Effect of Shields in Radiation Dose and Secondary Biological Risk of Gonads in Lumbosacral Digital and Computerized Radiography.

Background: The purpose of this study was to evaluate the effect of shields in imposed radiation dose to gonads in anterior-posterior (AP) and lateral views of lumbosacral radiography using digital radiography (DR) and computerized radiography (CR) methods. Materials and Methods: Sixty patients who were suspected to AP and lateral view of lumbosacral radiography were included in this study. The patients were exposed with and without shields which have 0.25 mm thickness. This study also compared the imposed dose to gonads for one and two plates of shields with none shields situation. Measurement of the radiation dose was performed using thermo luminescence dosimeters on the surface of the gonads. Furthermore, the absolute and excess relative risk (ERR) of biological abnormalities was estimated in the above-mentioned method using the BEIR VII model. Results: The mean dose of the DR method (10.14 ± 0.27) for the AP view was significantly lower than CR (32.43 ± 0.17) with and without shields. In addition, the imposed dose to gonads in the lateral view of DR (6.41 ± 0.47) was lower compared to CR (9.38 ± 0.14). Furthermore, the mean imposed dose to gonads for one and two pate shields of DR was lower than CR. Moreover, the excess relative risk to gonads in the AP for DR was lower compared to CR in all mentioned situations. Conclusion: Lumbosacral radiography is suggested to be performed by DR systems, due to the lower imposed dose and ERR to the gonads. Moreover, using shields may lead to decrease of scatter rays and also ERR of the gonads.

Evaluation of Using Panoramic Radiography and Ultrasonography for Diagnosing Carotid Artery Calcifications.

Background: The aim of this study was to determine the reliability of panoramic radiograph (PR) as a screening tool for the detection of calcified carotid atheroma (CCA) in comparison with Doppler ultrasonography (DU) examination. Materials and Methods: In this study, DU was performed for 52 patients who had carotid calcification or other differential diagnoses of carotid calcification on PR routine screening. The data relating to the presence or absence of calcified atheroma in DU and PR were evaluated using SPSS software. Results: In the 52 stated patients, CCA of 9 (18%) patients was diagnosed in the PR. Significant differences in CCA between the two sexes were not found. Also, considerable differences between the left and right sides (P = 0/906) were not found. Moreover, the positive cases who are diagnosed using ultrasonography and PR were 2.25% and 6.5%, respectively. Conclusion: PR method is not a good choice for the primary diagnosis method for the carotid artery calcifications due to its less positive diagnosing ratio compared to DU.

Diffusion-Weighted MRI Monitoring of Embolic Brain Stroke for COVID-19 Patients.

Background: Coronavirus disease (COVID-19) pandemic around the world has some adverse effects on the human body, and there is limited data about the impacts of this pandemic disease on embolic brain stroke. Materials and Methods: Fifty-two COVID-19 patients with embolic brain stroke were included in this study. The COVID-19 patients were diagnosed according to their clinical findings. The patients underwent diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values of different points of their brain were calculated using MRIcro software. Results: The embolic strokes were mostly diagnosed in the medial temporal lobe for both COVID-19 and others. In addition, a combination of COVID-19 with other inflammations and infections was not diagnosed in the studied patients. The mean ADC values of the central region were significantly lower than other regions of the brain stroke for the COVID-19 and other patients. Moreover, the maximum and minimum ADC values of the central region for COVID-19 and other patients were significantly different compared to the other regions. Whereas, the mean and minimum ADC values of the brain's normal regions were not significantly different in the edge regions for both groups, while in the COVID-19 and other patients the maximum ADC value of the edge regions was considerably lower compared to the normal regions. Conclusion: The embolic stroke of COVID-19 patients is likely to occur in the medial temporal lobe of the brain. Moreover, the ADC and relative ADC (rADC) values of embolic brain stroke in COVID-19 patients are not significantly different compared to others.

Impact of Using Standard and High-Resolution Exposure Modalities of Cone-Beam Computed Tomography (CBCT) System for Dental Implants Dimension Measurements.

