scholarly journals Personalized computed tomography – Automated estimation of height and weight of a simulated digital twin using a 3D camera and artificial intelligence

2020 ◽  
Author(s):  
Frederik Geissler ◽  
Rafael Heiß ◽  
Markus Kopp ◽  
Marco Wiesmüller ◽  
Marc Saake ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Practice ◽  
Contrast Agent ◽  
Reference Values ◽  
Medical Staff ◽  
The Body ◽  
Digital Twin ◽  
Twin Model ◽  
3D Camera ◽  
The Impact

Purpose The aim of this study was to develop an algorithm for automated estimation of patient height and weight during computed tomography (CT) and to evaluate its accuracy in everyday clinical practice. Materials and methods Depth images of 200 patients were recorded with a 3D camera mounted above the patient table of a CT scanner. Reference values were obtained using a calibrated scale and a measuring tape to train a machine learning algorithm that fits a patient avatar into the recorded patient surface data. The resulting algorithm was prospectively used on 101 patients in clinical practice and the results were compared to the reference values and to estimates by the patient himself, the radiographer and the radiologist. The body mass index was calculated from the collected values for each patient using the WHO formula. A tolerance level of 5 kg was defined in order to evaluate the impact on weight-dependent contrast agent dosage in abdominal CT. Results Differences between values for height, weight and BMI were non-significant over all assessments (p > 0.83). The most accurate values for weight were obtained from the patient information (R² = 0.99) followed by the automated estimation via 3D camera (R² = 0.89). Estimates by medical staff were considerably less precise (radiologist: R² = 0.78, radiographer: R² = 0.77). A body-weight dependent dosage of contrast agent using the automated estimations matched the dosage using the reference measurements in 65 % of the cases. The dosage based on the medical staff estimates would have matched in 49 % of the cases. Conclusion Automated estimation of height and weight using a digital twin model from 3D camera acquisitions provide a high precision for protocol design in computer tomography. Key points:  Citation Format

scholarly journals Analyzing the Manufacturing Supply Chain Performance for Urgent Item During COVID-19 Outbreak

2021 ◽  
Vol 9 (1) ◽  
pp. 15-31
Author(s):  
Ali Arishi ◽  
Krishna K Krishnan ◽  
Vatsal Maru
Keyword(s):  
Raw Materials ◽  
Early Stage ◽  
Supply And Demand ◽  
Network Models ◽  
Combine System ◽  
Neural Network Models ◽  
Digital Twin ◽  
Twin Model ◽  
The Impact ◽  
Reaction Patterns

As COVID-19 pandemic spreads in different regions with varying intensity, supply chains (SC) need to utilize an effective mechanism to adjust spike in both supply and demand of resources, and need techniques to detect unexpected behavior in SC at an early stage. During COVID-19 pandemic, the demand of medical supplies and essential products increases unexpectedly while the availability of recourses and raw materials decreases significantly. As such, the questions of SC and society survivability were raised. Responding to this urgent demand quickly and predicting how it will vary as the pandemic progresses is a key modeling question. In this research, we take the initiative in addressing the impact of COVID-19 disruption on manufacturing SC performance overwhelmed by the unprecedented demands of urgent items by developing a digital twin model for the manufacturing SC. In this model, we combine system dynamic simulation and artificial intelligence to dynamically monitor SC performance and predict SC reaction patterns. The simulation modeling is used to study the disruption propagation in the manufacturing SC and the efficiency of the recovery policy. Then based on this model, we develop artificial neural network models to learn from disruptions and make an online prediction of potential risks. The developed digital twin model is aimed to operate in real-time for early identification of disruptions and the respective SC reaction patterns to increase SC visibility and resilience.

scholarly journals Longitudinal impact of Welsh clinical leadership fellowship

2020 ◽  
Vol 33 (1) ◽  
pp. 1-11
Author(s):  
Suzanne Phillips ◽  
Alison Bullock
Keyword(s):  
Clinical Practice ◽  
Medical Training ◽  
Healthcare Delivery ◽  
The Body ◽  
Longitudinal Impact ◽  
Structured Interviews ◽  
Clinical Leadership ◽  
Content Type ◽  
Training Programmes ◽  
The Impact

