Adapting low-dose CT denoisers for texture preservation using zero-shot local noise-level matching.

BACKGROUND: On enhancing the image quality of low-dose computed tomography (LDCT), various denoising methods have achieved meaningful improvements. However, they commonly produce over-smoothed results; the denoised images tend to be more blurred than the normal-dose targets (NDCTs). Furthermore, many recent denoising methods employ deep learning(DL)-based models, which require a vast amount of CT images (or image pairs). PURPOSE: Our goal is to address the problem of over-smoothed results and design an algorithm that works regardless of the need for a large amount of training dataset to achieve plausible denoising results. Over-smoothed images negatively affect the diagnosis and treatment since radiologists had developed clinical experiences with NDCT. Besides, a large-scale training dataset is often not available in clinical situations. To overcome these limitations, we propose locally-adaptive noise-level matching (LANCH), emphasizing the output should retain the same noise-level and characteristics to that of the NDCT without additional training. METHODS: We represent the NDCT image as the pixel-wisely weighted sum of an over-smoothed output from off-the-shelf denoiser (OSD) and the difference between the LDCT image and the OSD output. Herein, LANCH determines a 2D ratio map (i.e., pixel-wise weight matrix) by locally matching the noise-level of output and NDCT, where the LDCT-to-NDCT device flux (mAs) ratio reveals the NDCT noise-level. Thereby, LANCH can preserve important details in LDCT, and enhance the sharpness of the noise-free regions. Note that LANCH can enhance any LDCT denoisers without additional training data (i.e., zero-shot). RESULTS: The proposed method is applicable to any OSD denoisers, reporting significant texture plausibility development over the baseline denoisers in quantitative and qualitative manners. It is surprising that the denoising accuracy achieved by our method with zero-shot denoiser was comparable or superior to that of the best training-based denoisers; our result showed 1% and 33% gains in terms of SSIM and DISTS, respectively. Reader study with experienced radiologists shows significant image quality improvements, a gain of + 1.18 on a five-point mean opinion score scale. CONCLUSIONS: In this paper, we propose a technique to enhance any low-dose CT denoiser by leveraging the fundamental physical relationship between the x-ray flux and noise variance. Our method is capable of operating in a zero-shot condition, which means that only a single low-dose CT image is required for the enhancement process. We demonstrate that our approach is comparable or even superior to supervised DL-based denoisers that are trained using numerous CT images. Extensive experiments illustrate that our method consistently improves the performance of all tested LDCT denoisers.

Rigid and non-rigid motion artifact reduction in X-ray CT using attention module.

Motion artifacts are a major factor that can degrade the diagnostic performance of computed tomography (CT) images. In particular, the motion artifacts become considerably more severe when an imaging system requires a long scan time such as in dental CT or cone-beam CT (CBCT) applications, where patients generate rigid and non-rigid motions. To address this problem, we proposed a new real-time technique for motion artifacts reduction that utilizes a deep residual network with an attention module. Our attention module was designed to increase the model capacity by amplifying or attenuating the residual features according to their importance. We trained and evaluated the network by creating four benchmark datasets with rigid motions or with both rigid and non-rigid motions under a step-and-shoot fan-beam CT (FBCT) or a CBCT. Each dataset provided a set of motion-corrupted CT images and their ground-truth CT image pairs. The strong modeling power of the proposed network model allowed us to successfully handle motion artifacts from the two CT systems under various motion scenarios in real-time. As a result, the proposed model demonstrated clear performance benefits. In addition, we compared our model with Wasserstein generative adversarial network (WGAN)-based models and a deep residual network (DRN)-based model, which are one of the most powerful techniques for CT denoising and natural RGB image deblurring, respectively. Based on the extensive analysis and comparisons using four benchmark datasets, we confirmed that our model outperformed the aforementioned competitors. Our benchmark datasets and implementation code are available at https://github.com/youngjun-ko/ct_mar_attention.

Improvement in the Photocurrent of Inverted Organic Solar Cells Using MoO(x)-Doped TAPC as a P-Type Optical Spacer.

