Challenges and opportunities for artificial intelligence in oncological imaging.

Imaging plays a key role in oncology, including the diagnosis and detection of cancer, determining clinical management, assessing treatment response, and complications of treatment or disease. The current use of clinical oncology is predominantly qualitative in nature with some relatively crude size-based measurements of tumours for assessment of disease progression or treatment response; however, it is increasingly understood that there may be significantly more information about oncological disease that can be obtained from imaging that is not currently utilized. Artificial intelligence (AI) has the potential to harness quantitative techniques to improve oncological imaging. These may include improving the efficiency or accuracy of traditional roles of imaging such as diagnosis or detection. These may also include new roles for imaging such as risk-stratifying patients for different types of therapy or determining biological tumour subtypes. This review article outlines several major areas in oncological imaging where there may be opportunities for AI technology. These include (1) screening and detection of cancer, (2) diagnosis and risk stratification, (3) tumour segmentation, (4) precision oncology, and (5) predicting prognosis and assessing treatment response. This review will also address some of the potential barriers to AI research in oncological imaging.

Brain death in children: a retrospective review of patients at a paediatric intensive care unit.

PURPOSE: Among patients in paediatric intensive care units (PICUs), death is sometimes inevitable despite advances in treatment. Some PICU patients may have irreversible cessation of all brain function, which is considered as brain death (BD). This study investigated demographic and clinical differences between PICU patients with BD and those with cardiopulmonary death. METHODS: All children who died in the PICU at a university-affiliated trauma centre between October 2002 and October 2018 were included in this retrospective study. Demographics and clinical characteristics were compared between patients with BD and patients with cardiopulmonary death. RESULTS: Of the 2784 patients admitted to the PICU during the study period, 127 died (4.6%). Of these 127 deaths, 22 (17.3%) were BD and 105 were cardiopulmonary death. Length of PICU stay was shorter for patients with cardiopulmonary death than for patients with BD (2 vs 8.5 days, P=0.0042). The most common mechanisms of injury in patients with BD were hypoxic-ischaemic injury (40.9%), central nervous system infection (18.2%), and traumatic brain injury (13.6%). The combined proportion of accident and trauma-related injury was greater in patients with BD than in patients with cardiopulmonary death (27.3% vs 3.8%, P<0.001). Organ donation was approved by the families of four of the 22 patients with BD (18.2%) and was performed successfully in three of these four patients. CONCLUSIONS: These findings emphasise the importance of injury prevention in childhood, as well as the need for education of the public regarding acceptance of BD and support for organ donation.

Neonatal herpes: what lessons to learn.

Vesicular rashes in neonates are challenging in terms of diagnosis and management. Herpes infection is an important diagnostic consideration. We report two illustrative neonatal cases of herpesvirus infections with vesicular rashes. Such babies may be remarkably asymptomatic. A high index of suspicion leading to a prompt diagnosis, timely quarantine measures, and institution of antiviral treatment are pivotal for desirable outcomes.

Spontaneous spinal epidural haematoma in a 15-month-old boy presenting with a wry neck: a case report.

A 15-month-old boy presented with a 2-day history of a wry neck (bent to the left side) with no definite trauma. He had bilateral upper limb weakness and was afebrile, conscious, and stable. There was no spontaneous movement in both upper limbs. Magnetic resonance imaging of the cervical and thoracic spine demonstrated an extensive spontaneous spinal epidural haematoma from C3 to T8. 23 hours after admission, the patient underwent an emergency right-sided C3 to T8 hemi-laminectomy and haematoma evacuation. The patent's strength gradually recovered and he attained full power 3 weeks after operation. Spontaneous spinal epidural haematoma is a rare disease in children. A high index of suspicion is essential for its effective management as the interval to operation is the most important prognostic factor.

Fractures associated with non-accidental injury--an orthopaedic perspective in a local regional hospital.

