Detection of influenza virus by electrochemical surface plasmon resonance under potential modulation.

In this study we report the development of a novel viral pathogen immunosensor technology based on the electrochemical modulation of the optical signal from a surface plasmon wave interacting with a redox dye reporter. The device is formed by incorporating a sandwich immunoassay onto the surface of a plasmonic device mounted in a micro-electrochemical flow cell, where it is functionalized with a monoclonal antibody aimed to a specific target pathogen antigen. Once the target antigen is bound to the surface, it promotes the capturing of a secondary polyclonal antibody that has been conjugated with a redox-active methylene blue dye. The methylene blue displays a reversible change in the complex refractive index throughout a reduction-oxidation transition, which generates an optical signal that can be electrochemically modulated and detected at high sensitivity. For proof-of-principle measurements, we have targeted the hemagglutinin protein from the H5N1 avian influenza A virus to demonstrate the capabilities of our device for detection and quantification of a critical influenza antigen. Our experimental results of the EC-SPR-based immunosensor under potential modulation showed a 300 pM limit of detection for the H5N1 antigen.

An orbital shear platform for real-time, in vitro endothelium characterization.

Electrical impedance techniques have been used to characterize endothelium morphology, permeability, and motility in vitro. However, these impedance platforms have been limited to either static endothelium studies and/or induced laminar fluid flow at a constant, single shear stress value. In this work, we present a microfabricated impedance sensor for real-time, in vitro characterization of human umbilical vein endothelial cells (HUVECs) undergoing oscillatory hydrodynamic shear. Oscillatory shear was applied with an orbital shaker and the electrical impedance was measured by a microfabricated impedance chip with discrete electrodes positioned at radial locations of 0, 2.5, 5.0, 7.5, 10.0, and 12.5 mm from the center of the chip. Depending on their radial position within the circular orbital platform, HUVECs were exposed to shear values ranging between 0.6 and 6.71 dyne/cm(2) (according to numerical simulations) for 22 h. Impedance spectra were fit to an equivalent circuit model and the trans-endothelial resistance and monolayer's capacitance were extracted. Results demonstrated that, compared to measurements acquired before the onset of shear, cells at the center of the platform that experienced low steady shear stress (∼2.2 dyne/cm(2) ) had an average change in trans-endothelial resistance of 6.99 ± 4.06% and 1.78 ± 2.40% change in cell capacitance after 22 hours of shear exposure; cells near the periphery of the well (r = 12.5 mm) experienced transient shears (2.5-6.7 dyne/cm(2) ) and exhibited a greater change in trans-endothelial resistance (24.2 ± 10.8%) and cell capacitance (4.57 ± 5.39%). This study, demonstrates that the orbital shear platform provides a simple system that can capture and quantify the real-time cellular morphology as a result of induced shear stress. The orbital shear platform presented in this work, compared to traditional laminar platforms, subjects cells to more physiologically relevant oscillatory shear as well as exposes the sample to several shear values simultaneously. Biotechnol. Bioeng. 2016;113: 1336-1344. © 2015 Wiley Periodicals, Inc.

Release-Modulated Antioxidant Activity of a Composite Curcumin-Chitosan Polymer.

Curcumin is known to have immense therapeutic potential but is hindered by poor solubility and rapid degradation in solution. To overcome these shortcomings, curcumin has been conjugated to chitosan through a pendant glutaric anhydride linker using amide bond coupling chemistry. The hybrid polymer has been characterized by UV-visible, fluorescence, and infrared spectroscopies as well as zeta potential measurements and SEM imaging. The conjugation reactivity was confirmed through gel permeation chromatography and quantification of unconjugated curcumin. An analogous reaction of curcumin with glucosamine, a small molecule analogue for chitosan, was performed and the purified product characterized by mass spectrometry, UV-visible, fluorescence, and infrared spectroscopies. Conjugation of curcumin to chitosan has greatly improved curcumin aqueous solubility and stability, with no significant curcumin degradation detected after one month in solution. The absorbance and fluorescence properties of curcumin are minimally perturbed (λmax shifts of 2 and 5 nm, respectively) by the conjugation reaction. This conjugation strategy required use of one out of two curcumin phenols (one of the main antioxidant functional groups) for covalent linkage to chitosan, thus temporarily attenuating its antioxidant capacity. Hydrolysis-based release of curcumin from the polymer, however, is accompanied by full restoration of curcumin's antioxidant potential. Antioxidant assays show that curcumin radical scavenging potential is reduced by 40% after conjugation, but that full antioxidant potential is restored upon hydrolytic release from chitosan. Release studies show that curcumin is released over 19 days from the polymer and maintains a concentration of 0.23 ± 0.12 µM curcumin/mg polymer/mL solution based on 1% curcumin loading on the polymer. Release studies in the presence of carbonic anhydrase, an enzyme with known phenolic esterase activity, show no significant difference from nonenzymatic release studies, implying that simple ester hydrolysis is the dominant release mechanism. Conjugation of curcumin to chitosan through a phenol ester modification provides improved stability and solubility to curcumin, with ester hydrolysis restoring the full antioxidant potential of curcumin.