In this work, we demonstrate enhancement in the short-circuit current of inverted organic photovoltaic cells (OPVs) using a p-type optical spacer. The p-type optical spacer, which consists of molybdenum oxide (MoO(x))-doped 1,1-bis[(di-4-tolylamino)phenyl]cyclohexane (TAPC), shows improved transmittance at visible light with high electrical conductivity. The electrical field distribution of incident light at the active layer of OPVs can be controlled by tuning the thickness of the optical spacer in the OPVs. Specifically, the incorporation of the 20-nm optical spacer layer in the OPV leads to enhanced spectral response of the device in the wavelength range of 400-600 nm, which is consistent with the combined results of improved optical absorption and better charge transport characteristics. As a result, the OPV with a 20-nm p-type optical spacer shows improvement in the short-circuit current compared with a device with 10 nm of embedded MoO(x).

An efficacy study on improving balance and gait in subacute stroke patients by balance training with additional motor imagery: a pilot study.

[Purpose] The few studies conducted on subacute stroke patients have focused only on gait function improvement. This study therefore aimed to confirm the effect of balance training with additional motor imagery on balance and gait improvement in subacute stroke patients. [Subjects and Methods] Participants were divided into an experimental or control group. The experimental group received balance training for 20 minutes/day with mental imagery for 10 minutes/day, three days/week, for four weeks. The control group received only balance training for 30 minutes. Before and after the 12 sessions, balance and gait ability were assessed by the researcher and a physical therapist. [Results] After completion of the 4-week intervention, Berg Balance Scale, Timed Up and Go test, Functional Reach Test, and Four Square Step test scores significantly increased in the experimental group. In the control group, Berg Balance Scale and Functional Reach Test scores significantly improved. Changes in the Timed Up and Go test, Functional Reach Test, and Four Square Step Test scores after intervention were significantly higher in the experimental than in the control group. [Conclusion] Specific balance training with additional motor imagery may result in better rehabilitation outcomes of gait and balance ability than balance training alone.

The effects of progressive functional training on lower limb muscle architecture and motor function in children with spastic cerebral palsy.

[Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy.

Effect of space balance 3D training using visual feedback on balance and mobility in acute stroke patients.

[Purpose] The purpose of the study was to determine the effects of balance training with Space Balance 3D, which is a computerized measurement and visual feedback balance assessment system, on balance and mobility in acute stroke patients. [Subjects and Methods] This was a randomized controlled trial in which 52 subjects were assigned randomly into either an experimental group or a control group. The experimental group, which contained 26 subjects, received balance training with a Space Balance 3D exercise program and conventional physical therapy interventions 5 times per week during 3 weeks. Outcome measures were examined before and after the 3-week interventions using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Postural Assessment Scale for Stroke Patients (PASS). The data were analyzed by a two-way repeated measures ANOVA using SPSS 19.0. [Results] The results revealed a nonsignificant interaction effect between group and time period for both groups before and after the interventions in the BBS score, TUG score, and PASS score. In addition, the experimental group showed more improvement than the control group in the BBS, TUG and PASS scores, but the differences were not significant. In the comparisons within the groups by time, both groups showed significant improvement in BBS, TUG, and PASS scores. [Conclusion] The Space Balance 3D training with conventional physical therapy intervention is recommended for improvement of balance and mobility in acute stroke patients.

Feasibility and Safety of Early Physical Therapy and Active Mobilization for Patients on Extracorporeal Membrane Oxygenation.

Physical therapy (PT) and early mobilization for critically ill patients have been popularized to decrease the length of hospital stay and to improve the quality of life after discharge. We reviewed our experience of PT and active mobilization for patients on extracorporeal membrane oxygenation (ECMO) in terms of its technical feasibility and safety. Study endpoints were safety events during PT and PT interruptions due to unstable vital signs. Of the eight patients, one patient (12.5%) had venoarterial ECMO, seven patients (87.5%) had venovenous ECMO. Among total of 62 sessions including 31 sessions (50%) of passive range of motion and electrical muscle stimulation, 17 sessions (27.4%) were performed for patients who were sitting in bed or on the edge of bed, two sessions (3.2%) were for strengthening in sitting, 11 sessions (18%) were for standing or marching in place, one session (2%) was for walking. Eight sessions (13%) of sitting were supported with invasive mechanical ventilation. Three sessions (5%) were stopped due to tachycardia (n = 1) and tachypnea (n = 2). There was no clinically significant adverse event in patients. Thus, early PT and mobilization for patients on ECMO might be feasible and safe at an experienced ECMO center.

