Arsenicum albumas a treatment for pneumonia in snakes: three serial cases

two Python bivittatussnakes were received at Project Selva Viva, a zoo in Taubaté, Brazil, both presenting respiratory noises and oro-nasal discharge. A thoracic ultrasonographic examination was performed for evaluation on February 25th,2022, which diagnosed the presence of multiple vertical hyperechoic artifactsemerging from the pleural line, coalescing in some of the examined areas, and the presence a hypoechoic structure located in the subpleural region. Another serpent, from the Boa constrictor species, was apprehended and arrived at the same zoo without medical history, showing a low body score. During a thoracic ultrasonographic evaluation realized on April 1st,2022, B lines emerging from the pleural line were found. These vertical reverberating lines are a result of respiratory illness (SOLDATI et al., 2014).Methodology:The report was authorized by the owner of the zoo. All the patients received homeopathic therapy with 2 globules of Arsenicum album30 cH/ BID into the mouth, after being diagnosed with the respiratory condition by the ultrasonographic examination. The medication was chosen according to the similarity with the symptoms. The snakes had a runny nose and hissing breathing noise. Weekly ultrasound scans were performed on the Python bivittatus snakes to follow up on the respiratory condition. Results: On March 04th, it was observed that both snakes showed a reduction in respiratory noises and were more active. Ars 30 cH was maintained BID. On March 25th, both presented significant improvement in the ultrasound images, which showed only A lines, compatible with a healthy lung, and the treatment was suspended. Boa constrictor snake ́streatment started on April 1st. On April 8th, the ultrasonographic examination performed only presented A lines, which are characterized in ultrasound by parallel horizontal lines in the near field with the loss of image continuity in the far field, indicating improvement of the condition (LICHTENSTEIN et al., 2003). Conclusion:Given these results, the homeopathic treatment is an option to be considered for the treatment of respiratory symptoms in snakes, although the duration of the therapy varies based on the stage and chronicity of the disease.

Ultrasonographic characterization of the organs in the middle third and caudal coelomic cavity of snakes in the Boidae Family / Caracterização ultrassonográfica dos órgãos do terço médio e caudal da cavidade celomática de serpentes da família Boidae

The aim of this study was the ultrasonographic evaluation of the organs in the middle third and caudal coelomic cavity of healthy snakes in the Boidae family. For such, 15 adult snakes from five species were evaluated: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi and Epicrates crassus. The animals were physically restrained for examination. After the application of acoustic gel over the scales the transducer was positioned in the frontal plane of the coelomic cavity. Microconvex and linear transducers at 10MHz were used. The ultrasound examination was conducted in the craniocaudal direction, with longitudinal and transversal sections to assess syntropy, echogenicity and echotexture of the organs. The liver was bilobulated, hyperechoic, homogeneous echotexture, hyperechoic capsule, with a hepatic lobe measuring 1.15±0.64cm wide, and the presence of a central hepatic vein, measuring 0.44±0.21cm in diameter. The gallbladder was characterized as an anechoic structure with echogenic walls and dimensions of 2.91±1.18cm x 1.38±0.84cm (length x width). The stomach showed a pleated and linear texture, echogenic, with hypoechoic walls measuring 0.3±0.07cm wide. The splenopancreas was a circular and echogenic structure, homogeneous echotexture and measuring 1.18±0.62cm in width and 1.56±0.88cm in length. The kidneys were characterized by elongated, lobulated, hypoechoic structures, an echogenic capsule and an echogenic central line, measuring 1.05±0.7cm in width. The testis were characterized by fusiform, hypoechoic structures, homogeneous echotexture, measuring 2.31±0.79cm in length and 0.6±0.23cm in width. Ovarian follicles were seen in different stages, 0.67±0.39cm wide and 0.73±0.38cm long. No differences were found between species of syntropy, echogenicity and echotexture of the organs of the coelomic cavity. The ultrasound examination proved to be a safe, non-invasive and efficient technique for characterizing the organs of the coelomic cavity of snakes.(AU)