Electrochemical dissolved oxygen removal from microfluidic streams for LOC sample pretreatment.

Current water quality monitoring for heavy metal contaminants largely results in analytical snapshots at a particular time and place. Therefore, we have been interested in miniaturized and inexpensive sensors suitable for long-term, real-time monitoring of the drinking water distribution grid, industrial wastewater effluents, and even rivers and lakes. Among the biggest challenges for such sensors are the issues of in-field device calibration and sample pretreatment. Previously, we have demonstrated use of coulometric stripping analysis for calibration-free determination of copper and mercury. For more negatively reduced metals, O2 reduction interferes with stripping analysis; hence, most electroanalysis techniques rely on pretreatments to remove dissolved oxygen (DO). Current strategies for portable DO removal offer limited practicality, because of their complexity, and often cause inadvertent sample alterations. Therefore, we have designed an indirect in-line electrochemical DO removal device (EDOR), utilizing a silver cathode to reduce DO in a chamber that is fluidically isolated from the sample stream by an O2-permeable membrane. The resulting concentration gradient supports passive DO diffusion from the sample stream into the deoxygenation chamber. The DO levels in the sample stream were determined by cyclic voltammetry (CV) and amperometry at a custom thin-layer cell (TLC) detector. Results show removal of 98% of the DO in a test sample at flow rates approaching 50 µL/min and power consumption as low as 165 mW h L(-1) at steady state. Besides our specific stripping application, this device is well-suited for LOC applications where miniaturized DO removal and/or regulation are desirable.

A new technique for reversible permeabilization of live cells for intracellular delivery of quantum dots.

A major challenge with the use of quantum dots (QDs) for cellular imaging and biomolecular delivery is the attainment of QDs freely dispersed inside the cells. Conventional methods such as endocytosis, lipids based delivery and electroporation are associated with delivery of QDs in vesicles and/or as aggregates that are not monodispersed. In this study, we demonstrate a new technique for reversible permeabilization of cells to enable the introduction of freely dispersed QDs within the cytoplasm. Our approach combines osmosis driven fluid transport into cells achieved by creating a hypotonic environment and reversible permeabilization using low concentrations of cell permeabilization agents like Saponin. Our results confirm that highly efficient endocytosis-free intracellular delivery of QDs can be accomplished using this method. The best results were obtained when the cells were treated with 50 µg ml⁻¹ Saponin in a hypotonic buffer at a 3:2 physiological buffer:DI water ratio for 5 min at 4 °C.

Enhanced drug delivery via hyperthermal membrane disruption using targeted gold nanoparticles with PEGylated Protein-G as a cofactor.

Gold nanoparticles (GNPs) with near infrared (NIR) plasmon resonance have been promisingly used in photothermal cancer therapy as a less invasive treatment. Recombinant Protein-G (ProG) was PEGylated to act as a cofactor to immobilize immunoglobulins (IgGs) on GNPs by the Fc region, resulting in optimal orientation of IgGs for efficient cancer targeting. In-vitro studies showed that HER-2 overexpressing breast cancer cells, SK-BR-3, were efficiently targeted and ablated at a laser power of 900 J/cm(2) (5 W/cm(2) for 3 min). However, as a means of enhancing treatment efficacy by increasing cellular sensitivity to chemotherapeutic agents, we showed that GNP exposure to lower power laser resulted in small disruptions of cell membrane due to localized hyperthermia. This did not lead to cell death but provided a mechanism for killing cancer cells by providing enhanced uptake of drug molecules thus leading to a new avenue for hyperthermia-anticancer drug combined cancer therapeutics. FROM THE CLINICAL EDITOR: PEGylated recombinant Protein-G was used as a cofactor to optimize the orientation of IgGs providing "target seeking" properties to gold nanoparticles used in photothermal cancer therapy. The system demonstrated excellent properties in cancer therapy, with the hope and expectation of future clinical translation.

