DECIDE-AI: a new reporting guideline and its relevance to artificial intelligence studies in radiology.

DECIDE-AI is a new, stage-specific reporting guideline for the early and live clinical evaluation of decision-support systems based on artificial intelligence (AI). It answers a need for more attention to the human factors influencing clinical AI performance and more transparent reporting of clinical studies investigating AI systems. Given the rapid expansion of AI systems and the concentration of related studies in radiology, these new standards are likely to find a place in radiological literature in the near future. This review highlights some of the specificities of AI as complex intervention, why a new reporting guideline was needed for early stage, live evaluation of this technology, and how DECIDE-AI and other AI reporting guidelines can be useful to radiologists and researchers.

Impact of COVID-19 on radiology training: Royal College of Radiologists Junior Radiologists Forum national survey.

AIM: To obtain a national snapshot of radiology trainees' experience during the first wave of the pandemic. MATERIALS AND METHODS: A 25-item questionnaire was disseminated to representatives from all training regions across the UK in July 2020. Each representative collated the collective experiences of trainees in their training programme in key domains, including redeployment, shielding, training, and teaching. RESULTS: Ninety-five percent (38 of 40) of representatives completed the questionnaire. Trainees in up to 76% of training programmes were redeployed to wards and some trainees were shielding in 81% of programmes. Only 27% of programmes enabled remote reporting for isolating or shielding trainees. Sixty-two percent of respondents felt their well-being needs were supported. There was an overall increase in the attendance, volume, and quality of teaching and training nationally due to improved accessibility via remote-learning methods. Significant challenges were described with reporting, interventional procedures, and multidisciplinary team meeting attendance, although 62% of programmes noted an increase in service provision. Less in-person feedback was reported with in-person training still deemed necessary for practical skills. The Royal College of Radiologists Junior Radiologists Forum webinars were well received by all trainees with continuation of the series recommended. CONCLUSION: The COVID-19 pandemic has had a clear impact on many areas of radiology training in the UK. Early strategies have been adopted to mitigate the challenges faced by trainees and opportunities for future improvement are highlighted.

Artificial intelligence and radiomics in pulmonary nodule management: current status and future applications.

Artificial intelligence (AI) has been present in some guise within the field of radiology for over 50 years. The first studies investigating computer-aided diagnosis in thoracic radiology date back to the 1960s, and in the subsequent years, the main application of these techniques has been the detection and classification of pulmonary nodules. In addition, there have been other less intensely researched applications, such as the diagnosis of interstitial lung disease, chronic obstructive pulmonary disease, and the detection of pulmonary emboli. Despite extensive literature on the use of convolutional neural networks in thoracic imaging over the last few decades, we are yet to see these systems in use in clinical practice. The article reviews current state-of-the-art applications of AI and in detection, classification, and follow-up of pulmonary nodules and how deep-learning techniques might influence these going forward. Finally, we postulate the impact of these advancements on the role of radiologists and the importance of radiologists in the development and evaluation of these techniques.

Gene-Tree Reconciliation with MUL-Trees to Resolve Polyploidy Events.

Polyploidy can have a huge impact on the evolution of species, and it is a common occurrence, especially in plants. The two types of polyploids-autopolyploids and allopolyploids-differ in the level of divergence between the genes that are brought together in the new polyploid lineage. Because allopolyploids are formed via hybridization, the homoeologous copies of genes within them are at least as divergent as orthologs in the parental species that came together to form them. This means that common methods for estimating the parental lineages of allopolyploidy events are not accurate, and can lead to incorrect inferences about the number of gene duplications and losses. Here, we have adapted an algorithm for topology-based gene-tree reconciliation to work with multi-labeled trees (MUL-trees). By definition, MUL-trees have some tips with identical labels, which makes them a natural representation of the genomes of polyploids. Using this new reconciliation algorithm we can: accurately place allopolyploidy events on a phylogeny, identify the parental lineages that hybridized to form allopolyploids, distinguish between allo-, auto-, and (in most cases) no polyploidy, and correctly count the number of duplications and losses in a set of gene trees. We validate our method using gene trees simulated with and without polyploidy, and revisit the history of polyploidy in data from the clades including both baker's yeast and bread wheat. Our re-analysis of the yeast data confirms the allopolyploid origin and parental lineages previously identified for this group. The method presented here should find wide use in the growing number of genomes from species with a history of polyploidy. [Polyploidy; reconciliation; whole-genome duplication.].

Chemotherapy alone or combined chemotherapy and involved field radiotherapy in favorable risk early-stage classical Hodgkin lymphoma-a 10 years experience.

OBJECTIVE: To determine the outcome of patients with early-stage (stage I-II) favorable risk classical Hodgkin lymphoma treated with chemotherapy alone or combined modality treatment (CMT) utilizing chemotherapy and involved field radiotherapy. METHODS: This retrospective study was done at Department of Medical oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan from January 2004 to December 2013. RESULTS: There were 101 patients, with male predominance (71.3%). Mean age was 34 years. Sixty three (62.4%) patients received CMT and 38 (37.6%) patients had chemotherapy alone. Ninety eight percent patients had ABVD chemotherapy. Dose of radiotherapy ranged from 20 to 36 gray. Difference between baseline characteristics and major toxicities among the two groups was insignificant. Patients treated with CMT had better overall survival compared to chemotherapy alone: 100% versus 91% at five years and 96% versus 81% at 10 years, respectively (p=0.03). Progression free survival was also better with CMT against chemotherapy alone at five years (98% versus 81%) and 10 years (82% versus 71%) (p=0.01). CONCLUSION: Favorable risk classical Hodgkin lymphoma patients had better overall survival and progression free survival when treated with CMT against chemotherapy alone.