Background: This study aimed to analyze the effects of standard and high-resolution exposures on the diagnostic accuracy of CBCT in the evaluation of dental implant dimensions. Materials and Methods: A descriptive-analytical study was carried out on 40 dry human mandibles with appropriate ridge quality based on panoramic radiography. CBCT (Soredex, Cranex 3D, Finland) with a large field of view (FOV) and CMOS flat panel detector were used. CBCT with standard and a high resolution was performed in each mandible. Axial images, reconstructed by OnDemand 3D software, were processed to prepare cross-sectional images from the areas marked by gutta-percha, and then measured by a ruler with an accuracy of 0.01 millimeter in the computer. Measurements were recorded by two observers and the obtained data were compared with the real ones. Results: The results showed suitable repeatability in radiologic measurements (r = 0.971), which is indicative of the high reliability of intraobserver measurement. The measurement of width with high-resolution exposure indicated a significant difference with the real condition (P < 0.001); however, this difference was not significant in the case of standard resolution (P > 0.05). Measurement of height with high resolution showed a significant difference with the real condition in the right mandible (P = 0.04) and left mandible (P = 0.05); however, this difference was not significant in standard resolution (P > 0.05). Conclusion: Based on our findings, the standard CBCT resolution modality is suggested for dental implant images due to its higher accuracy than high-resolution methods for diagnosing the implant dimensions.

Diagnostic criteria for Buerger's disease: International Consensus of VAS - European Independent Foundation in Angiology/Vascular Medicine.

Buerger's disease (BD) remains a debilitating condition and early diagnosis is paramount for its effective management. Despite many published diagnostic criteria for BD, selective criteria have been utilized in different vascular centers to manage patients with BD worldwide. A recent international Delphi Consensus Study on the diagnostic criteria of BD showed that none of these published diagnostic criteria have been universally accepted as a gold standard. Apart from the presence of smoking, these published diagnostic criteria have distinct differences between them, rendering the direct comparison of patient outcomes difficult. Hence, the expert committees from the Working Group of the VAS-European Independent Foundation in Angiology/Vascular Medicine critically reviewed the findings from the Delphi study and provided practical recommendations on the diagnostic criteria for BD, facilitating its universal use. We recommend that the 'definitive' diagnosis of BD must require the presence of three features (history of smoking, typical angiographic features and typical histopathological features) and the use of a combination of major and minor criteria for the 'suspected' diagnosis of BD. The major criterion is the history of active tobacco smoking. The five minor criteria are disease onset at age less than 45 years, ischemic involvement of the lower limbs, ischemic involvement of one or both of the upper limbs, thrombophlebitis migrans and red-blue shade of purple discoloration on edematous toes or fingers. We recommend that a 'suspected' diagnosis of BD is confirmed in the presence of a major criterion plus four or more minor criteria. In the absence of the major criterion or in cases of fewer than four minor criteria, imaging and laboratory data could facilitate the diagnosis. Validation studies on the use of these major and minor criteria are underway.

Recent Studies of Membranes for Liquids Separation and Water Treatment.

Rapid urbanization and industrialization in the past decades have resulted in vast amounts of wastewater containing pollutants such as inorganic chemicals, pathogens, pharmaceuticals, plant nutrients, petrochemical products, and microplastics [...].

Asymptotic Behavior of Adversarial Training in Binary Linear Classification.

Adversarial training using empirical risk minimization (ERM) is the state-of-the-art method for defense against adversarial attacks, that is, against small additive adversarial perturbations applied to test data leading to misclassification. Despite being successful in practice, understanding the generalization properties of adversarial training in classification remains widely open. In this article, we take the first step in this direction by precisely characterizing the robustness of adversarial training in binary linear classification. Specifically, we consider the high-dimensional regime where the model dimension grows with the size of the training set at a constant ratio. Our results provide exact asymptotics for both standard and adversarial test errors under general lq -norm bounded perturbations ( q ≥ 1 ) in both discriminative binary models and generative Gaussian-mixture models with correlated features. We use our sharp error formulae to explain how the adversarial and standard errors depend upon the over-parameterization ratio, the data model, and the attack budget. Finally, by comparing with the robust Bayes estimator, our sharp asymptotics allow us to study the fundamental limits of adversarial training.