Curcumin encapsulation in submicrometer spray-dried chitosan/Tween 20 particles.

Optimal curcumin delivery for medicinal applications requires a drug delivery system that both solubilizes curcumin and prevents degradation. To achieve this, curcumin has been encapsulated in submicrometer chitosan/Tween 20 particles via a benchtop spray-drying process. Spray-drying parameters have been optimized using a Taguchi statistical approach to minimize particle size and to favor spheroid particles with smooth surfaces, as evaluated with scanning electron microscopy (SEM) imaging. Nearly spherical particles with 285 ± 30 nm diameter and 1.21 axial ratio were achieved. Inclusion of curcumin in the spray-drying solution results in complete encapsulation of curcumin within the chitosan/Tween 20 particles. Release studies confirm that curcumin can be released completely from the particles over a 2 h period.

A microfluidic impedance platform for real-time, in vitro characterization of endothelial cells undergoing fluid shear stress.

We introduce a microfluidic impedance platform to electrically monitor in real-time, endothelium monolayers undergoing fluid shear stress. Our platform incorporates sensing electrodes (SEs) that measure cell behavior and cell-free control electrodes that measure cell culture media resistance simultaneously but independently from SEs. We evaluated three different cellular subpopulations sizes through 50, 100, and 200 µm diameter SEs. We tested their utility in measuring the response of human umbilical vein endothelial cells (HUVECs) at static, constant (17.6 dyne per cm2), and stepped (23.7-35-58.1 dyne per cm2) shear stress conditions. For 14 hours, we collected the impedance spectra (100 Hz-1 MHz) of sheared cells. Using equivalent circuit models, we extracted monolayer permeability (RTER), cell membrane capacitance, and cell culture media resistance. Platform evaluation concluded that: (1) 50 µm SEs (∼2 cells) suffered interfacial capacitance and reduced cell measurement sensitivity, (2) 100 µm SEs (∼6 cells) was limited to measuring cell behavior only and cannot measure cell culture media resistance, and (3) 200 µm SEs (∼20 cells) detected cell behavior with accurate prediction of cell culture media resistance. Platform-based shear stress studies indicated a shear magnitude dependent increase in RTER at the onset of acute flow. Consecutive stepped shear conditions did not alter RTER in the same magnitude after shear has been applied. Finally, endpoint staining of VE-cadherin on the actual SEs and endpoint RTER measurements were greater for 23.7-35-58.1 dyne per cm2 than 17.6 dyne per cm2 shear conditions.

Enhancing the compatibility of BioCaRGOS silica sol-gel technology with ctDNA extraction and droplet digital PCR (ddPCR) analysis.

Previously, our group had demonstrated long term stabilization of protein biomarkers using BioCaRGOS, a silica sol-gel technology. Herein, we describe workflow modifications to allow for extraction of cell free DNA (cfDNA) from primary samples containing working concentrations of BioCaRGOS, as well as the compatibility of BioCaRGOS with droplet digital PCR (ddPCR) analysis for pancreatic cancer biomarkers i.e., KRAS circulating tumor DNA (ctDNA). Preliminary attempts to extract ctDNA from BioCaRGOS containing samples demonstrated interference in the extraction of primary samples and the interference with ddPCR analysis when BioCaRGOS was directly introduced to stabilize sample extracts. In our modified technique, we have minimized the interference caused by methanol with ddPCR by complete removal of methanol from the activated BioCaRGOS formulation prior to addition to the biospecimen or ctDNA extract. Interference of the silica matrix present in BioCaRGOS with ctDNA extraction was eliminated through the introduction of invert filtration of the sample prior to extraction. These modifications to the workflow of BioCaRGOS containing samples allow for use of BioCaRGOS for stabilization of trace quantities of nucleic acid biomarkers such as plasma ctDNA, while retaining the capability to extract the biomarker and quantify based on ddPCR.