O objetivo do estudo foi realizar a avaliação ultrassonográfica de órgãos do terço médio e caudal da cavidade celomática de serpentes hígidas da família Boidae. Para isto, foram avaliadas 15 serpentes adultas de cinco espécies: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi e Epicrates crassus. Os animais foram contidos fisicamente para a realização do exame. Após aplicação de gel acústico sobre as escamas, o transdutor foi posicionado no plano frontal da cavidade celomática. Foram utilizados transdutores microconvexo e linear em 10MHz. O exame ultrassonográfico foi conduzido no sentido craniocaudal, com cortes longitudinais e transversais para avaliar sintopia, ecogenicidade e ecotextura dos órgãos. O fígado se apresentou bilobulado, hiperecoico, ecotextura homogênea, cápsula hiperecoica, com lobo hepático medindo 1,15±0,64cm de largura, e presença de uma veia central hepática, medindo 0,44±0,21cm de diâmetro. A vesícula biliar foi caracterizada como uma estrutura anecoica de paredes ecogênicas e dimensões de 2,91±1,18cm x 1,38±0,84cm(comprimento x largura). O estômago apresentou-se com o aspecto pregueado e linear, ecogênico, com paredes hipoecoicas medindo 0,3±0,07cm de largura. O esplenopâncreasse apresentou como uma estrutura circular e ecogênica, ecotextura homogênea e medindo de 1,18±0,62cm de largura e 1,56±0,88cm de comprimento. Os rins se caracterizaram por estruturas alongadas, lobuladas, hipoecoicas, cápsula ecogênica e uma linha central ecogênica, medindo 1,05±0,7cm de largura. Os testículos foram caracterizados por estruturas fusiformes, hipoecoicas, ecotextura homogênea, medindo 2,31±0,79cm de comprimento e 0,6±0,23cm de largura. Foram visualizados folículos ovarianos em diferentes estágios, de 0,67±0,39cm de largura e 0,73±0,38cm de comprimento. Não foram encontradas diferenças entre espécies de sintopia, ecogenicidade e ecotextura dos órgãos da cavidade celomática. O exame ultrassonográfico demonstrou-se uma técnica segura, não invasiva e eficiente para caracterização dos órgãos da cavidade celomática de serpentes.(AU)

Anatomic-radiographic aspects and gastrointestinal transit time in Boa constrictor amarali Stull, 1932 (Squamata, Boidae) / [Aspectos anátomo-radiográficos e tempo de trânsito gastrointestinal em jiboia-cinzenta Boa constrictor amarali Stull, 1932 (Squamata, Boidae)]

The goal of this study was to describe the gastrointestinal transit technique in the Boa constrictor amarali. For that purpose, we obtained simple radiographic images of seven serpents, subsequently administering a 25mL/kg dose of barium sulfate and establishing a radiographic sequence at the following times: 5 minutes; 1, 2, 3, 6, 9, 24, 48, 72 and 96 hours, extending to 120 and 126 hours for one animal. The mean esophageal transit was 26.71±19.48 hours; the mean gastric filling time was 28.57±27.22 minutes and the emptying time was 60±12 hours; the mean filling time of the contrast medium in the small intestine was 3±2.16 hours and the emptying time was 97±15.65 hours. We also obtained the mean filling time of the large intestine, which was 40±11.31 hours. We found that the mean passage time of the contrast medium through the cranial gastrointestinal tract - until the complete elimination of barium sulfate from the small intestine -was 97±15.65 hours. In addition to determining the gastrointestinal transit time, the technique used allowed for the morphological identification of the alimentary canal.(AU)

O objetivo deste trabalho foi descrever a técnica de trânsito gastrointestinal em Boa constrictor amarali. Para tanto, foram obtidas radiografias simples de sete serpentes, e, subsequentemente a essas, foi administrado sulfato de bário na dose de 25mL/kg. A partir disso, foi estabelecida a sequência radiográfica nos seguintes tempos: cinco minutos; uma, duas, três, seis, nove, 24, 48, 72 e 96 horas, e em um animal estendeu-se para 120 e 126 horas. O trânsito esofágico médio foi de 26,71±19,48 horas, o tempo médio de preenchimento gástrico foi de 28,57±27,22 minutos, e o esvaziamento de 60±12 horas; a média de tempo de enchimento do meio de contraste no intestino delgado foi de 3±2,16 horas e, por fim, o esvaziamento foi de 97±15,65 horas, e ainda obteve-se o tempo médio de enchimento do intestino grosso igual a 40±11,31 horas. Desse modo, verificou-se que a média do tempo de passagem do contraste pelo trato gastrointestinal cranial - até a completa eliminação do sulfato de bário do intestino delgado - foi de 97±15,65 horas. Além da determinação do tempo de trânsito gastrointestinal, a técnica empregada permitiu a identificação morfológica do canal alimentar.(AU)

Prevalencia de endoparásitos gastrointestinales y ectoparásitos en serpientes ex situ en Barranquilla, Colombia / Prevalence of gastrointestinal endoparasites and ectoparasites in ex situ snakes in Barranquilla, Colombia

