Purpose: To develop and validate an effective and user-friendly AI platform based on a few unbiased clinical variables integrated with advanced CT automatic analysis for COVID-19 patients' risk stratification.
Material And Methods: In total, 1575 consecutive COVID-19 adults admitted to 16 hospitals during wave 1 (February 16-April 29, 2020), submitted to chest CT within 72 h from admission, were retrospectively enrolled. In total, 107 variables were initially collected; 64 extracted from CT.
Scand J Trauma Resusc Emerg Med
November 2021
Background: We leveraged the data of the international CREACTIVE consortium to investigate whether the outcome of traumatic brain injury (TBI) patients admitted to intensive care units (ICU) in hospitals without on-site neurosurgical capabilities (no-NSH) would differ had the same patients been admitted to ICUs in hospitals with neurosurgical capabilities (NSH).
Methods: The CREACTIVE observational study enrolled more than 8000 patients from 83 ICUs. Adult TBI patients admitted to no-NSH ICUs within 48 h of trauma were propensity-score matched 1:3 with patients admitted to NSH ICUs.
Individualized patient care is essential to reduce the global burden of traumatic brain injury (TBI). This pilot study focused on TBI patients admitted to intensive care units (ICUs) and aimed at identifying patterns of circulating biomarkers associated with the disability level at 6 months from injury, measured by the extended Glasgow Outcome Scale (GOS-E). The concentration of 107 biomarkers, including proteins related to inflammation, innate immunity, TBI, and central nervous system, were quantified in blood samples collected on ICU admission from 80 patients.
View Article and Find Full Text PDFBackground: Long-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present PROSAFE, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. The project involved 343 ICUs in seven countries.
View Article and Find Full Text PDFRecent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks.
View Article and Find Full Text PDFAim: To develop an algorithm, based on convolutional neural network (CNN), for the classification of lung cancer lesions as T1-T2 or T3-T4 on staging fluorodeoxyglucose positron emission tomography (FDG-PET)/CT images.
Methods: We retrospectively selected a cohort of 472 patients (divided in the training, validation, and test sets) submitted to staging FDG-PET/CT within 60 days before biopsy or surgery. TNM system seventh edition was used as reference.
Int J Numer Method Biomed Eng
September 2018
Image-based computational fluid dynamics (CFD) has shown potential to aid in the clinical management of intracranial aneurysms, but its adoption in the clinical practice has been missing, partially because of lack of accuracy assessment and sensitivity analysis. To numerically solve the flow-governing equations, CFD solvers generally rely on 2 spatial discretization schemes: finite volume (FV) and finite element (FE). Since increasingly accurate numerical solutions are obtained by different means, accuracies and computational costs of FV and FE formulations cannot be compared directly.
View Article and Find Full Text PDFAnnu Int Conf IEEE Eng Med Biol Soc
July 2017
This paper introduces the use of fluid-dynamic modeling to determine the connectivity of overlapping venous and arterial vessels in fundus images. Analysis of the retinal vascular network may provide information related to systemic and local disorders. However, the automated identification of the vascular trees in retinal images is a challenging task due to the low signal-to-noise ratio, nonuniform illumination and the fact that fundus photography is a projection on to the imaging plane of three-dimensional retinal tissue.
View Article and Find Full Text PDFBackground And Objectives: The effect of mammalian target of rapamycin (mTOR) inhibitors has never been tested in patients with autosomal dominant polycystic kidney disease (ADPKD) and severe renal insufficiency.
Design, Setting, Participants, & Measurements: In this academic, prospective, randomized, open label, blinded end point, parallel group trial (ClinicalTrials.gov no.
Intracranial aneurysms (IAs) occur in around 3% of the entire population. IA rupture is responsible for the most devastating type of hemorrhagic strokes, with high fatality and disability rates as well as healthcare costs. With increasing detection of unruptured aneurysms, clinicians are routinely faced with the dilemma whether to treat IA patients and how to best treat them.
View Article and Find Full Text PDFA number of computational approaches have been proposed for the simulation of haemodynamics and vascular wall dynamics in complex vascular networks. Among them, 0D pulse wave propagation methods allow to efficiently model flow and pressure distributions and wall displacements throughout vascular networks at low computational costs. Although several techniques are documented in literature, the availability of open-source computational tools is still limited.