Purpose This paper aims to evaluate the longer-term impact of the 12-month Welsh clinical leadership fellowship. Design/methodology/approach Semi-structured interviews with 10 out of 14 trainee doctors who were fellows between 2013-2016, exploring how leadership knowledge and skills were used in clinical practice, impact on patient care and influence on careers. Data, gathered in 2017 when participants had completed the fellowship between 1-3 years, were analysed thematically. Findings All found the fellowship rewarding. The experience was felt to advantage them in consultant interviews. They gained insight into the wider influence on organisations and the complexity of issues facing senior clinicians. Although subtle, the impact was significant, equipping fellows with negotiation skills, enabling them to better influence change. Indirect impact on clinical practice was evidenced by enhanced confidence, teamworking skills and progression of improvement projects. However, the use of skills was limited by lack of seniority within teams, demands of medical training and examinations. The negativity of others towards management and leadership was also noted by some. Research limitations/implications Small participant numbers limit generalisability. Practical implications The fellowship is designed to equip participants with skills to lead improvements in healthcare delivery. Those more advanced in their medical training had greater opportunity and seniority to lead change and were better placed to apply the learning. This has implications for whom the training should be targeted. Originality/value A rare study exploring the longer-term impact of a leadership programme on later clinical practice, which adds to the body of knowledge of impact and efficacy of leadership training programmes in healthcare environments.

scholarly journals Nutritional Complications and the Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors

2019 ◽  
Vol 110 (5) ◽  
pp. 430-442 ◽  
Author(s):  
Erin Laing ◽  
Nicole Kiss ◽  
Michael Michael ◽  
Meinir Krishnasamy
Keyword(s):  
Clinical Practice ◽  
Neuroendocrine Tumors ◽  
Dietary Habits ◽  
Somatostatin Analogs ◽  
The United States ◽  
The Body ◽  
Care Needs ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Vitamin Deficiencies ◽  
The Impact

Neuroendocrine tumors (NETs) have increased in incidence and prevalence over the past 2 decades and affect approximately 170,000 people in the United States alone. Gastroenteropancreatic (GEP) NETs (GEP NET) are a heterogeneous group of rare tumors that have distinct effects on the body due to their tumor location and potential to secrete hormones and peptides. Clinical practice guidelines and consensus guidelines for GEP NETs with regard to best practice for diagnosis, treatment, and medical management are available, but the supportive care needs and optimal nutritional management of patients affected by these unique tumors remain under-researched: evidence to guide clinical practice is lacking. The pathophysiology of the disease and its treatment can cause various symptoms that can have significant effects on vitamin synthesis and absorption, dietary habits, weight change, and appetite. Deficiency of fat-soluble vitamins and niacin exists amongst patients with GEP NET, particularly those on treatment with somatostatin analogs and with serotonin-secreting tumors, respectively. Malnutrition and dietary modification amongst patients with GEP NET is more prevalent than initially thought: up to 25% of inpatients with GEP NET are malnourished. Food intolerance is also reported in up to 40–90% of these patients, though its misdiagnosis is common. This review summarizes the evidence regarding the impact of GEP NET and its treatment on nutritional factors in these patients with emphasis on malnutrition, vitamin deficiencies, dietary intake, and quality of life. Recommendations for clinical practice and research approaches to address these nutritional issues are discussed.

scholarly journals Impact of the grasping test on women’s cardiovascular systems, and the possibility of replacing the orthostatic tolerance test with it

2014 ◽  
Vol 27 (4) ◽  
pp. 217-219
Author(s):  
Karolina Zaluska ◽  
Tomasz Sawicki ◽  
Bartlomiej Kulesza ◽  
Adam Nogalski
Keyword(s):  
Clinical Practice ◽  
Cardiovascular System ◽  
Tolerance Test ◽  
Female Students ◽  
Physiological Parameters ◽  
The Body ◽  
Orthostatic Tolerance ◽  
Heart Rates ◽  
Blood Pressures ◽  
The Impact