Adsorption Properties and Electron-transfer Rates of a Redox Probe at Different Interfaces of an Immunoassay Assembled on an Electro-active Photonic Platform.

Physical and chemical properties of a redox protein adsorbed to different interfaces of a multilayer immunoassay assembly were studied using a single-mode, electro-active, integrated optical waveguide (SM-EA-IOW) platform. For each interface of the immunoassay assembly (indium tin oxide, 3-aminopropyl triethoxysilane, recombinant protein G, antibody, and bovine serum albumin) the surface density, the adsorption kinetics, and the electron-transfer rate of bound species of the redox-active cytochrome c (Cyt-C) protein were accurately quantified at very low surface concentrations of redox species (from 0.4 to 4% of a full monolayer) using a highly sensitive optical impedance spectroscopy (OIS) technique based on measurements obtained with the SM-EA-IOW platform. The technique is shown here to provide quantitative insights into an important immunoassay assembly for characterization and understanding of the mechanisms of electron transfer rate, the affinity strength of molecular binding, and the associated bio-selectivity. Such methodology and acquired knowledge are crucial for the development of novel and advanced immuno-biosensors.

Long term storage of miRNA at room and elevated temperatures in a silica sol-gel matrix.

Storage of biospecimens in their near native environment at room temperature can have a transformative global impact, however, this remains an arduous challenge to date due to the rapid degradation of biospecimens over time. Currently, most isolated biospecimens are refrigerated for short-term storage and frozen (-20 °C, -80 °C, liquid nitrogen) for long-term storage. Recent advances in room temperature storage of purified biomolecules utilize anhydrobiosis. However, a near aqueous storage solution that can preserve the biospecimen nearly "as is" has not yet been achieved by any current technology. Here, we demonstrate an aqueous silica sol-gel matrix for optimized storage of biospecimens. Our technique is facile, reproducible, and has previously demonstrated stabilization of DNA and proteins, within a few minutes using a standard benchtop microwave. Herein, we demonstrate complete integrity of miRNA 21, a highly sensitive molecule at 4, 25, and 40 °C over a period of ∼3 months. In contrast, the control samples completely degrade in less than 1 week. We attribute excellent stability to entrapment of miRNA within silica-gel matrices.

A novel 3D segmentation approach for extracting retinal layers from optical coherence tomography images.

PURPOSE: Accurate segmentation of retinal layers of the eye in 3D Optical Coherence Tomography (OCT) data provides relevant information for clinical diagnosis. This manuscript describes a 3D segmentation approach that uses an adaptive patient-specific retinal atlas, as well as an appearance model for 3D OCT data. METHODS: To reconstruct the atlas of 3D retinal scan, the central area of the macula (macula mid-area) where the fovea could be clearly identified, was segmented initially. Markov Gibbs Random Field (MGRF) including intensity, spatial information, and shape of 12 retinal layers were used to segment the selected area of retinal fovea. A set of coregistered OCT scans that were gathered from 200 different individuals were used to build a 2D shape prior. This shape prior was adapted subsequently to the first order appearance and second order spatial interaction MGRF model. After segmenting the center of the macula "foveal area", the labels and appearances of the layers that were segmented were utilized to segment the adjacent slices. The final step was repeated recursively until a 3D OCT scan of the patient was segmented. RESULTS: This approach was tested in 50 patients with normal and with ocular pathological conditions. The segmentation was compared to a manually segmented ground truth. The results were verified by clinical retinal experts. Dice Similarity Coefficient (DSC), 95% bidirectional modified Hausdorff Distance (HD), Unsigned Mean Surface Position Error (MSPE), and Average Volume Difference (AVD) metrics were used to quantify the performance of the proposed approach. The proposed approach was proved to be more accurate than the current state-of-the-art 3D OCT approaches. CONCLUSIONS: The proposed approach has the advantage of segmenting all the 12 retinal layers rapidly and more accurately than current state-of-the-art 3D OCT approaches.