Relationships among foot position, lower limb alignment, and knee adduction moment in patients with degenerative knee osteoarthritis.

[Purpose] The aim of this study was to determine the relationships among the foot progression angle, foot rotation angle, lower limb alignment, and knee adduction moments in patients with degenerative knee osteoarthritis (OA). [Subjects] Forty-eight patients diagnosed with degenerative knee OA (Kellgren-Lawrence grades 2 and 3) were included. [Methods] To assess the lower extremity alignment and weight-bearing ratio, static radiographic measurement was used. Foot progression angle, foot rotation angle, and knee adduction moments were measured by using a three-dimensional motion analysis system. [Results] The results of this study were as follows: the foot progression angle in the early and late stance phase was significantly correlated with the first and second peak knee adduction moments; the weight-bearing ratio was significantly correlated with the first and second peak knee adduction moments; and the tibiofemoral angle was significantly correlated with the first and second peak knee adduction moments. [Conclusion] The results of the present study indicated that as the foot progression angle and the foot lateral rotation angle increased, the knee adduction moment decreased. The weight-bearing ratio and tibiofemoral angle assessment with mechanical axis alignment were correlated with the knee adduction moments. These parameters may be helpful for selecting therapeutic options for patients with degenerative knee OA.

Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial.

[Purpose] The purpose of this study was to investigate the changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis and to suggest the appropriate treatment frequency and period. [Subjects] The subjects were divided into three: 2 days per week group (n=12), 3 days per week group (n=15), and 6 days per week group (n=13). [Methods] All groups received conventional physical therapy for 40 minutes and therapeutic exercises for 20 minutes per session during 6 weeks. The outcome measurements were the visual analogue scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE), and grip strength. [Results] The results of this study were as follows: at 3 weeks, there were no significant differences in VAS and PRTEE in the 3 groups, but at 6 weeks, 6 days per week group significantly decreased these two outcomes. Grip strength was significantly increased in 3 and 6 days per week groups at 6 weeks. [Conclusion] In conclusion, physical therapy is needed 3 days per week for 3 weeks in patients with acute lateral epicondylitis. After 3 weeks, 6 days per week is the most effective treatment frequency.

High-efficiency inverted organic solar cells with polyethylene oxide-modified Zn-doped TiO2 as an interfacial electron transport layer.

High efficiency inverted organic solar cells are fabricated using the PTB7:PC71BM polymer by incorporating Zn-doped TiO2 (ZTO) and 0.05 wt% PEO:ZTO as interfacial electron transport layers. The 0.05 wt% PEO-modified ZTO device shows a significantly increased power conversion efficiency (PCE) of 8.10%, compared to that of the ZTO (7.67%) device.

Plasmonic organic solar cells employing nanobump assembly via aerosol-derived nanoparticles.

We report the effect of a nanobump assembly (NBA) constructed with molybdenum oxide (MoO3) covering Ag nanoparticles (NPs) under the active layer on the efficiency of plasmonic polymer solar cells. Here, the NPs with precisely controlled concentration and size have been generated by an atmospheric evaporation/condensation method and a differential mobility classification and then deposited on an indium tin oxide electrode via room temperature aerosol method. NBA structure is made by enclosing NPs with MoO3 layer via vacuum thermal evaporation to isolate the undulated active layer formed onto the underlying protruded NBA. Simulated scattering cross sections of the NBA structure reveal higher intensities with a strong forward scattering effect than those from the flat buffer cases. Experimental results of the device containing the NBA show 24% enhancement in short-circuit current density and 18% in power conversion efficiency compared to the device with the flat MoO3 without the NPs. The observed improvements are attributed to the enhanced light scattering and multireflection effects arising from the NBA structure combined with the undulated active layer in the visible and near-infrared regions. Moreover, we demonstrate that the NBA adopted devices show better performance with longer exciton lifetime and higher light absorption in comparison with the devices with Ag NPs incorporated flat poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS). Thus, the suggested approach provides a reliable and efficient light harvesting in a broad range of wavelength, which consequently enhances the performance of various organic solar cells.

Origin of the mixing ratio dependence of power conversion efficiency in bulk heterojunction organic solar cells with low donor concentration.