RESUMEN Objetivo. Identificar la prevalencia de endoparásitos y ectoparásitos en serpientes ex situ en la Fundación Botánica y Zoológica de Barranquilla "Barranquilla Zoo". Materiales y métodos. Para esto se analizaron muestras de materia fecal y ectoparásitos de 2 colúbridos (Leptophis ahaetulla y Spilotes pullatus), 2 dipsadinos (Oxybelys aeneus y Thamnodynastes paraguanae) y 13 boidos (9 individuos de la especie Boa constrictor, 2 de Epicrates maurus y 2 de Eunectes murinus) utilizando los métodos de flotación en solución saturada de azúcar y observación directa. Resultados. Los resultados obtenidos mostraron que el 65% (11/17) de los animales evaluados fueron positivos a la presencia de parásitos, de los cuales el 91% (10/11) de los ejemplares pertenece a la familia Boidae presentando en su mayoría nematodos, mientras que en los dipsadinos se observaron principalmente protozoarios y los colúbridos resultaron negativos. Finamente como ectoparásitos se identificaron 2 especies de garrapatas (Amblyomma dissimile y Ornothodoros turicata) halladas en ejemplares de Boa constrictor, Epicrates maurus y Spilotes pullatus. Conclusiones. La identificación de las formas parasitarias en este trabajo representa una contribución para el conocimiento de los parásitos en serpientes ex situ en Colombia. Provee información para desarrollar medidas profilácticas y permite comparar los datos sobre las formas parasitarias encontradas con muestreos de estas especies en vida silvestre y bajo cuidados humanos.

ABSTRACT Objective. Identify the prevalence of internal and external parasites in ex situ snakes at the Fundación Botánica y Zoológica de Barranquilla "Barranquilla Zoo". Materials and methods. Stool samples and ectoparasites of 2 colubrids (Leptophis ahaetulla and Spilotes pullatus), 2 diapsids (Oxybelys aeneus and Thamnodynastes paraguanae) and 13 boids (9 individuals of Boa constrictor, 2 of Epicrates maurus and 2 Eunectes murinus) were analyzed using flotation method in saturated sugar solution and direct observation. Results. The results showed that 65% (11/17) of the population was positive to the presence of parasites. In relation to the positive specimens, 91% (10/11) belong to the Boidae family, presenting mostly nematodes, in the dipsadid's samples mainly protozoans were observed and the colubrid's samples were negative. Regarding ectoparasites, 2 species of ticks (Amblyomma dissimile and Ornothodoros turicata) were found in specimens of Boa constrictor, Epicrates maurus and Spilotes pullatus. Conclusions. The identification of parasitic forms in this paper represents a contribution to the knowledge of parasites in snakes ex situ in Colombia. It provides information to develop prophylactic measures against these pathological agents and also allows comparing the data about the parasitic forms found with other researches in the wild and in captivity.

Aspectos da biologia reprodutiva de Boa constrictor constrictor: um estudo histológico dos testículos nos períodos reprodutivos de quiescência e máxima atividade / Boa constrictor constrictor reproductive biology aspects: the testes histological study in the reproductive periods of quiescence and maximal activity

As serpentes pertencem ao segundo maior grupo dentro dos répteis, podendo apresentar sazonalidade quanto à espermatogênese, com produção descontínua ou contínua. O presente trabalho tem como objetivo caracterizar aspectos da biologia reprodutiva de Boa constrictor constrictor com base nos achados histológicos dos testículos nos períodos de máxima atividade (período de gametogênese) e quiescência. Os testículos de dois espécimes de Boa c. constrictor (7767 e 11752) foram cortados a uma espessura de 3µm em micrótomo, corados com azul de toluidina 1%, fotodocumentados e descritos. A presença de espermatozoides na luz do túbulo seminífero no indivíduo 7767 indica um período de máxima gametogênese, enquanto o lúmen dos túbulos seminíferos pouco evidentes, sem a presença de espermatozoides e de células gaméticas em divisão, caracteriza o indivíduo 11752 em período quiescente. Mediante os achados histológicos descritos no presente estudo, concluiu-se que Boa c. constrictor apresenta sazonalidade em relação à gametogênese, sendo esse padrão de sazonalidade associado ao período de cópulas relatado em literatura característico de serpentes com padrão pré-nupcial.(AU)