View Article and Find Full Text PDFBackground: Autosomal dominant polycystic kidney disease slowly progresses to end-stage renal disease and has no effective therapy. A pilot study suggested that the somatostatin analogue octreotide longacting release (LAR) could be nephroprotective in this context. We aimed to assess the effect of 3 years of octreotide-LAR treatment on kidney and cyst growth and renal function decline in participants with this disorder.
View Article and Find Full Text PDFThe aim of the present work is to quantitatively assess the three-dimensional distributions of the displacements experienced during the cardiac cycle by the luminal boundary of abdominal aortic aneurysm (AAA) and to correlate them with the local bulk hemodynamics. Ten patients were acquired by means of time resolved computed tomography, and each patient-specific vascular morphology was reconstructed for all available time frames. The AAA lumen boundary motion was tracked, and the lumen boundary displacements (LBD) computed for each time frame.
View Article and Find Full Text PDFComput Methods Biomech Biomed Engin
September 2014
An important number of surgical procedures for creation of vascular access (VA) in haemodialysis patients still results in non-adequate increase in blood flow (non-maturation). The rise in blood flow in arteriovenous shunts depends on vascular remodelling. Computational tools to predict the outcome of VA surgery would be important in this clinical context.
View Article and Find Full Text PDFIn StereoElectroEncephaloGraphy (SEEG) procedures, intracerebral electrodes are implanted in order to identify the epileptogenic zone in drug-resistant epileptic patients. This paper presents an automatic multitrajectory planner that computes the best trajectory in terms of distance from vessels and guiding screws angle, once the candidate entry and target regions are quickly and roughly defined. The planning process is designed also to spare some brain structures, such as cella media and trigone of the lateral ventricles and brain stem.
View Article and Find Full Text PDFPurpose: Maturation of an arterio-venous fistula (AVF) frequently fails, with low post-operative fistula flow as a prognostic marker for this event. As pulsed wave Doppler (PWD) is commonly used to assess volume flow, we studied the accuracy of this measurement in the setting of a radio-cephalic AVF.
Methods: As in-vivo validation of fistula flow measurements is cumbersome, we performed simulations, integrating computational fluid dynamics with an ultrasound (US) simulator.
Bicuspid aortic valve (BAV) is associated with aortic dilatation and aneurysm. Several studies evidenced an eccentric systolic flow in ascending aorta associated with increased wall shear stresses (WSS) and the occurrence of an helical systolic flow. This study seeks to elucidate the connections between jet asymmetry and helical flow in patients with normally functioning BAV and dilated ascending aorta.
View Article and Find Full Text PDFPurpose: To report the technical aspects of a novel method to generate patient-specific vascular network models of arterial vasculature for the surgical planning of vascular access (VA) for hemodialysis.
Methods: On the basis of literature data, we defined a set of rules for estimation of diameter, length and compliance of arterial network segments, at patient-specific level, as a function of general descriptors (i.e.
Arterial geometry has long been considered as a pragmatic alternative for inferring arterial flow disturbances, and their impact on the natural history and treatment of vascular diseases. Traditionally, definition of geometric variables is based on convenient shape descriptors, with only superficial consideration of their influence on flow and wall shear stress patterns. In the present study we demonstrate that a more studied consideration of the actual (cf.
View Article and Find Full Text PDFGeometric indices defined on intracranial aneurysms have been widely used in rupture risk assessment and surgical planning. However, most indices employed in clinical settings are currently evaluated based on two-dimensional images that inevitably fail to capture the three-dimensional nature of complex aneurysmal shapes. In addition, since measurements are performed manually, they can suffer from poor inter and intra operator repeatability.
View Article and Find Full Text PDFCell Physiol Biochem
April 2012
Background/aims: It has been shown that MDCK cells, a cell line derived from canine renal tubules, develop cell domes due to fluid pumped under cell monolayer and focal detachment from the adhesion surface. In vitro studies have shown that primary cilia of kidney tubular epithelial cells act as mechanosensors, increasing intracellular calcium within seconds upon changes in fluid shear stress (SS) on cell membrane. We then studied the effect of prolonged SS exposure on cell dome formation in confluent MDCK cell monolayers.
View Article and Find Full Text PDFBicuspid aortic valve (BAV) predisposes to aortic aneurysms with a high prevalence. A first hypothesis for this phenomenon is related to fibrillin deficiency (genetic hypothesis). The present article focused on a complementary, hemodynamic hypothesis stating that it is the peculiar fluid dynamics of blood in the ascending aorta of patients with BAV configurations that leads to aneurysm formation.
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