Bio-CaRGOS: capture and release gels for optimized storage of hemoglobin.

Room temperature biospecimen storage for prolonged periods is essential to eliminate energy consumption by ultra-low freezing or refrigeration-based storage techniques. State of the art practices that sufficiently minimize the direct or hidden costs associated with cold-chain logistics include ambient temperature storage of biospecimens (i.e., DNA, RNA, proteins, lipids) in the dry state. However, the biospecimens are still well-exposed to the stress associated with drying and reconstitution cycles, which augments the pre-analytical degradation of biospecimens prior to their downstream processing. An aqueous storage solution that can eliminate these stresses which are correlated to several cycles of drying/rehydration or freezing of biospecimens, is yet to be achieved by any current technology. In our study, we have addressed this room temperature biospecimen-protection challenge using aqueous capture and release gels for optimized storage (Bio-CaRGOS) of biospecimens. Herein, we have demonstrated a single-step ∼95% recovery of a metalloprotein hemoglobin at room temperature using a cost-effective standard microwave-based aqueous formulation of Bio-CaRGOS. Although hemoglobin samples are currently stored at sub-zero or under refrigeration (4 °C) conditions to avoid loss of integrity and an unpredictable diagnosis during their downstream assays, our results have displayed an unprecedented room temperature integrity preservation of hemoglobin. Bio-CaRGOS formulations efficiently preserve hemoglobin in its native state, with single-step protein recovery of ∼95% at ambient conditions (1 month) and ∼96% (7 months) under refrigeration conditions. In contrast, two-thirds of the control samples degrade under ambient (1 month) and refrigeration (7 months) settings.

Impact of stress and hypertension on the cerebrovasculature.

OBJECTIVES: Both stress and hypertension (HTN) are considered major health problems that negatively impact the cerebral vasculature. In this article we summarize the possible relationship between stress and HTN. METHODS: We conducted a systematic review of the literature using a database search of MEDLINE, PubMed, Scopus, and Web of Science. RESULTS: Psychological stress is known to be an important risk factor for essential hypertension. Acute stress can induce transient elevations of blood pressure in the context of the fight-or-flight response. With increased intensity and duration of a perceived harmful event, the normal physiological response is altered, resulting in a failure to return to the resting levels. These changes are responsible for the development of HTN. Genetic and behavioral factors are also very important for the pathogenesis of hypertension under chronic stress situation. In addition, HTN and chronic stress may lead to impaired auto-regulation, regional vascular remodeling, and breakdown of the blood brain barrier (BBB). The effects of both HTN and chronic stress on the cerebral blood vessels shows that both have common structural and functional effects including endothelial damage with subsequent increased wall thickness, vessel resistance, stiffness, arterial atherosclerosis, and altered hemodynamics. CONCLUSION: Most of the above mentioned vascular effects of stress were primarily reported in animal models. Further in-vivo standardization of pathological vascular indices and imaging modalities is warranted. Radiological quantification of these cerebrovascular changes is therefore essential for in depth understanding of the healthy and diseased cerebral arteries functions, identification and stratification of patients at risk of cardiovascular and neurological adverse events, enactment of preventive measures prior to the onset of systemic HTN, and the initiation of personalized medical management.

Radiation-induced curcumin release from curcumin-chitosan polymer films.

The probability of human exposure to damaging radiation is increased in activities associated with long-term space flight, medical radiation therapies, and responses to nuclear accidents. However, the development of responsive countermeasures to combat radiation damage to biological tissue is lagging behind rates of human exposure. Herein, we report a radiation-responsive drug delivery system that releases doses of curcumin from a chitosan polymer/film in response to low level gamma radiation exposure. As a fibrous chitosan-curcumin polymer, 1 Gy gamma irradiation (137Cs) released 5 ± 1% of conjugated curcumin, while 6 Gy exposure releases 98 ± 1% of conjugated curcumin. The same polymer was formed into a film through solvent casting. The films showed similar, albeit attenuated behavior in water (100% released) and isopropyl alcohol (32% released) with statistically significant drug release following 2 Gy irradiation. ATR FT-IR studies confirmed glycosidic bond cleavage in the chitosan-curcumin polymer in response to gamma radiation exposure. Similar behavior was noted upon exposure of the polymer to 20 cGy (1 GeV amu-1, at 20 cGy min-1) high linear energy transfer (LET) 56Fe radiation based on FTIR studies. Density Functional Theory calculations indicate homolytic bond scission as the primary mechanism for polymer disintegration upon radiation exposure. Films did not change in thickness during the course of radiation exposure. The successful demonstration of radiation-triggered drug release may lead to new classes of radio-protective platforms for developing countermeasures to biological damage from ionizing radiation.