These snakes belong to the second largest group within the reptiles, being able to present seasonality regarding spermatogenesis, with discontinuous or continuous production. The present study aims to characterize Boa constrictor constrictor reproductive biology aspects from histological findings in testicles during periods of maximum activity (period of gametogenesis) and quiescence. The testicles of two specimens of Boa c. constrictor (7767 and 11752) were cut to a thickness of 3µm in microtome, stained with 1% toluidine blue, photodocumented and described. The spermatozoa presence in the seminiferous tubule lumen in individual 7767 indicates a period of maximum gametogenesis, whereas the seminiferous tubules lumen is not very evident without spermatozoa and the absence of dividing gametic cells characterizes individual 11752 in the quiescent period. Through the histological findings we concluded that Boa c. constrictor presents seasonality in relation to gametogenesis, and the pattern of reproductive seasonality observed along with the period of copulas reported in the literature resembles the pre-nuptial pattern.(AU)

Cutaneous mycobiota of boid snakes kept in captivity / Microbiota cutânea de serpentes Boidae mantidas em cativeiro

Boids are large, constrictor snakes that feed mostly on mammals, reptiles, and birds. These animals are commonly raised as pets, and their improper handling can favor the emergence of fungal infections, which can lead to dermatological diseases that are undiagnosed in nature. Here, we isolate and identify the filamentous fungi that compose the mycobiota of the scales of boid snakes kept in captivity at the Biological Museum of the Butantan Institute. Thirty individuals of four species were evaluated: four Eunectes murinus, twelve Boa constrictor constrictor, seven Corallus hortulanus, and seven Epicrates crassus. Microbiological samples were collected by rubbing small square carpets on the snake scales. We isolated five genera of fungi: Penicillium sp. (30%), Aspergillus sp. (25%), Mucor sp. (25%), Acremonium sp. (10%), and Scopulariopsis sp. (10%). Approximately half of the snakes evaluated had filamentous fungi on the scales, but only 12% of the individuals were colonized by more than one fungal genus. We found no dermatophytes in the evaluated species. Our results provide an overview of the fungal mycobiota of the population of boids kept in the Biological Museum, allowing the identification of possible pathogens.(AU)

Boidae são serpentes grandes e constritoras, que comem normalmente mamíferos, répteis e aves. São comumente criadas como animais de estimação, e seu manuseio inadequado pode favorecer infecções fúngicas emergentes, as quais podem causar doenças dermatológicas que não são diagnosticadas na natureza. Foram isolados e identificados os fungos filamentosos da microbiota das escamas das serpentes Boidae mantidas em cativeiro no Museu Biológico do Instituto Butantan. Trinta indivíduos de quatro espécies foram avaliados: quatro Eunectes murinus, 12 Boa constrictor constrictor, sete Corallus hortulanus e sete Epicrates crassus. As amostras microbiológicas foram coletadas por fricção, em pequenos quadrados de carpete das escamas das serpentes. Isolaram-se cinco gêneros de fungos: Penicillium sp. (30%), Aspergillus sp. (25%), Mucor sp. (25%), Acremonium sp. (10%) e Scopulariopsis sp. (10%). Aproximadamente metade das serpentes avaliadas tinham fungos filamentosos nas escamas e apenas 12% dos indivíduos foram colonizados por mais de um gênero. Não foram encontrados dermatófitos nas espécies avaliadas. Os resultados mostraram uma visão geral da microbiota fúngica da população de boídeos mantidos no Museu Biológico, o que permitiu a identificação de possíveis patógenos.(AU)

Identification and mapping of real acupoints in the anatomical topography of Boa constrictor / Identificação e mapeamento de acupontos reais na topografia anatômica de Boa constrictor

Abstract Acupuncture is a therapy of the traditional Chinese medicine technique, which over the years has been widespread in the West. Defined as a needle-point treatment technique (acupoints), exactly preconfigured in the body to produce a specific physiological reaction to restore the balance between the function of conflicting states and homeostasis, alternating states of energy and thus maintain the ideal organ and body organization. Thus, the objective of this study was to map and describe the main points of acupuncture in the species Boa constrictor , and their indications to promote the balance of this species. The unprecedented result of the mapping was the discovery of specific acupoints with individual location indications without distribution in specific meridians and dispersedly distributed in the body.

