Development of an opportunistic diagnostic prediction algorithm for osteoporosis and fragility fracture risk estimates from forearm radiographs (The OFFER1 Study).

Osteoporosis and associated fractures are an increasingly prevalent concern with an ageing population. This study reports testing of IBEX Bone Health (IBEX BH) software, applied following acquisition of forearm radiographs. IBEX Bone Health analyses the radiograph to measure areal bone mineral density (aBMD) at the examination site. A non-randomized cross-sectional study design was performed involving 261 (254 after exclusions) participants (112/142 m/f; mean age 70.8 years (SD+/-9.0); 53 with osteoporosis). They underwent posterior-anterior distal forearm radiographs; dual X-ray absorptiometry (DXA) of the wrists, hips, and lumbar spine; and questionnaires exploring clinical risk factors. IBEX Bone Health automatically identifies regions of interest (ROI) at the ultra-distal (UD) and distal third (TD) regions of the radius. Analysis investigated area under the receiver operating characteristics curve performance of IBEX BH for prediction of (i) osteoporosis (based on clinical reporting of the hip and spine DXA) and (ii) treatment recommendations by Fracture Risk Assessment Tool (FRAX) inclusive of neck of femur (NoF) areal bone mineral density (aBMD) results following National Osteoporosis Guideline Group (NOGG) guidelines. Area under the receiver operating characteristics curve for osteoporosis prediction at the UD and TD ROIs were 0.86 (99% confidence interval (CI) [0.80, 0.91]) and 0.81 (99% CI [0.75, 0.88]), respectively. Area under the receiver operating characteristics curve for treatment recommendation using FRAX inclusive of NoF aBMD at the UD and TD ROIs were 0.95 (99% CI [0.91, 1.00]) and 0.97 (99% CI [0.93,1.00]), respectively. With a matched sensitivity to FRAX (without NoF aBMD) 0.93 (99% CI [0.78, 0.99]), IBEX BH predicted at the UD and TD ROIs recommended treatment outcomes by NOGG guidelines using FRAX (with NoF aBMD) with specificity 0.89 (99% CI 0.83, 0.94]) and 0.93 (99% CI [0.87, 0.97]), respectively. This is compared with 0.60 (99% CI [0.51, 0.69]) for FRAX (without NoF aBMD). Results demonstrate the potential clinical utility of IBEX BH as an opportunistic screening tool.

Enhanced visualization of mobile chest X-ray images in the intensive care setting using software scatter correction.

BACKGROUND: Mobile chest X-ray (CXR) scans are performed within intensive treatment units (ITU) without anti-scatter grids for confirming tube and line hardware placement. Assessment is therefore challenging due to degraded subject contrast resulting from scatter. PURPOSE: To evaluate the efficacy of a software scatter correction method (commercially named Trueview) for enhanced hardware visualization and diagnostic quality in the ITU setting. MATERIAL AND METHODS: A total of 30 CXR scans were processed using Trueview and compared with standard original equipment manufacturer (OEM) images via observer scoring study involving two radiology and four ITU doctors to compare visualization of tubes and lines. Results were analyzed to determine observer preference and likelihood of diagnostic quality. RESULTS: Reviewers were more likely to score Trueview higher than OEM for mediastinal structures, bones, retrocardiac region, tube visibility, and tube safety (P < 0.01). Visual grading characteristic analysis suggested a clinical preference for Trueview compared with OEM for mediastinal structures (area under the visual grading characteristic curve [AUCVGC] = 0.60, 95% confidence interval [CI] = 0.55-0.65), bones (AUCVGC = 0.61, 95% CI = 0.55-0.66), retrocardiac region (AUCVGC = 0.64, 95% CI = 0.59-0.69), tube visibility (AUCVGC = 0.65, 95% CI = 0.60-0.70), and tube safety (AUCVGC = 0.68, 95% CI = 0.64-0.73). Reviewers were indifferent to visualization of the lung fields (AUCVGC = 0.49, 95% CI = 0.44-0.55). Registrars (3/6 reviewers) were indifferent to the mediastinal structure regions (AUCVGC = 0.54, 95% CI = 0.47-0.62). CONCLUSION: Reviewers were more confident in identifying the placement and safety of tubes and lines when reviewing Trueview images than they were when reviewing OEM.

High-contrast pattern reconstructions using a phase-seeded point CGH method.

A major challenge encountered in digital holography applications is the need to synthesize computer-generated holograms (CGHs) that are realizable as phase-only elements while also delivering high quality reconstruction. This trade-off is particularly acute in high-precision applications such as photolithography where contrast typically must exceed 0.6. A seeded-phase point method is proposed to address this challenge, whereby patterns composed of fine lines that intersect and form closed shapes are reconstructed with high contrast while maintaining a phase-only CGH. The method achieves superior contrast to that obtained by uniform or random seeded-phase methods while maintaining computational efficiency for large area exposures. It is also shown that binary phase modulation achieves similar contrast performance with benefits for the fabrication of simpler diffractive optical elements.

Use of a computer interviewing system in a chiropractic clinic during periodic patient reassessment.

OBJECTIVE: The purpose of this study was to investigate whether a computer interviewing system (CIS) could be used as part of the periodic patient reassessment process, if patients and practitioners perceived that the CIS enhanced communication, and if the CIS could be used to identify patients with possible anxiety and/or depression. METHODS: An observational method was used, whereby the CIS was used to augment the usual patient reassessment routine in a chiropractic clinic. One clinic in the Dundee region, with 3 chiropractors, collected information from 60 patients using a CIS directly before the patient treatment session. The patients were then asked to rate whether they had disclosed new information relative to their care, if they felt better prepared, or if it had helped them to formulate questions. The chiropractors reported whether the interview transcript was useful, if it helped to identify communication issues, and if it had altered the treatment session. RESULTS: The doctors of chiropractic rated the interview transcript as useful for 83% of patients, they altered the treatment session for 20% of patients, and the CIS helped to identify communication difficulties for 13% of patients. The chiropractors were surprised by the Hospital Anxiety and Depression Scale results for 23% of patients. The patients were positive about the inclusion of the CIS, with 42% saying that they disclosed new information and 33% saying that they felt better prepared for the session with the chiropractor after having used the CIS. The CIS was acceptable to 90% of patients. CONCLUSIONS: The inclusion of the CIS at this one clinic appeared to be a useful addition to the periodic patient reassessment process and was perceived to be an efficient media to evaluate Hospital Anxiety and Depression Scale scores.

Three-dimensional holographic lithography by an iterative algorithm.

We have applied an iterative algorithm for hologram design with multiple output image planes arranged in close proximity to create continuous patterns within an imaging volume. These holograms have been designed for photolithography on three-dimensional surfaces. The influence of simulated image plane separation on the final image, and its suitability for lithography, is assessed. Results are presented and the most suitable case is demonstrated experimentally.

Designing convergent cellular automata.

Cellular automata (CA) have been used by biologists to study dynamic non-linear systems where the interaction between cell behaviour and end-pattern is investigated. It is difficult to achieve convergence of a CA towards a specific static pattern and a common solution is to use genetic algorithms and evolve a ruleset that describes cell behaviour. This paper presents an alternative means of designing CA to converge to specific static patterns. A matrix model is introduced and analysed then a design algorithm is demonstrated. The algorithm is significantly less computationally intensive than equivalent evolutionary algorithms, and not limited in scale, complexity or number of dimensions.