Positive- and Negative-Pressure Ventilation Characterized by Local and Global Pulmonary Mechanics.

Rationale: There is continued debate regarding the equivalency of positive-pressure ventilation (PPV) and negative-pressure ventilation (NPV). Resolving this question is important because of the different practical ramifications of the two paradigms. Objectives: We sought to investigate the parallel between PPV and NPV and determine whether or not these two paradigms cause identical ventilation profiles by analyzing the local strain mechanics when the global tidal volume (Vt) and inflation pressure was matched. Methods: A custom-designed electromechanical apparatus was used to impose equal global loads and displacements on the same ex vivo healthy porcine lung using PPV and NPV. High-speed high-resolution cameras recorded local lung surface deformations and strains in real time, and differences between PPV and NPV global energetics, viscoelasticity, as well as local tissue distortion were assessed. Measurements and Main Results: During initial inflation, NPV exhibited significantly more bulk pressure-volume compliance than PPV, suggestive of earlier lung recruitment. NPV settings also showed reduced relaxation, hysteresis, and energy loss compared with PPV. Local strain trends were also decreased in NPV, with reduced tissue distortion trends compared with PPV, as revealed through analysis of tissue anisotropy. Conclusions: Apparently, contradictory previous studies are not mutually exclusive. Equivalent changes in transpulmonary pressures in PPV and NPV lead to the same changes in lung volume and pressures, yet local tissue strains differ between PPV and NPV. Although limited to healthy specimens and ex vivo experiments in the absence of a chest cavity, these results may explain previous reports of better oxygenation and less lung injury in NPV.

On Smart Geometric Non-Destructive Evaluation: Inspection Methods, Overview, and Challenges.

Inspection methods, also known as non-destructive evaluation (NDE), is a process for inspecting materials, products, and facilities to identify flaws, imperfections, and malfunctions without destruction or changing the integrity of materials, structures, and mechanisms. However, detecting those defects requires test conducting and results inferring, which is highly demanding in terms of analysis, performance, and time. New technologies are therefore needed to increase the efficiency, probability of detection, and interpretability of NDE methods to establish smart inspection. In this context, Artificial intelligence (AI), as a fundamental component of the Industry 4.0, is a well-suited tool to address downsides associated with the current NDE methods for analysis and interpretation of inspection results, where methods integrating AI into their inspection process become automated and are known as smart inspection methods. This article sheds a light on the conventional methods and the smart techniques used in defects detection. Subsequently, a comparison between the two notions is presented. Furthermore, it investigates opportunities for the integration of non-destructive evaluation (NDE) methods and Industry 4.0 technologies. In addition, the challenges hindering the progress of the domain are mentioned as the potential solutions. To this end, along with Industry 4.0 technologies, a virtual inspection system has been proposed to deploy smart inspection.

Secondary Infertility: A Neglected Aspect of Buerger's Disease.

Background: During the gathering of demographic data for the biobank on Buerger's Disease (BD), we found that, after the clinical manifestation of BD, the patients usually became infertile, and the age of their last child was compatible with the time of disease diagnosis. The aim of this study was to evaluate the underlying cause of secondary infertility in BD patients. Methods: Anti-sperm antibodies (ASA), testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the sera of 39 male BD patients were measured and compared with 39 age-matched Caucasian male controls. Results: Six patients declared that they suffered from impotency. The ASA level was positive in 25.6% of the patients and 2.4% of the controls (p= 0.003, CC= 6.96). The mean levels of testosterone in the patients and controls were 393.12±32.9 ng/dl and 354.37±30.9 ng/dl, respectively. The mean levels of LH in the patients and controls were 0.88±0.12 mIU/r and 0.85±0.1 mIU/r, respectively. The mean levels of FSH in the patients and controls were 4.1± 0.35 mIU/r and 3.56±0.33 mIU/r, respectively. No significant difference in the serum levels of testosterone, LH, or FSH was found between the patients and controls (p> 0.05). The spermograms of three ASA-negative patients demonstrated impaired sperm motility. Discussion: Anti-sperm antibodies, disturbed genital circulation, autonomic dysfunction and sperm motility may be responsible for secondary infertility in Buerger's Disease.