Resumo A acupuntura é uma técnica terapêutica da Medicina Tradicional Chinesa, que ao longo dos anos tem sido muito difundida no Ocidente. Definida como uma técnica de tratamento com inserção de agulhas em pontos (acupontos) exatamente pré-estabelecidos sobre o organismo, para produzir uma reação fisiológica específica com o intuito de restabelecer o equilíbrio entre estados contraditórios de função e a homeostase, alternando os estados de energia e com isto mantendo a organização do órgão e do organismo. Com isso, o objetivo do presente trabalho foi mapear e descrever os principais pontos de acupuntura nas espécies Boa constrictore suas indicações para promover o equilíbrio dessa espécie. O resultado inédito do mapeamento foi à descoberta de pontos de acupuntura específicos com indicações de localização individuais sem distribuição em meridianos específicos e dispersamente distribuídos no corpo.

Predation of an American fruit-eating bat (Artibeus sp. ) by an Amazon tree boa (Corallus hortulanus) in the northern Brazilian Amazon / Predação de um morcego frugívoro (Artibeus sp. ) por uma suaçubóia (Corallus hortulanus) no norte da Amazônia brasileira

We report an observation of predation by an Amazon tree boa, Corallus hortulanus, on an American fruit-eating bat, Artibeus sp., in an area of seasonal forest close to a small stream in the northern Brazilian Amazon. While bats appear to be one of the main food items of C. hortulanus, our observation is only the fourth such event to be recorded in the Brazilian Amazon. The Artibeus sp. individual was observed making distress (agony) calls continuously over a period of three hours, much longer than recorded on previous observations. Records of this type are important to further our knowledge on bat predators, and the defensive behavior of bats. (AU)

Nós relatamos uma observação de predação por uma serpente Corallus hortulanus sobre um morcego do gênero Artibeus em uma área de floresta estacional perto de um córrego, no norte da Amazônia brasileira. Enquanto os morcegos parecem ser um dos principais itens alimentares de C. hortulanus, a nossa observação representa somente o quarto relato para a Amazônia brasileira. O indivíduo de Artibeus sp. foi observado vocalizando com chamados de distress (agonia) durante um período de três horas, o que representa uma duração muito maior do que o reportado em registros anteriores. Registros deste tipo são extremamente importantes para aumentar o nosso conhecimento sobre os predadores de morcegos e sobre o comportamento de defesa dos morcegos.(AU)

Augmentation of Doppler Radar Data Using Generative Adversarial Network for Human Motion Analysis / 대한의료정보학회지

OBJECTIVES: Human motion analysis can be applied to the diagnosis of musculoskeletal diseases, rehabilitation therapies, fall detection, and estimation of energy expenditure. To analyze human motion with micro-Doppler signatures measured by radar, a deep learning algorithm is one of the most effective approaches. Because deep learning requires a large data set, the high cost involved in measuring large amounts of human data is an intrinsic problem. The objective of this study is to augment human motion micro-Doppler data employing generative adversarial networks (GANs) to improve the accuracy of human motion classification. METHODS: To test data augmentation provided by GANs, authentic data for 7 human activities were collected using micro-Doppler radar. Each motion yielded 144 data samples. Software including GPU driver, CUDA library, cuDNN library, and Anaconda were installed to train the GANs. Keras-GPU, SciPy, Pillow, OpenCV, Matplotlib, and Git were used to create an Anaconda environment. The data produced by GANs were saved every 300 epochs, and the training was stopped at 3,000 epochs. The images generated from each epoch were evaluated, and the best images were selected. RESULTS: Each data set of the micro-Doppler signatures, consisting of 144 data samples, was augmented to produce 1,472 synthesized spectrograms of 64 × 64. Using the augmented spectrograms, the deep neural network was trained, increasing the accuracy of human motion classification. CONCLUSIONS: Data augmentation to increase the amount of training data was successfully conducted through the use of GANs. Thus, augmented micro-Doppler data can contribute to improving the accuracy of human motion recognition.

Generating Motion- and Distortion-Free Local Field Map Using 3D Ultrashort TE MRI: Comparison with T₂* Mapping