OBJECTIVES: To identify the potential risk factors for fractures due to non-accidental injury in children, and to alert clinicians and health care workers to the diagnosis of child abuse. DESIGN: Retrospective review. SETTING: Regional hospital, Hong Kong. PATIENTS: Children who were admitted to the hospital with a clinical diagnosis of child abuse with associated fracture(s) between January 1996 and April 2004. MAIN OUTCOME MEASURES: Demographic data, site of fractures, and investigations performed. RESULTS: Of the 377 children presented with non-accidental injuries, 29 (15 male, 14 female) had bone fractures. The mean age of the 29 children at the time of injury was 5 years and 5 months. Of the nine records showing pregnancy, seven were unplanned. Approximately 75% of the families were living in public housing estates, and 28% were receiving social security subsidy. Over half (52%) of the abused children were aged 3 years or less. A total of 78 fractures were documented with a mean of 2.7 fractures per child. The most common sites of fracture were the forearm (29%), followed by the ribs (24%). Most long bone fractures occurred in those aged 3 years or less. Fractures were detected by skeletal survey and bone scan for 90% of the children. CONCLUSION: A number of potential risk factors were identified in children with fractures associated with non-accidental injury. They included age younger than 3 years, lower socio-economic status, presentation with long bone fracture, and unplanned pregnancy. Bone scan and skeletal survey are mutually complementary, and both should be performed in cases of suspected child abuse. Subsequent management requires cooperation of multi-disciplinary health care professionals.

Effects of pressure, temperature, and pH on the sonochemical destruction of 1,1,1-trichloroethane in dilute aqueous solution.

There is an increasing interest in the application of high intensity ultrasound as an advanced oxidation technique. In this study, 1,1,1-trichloroethane (TCA) is the compound being subjected to ultrasonic irradiation. The study focuses on the effects of pressure (0.103-0.241 MPa), temperature (6-19.4 degrees C) and pH (3.96-12.5). Optimum conditions of treatment are discerned from the results of the experiments based on a center composite design. The results show that about 98% of TCA can be removed in 1 h of treatment (starting concentrations average 80 mg/l). Also, experiments indicate that the initial concentration does not affect destruction rate in this system. Optimum conditions as indicated by statistical analysis are at T = 14.2 degrees C, P = 0.212 MPa and pH = 10.9. This study also presents a method to normalize rate constants for changes in the power-to-volume ratio.

Hybrid reflection-transmission surface light-scattering instrument with reduced sensitivity to surface sloshing.

A hybrid reflection-transmission surface light-scattering instrumental design is presented, examined theoretically, and tested experimentally. The purpose of the design is to reduce the sensitivity of the instrument to vibration in general and surface sloshing in particular while sacrificing little performance. Traditional optical arrangements and two new optical configurations with varying trade-offs between slosh resistance and instrumental simplicity and accuracy are examined by use of Fourier optics methods. The most promising design was constructed and tested with acetone, ethanol, and water as subject fluids. The test involved backcalculation of the wave number of the capillary wave examined with the known physical parameters for the test fluids. The agreement of the computed wave number was +/-1.4%.

Microemulsion characterization by the use of a noninvasive backscatter fiber optic probe.

This paper demonstrates the utility of a noninvasive backscatter fiber optic probe for dynamic light-scattering characterization of a microemulsion comprising sodium dodecyl sulfate/1-butanol/ brine/heptane. The fiber probe, comprising two optical fibers precisely positioned in a stainless steel body, is a miniaturized and efficient self-beating dynamic light-scattering system. Accuracy of particle size estimation is better than ±2%.

Unusual origins of the buccal and mylohyoid nerves.

Dissection of the mandibular nerve in a cadaver of southern Chinese origin showed the mylohyoid nerve arising from the lingual nerve and the buccal nerve arising from the inferior alveolar nerve within the mandibular ramus. It is estimated that this variation in the origin of the buccal nerve occurs in 6.1% of the southern Chinese population.