A deep learning-based approach for automatic segmentation and quantification of the left ventricle from cardiac cine MR images.

Cardiac MRI has been widely used for noninvasive assessment of cardiac anatomy and function as well as heart diagnosis. The estimation of physiological heart parameters for heart diagnosis essentially require accurate segmentation of the Left ventricle (LV) from cardiac MRI. Therefore, we propose a novel deep learning approach for the automated segmentation and quantification of the LV from cardiac cine MR images. We aim to achieve lower errors for the estimated heart parameters compared to the previous studies by proposing a novel deep learning segmentation method. Our framework starts by an accurate localization of the LV blood pool center-point using a fully convolutional neural network (FCN) architecture called FCN1. Then, a region of interest (ROI) that contains the LV is extracted from all heart sections. The extracted ROIs are used for the segmentation of LV cavity and myocardium via a novel FCN architecture called FCN2. The FCN2 network has several bottleneck layers and uses less memory footprint than conventional architectures such as U-net. Furthermore, a new loss function called radial loss that minimizes the distance between the predicted and true contours of the LV is introduced into our model. Following myocardial segmentation, functional and mass parameters of the LV are estimated. Automated Cardiac Diagnosis Challenge (ACDC-2017) dataset was used to validate our framework, which gave better segmentation, accurate estimation of cardiac parameters, and produced less error compared to other methods applied on the same dataset. Furthermore, we showed that our segmentation approach generalizes well across different datasets by testing its performance on a locally acquired dataset. To sum up, we propose a deep learning approach that can be translated into a clinical tool for heart diagnosis.

A novel computer-aided diagnosis system for the early detection of hypertension based on cerebrovascular alterations.

Hypertension is a leading cause of mortality in the USA. While simple tools such as the sphygmomanometer are widely used to diagnose hypertension, they could not predict the disease before its onset. Clinical studies suggest that alterations in the structure of human brains' cerebrovasculature start to develop years before the onset of hypertension. In this research, we present a novel computer-aided diagnosis (CAD) system for the early detection of hypertension. The proposed CAD system analyzes magnetic resonance angiography (MRA) data of human brains to detect and track the cerebral vascular alterations and this is achieved using the following steps: i) MRA data are preprocessed to eliminate noise effects, correct the bias field effect, reduce the contrast inhomogeneity using the generalized Gauss-Markov random field (GGMRF) model, and normalize the MRA data, ii) the cerebral vascular tree of each MRA volume is segmented using a 3-D convolutional neural network (3D-CNN), iii) cerebral features in terms of diameters and tortuosity of blood vessels are estimated and used to construct feature vectors, iv) feature vectors are then used to train and test various artificial neural networks to classify data into two classes; normal and hypertensive. A balanced data set of 66 subjects were used to test the CAD system. Experimental results reported a classification accuracy of 90.9% which supports the efficacy of the CAD system components to accurately model and discriminate between normal and hypertensive subjects. Clinicians would benefit from the proposed CAD system to detect and track cerebral vascular alterations over time for people with high potential of developing hypertension and to prepare appropriate treatment plans to mitigate adverse events.

A DEEP LEARNING-BASED CAD SYSTEM FOR RENAL ALLOGRAFT ASSESSMENT: DIFFUSION, BOLD, AND CLINICAL BIOMARKERS.