Abstract The aim of this study was to test the impact of the Grasping Test (GT) on the female cardiovascular system and to ascertain the possibility of using this to replace the Orthostatic Tolerance Test (OT). In this study, 15 volunteer female students were examined, and their physiological parameters - their systolic (SBP) and diastolic blood pressures (DBP), and their heart rates (HR) - were compared. We found that the Orthostatic Tolerance Test (changing the position of the body from recumbent to upright) and the Grasping Test induced meaningful but similar changes in the functioning of the women’s cardiovascular system. The results confirm that there were significant similarities between the cardiovascular system measurements as produced through the Orthostatic Tolerance Test and the Grasping Test. The possibility of introducing the procedure into clinical practice is a crucial factor for continuing our research in the wider population.

scholarly journals Assessment of Thyroid Cancer Risk After Cervical Computed Tomography: The Impact of Bismuth Shielding

2021 ◽  
Vol 10 (2) ◽  
pp. 70-74
Author(s):  
Hamid Ghaznavi ◽  
Zeinab Momeni ◽  
Sadegh Ghaderi
Keyword(s):  
Computed Tomography ◽  
Thyroid Cancer ◽  
Cancer Risk ◽  
Biological Effects ◽  
The Body ◽  
Male And Female ◽  
Thyroid Dose ◽  
Thyroid Cancer Risk ◽  
Bismuth Shielding ◽  
The Impact

Background: Computed tomography (CT) is vastly applied in X-ray procedures because of its high quality in detecting the anatomical structures of the body. However, it leads to an increase in patient dose, resulting in carcinogenesis. In the head and neck CT, the thyroid is the most important at-risk organ. The aim of this study was to estimate thyroid cancer risk in cervical CT with and without a bismuth shield. Materials and Methods: After obtaining permission from the authors, data related to the thyroid dose of patients undergoing cervical CT in the study by Santos et al (2019) were used, and then thyroid cancer risk was calculated for different ages at exposure in male and female patients using the biological effects of the ionizing radiation (BEIR) VII model. Results: Using bismuth shielding reduced thyroid dose by 37% and 39% in male and female phantoms, respectively. Thyroid cancer estimation demonstrated that the risk was nearly two-fold in females compared to males. Finally, bismuth shielding reduced 40% of cancer risk, and it decreased in both genders by increasing age at exposure. Conclusion: According to our findings, excess relative risk (ERR) up to 0.06% was associated with cervical CT. Although ERR amounts were low, the effect of radiation on thyroid cancer risk should not be neglected. Accordingly, it is suggested that future trials use bismuth shielding to reduce thyroid cancer risk.

scholarly journals Diagnostic Evaluation and Management of Chronic Thromboembolic Pulmonary Hypertension: A Clinical Practice Guideline

2010 ◽  
Vol 17 (6) ◽  
pp. 301-334 ◽  
Author(s):  
Sanjay Mehta ◽  
Doug Helmersen ◽  
Steeve Provencher ◽  
Naushad Hirani ◽  
Fraser D Rubens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Computed Tomography Angiography ◽  
Practice Guideline ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Endarterectomy ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Impact