PURPOSE: To generate phase images with free of motion-induced artifact and susceptibility-induced distortion using 3D radial ultrashort TE (UTE) MRI.MATERIALS AND METHODS: The field map was theoretically derived by solving Laplace's equation with appropriate boundary conditions, and used to simulate the image distortion in conventional spin-warp MRI. Manufacturer's 3D radial imaging sequence was modified to acquire maximum number of radial spokes in a given time, by removing the spoiler gradient and sampling during both rampup and rampdown gradient. Spoke direction randomly jumps so that a readout gradient acts as a spoiling gradient for the previous spoke. The custom raw data was reconstructed using a homemade image reconstruction software, which is programmed using Python language. The method was applied to a phantom and in-vivo human brain and abdomen. The performance of UTE was compared with 3D GRE for phase mapping. Local phase mapping was compared with T₂* mapping using UTE.RESULTS: The phase map using UTE mimics true field-map, which was theoretically calculated, while that using 3D GRE revealed both motion-induced artifact and geometric distortion. Motion-free imaging is particularly crucial for application of phase mapping for abdomen MRI, which typically requires multiple breathold acquisitions. The air pockets, which are caught within the digestive pathway, induce spatially varying and large background field. T₂* map, that was calculated using UTE data, suffers from non-uniform T₂* value due to this background field, while does not appear in the local phase map of UTE data.CONCLUSION: Phase map generated using UTE mimicked the true field map even when non-zero susceptibility objects were present. Phase map generated by 3D GRE did not accurately mimic the true field map when non-zero susceptibility objects were present due to the significant field distortion as theoretically calculated. Nonetheless, UTE allows for phase maps to be free of susceptibility-induced distortion without the use of any post-processing protocols.

Machine Learning Model to Predict Osteoporotic Spine with Hounsfield Units on Lumbar Computed Tomography

OBJECTIVE: Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT.METHODS: We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation.RESULTS: The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900).CONCLUSION: This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

Development of Artificial Intelligence to Support Needle Electromyography Diagnostic Analysis / 대한의료정보학회지

OBJECTIVES: This study proposes a method for classifying three types of resting membrane potential signals obtained as images through diagnostic needle electromyography (EMG) using TensorFlow-Slim and Python to implement an artificial-intelligence-based image recognition scheme. METHODS: Waveform images of an abnormal resting membrane potential generated by diagnostic needle EMG were classified into three types—positive sharp waves (PSW), fibrillations (Fibs), and Others—using the TensorFlow-Slim image classification model library. A total of 4,015 raw waveform data instances were reviewed, with 8,576 waveform images subsequently collected for training. Images were learned repeatedly through a convolutional neural network. Each selected waveform image was classified into one of the aforementioned categories according to the learned results. RESULTS: The classification model, Inception v4, was used to divide waveform images into three categories (accuracy = 93.8%, precision = 99.5%, recall = 90.8%). This was done by applying the pretrained Inception v4 model to a fine-tuning method. The image recognition model was created for training using various types of image-based medical data. CONCLUSIONS: The TensorFlow-Slim library can be used to train and recognize image data, such as EMG waveforms, through simple coding rather than by applying TensorFlow. It is expected that a convolutional neural network can be applied to image data such as the waveforms of electrophysiological signals in a body based on this study.

Health Information Technology Trends in Social Media: Using Twitter Data / 대한의료정보학회지

OBJECTIVES: This study analyzed the health technology trends and sentiments of users using Twitter data in an attempt to examine the public's opinions and identify their needs. METHODS: Twitter data related to health technology, from January 2010 to October 2016, were collected. An ontology related to health technology was developed. Frequently occurring keywords were analyzed and visualized with the word cloud technique. The keywords were then reclassified and analyzed using the developed ontology and sentiment dictionary. Python and the R program were used for crawling, natural language processing, and sentiment analysis. RESULTS: In the developed ontology, the keywords are divided into ‘health technology‘ and ‘health information‘. Under health technology, there are are six subcategories, namely, health technology, wearable technology, biotechnology, mobile health, medical technology, and telemedicine. Under health information, there are four subcategories, namely, health information, privacy, clinical informatics, and consumer health informatics. The number of tweets about health technology has consistently increased since 2010; the number of posts in 2014 was double that in 2010, which was about 150 thousand posts. Posts about mHealth accounted for the majority, and the dominant words were ‘care‘, ‘new‘, ‘mental‘, and ‘fitness‘. Sentiment analysis by subcategory showed that most of the posts in nearly all subcategories had a positive tone with a positive score. CONCLUSIONS: Interests in mHealth have risen recently, and consequently, posts about mHealth were the most frequent. Examining social media users' responses to new health technology can be a useful method to understand the trends in rapidly evolving fields.

