra-low-count FDG PET/CT scan (whole-body acquisition time about 30 s) were acquired. A modified pix2pixHD deep-learning network was trained employing 387 data sets as training and 200 as test cohort. Three models (PET-only and PET/CT with or without group convolution) were compared. Detectability and quantification were evaluated. RESULTS: The PET/CT input model with group convolution performed best regarding lesion signal recovery and was selected for detailed evaluation. Synthetic PET images were of high visual image quality; mean absolute lesion SUVmax (maximum standardized uptake value) difference was 1.5. Patient-based sensitivity and specificity for lesion detection were 79% and 100%, respectively. Not-detected lesions were of lower tracer uptake and lesion volume. In a matched-pair comparison, patient-based (lesion-based) detection rate was 89% (78%) for PERCIST (PET response criteria in solid tumors)-measurable and 36% (22%) for non PERCIST-measurable lesions. CONCLUSION: Lesion detectability and lesion quantification were promising in the context of extremely fast acquisition times. Possible application scenarios might include re-staging of late-stage cancer patients, in whom assessment of total tumor burden can be of higher relevance than detailed evaluation of small and low-uptake lesions.

Tumor Burden in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Head-to-Head Comparison of Current Scoring Systems.

Objectives: Recently, several scoring systems for prognosis prediction based on tumor burden have been promoted for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). This multicenter study aimed to perform the first head-to-head comparison of three scoring systems. Methods: We retrospectively enrolled 849 treatment-naïve patients with HCC undergoing TACE at six tertiary care centers between 2010 and 2020. The tumor burden score (TBS), the Six-and-Twelve score (SAT), and the Seven-Eleven criteria (SEC) were calculated based on the maximum lesion size and the number of tumor nodes. All scores were compared in univariate and multivariate regression analyses, adjusted for established risk factors. Results: The median overall survival (OS) times were 33.0, 18.3, and 12.8 months for patients with low, medium, and high TBS, respectively (p<0.001). The median OS times were 30.0, 16.9, and 10.2 months for patients with low, medium, and high SAT, respectively (p<0.001). The median OS times were 27.0, 16.7, and 10.5 for patients with low, medium, and high SEC, respectively (p<0.001). In a multivariate analysis, only the SAT remained an independent prognostic factor. The C-Indexes were 0.54 for the TBS, 0.59 for the SAT, and 0.58 for the SEC. Conclusion: In a direct head-to-head comparison, the SAT was superior to the TBS and SEC in survival stratification and predictive ability. Therefore, the SAT can be considered when estimating the tumor burden. However, all three scores showed only moderate predictive power. Therefore, tumor burden should only be one component among many in treatment decision making.

A Potential Role for Bile Acid Signaling in Celiac Disease-Associated Fatty Liver.

Celiac disease (CeD) is a chronic autoimmune disorder characterized by an intolerance to storage proteins of many grains. CeD is frequently associated with liver damage and steatosis. Bile acid (BA) signaling has been identified as an important mediator in gut-liver interaction and the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Here, we aimed to analyze BA signaling and liver injury in CeD patients. Therefore, we analyzed data of 20 CeD patients on a gluten-free diet compared to 20 healthy controls (HC). We furthermore analyzed transaminase levels, markers of cell death, BA, and fatty acid metabolism. Hepatic steatosis was determined via transient elastography, by MRI and non-invasive scores. In CeD, we observed an increase of the apoptosis marker M30 and more hepatic steatosis as compared to HC. Fibroblast growth factor 19 (FGF19) was repressed in CeD, while low levels were associated with steatosis, especially in patients with high levels of anti-tissue transglutaminase antibodies (anti-tTG). When comparing anti-tTG-positive CeD patients to individuals without detectable anti-tTG levels, hepatic steatosis was accentuated. CeD patients with significant sonographic steatosis (defined by CAP ≥ 283 db/m) were exclusively anti-tTG-positive. In summary, our results suggest that even in CeD patients in clinical remission under gluten-free diet, alterations in gut-liver axis, especially BA signaling, might contribute to steatotic liver injury and should be further addressed in future studies and clinical practice.