We studied the origin of the improvement in device performance of thermally evaporated bulk heterojunction organic photovoltaic devices (OPVs) with low donor concentration. Samples with three different donor-acceptor mixing ratios, 0:10 (C70-only), 1:9 (low-doped) and 3:7 (high-doped), were fabricated with 1,1-bis-(4-bis(4-methyl-phenyl)-amino-phenyl)-cyclohexane (TAPC):C70. The power conversion efficiencies (PCEs) of these samples were 1.14%, 2.74% and 0.69%, respectively. To determine why the low-doped device showed a high PCE, we measured various properties of the devices in terms of the effective energy band gap, activation energy, charge carrier mobility and recombination loss. We found that the activation energy for charge carrier transport was increased as we increased the TAPC concentration in the blends whereas the hole and electron mobilities became more balanced as the TAPC concentration was increased. Furthermore, the recombination loss parameter alpha (from the light intensity dependence) remained alpha to approximately 0.9 in the low-doped device, but it decreased to alpha to approximately 0.77 in the high-doped device, indicating a large recombination loss as a result of space charge. Therefore, the improved PCE of low-doped OPVs can be attributed to the balance between carrier mobilities with no increase in recombination loss.

[Effects of oxidative DNA damage and genetic polymorphism of the glutathione peroxidase 1 (GPX1) and 8-oxoguanine glycosylase 1 (hOGG1) on lung cancer].

OBJECTIVES: Oxidative DNA damage is a known risk factor of lung cancer. The glutathione peroxidase (GPX) antioxidant enzyme that reduces hydrogen peroxide and lipid peroxides plays a significant role in protecting cells from the oxidative stress induced by reactive oxygen species. The aim of this case-control study was to investigate effects of oxidative stress and genetic polymorphisms of the GPX1 genes and the interaction between them in the carcinogenesis of lung cancer. METHODS: Two hundreds patients with lung cancer and 200 age- and sex-matched controls were enrolled in this study. Every subject was asked to complete a questionnaire concerning their smoking habits and their environmental exposure to PAHs. The genotypes of the GPX1 and 8-oxoguanine glycosylase 1 (hOGG1) genes were examined and the concentrations of urinary 1-hydroxypyrene (1-OHP), 2-naphthol and 8-hydroxydeoxyguanosine (8-OH-dG) were measured. RESULTS: Cigarette smoking was a significant risk factor for lung cancer. The levels of urinary 8-OH-dG were higher in the patients (p < 0.001), whereas the urinary 1-OHP and 2-naphthol levels were higher in the controls. The GPX1 codon 198 polymorphism was associated with an increased risk of lung cancer. Individuals carrying the Pro/Leu or Leu/Leu genotype of GPX1 were at a higher risk for lung cancer (adjusted OR = 2.29). In addition, these individuals were shown to have high urinary 8-OH-dG concentrations compared to the individuals with the GPX1 Pro/Pro genotype. On the other hand, the polymorphism of the hOGG1 gene did not affect the lung cancer risk and the oxidative DNA damage. CONCLUSIONS: These results lead to a conclusion that individuals with the GPX1 Pro/Leu or Leu/Leu genotype would be more susceptible to the lung cancer induced by oxidative stress than those individuals with the Pro/Pro genotype.

The effects of 1-nitropyrene on oxidative DNA damage and expression of DNA repair enzymes.

Nitropyrenes (NPs) present in diesel and gasoline emissions are mutagenic and carcinogenic in experimental animals. Nitro-reduction of 1-NP causes oxidative stress. It is unclear whether 8-hydroxydeoxyguanosine (8-OH-dG) is produced from 1-NP and whether it contributes to the carcinogenic activity of 1-NP. In this study, we measured the level of reactive oxygen species (ROS) in cultured human lung epithelial cells after exposure to 1-NP and the intracellular level of 8-OH-dG and expression level of the 8-OH-dG repair enzymes. As results, 1-NP induced the generation of 8-OH-dG via ROS, but 8-OH-dG repair enzymes prevented an increase of 8-OH-dG formation in cellular DNA of the A549 cell line below 250 microM of 1-NP. These data suggest that 1-NP can induce oxidative DNA damage by generation of ROS, which may play a role in the carcinogenesis induced by 1-NP. These data also suggest that individuals with impaired DNA repair enzymes might be more susceptible to lung cancer induced by 1-NP.