Machine Learning Model to Predict Osteoporotic Spine with Hounsfield Units on Lumbar Computed Tomography

OBJECTIVE: Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. METHODS: We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. RESULTS: The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). CONCLUSION: This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

Uso de cetamina pela via cólon-retal para contenção química de jiboias Boa constrictor Linnaeus, 1758 com teste de influência da droga sobre o sistema renal / Use of ketamine by colon-rectal route for chemical restraint in Boa constrictor Linnaeus, 1758 with test of influence of the drug on renal system

Por serem frequentes na clínica de animais silvestres, faz-se necessária a manipulação de jiboias e para isso, indispensável o conhecimento sobre as manobras precisas para o tratamento das possíveis afecções. Quando se opta pela contenção química, ou pela realização de procedimentos cirúrgicos, um dos fármacos utilizados na anestesia de serpentes é a cetamina. Viu-se a necessidade de buscar uma via alternativa, semelhante em eficácia às tradicionais para a contenção química, porém que minimizasse os riscos e efeitos adversos encontrados na sua execução. O presente trabalho sugere que a via retal seja esta alternativa, por isso, treze jiboias foram submetidas à administração de 70mg/kg de cloridrato de cetamina, com sonda uretral, através da cloaca até o cólon-reto. Foram avaliados, nos tempos 0, 10, 20, 30, 40, 50, 60, 70, 80, 90 e 120 minutos, a partir da administração do fármaco, os seguintes parâmetros: frequência cardíaca, relaxamento muscular e mobilidade, resistência à contenção ou manipulação e reação postural de endireitamento. Foi realizada coleta de 0,5mL de sangue por punção do seio venoso paravertebral cervical, antes da administração do fármaco, no dia seguinte e após nove dias. Foram dosadas as concentrações plasmáticas de cálcio, fósforo e ácido úrico de todos os exemplares a fim de verificar o perfil bioquímico renal e avaliar a influência do fármaco neste sistema. Não foram observadas alterações bioquímicas plasmáticas durante o período de avaliação. Foi possível promover a contenção química das jiboias Boa constrictor, utilizando cloridrato de cetamina pela via cólon-retal.(AU)

It is necessary to deal with Boa constrictor snakes because they are frequently treated in wild and exotic animal clinics and the knowledge about the required procedures in the treatment of the possible affections becomes imperative. When the choice for chemical restraint or sedation for surgical procedures is made, one of the drugs used in snakes is ketamine. We believed it was necessary to look for an alternative route of drug administration as effective as the regular ones, but with minimum risks and less adverse effects in its execution. Therefore thirteen snakes were submitted to the administration of 70mg/kg of ketamine hydrochloride, with an urethral tube, through the cloaca into the colon-rectum. After this, they were evaluated during the 0, 10, 20, 30, 40, 50, 60, 70, 80, 90 and 120 next minutes from the administration time using the following parameters: heart rate, muscle relaxation and mobility, handling or restraint resistance and righting reflex. Blood samples were collected from each snake by cervical paravertebral venous sinus punction, before the drug administration, on the next day and nine days after. Serum concentrations of calcium, phosphorus and uric acid were measured in order to check the renal biochemical profile and the possibility of influence of the drug on this system. It was possible to provoke chemical restraint in Boa constrictor snakes, with ketamine hydrochloride administered by the colon-rectal route.(AU)

Diagnosis and prediction of periodontally compromised teeth using a deep learning-based convolutional neural network algorithm

PURPOSE: The aim of the current study was to develop a computer-assisted detection system based on a deep convolutional neural network (CNN) algorithm and to evaluate the potential usefulness and accuracy of this system for the diagnosis and prediction of periodontally compromised teeth (PCT). METHODS: Combining pretrained deep CNN architecture and a self-trained network, periapical radiographic images were used to determine the optimal CNN algorithm and weights. The diagnostic and predictive accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve, area under the ROC curve, confusion matrix, and 95% confidence intervals (CIs) were calculated using our deep CNN algorithm, based on a Keras framework in Python. RESULTS: The periapical radiographic dataset was split into training (n=1,044), validation (n=348), and test (n=348) datasets. With the deep learning algorithm, the diagnostic accuracy for PCT was 81.0% for premolars and 76.7% for molars. Using 64 premolars and 64 molars that were clinically diagnosed as severe PCT, the accuracy of predicting extraction was 82.8% (95% CI, 70.1%–91.2%) for premolars and 73.4% (95% CI, 59.9%–84.0%) for molars. CONCLUSIONS: We demonstrated that the deep CNN algorithm was useful for assessing the diagnosis and predictability of PCT. Therefore, with further optimization of the PCT dataset and improvements in the algorithm, a computer-aided detection system can be expected to become an effective and efficient method of diagnosing and predicting PCT.