Anti-TNFα treatment in Crohn's disease: Impact on hepatic steatosis, gut-derived hormones and metabolic status.

BACKGROUND AND AIMS: An association between Crohn's disease (CD) and hepatic steatosis has been reported. However, the underlying mechanisms of steatosis progression in CD are not clear. Among the most effective CD treatments are agents that inhibit Tumor-Necrosis-Factor (TNF) activity, yet it is unclear why anti-TNFα agents would affect steatosis in CD. Recent studies suggest that microbiome can affect both, CD and steatosis pathogenesis. Therefore, we here analysed a potential relationship between anti-TNF treatment and hepatic steatosis in CD, focusing on the gut-liver axis. METHODS: This cross-sectional study evaluated patients with established CD, with and without anti-TNFα treatment, analysing serum markers of liver injury, measurement of transient elastography, controlled attenuation parameter (CAP) and MRI for fat detection. Changes in lipid and metabolic profiles were assessed by serum and stool lipidomics and metabolimics. Additionally, we analysed gut microbiota composition and mediators of bile acid (BA) signalling via stool and serum analysis. RESULTS: Patients on anti-TNFα treatment had less hepatic steatosis as assessed by CAP and MRI. Serum FGF19 levels were significantly higher in patients on anti-TNFα therapy and associate with reduced steatosis and increased bowel motility. Neutral lipids including triglycerides were reduced in the serum of patients on anti-TNF treatment. Bacteria involved in BA metabolism and FGF19 regulation, including Firmicutes, showed group-specific alterations with low levels in patients without anti-TNFα treatment. Low abundance of Firmicutes was associated with higher triglyceride levels. CONCLUSIONS: Anti-TNFα treatment is associated with reduced steatosis, lower triglyceride levels, alterations in FXR-signalling (eg FGF19) and microbiota composition in CD.

Automatic Scan Range Delimitation in Chest CT Using Deep Learning.

PURPOSE: To develop and evaluate fully automatic scan range delimitation for chest CT by using deep learning. MATERIALS AND METHODS: For this retrospective study, scan ranges were annotated by two expert radiologists in consensus in 1149 (mean age, 65 years ± 16 [standard deviation]; 595 male patients) chest CT topograms acquired between March 2002 and February 2019 (350 with pleural effusion, 376 with atelectasis, 409 with neither, 14 with both). A conditional generative adversarial neural network was trained on 1000 randomly selected topograms to generate virtual scan range delimitations. On the remaining 149 topograms the software-based scan delimitations, scan lengths, and estimated radiation exposure were compared with those from clinical routine. For statistical analysis an equivalence test (two one-sided t tests) was used, with equivalence limits of 10 mm. RESULTS: The software-based scan ranges were similar to the radiologists' annotations, with a mean Dice score coefficient of 0.99 ± 0.01 and an absolute difference of 1.8 mm ± 1.9 and 3.3 mm ± 5.6 at the upper and lower boundary, respectively. An equivalence test indicated that both scan range delimitations were similar (P < .001). The software-based scan delimitation led to shorter scan ranges compared with those used in clinical routine (298.2 mm ± 32.7 vs 327.0 mm ± 42.0; P < .001), resulting in a lower simulated total radiation exposure (3.9 mSv ± 3.0 vs 4.2 mSv ± 3.3; P < .001). CONCLUSION: A conditional generative adversarial neural network was capable of automating scan range delimitation with high accuracy, potentially leading to shorter scan times and reduced radiation exposure.Keywords: Adults and Pediatrics, CT, Computer Applications-Detection/Diagnosis, Convolutional Neural Network (CNN), Lung, Radiation Safety, Segmentation, Supervised learning, Thorax © RSNA, 2021Supplemental material is available for this article.

Detecting the pulmonary trunk in CT scout views using deep learning.