Artificial Intelligence, Machine Learning and Smart Technologies for Nondestructive Evaluation.

Nondestructive evaluation (NDE) techniques are used in many industries to evaluate the properties of components and inspect for flaws and anomalies in structures without altering the part's integrity or causing damage to the component being tested. This includes monitoring materials' condition (Material State Awareness (MSA)) and health of structures (Structural Health Monitoring (SHM)). NDE techniques are highly valuable tools to help prevent potential losses and hazards arising from the failure of a component while saving time and cost by not compromising its future usage. On the other hand, Artificial Intelligence (AI) and Machine Learning (ML) techniques are useful tools which can help automating data collection and analyses, providing new insights, and potentially improving detection performance in a quick and low effort manner with great cost savings. This paper presents a survey on state of the art AI-ML techniques for NDE and the application of related smart technologies including Machine Vision (MV) and Digital Twins in NDE.

An International Delphi Consensus on Diagnostic Criteria for Buerger's Disease.

BACKGROUND: Buerger's disease (BD) remains a debilitating condition. Despite multiple published diagnostic criteria for BD, none is universally accepted as a gold standard. METHODS: We conducted a 2-round modified Delphi consensus study to establish a consensus on the diagnostic. The questionnaire included statements from several commonly used diagnostic criteria for BD. Qualitative and quantitative analysis methods were performed. An agreement level of 70% was applied. RESULTS: Twenty nine experts from 18 countries participated in this study. Overall, 75 statements were circulated in Round 1. Of these, 28% of statements were accepted. Following comments, 21 statements were recirculated in Round 2 and 90% were accepted. Although more than 90% of the experts did not agree that the diagnosis of BD can be based only on clinical manifestation, none of the nonclinical manifestations of BD were agreed as a part of the diagnostic criteria. There was an agreement that a history of tobacco consumption in any form, not necessarily confined to the current use, should be a part of the diagnostic criteria of BD. The history of thrombophlebitis migrans, even if not present at presentation, was accepted as a clue for BD diagnosis. It was also agreed that discoloration of the toes or fingers could be included in the diagnostic criteria of BD. Experts agreed that histology results could differentiate BD from atherosclerosis obliterans and other types of vasculitis. The presence of corkscrew collaterals on imaging and burning pain reached the agreement at the first round but not at the second. There was no consensus regarding age cut-off, the requirement of normal lipid profile, and normal blood glucose for BD diagnosis. CONCLUSIONS: The present study demonstrated discrepancies in the various published diagnostic criteria for BD and their selective utilization in routine clinical practice worldwide. We propose that all published diagnostic criteria for BD be re-evaluated for harmonization and universal use.

All-optical dissipative discrete time crystals.

Time crystals are periodic states exhibiting spontaneous symmetry breaking in either time-independent or periodically-driven quantum many-body systems. Spontaneous modification of discrete time-translation symmetry in periodically-forced physical systems can create a discrete time crystal (DTC) constituting a state of matter possessing properties like temporal rigid long-range order and coherence, which are inherently desirable for quantum computing and information processing. Despite their appeal, experimental demonstrations of DTCs are scarce and significant aspects of their behavior remain unexplored. Here, we report the experimental observation and theoretical investigation of DTCs in a Kerr-nonlinear optical microcavity. Empowered by the self-injection locking of two independent lasers with arbitrarily large frequency separation simultaneously to two same-family cavity modes and a dissipative Kerr soliton, this versatile platform enables realizing long-awaited phenomena such as defect-carrying DTCs and phase transitions. Combined with monolithic microfabrication, this room-temperature system paves the way for chip-scale time crystals supporting real-world applications outside sophisticated laboratories.

Milestones in thromboangiitis obliterans: a position paper of the VAS-European independent foundation in angiology/vascular medicine.