A phase IIA randomized, placebo-controlled clinical trial to study the efficacy and safety of the selective androgen receptor modulator (SARM), MK-0773 in female participants with sarcopenia.

BACKGROUND: Sarcopenia, the age-related loss of muscle mass [defined as appendicular LBM/Height2 (aLBM/ht2) below peak value by>1SD], strength and function, is a major contributing factor to frailty in the elderly. MK-0773 is a selective androgen receptor modulator designed to improve muscle function while minimizing effects on other tissues. OBJECTIVES: The primary objective of this study was to demonstrate an improvement in muscle strength and lean body mass (LBM) in sarcopenic frail elderly women treated with MK-0773 relative to placebo. DESIGN: This was a randomized, double-blind, parallel-arm, placebo-controlled, multicenter, 6-month study. Participants were randomized in a 1:1 ratio to receive either MK-0773 50mg b.i.d. or placebo; all participants received Vitamin D and protein supplementation. SETTING: General community. PARTICIPANTS: 170 Women aged ≥65 with sarcopenia and moderate physical dysfunction. MEASUREMENTS: Dual energy X-ray absorptiometry, muscle strength and power, physical performance measures. RESULTS: Participants receiving MK-0773 showed a statistically significant increase in LBM from baseline at Month 6 vs. placebo (p<0.001). Participants receiving both MK-0773 and placebo showed a statistically significant increase in strength from baseline to Month 6, but the mean difference between the two groups was not significant (p=0.269). Both groups showed significant improvement from baseline at Month 6 in physical performance measures, but there were no statistically significant differences between participants receiving MK-0773 and placebo. A greater number of participants experienced elevated transaminases in the MK-0773 group vs. placebo, which resolved after discontinuation of study therapy. MK-0773 was generally well-tolerated with no evidence of androgenization. CONCLUSIONS: The MK-0773-induced increase in LBM did not translate to improvement in strength or function vs. placebo. The improvement of strength and physical function in the placebo group could be at least partly attributed to protein and vitamin D supplementation.

Clinical and radiological study of Iraqi multiple sclerosis patients with childhood onset.

OBJECTIVE: To study the clinical and radiological characteristics of multiple sclerosis (MS) with onset below 18 years. METHODS: This retrospective study was carried out at the MS Clinic in the Medical City Hospital in Baghdad, Iraq between March 2008 and March 2009. The records of the center were surveyed, and 77 patients with the onset of MS below 18 years were identified. Their clinical and radiological data were then analyzed. RESULTS: The female:male ratio was 1.6:1, and the mean age at onset was 14.95 years. Seven (9.1%) patients where children (age below 10 years), and 70 (90.9%) patients where adolescents (age 10-18 years) at onset. Seventy patients (90.9%) had an initial course of relapsing remitting MS, 9 (11.7% of the total) of them progressed to secondary progressive MS after a mean duration of 9.87+/-4.135 years. Seven patients had primary progressive MS as the initial course. The most common presenting symptom was optic neuritis (35.8%). Fifty-nine (76.6%) patients had monofocal presentation, and 18 (23.4%) had polyfocal presentation. Fifty-one (63%) patients had periventricular MRI lesions. The percentage of supratentorial lesions was higher than infratentorial lesions, children had a higher incidence of basal ganglionic lesions than adolescents (p=0.002), and males had a higher incidence of infratentorial lesion than females (p=0.033). CONCLUSION: Male patients have a higher incidence of infratentorial MRI lesions than female patients. Children had a higher incidence of MRI lesions in the basal ganglia than adolescents.

Rosai Dorfman disease--a clinico-pathological presentation.

Rosai Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is a rare disorder that typically manifests as lymphadenopathy and systemic symptoms. The authors report a 45 year old lady who presented with nasal mass and generalised lymphadenopathy. Histopathological examination demonstrated lymphophagocytosis (emperipolesis) consistent with a diagnosis of RDD. The clinical and histologic aspects of the disease are discussed as a rare cause of generalised lymphadenopathy.

A comparative study of conventional and controlled-release formulations of trazodone in elderly depressed patients.

One hundred sixty-six elderly depressed patients were recruited from six hospital centers and entered in a double-blind, randomized, parallel group comparative study of conventional and controlled-release formulations of trazodone. Patients received a single nighttime dose of 100 mg for 1 week, followed by 3 weeks of 200 mg or less, depending upon tolerance. Efficacy was measured using the modified Hamilton depression rating scale and global assessments of the severity of depression and improvement relative to baseline. Both treatments were equally effective with 39 (68%) patients completing 4 weeks of treatment with the conventional formulation and 41 (77%) patients completing 4 weeks treatment with the controlled-release formulation rated as very much improved. Sleep improved shortly after initiation of treatment in most patients and there were no significant differences between groups. There was a tendency for fewer side effects to be recorded during the first week of treatment in patients receiving the controlled-release formulation but no difference reached statistical significance.

A comparison of chlormethiazole and thioridazine in agitated confusional states of the elderly.

Chlormethiazole and thioridazine were found to be equally effective in the management of the agitational component of agitated confusional states in the elderly. Confusion and nocturnal awakening were found to be controlled more effectively with chlormethiazole than with thioridazine. Chlormethiazole treatment also resulted in significant reductions in physical disability as assessed by the Clifton Behaviour Rating Scale. A greater incidence of adverse effects was associated with thioridazine treatment.