For CT pulmonary angiograms, a scout view obtained in anterior-posterior projection is usually used for planning. For bolus tracking the radiographer manually locates a position in the CT scout view where the pulmonary trunk will be visible in an axial CT pre-scan. We automate the task of localizing the pulmonary trunk in CT scout views by deep learning methods. In 620 eligible CT scout views of 563 patients between March 2003 and February 2020 the region of the pulmonary trunk as well as an optimal slice ("reference standard") for bolus tracking, in which the pulmonary trunk was clearly visible, was annotated and used to train a U-Net predicting the region of the pulmonary trunk in the CT scout view. The networks' performance was subsequently evaluated on 239 CT scout views from 213 patients and was compared with the annotations of three radiographers. The network was able to localize the region of the pulmonary trunk with high accuracy, yielding an accuracy of 97.5% of localizing a slice in the region of the pulmonary trunk on the validation cohort. On average, the selected position had a distance of 5.3 mm from the reference standard. Compared to radiographers, using a non-inferiority test (one-sided, paired Wilcoxon rank-sum test) the network performed as well as each radiographer (P < 0.001 in all cases). Automated localization of the region of the pulmonary trunk in CT scout views is possible with high accuracy and is non-inferior to three radiographers.

Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery.

Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and computed tomography revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

Economic Analysis of an Image-Based Beef Carcass Yield Estimation System in Korea.

To minimize production costs, reduce mistakes, and improve consistency, modern-day slaughterhouses have turned to automated technologies for operations such as cutting, deboning, etc. One of the most vital operations in the slaughterhouse is carcass grading, usually performed manually by grading staff, which creates a bottleneck in terms of production speed and consistency. To speed up the carcass grading process, we developed an online system that uses image analysis and statistical tools to estimate up to 23 key yield parameters. A thorough economic analysis is required to aid slaughterhouses in making informed decisions about the risks and benefits of investing in the system. We therefore conducted an economic analysis of the system using a cost-benefit analysis (the methods considered were net present value (NPV), internal rate of return (IRR), and benefit/cost ratio (BCR)) and sensitivity analysis. The benefits considered for analysis include labor cost reduction and gross margin improvement arising from optimizing breeding practices with the use of the data obtained from the system. The cost-benefit analysis of the system resulted in an NPV of approximately 310.9 million Korean Won (KRW), a BCR of 1.72, and an IRR of 22.28%, which means the benefits outweigh the costs in the long term.

Hyperspectral Shortwave Infrared Image Analysis for Detection of Adulterants in Almond Powder with One-Class Classification Method.

The widely used techniques for analyzing the quality of powdered food products focus on targeted detection with a low-throughput screening of samples. Owing to potentially significant health threats and large-scale adulterations, food regulatory agencies and industries require rapid and non-destructive analytical techniques for the detection of unexpected compounds present in products. Accordingly, shortwave-infrared hyperspectral imaging (SWIR-HSI) for high throughput authenticity analysis of almond powder was investigated in this study. Two different varieties of almond powder, adulterated with apricot and peanut powder at different concentrations, were imaged using the SWIR-HSI system. A one-class classifier technique, known as data-driven soft independent modeling of class analogy (DD-SIMCA), was used on collected data sets of pure and adulterated samples. A partial least square regression (PLSR) model was further developed to predict adulterant concentrations in almond powder. Classification results from DD-SIMCA yielded 100% sensitivity and 89-100% specificity for different validation sets of adulterated samples. The results obtained from the PLSR analysis yielded a high determination coefficient (R2) and low error values (<1%) for each variety of almond powder adulterated with apricot; however, a relatively higher error rates of 2.5% and 4.4% for the two varieties of almond powder adulterated with peanut powder, which indicates the performance of quantitative analysis model could vary with sample condition, such as variety, originality, etc. PLSR-based concentration mapped images visually characterized the adulterant (apricot) concentration in the almond powder. These results demonstrate that the SWIR-HSI technique combined with the one-class classifier DD-SIMCA can be used effectively for a high-throughput quality screening of almond powder regarding potential adulteration.

Estimation of heavy metals using deep neural network with visible and infrared spectroscopy of soil.

Heavy metal contamination in soil disturbs the chemical, biological, and physical soil conditions and adversely affects the health of living organisms. Visible and near-infrared spectroscopy (VNIRS) shows a potential feasibility for estimating heavy metal elements in soil. Moreover, deep learning models have been shown to successfully deal with complex multi-dimensional and multivariate nonlinear data. Thus, this study implemented a deep learning method on reflectance spectra of soil samples to estimate heavy metal concentrations. A convolutional neural network (CNN) was adopted to estimate arsenic (As), copper (Cu), and lead (Pb) concentrations using measured soil reflectance. In addition, a convolutional autoencoder was utilized as a joint method with the CNN for dimensionality reduction of the reflectance spectra. Furthermore, artificial neural network (ANN) and random forest regression (RFR) models were built for heavy metal estimation. Principal component analysis was utilized for dimensionality reduction of the ANN and RFR models. Among these models, the CNN model with convolutional autoencoder showed the highest accuracies for As, Cu, and Pb estimates, having R2 values of 0.86, 0.74, and 0.82, respectively. The convolutional autoencoder disentangled the relevant features of multiple heavy metal elements and delivered robust features to the CNN model, thereby generating relatively accurate estimates.

The Effects of a Vasodilator on Transluminal Attenuation Gradient at Coronary Computed Tomography Angiography.

OBJECTIVE: To evaluate the effects of vasodilators on contrast enhancement and transluminal attenuation gradient (TAG) of coronary arteries at coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: We retrospectively reviewed CCTA scans of patients who underwent double-acquisition CCTA; CCTA without a vasodilator, and CCTA during a intravenous (IV) infusion of nitrate. Among them, we enrolled 19 patients who had no significant atherosclerotic lesions or coronary spasms. In the control group, 28 patients were enrolled who showed normal coronary arteries on CCTA, which was acquired by a conventional method (sublingual vasodilator). We measured the TAG and Hounsfield units for each of the three major epicardial coronary arteries (reported as 'ProxHU') and then compared the results between the nitrate administration methods (CT without vasodilator [CTpre], CT with IV vasodilator [CTiv], and CT with sublingual vasodilator [CTsub]). RESULTS: The mean TAG showed a significant difference between the coronary arteries (right coronary artery [RCA] > left anterior descending artery [LAD] > left circumflex artery [LCX], p < 0.05), while there was no difference in ProxHU of each coronary artery in all three types of nitrate administration methods (p > 0.05). The TAG of CTpre group showed steeper slope than those of vasodilator groups (CTiv and CTsub) on LAD and LCX ([LAD: CTpre = -22.1 ± 6.66, CTiv = -16.76 ± 5.78, and CTsub = -16.47 ± 5.78, p = 0.005], [LCX: CTpre = -31.26 ± 17.43, CTiv = -23.74 ± 14.06, and CTsub = -20.94 ± 12.15, p = 0.051]), while that of RCA showed no significant differences (p = 0.600). When comparing proxHU, CTiv showed higher proxHU than that of CTpre or CTsub, especially on LCX (CTpre = 426.7 ± 68.3, CTiv = 467.9 ± 84.9, and CTsub = 404.9 ± 63.3, p = 0.013). ProxHU showed a negative correlation with TAG on all three of methods (r = -0.280, p < 0.001). CONCLUSION: TAG in CCTA was significantly affected by vasodilator administration. Both TAG and ProxHU of coronary arteries tend to increase with vasodilator administration on CCTA.

Improvement in Purity of Healthy Tomato Seeds Using an Image-Based One-Class Classification Method.

The feasibility of a color machine vision technique with the one-class classification method was investigated for the quality assessment of tomato seeds. The health of seeds is an important quality factor that affects their germination rate, which may be affected by seed contamination. Hence, segregation of healthy seeds from diseased and infected seeds, along with foreign materials and broken seeds, is important to improve the final yield. In this study, a custom-built machine vision system containing a color camera with a white light emitting diode (LED) light source was adopted for image acquisition. The one-class classification method was used to identify healthy seeds after extracting the features of the samples. A significant difference was observed between the features of healthy and infected seeds, and foreign materials, implying a certain threshold. The results indicated that tomato seeds can be classified with an accuracy exceeding 97%. The infected tomato seeds indicated a lower germination rate (<10%) compared to healthy seeds, as confirmed by the organic growing media germination test. Thus, identification through image analysis and rapid measurement were observed as useful in discriminating between the quality of tomato seeds in real time.

Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease.

OBJECTIVE: To evaluate the value of airway computed tomography (CT) in patients with obstructive sleep apnea (OSA) as a predictor of cerebrocardiovascular disease (CCVD) clinically, by quantitatively analyzing carotid arterial calcification (CarAC). MATERIALS AND METHODS: This study included 287 patients aged 40-80 years, who had undergone both polysomnography (PSG) and airway CT between March 2011 and October 2015. The carotid arterial calcium score (CarACS) was quantified using the modified Agatston method on each upper airway CT. The OSA severity was categorized as normal, mild, moderate, and severe using the PSG results. Clinical characteristics, comorbid diseases, and lipid profiles of all patients were analyzed, and the prevalence of CCVDs was investigated during the follow up period (52.2 ± 16.0 months). RESULTS: CCVD occurred in 27 patients (9.3%) at the end of follow-up, and the CCVD-present groups showed a significantly older mean age (57.5 years vs. 54.2 years), higher prevalence of hypertension (59% vs. 34%) and CarAC (51.9% vs. 20.8%), whereas sex, other comorbid diseases, and severity of OSA were not significantly different from the CCVD-absent group. A univariate analysis showed that age, hypertension, incidence of CarAC, and CarACS were risk factors for the occurrence of CCVD events. In a multivariate analysis, the incidence of CarAC was the only independent risk factor for CCVD. CONCLUSION: CarAC is an independent risk factor for CCVD, whereas the severity of OSA is not a contributory risk factor in patients with OSA. Therefore, additional analysis of CarACS based on airway CT scans may be useful for predicting CCVD.

Quantitative analysis of carotid arterial calcification using airway CT in obstructive sleep apnea.

OBJECTIVE: To evaluate the relationship between obstructive sleep apnea (OSA) severity and carotid arterial calcification by quantitative analysis using airway computed tomography (CT). METHODS: This study included a total of 180 consecutive OSA patients aged 45-80years underwent polysomnography and airway CT between March 2014 and October 2016. The subjects were divided into three groups based on the results of the respiratory disturbance index (RDI): mild (RDI 5-14, n=29), moderate (RDI 15-29, n=50), and severe (RDI≥30, n=101). The extent of carotid arterial calcification on each airway CT scan was quantified according to the modified Agatston scoring method. Differences among the three groups in clinical characteristics including age, gender, body mass index (BMI), comorbid disease, blood pressure, total cholesterol, and carotid arterial calcification score (CarACS) were analyzed. RESULTS: The severe OSA group showed significantly stronger predominance for male and smoker, higher prevalence of diabetes, and larger BMI than those of mild and moderate OSA groups. The mean CarACS was significantly different among the three groups (mild RDI: 4.3±13.4, moderate RDI: 7.4±28.8, severe RDI: 48.6±121.6, P=0.011). Univariate linear regression showed that RDI, age, hypertension, male sex and diabetes significantly influenced on the CarACS. In a multivariate linear regression model, the CarACS was related to age, male sex, and diabetes. CONCLUSIONS: The patients with severe OSA showed larger CarACS and a higher prevalence of atherosclerotic risk factors. The CarACS was correlated with severity of OSA, which might be more dependent on the conventional risk factors of atherosclerosis.