Even today thromboangiitis obliterans has disease features that remain misunderstood or underappreciated. The epidemiology, etiology and pathophysiology of the disease are still unclear. Biomarkers and disease activity markers are lacking, thus clinical assessment is difficult. We are still struggling to establish unique diagnostic, staging and treatment criteria. This is an academic-collaborative effort to describe the pathophysiology, the clinical manifestations, the diagnostic approach, and the challenges of management of patients with TAO. A systematic search for relevant studies dating from 1900 to the end of 2020 was performed on the PubMed, SCOPUS, and Science Direct databases. Given the intriguing nature of presentation of TAO, its management, to some extent is not only different in different regions of the world but also varies within the same region. Following this project, we discovered ambiguity, overlap and lack of clear-cut criteria for management of TAO. An international group of experts however came to one conclusion. They all agree that management of TAO needs a call for action for a renewed global look with multi-center studies, to update the geographical distribution of the disease and to establish a unique set of diagnostic criteria and a consensus-based guideline for best treatment based on current evidence.

Sharp Guarantees and Optimal Performance for Inference in Binary and Gaussian-Mixture Models.

We study convex empirical risk minimization for high-dimensional inference in binary linear classification under both discriminative binary linear models, as well as generative Gaussian-mixture models. Our first result sharply predicts the statistical performance of such estimators in the proportional asymptotic regime under isotropic Gaussian features. Importantly, the predictions hold for a wide class of convex loss functions, which we exploit to prove bounds on the best achievable performance. Notably, we show that the proposed bounds are tight for popular binary models (such as signed and logistic) and for the Gaussian-mixture model by constructing appropriate loss functions that achieve it. Our numerical simulations suggest that the theory is accurate even for relatively small problem dimensions and that it enjoys a certain universality property.

Cholesteryl Ester Transfer Protein Inhibitors and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Cholesteryl ester transfer protein (CETP) inhibitors increase serum high-density lipoprotein cholesterol (HDL-c) concentration; however, their impact on cardiovascular outcomes is not clear. This systematic review examines the effect of CETP inhibitors on serum lipid profiles, cardiovascular events, and all-cause mortality. METHODS: We searched MEDLINE, Embase, and the Cochrane Library of Clinical Trials for placebo-controlled randomized controlled trials (RCTs) that examined the effect of a CETP inhibitor (dalcetrapib, anacetrapib, evacetrapib, or TA-8995) on all-cause mortality, major adverse cardiovascular events (MACE), or the components of MACE at ≥6 months. Data were pooled using random-effects models. RESULTS: A total of 11 RCTs (n = 62,431) were included in our systematic review; 4 examined dalcetrapib (n = 16,612), 6 anacetrapib (n = 33,682), and 1 evacetrapib (n = 12,092). Compared to dalcetrapib, ana-cetrapib and evacetrapib were more efficacious at raising HDL-c levels (∼100-130 vs. ∼30%). Anacetrapib and evacetrapib also decreased low-density lipoprotein cholesterol (LDL-c) by approximately 30% while dalcetrapib did not affect the LDL-c level. Overall, CETP inhibitors were not associated with the incidence of MACE (pooled relative risk [RR]: 0.97; 95% confidence interval [CI]: 0.91-1.04). CETP inhibitors may decrease the risks of nonfatal myocardial infarction (MI) (RR: 0.93; 95% CI: 0.87-1.00) and cardiovascular death (RR: 0.92; 95% CI: 0.83-1.01), though these trends did not reach statistical significance. CONCLUSIONS: CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality. There is a trend towards small reductions in nonfatal MI and cardiovascular death, though the clinical im-portance of such reductions is likely modest.

Detection of Rickettsia Endosymbiont Bemisia Tabaci in the Amputated Limbs of Three Buerger's Disease Patients.