Recently, studies for non-invasive renal transplant evaluation have been explored to control allograft rejection. In this paper, a computer-aided diagnostic system has been developed to accommodate with an early-stage renal transplant status assessment, called RT-CAD. Our model of this system integrated multiple sources for a more accurate diagnosis: two image-based sources and two clinical-based sources. The image-based sources included apparent diffusion coefficients (ADCs) and the amount of deoxygenated hemoglobin (R2*). More specifically, these ADCs were extracted from 47 diffusion weighted magnetic resonance imaging (DW-MRI) scans at 11 different b-values (b0, b50, b100, …, b1000 s/mm2), while the R2* values were extracted from 30 blood oxygen level-dependent MRI (BOLD-MRI) scans at 5 different echo times (2ms, 7ms, 12ms, 17ms, and 22ms). The clinical sources included serum creatinine (SCr) and creatinine clearance (CrCl). First, the kidney was segmented through the RT-CAD system using a geometric deformable model called a level-set method. Second, both ADCs and R2* were estimated for common patients (N = 30) and then were integrated with the corresponding SCr and CrCl. Last, these integrated biomarkers were considered the discriminatory features to be used as trainers and testers for future deep learning-based classifiers such as stacked auto-encoders (SAEs). We used a k-fold cross-validation criteria to evaluate the RT-CAD system diagnostic performance, which achieved the following scores: 93.3%, 90.0%, and 95.0% in terms of accuracy, sensitivity, and specificity in differentiating between acute renal rejection (AR) and non-rejection (NR). The reliability and completeness of the RT-CAD system was further accepted by the area under the curve score of 0.92. The conclusions ensured that the presented RT-CAD system has a high reliability to diagnose the status of the renal transplant in a non-invasive way.

A Comprehensive Framework for Differentiating Autism Spectrum Disorder From Neurotypicals by Fusing Structural MRI and Resting State Functional MRI.

Autism spectrum disorder is a neurodevelopmental disorder characterized by impaired social abilities and communication difficulties. The golden standard for autism diagnosis in research rely on behavioral features, for example, the autism diagnosis observation schedule, the Autism Diagnostic Interview-Revised. In this study we introduce a computer-aided diagnosis system that uses features from structural MRI (sMRI) and resting state functional MRI (fMRI) to help predict an autism diagnosis by clinicians. The proposed system is capable of parcellating brain regions to show which areas are most likely affected by autism related abnormalities and thus help in targeting potential therapeutic interventions. When tested on 18 data sets (n = 1060) from the ABIDE consortium, our system was able to achieve high accuracy (sMRI 0.75-1.00; fMRI 0.79-1.00), sensitivity (sMRI 0.73-1.00; fMRI 0.78-1.00), and specificity (sMRI 0.78-1.00; fMRI 0.79-1.00). The proposed system could be considered an important step toward helping physicians interpret results of neuroimaging studies and personalize treatment options. To the best of our knowledge, this work is the first to combine features from structural and functional MRI, use them for personalized diagnosis and achieve high accuracies on a relatively large population.

Automated Diagnosis of Diabetic Retinopathy Using Clinical Biomarkers, Optical Coherence Tomography, and Optical Coherence Tomography Angiography.

PURPOSE: To determine if combining clinical, demographic, and imaging data improves automated diagnosis of nonproliferative diabetic retinopathy (NPDR). DESIGN: Cross-sectional imaging and machine learning study. METHODS: This was a retrospective study performed at a single academic medical center in the United States. Inclusion criteria were age >18 years and a diagnosis of diabetes mellitus (DM). Exclusion criteria were non-DR retinal disease and inability to image the macula. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed, and data on age, sex, hypertension, hyperlipidemia, and hemoglobin A1c were collected. Machine learning techniques were then applied. Multiple pathophysiologically important features were automatically extracted from each layer on OCT and each OCTA plexus and combined with clinical data in a random forest classifier to develop the system, whose results were compared to the clinical grading of NPDR, the gold standard. RESULTS: A total of 111 patients with DM II were included in the study, 36 with DM without DR, 53 with mild NPDR, and 22 with moderate NPDR. When OCT images alone were analyzed by the system, accuracy of diagnosis was 76%, sensitivity 85%, specificity 87%, and area under the curve (AUC) was 0.78. When OCT and OCTA data together were analyzed, accuracy was 92%, sensitivity 95%, specificity 98%, and AUC 0.92. When all data modalities were combined, the system achieved an accuracy of 96%, sensitivity 100%, specificity 94%, and AUC 0.96. CONCLUSIONS: Combining common clinical data points with OCT and OCTA data enhances the power of computer-aided diagnosis of NPDR.