HEDEA: A Python Tool for Extracting and Analysing Semi-structured Information from Medical Records / 대한의료정보학회지

OBJECTIVES: One of the most important functions for a medical practitioner while treating a patient is to study the patient's complete medical history by going through all records, from test results to doctor's notes. With the increasing use of technology in medicine, these records are mostly digital, alleviating the problem of looking through a stack of papers, which are easily misplaced, but some of these are in an unstructured form. Large parts of clinical reports are in written text form and are tedious to use directly without appropriate pre-processing. In medical research, such health records may be a good, convenient source of medical data; however, lack of structure means that the data is unfit for statistical evaluation. In this paper, we introduce a system to extract, store, retrieve, and analyse information from health records, with a focus on the Indian healthcare scene. METHODS: A Python-based tool, Healthcare Data Extraction and Analysis (HEDEA), has been designed to extract structured information from various medical records using a regular expression-based approach. RESULTS: The HEDEA system is working, covering a large set of formats, to extract and analyse health information. CONCLUSIONS: This tool can be used to generate analysis report and charts using the central database. This information is only provided after prior approval has been received from the patient for medical research purposes.

Quantitative Evaluation of the First Order Creatine-Kinase Reaction Rate Constant in in vivo Shunted Ovine Heart Treated with Oxandrolone Using Magnetization Transfer 31P Magnetic Resonance Spectroscopy (MT-31P-MRS) and 1H/31P Double-Tuned Surface Coil: a Preliminary Study

PURPOSE: Children born with single ventricle physiology demonstrate poor growth rate and suffer from malnutrition, which lead to increased morbidity and mortality in this population. We assume that an anabolic steroid, oxandrolone, will promote growth in these infants by improving myocardial energy utilization. The purpose of this paper is to study the efficacy of oxandrolone on myocardial energy consumption in these infants. MATERIALS AND METHODS: We modeled single ventricle physiology in a lamb by prenatally shunting the aorta to the pulmonary artery and then postnatally, we monitored cardiac energy utilization by quantitatively measuring the first order reaction rate constant, kf of the creatine-kinase reaction in the heart using magnetization transfer 31P magnetic resonance spectroscopy, home built 1H/31P transmit/receive double tuned coil, and transmit/receive switch. We also performed cine MRI to study the structure and dynamic function of the myocardium and the left ventricular chamber. The spectroscopy data were processed using home-developed python software, while cine data were analyzed using Argus software. RESULTS: We quantitatively measured both the first order reaction rate constant and ejection fraction in the control, shunted, and the oxandrolone-treated lambs. Both kf and ejection fraction were found to be more significantly reduced in the shunted lambs compared to the control lambs, and they are increased in oxandrolone-treated lambs. CONCLUSION: Some improvement was observed in both the first order reaction rate constant and ejection fraction for the lamb treated with oxandrolone in our preliminary study.

Applying Deep Learning in Medical Images: The Case of Bone Age Estimation / 대한의료정보학회지

OBJECTIVES: A diagnostic need often arises to estimate bone age from X-ray images of the hand of a subject during the growth period. Together with measured physical height, such information may be used as indicators for the height growth prognosis of the subject. We present a way to apply the deep learning technique to medical image analysis using hand bone age estimation as an example. METHODS: Age estimation was formulated as a regression problem with hand X-ray images as input and estimated age as output. A set of hand X-ray images was used to form a training set with which a regression model was trained. An image preprocessing procedure is described which reduces image variations across data instances that are unrelated to age-wise variation. The use of Caffe, a deep learning tool is demonstrated. A rather simple deep learning network was adopted and trained for tutorial purpose. RESULTS: A test set distinct from the training set was formed to assess the validity of the approach. The measured mean absolute difference value was 18.9 months, and the concordance correlation coefficient was 0.78. CONCLUSIONS: It is shown that the proposed deep learning-based neural network can be used to estimate a subject's age from hand X-ray images, which eliminates the need for tedious atlas look-ups in clinical environments and should improve the time and cost efficiency of the estimation process.

Semantic Network Analysis of Online News and Social Media Text Related to Comprehensive Nursing Care Service

PURPOSE: As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis. METHODS: The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword ‘comprehensive nursing care service’ using Python. A morphological analysis was performed using KoNLPy. Nodes on a ‘comprehensive nursing care service’ cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network. RESULTS: A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, ‘nursing workforce’ and ‘nursing service’ were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were ‘National Health Insurance Service’ and ‘comprehensive nursing care service hospital.’ The nodes with the highest edge weight were ‘national health insurance,’‘wards without caregiver presence,’ and ‘caregiving costs.’‘National Health Insurance Service’ was highest in degree centrality. CONCLUSION: This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies.