A multistage framework for respiratory disease detection and assessing severity in chest X-ray images.

Chest Radiography is a non-invasive imaging modality for diagnosing and managing chronic lung disorders, encompassing conditions such as pneumonia, tuberculosis, and COVID-19. While it is crucial for disease localization and severity assessment, existing computer-aided diagnosis (CAD) systems primarily focus on classification tasks, often overlooking these aspects. Additionally, prevalent approaches rely on class activation or saliency maps, providing only a rough localization. This research endeavors to address these limitations by proposing a comprehensive multi-stage framework. Initially, the framework identifies relevant lung areas by filtering out extraneous regions. Subsequently, an advanced fuzzy-based ensemble approach is employed to categorize images into specific classes. In the final stage, the framework identifies infected areas and quantifies the extent of infection in COVID-19 cases, assigning severity scores ranging from 0 to 3 based on the infection's severity. Specifically, COVID-19 images are classified into distinct severity levels, such as mild, moderate, severe, and critical, determined by the modified RALE scoring system. The study utilizes publicly available datasets, surpassing previous state-of-the-art works. Incorporating lung segmentation into the proposed ensemble-based classification approach enhances the overall classification process. This solution can be a valuable alternative for clinicians and radiologists, serving as a secondary reader for chest X-rays, reducing reporting turnaround times, aiding clinical decision-making, and alleviating the workload on hospital staff.

Pharmacoeconomic Aspects of Diabetes Mellitus: Outcomes and Analysis of Health Benefits Approach.

Pharmacoeconomics is an important tool for investigating and restructuring healthcare policies. In India, recent statistical studies have shown that the number of diabetic patients is rapidly increasing in the rural, middle and upper-class settings. The aim of this review is to call attention towards the need to carry out pharmacoeconomic studies for diabetes mellitus and highlight the outcome of these studies on healthcare. A well-structured literature search from PubMed, Embase, Springer, ScienceDirect, and Cochrane was done. Studies that evaluated the cost-effectiveness of various anti-diabetic agents for type 2 diabetes were eligible for inclusion in the analysis and review. Two independent reviewers sequentially assessed the titles, abstracts, and full articles to select studies that met the predetermined inclusion and exclusion criteria for data abstraction. Any discrepancies between the reviewers were resolved through consensus. By employing search terms such as pharmacoeconomics, diabetes mellitus, cost-effective analysis, cost minimization analysis, cost-utility analysis, and cost-benefit analysis, a total of 194 papers were gathered. Out of these, 110 papers were selected as they aligned with the defined search criteria and underwent the removal of duplicate entries. This review outlined four basic pharmacoeconomic studies carried out on diabetes mellitus. It gave a direction that early detection, patient counseling, personalized medication, appropriate screening intervals, and early start of pharmacotherapy proved to be a cost-effective as well as health benefits approach.

Coronavirus Disease 2019 (COVID-19)-Associated Rhino-Orbito-Cerebral Mucormycosis: A Multi-Institutional Retrospective Study of Imaging Patterns.

BACKGROUND: Mucormycosis infection of the maxillofacial region and brain has been associated with coronavirus disease 2019 (COVID-19) infection. Mucormycosis was relatively a rare infection before COVID-19, and imaging findings are not very well described. MATERIALS AND METHODS: A retrospective imaging study of 101 patients diagnosed with COVID-19-associated mucormycosis by histopathology and/or culture was performed. All patients underwent computed tomography and/or magnetic resonance imaging based on the clinical condition of the patient and on consensus decision by the team of treating physicians. A simple 3-stage classification system based on imaging findings was adopted. RESULTS: One hundred one cases were included in the final analysis (mean age = 55.1 years; male/female ratio = 67:34). The affected patients had diabetes in 94% of the instances (n = 95), 80.1% (n = 81) received steroids), whereas 59.4% (n = 60) patients received supplemental oxygen. The majority underwent surgical intervention, whereas in 6 cases, patients were treated with antibiotic regimens. Sixty subjects improved following therapy, whereas 18 eventually succumbed to the illness. We noted a significant positive correlation between the imaging stage and outcomes. No association was seen between other clinical parameters and final clinical outcomes. Salient imaging findings include lack of normal sinonasal mucosal enhancement, perisinus inflammation, ischemic optic neuropathy, perineural spread, pachymeningeal enhancement, and presence of strokes. CONCLUSIONS: We describe the imaging findings in the largest cohort of patients with rhino-orbito-cerebral mucormycosis in the context of the current COVID-19 pandemic. A simplified staging system described here is helpful for standardized reporting and carries prognostic information.

How a sticky fluid facilitates prey retention in a carnivorous pitcher plant (Nepenthes rafflesiana).

Nepenthes pitcher plants grow in nutrient-poor soils and produce large pitfall traps to obtain additional nutrients from animal prey. Previous research has shown that the digestive secretion in N. rafflesiana is a sticky viscoelastic fluid that retains insects much more effectively than water, even after significant dilution. Although the retention of prey is known to depend on the fluid's physical properties, the details of how the fluid interacts with insect cuticle and how its sticky nature affects struggling insects are unclear. In this study, we investigated the mechanisms behind the efficient prey retention in N. rafflesiana pitcher fluid. By measuring the attractive forces on insect body parts moved in and out of test fluids, we show that it costs insects more energy to free themselves from pitcher fluid than from water. Moreover, both the maximum force and the energy required for retraction increased after the first contact with the pitcher fluid. We found that insects sink more easily into pitcher fluid than water and, accordingly, the surface tension of N. rafflesiana pitcher fluid was lower than that of water (60.2 vs. 72.3 mN/m). By analysing the pitcher fluid's wetting behaviour, we demonstrate that it strongly resists dewetting from all surfaces tested, leaving behind residual films and filaments that can facilitate re-wetting. This inhibition of dewetting may be a further consequence of the fluid's viscoelastic nature and likely represents a key mechanism underlying prey retention in Nepenthes pitcher plants. STATEMENT OF SIGNIFICANCE: Carnivorous Nepenthes pitcher plants secrete sticky viscoelastic fluids that prevent insects from escaping after falling into the pitcher. What physical mechanisms are responsible for the fluid's retentive function? First, insects sink and drown more readily in N. rafflesiana pitcher fluid due to its reduced surface tension. Second, once within the fluid, our force measurements show that it costs more energy to separate insects from pitcher fluid than from water. Third, the fluid strongly resists dewetting, making it harder for insects to extract themselves and covering their cuticle with residues that facilitate re-wetting. Such striking inhibition of dewetting may represent a previously unrecognised mechanism of prey retention by Nepenthes. Pitcher fluid fulfils a well-defined biological function and may serve as a model for studying the mechanics of complex fluids.

Self-propelled cellulose nanocrystal based catalytic nanomotors for targeted hyperthermia and pollutant remediation applications.

Inspired from biological motors, cellulose nanocrystals (CNCs) are strategically modified to induce self-propulsion behavior with the capabilities to catalytically degrade pollutants along with magnetic hyperthermia to clean arterial plaques during its course of propulsion. CNCs derived from renewable biomass, are decorated with catalytically active, magneto-responsive nanomaterials (Fe2O3/Pd nanoparticles) through sustainable routes. CNC nanomotors show improved propulsion at lowered peroxide concentrations with remotely controlled trajectory through chemo-magnetic field gradients and ideal surface-wettability characteristics, overcoming the requirement of surfactants, as with traditional nanomotors. We observed that nanomotors undergo motion through heterogeneous bubble propulsion mechanism, with capability to in situ degrade pollutants and generate local heat through hyperthermia, enhancing the rate of degradation process in real time. As proof of concept, we demonstrate that the dynamics of nanomotors can be controlled in a microfluidic channel through site-directed magnetic field and induction of pH gradient, mimicking the chemotaxis in cell-like environment and as swarm of nano-surgeons removes plaques from clogged arteries. Our study shows that strategic modification of CNCs results in fabrication of nanomotors with efficient propulsion system infused with multi-functional characteristics of high catalytic activity and magnetic hyperthermia which opens up new avenues for utilization of bio-based nanomotors derived from lignocellulose for myriad applications.

Universal representations of evaporation modes in sessile droplets.

In this work, we provide a simple method to represent the contact line dynamics of an evaporating sessile droplet. As a droplet evaporates, two distinct contact line dynamics are observed. They are collectively known as modes of evaporation, namely Constant Contact Radius (CCR) and Constant Contact Angle (CCA). Another intermediate mode-Stick-Slide (SS) or mixed mode is also commonly observed. In this article, we are able to provide a graphical representation to these modes (named as MOE plot), which is visually more comprehensive especially for comparative studies. In addition, the method facilitates quantitative estimation for mode of evaporation (named as MOE fraction or MOEf), which doesn't exist in literature. Thus, various substrates can now be compared based on mode of evaporation (or contact line dynamics), which are governed by fluid property and surface characteristics.