Until recently, the aetiology of Buerger's disease (BD) has been unknown. Although there is a close relationship between BD and smoking, it cannot explain the low prevalence of BD among smokers or the disease's geographical distribution. Infectious pathogens, such as Rickettsial infection, have also been suggested as the trigger of BD development, but this theory has neither been proven nor ruled out. The aim of this study was to evaluate the footprint of Rickettsial infection in tissue specimens obtained from amputees with Buerger's disease. Forty-nine tissue biopsies were obtained from three below-the-knee amputees who also had a diagnosis of BD according to Olin's criteria (between 14-21 biopsies for each patient). After extraction of DNA from the tissue samples, the existence of 16srRNA was evaluated using a PCR test. The sequence of PCR products was evaluated using Geneious 11.1.2 software and NCBI blast. The 16srRNA was found in 3 to 7 samples from each patient. The sequence of the PCR products had a 98% homology with Rickettsia Tabaci. The sequences of the three patients were aligned, and no difference was found in the sequence of 16srRNA amongst the patients. Rickettsia Tabaci is a pathogen that infects tobacco leaves. Thus, BD might be an infectious disease for which smoking could be the route of pathogen entry into the bloodstreams of the sufferers. However, further studies are highly recommended to confirm this hypothesis.

Improved coupled-mode theory for high-index-contrast photonic platforms.

Coupled-mode theory (CMT) has been widely used in optics and photonics design. Despite its popularity, several different formulations of CMT exist in the literature, and their applicable range is not entirely clear, in particular when it comes to high-index-contrast photonics platforms. Here we propose an improved formulation of CMT and demonstrate its superior performance through numerical simulations that compare CMT-derived quantities with supermode calculations and full wave propagation simulations. In particular, application of the improved CMT to asymmetric waveguides reveals a necessary correction in the conventional phase matching condition for high-index-contrast systems, which could lead to more accurate photonic circuit designs involving asymmetric elements.

A Novel Algorithm in Radiation Dosimetry of Regular and Irregular Treatment Fields.

BACKGROUND: The aim of this study was to design an algorithm for the calculation of monitor unit (MU) in a short time and high precision for different radiotherapy (RT) fields. MATERIALS AND METHODS: The algorithm for calculating MU for the stated patients was designed in MATLAB software. To investigate the efficiency of this algorithm, 11 regular chest fields with the sizes of 7 cm × 7 cm up to 17 cm × 17 cm were considered, and the obtained MUs were compared with MUs of 13 patients which were calculated with a "hand calculation" which is used in some RT centers for the aforementioned fields. RESULTS: The maximum percentage of calculation errors of regular fields at the depths of 4 and 10 cm were 1 and 0.8, respectively. The maximum and minimum percentage of calculation errors in irregular fields was 3 and 0.9, respectively. Furthermore, the maximum and minimum errors were 8.8 and 0.14, respectively. In addition, relative percentages of the MUs for irregular fields of chest and supraclavicular were 1.63 and 1.01, respectively. CONCLUSION: Calculation of MUs is suggested to be performed with the novel proposed algorithm, due to reduce the treatment time, and also provide high accuracy and precision compared to hand calculation.

Angiogenesis induction in Buerger's disease: a disease management double-edged sword?

Due to unknown aetiology of Thromboangiitis obliterans (TAO), its effectively treating is challenging. However, angiogenesis induction is one of the acceptable treatments for TAO patients. Recently, we have noticed that TAO patients who were under long-term treatment with angiogenesis-inducing medication showed considerable improvement in terms of healing chronic ulcers over the course of one to 2 years of treatment. However, some of them developed dermal gangrene despite the warming of their feet, with or without palpable pulses in the extremities, and with hair growth on the affected skin. Unfortunately, following the progression of dermal gangrene, some of these patients had to undergo amputation and limb loss.During histopathological evaluation, we detected some changes in the amputee TAO patients under long-term angiogenic medical treatment that were not present in amputee TAO patients who had not received any treatment for many years. The greatest pathological changes were observed in the microvascular of the skin, appearing as a proliferation of endothelial cells, NETosis and thrombus formation inside the vessels with proliferation of endothelial cells. The immunohistochemistry for CD31 and Ki67 as markers of vascular endothelium differentiation and cell mitosis confirmed the proliferation of endothelial cells. However, in the patients who had not received any treatment for years the typical pathology view of BD, including preserved vascular architecture with infiltration of inflammatory cells and inflammatory cells inside the thrombus, organised thrombus with recanalisation and intimal thickening was observed. Further longitudinal cohort studies regarding long-term treatment with angiogenic medications for TAO in different geographic areas are highly recommended.