BACKGROUND: Pulmonary embolism is a common condition. Some patients subsequently develop chronic thromboembolic pulmonary hypertension (CTEPH). Many care gaps exist in the diagnosis and management of CTEPH patients including lack of awareness, incomplete diagnostic assessment, and inconsistent use of surgical and medical therapies.METHODS: A representative interdisciplinary panel of medical experts undertook a formal clinical practice guideline development process. A total of 20 key clinical issues were defined according to the patient population, intervention, comparator, outcome (PICO) approach. The panel performed an evidence-based, systematic, literature review, assessed and graded the relevant evidence, and made 26 recommendations.RESULTS: Asymptomatic patients postpulmonary embolism should not be screened for CTEPH. In patients with pulmonary hypertension, the possibility of CTEPH should be routinely evaluated with initial ventilation/ perfusion lung scanning, not computed tomography angiography. Pulmonary endarterectomy surgery is the treatment of choice in patients with surgically accessible CTEPH, and may also be effective in CTEPH patients with disease in more ‘distal’ pulmonary arteries. The anatomical extent of CTEPH for surgical pulmonary endarterectomy is best assessed by contrast pulmonary angiography, although positive computed tomography angiography may be acceptable. Novel medications indicated for the treatment of pulmonary hypertension may be effective for selected CTEPH patients.CONCLUSIONS: The present guideline requires formal dissemination to relevant target user groups, the development of tools for implementation into routine clinical practice and formal evaluation of the impact of the guideline on the quality of care of CTEPH patients. Moreover, the guideline will be updated periodically to reflect new evidence or clinical approaches.

Cancer and depression: Integrating scientific evidence with clinical practice

2011 ◽  
Vol 26 (S2) ◽  
pp. 2210-2210
Author(s):  
D. Eraslan
Keyword(s):  
Clinical Practice ◽  
Everyday Life ◽  
Clinical Setting ◽  
Scientific Evidence ◽  
The Body ◽  
Normal Reaction ◽  
Patients With Cancer ◽  
Existential Crisis ◽  
Diagnosis Of Cancer ◽  
The Impact

A diagnosis of cancer is one of the most distressing events in life. It changes the course of everyday life and causes an existential crisis. This makes some clinicians think that depression is a normal reaction to a diagnosis of cancer. However, the body of evidence suggests that not all people diagnosed with cancer develop depression, but patients with cancer have an increased rate of depression. This presentation will try to combine the latest data on depression and cancer, including the mechanisms underlying depression in these patients and the impact of psychiatric diagnosis on the outcome of cancer. We will then focus on the implications of these data on the diagnosis and management of depression in the clinical setting.

Contrast enhancement of iohexol-cisplatin-gelatin complex under computed tomography imaging

2014 ◽  
Vol 34 (3) ◽  
pp. 267-271
Author(s):  
Wei-Hung Liu ◽  
Yang-Kao Wang ◽  
Chi-Chang Wu ◽  
Win-Pin Deng ◽  
Kuang-Hsun Lin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Diagnostic Techniques ◽  
The Body ◽  
X Ray ◽  
Non Invasive ◽  
Ct Contrast Agent ◽  
X Ray Computed ◽  
Ct Contrast

Abstract X-ray computed tomography (CT) is one of the most powerful non-invasive diagnostic techniques nowadays. The iodinated molecules used as CT contrast agents in the clinic have short circulation times in the body, which significantly restrict its applications. Furthermore, some patients are hypersensitive to iodine. So, researchers have made tremendous efforts to improve the property of iodine. Besides, cis-diammineplatinum (II) dichloride (cisplatin), a major chemo agent for cancer treatment, possess higher X-ray attenuation coefficient being a CT contrast agent. The incorporation of cisplatin with an iodinated agent could facilitate the quality of CT images and damage cancer cells simultaneously. To reduce toxicity of a contrast agent, polymer matrix, gelatin, was incorporated for avoiding contact with nontarget cells. In this study, we combined the iodine contrast agent, 1,3-N-bis (2,3-dihydroxypropyl)-5-[N-(2,3-dihydroxypropyl)acetamido]-2,4,6-triiodobenzene-1,3-dicarboxamide (iohexol), with cisplatin, and then examined them in a micro CT with different X-ray tube voltages (50 kV, 80 kV, 100 kV) to find optimal scanning conditions for imaging. As expected, iohexol combined with cisplatin enhanced X-ray attenuation and image contrast. The optimal CT image could be acquired at iohexol and cisplatin concentrations of 50 mg/ml and 3 mg/ml, respectively, under 80 kV irradiation. Finally, the iohexol-cisplatin-gelatin solution was then fabricated into nanoparticles of sizes about 240 nm, which may suitable for in vivo delivery.

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