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Objectives: The purpose of the present study was to utilize ShearWave™ Elastography to assess tissue stiffness by measuring shear wave speed before and after applying the direct Myofascial release (MFR) technique to the lateral gastrocnemius muscle of competitive tennis athletes., Methods: Shear wave speed values were measured in the regions of interest within the lateral gastrocnemius fascia and muscle areas from the elastographic images. Measurements were taken in three different situations: before, immediately after and 5 min after MFR protocol. Subsequently, the results from each situation were statistically compared., Results: The protocol was administered to a group of eighteen tennis players with a mean age of 18 ± 1.23 years. The shear wave speed values increased for both fascia and muscles sites, after applying the MFR technique: From 3.01 ± 0.64 to 3.33 ± 0.86 m/s in the deep fascia and from 2.23 ± 0.41 to 2.57 ± 0.51 m/s in superficial fascia. In the deep and superficial muscles sites the increases were from 4.12 ± 0.95 to 4.40 ± 1.22 m/s, and from 2.94 ± 0.71 to 3.38 ± 0.95 m/s, respectively., Conclusion: This study showed that after the myofascial manipulation in tennis athletes, the lateral gastrocnemius muscle and fascia tissues stiffness increased, according to elastography, and possible mechanisms were discussed. ShearWave™ Elastography could be utilized to assess the acute effects of applying a direct myofascial release (MFR) technique., Competing Interests: Declaration of competing interest All authors declare that there are no conflicts of interest to report related to this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Bone recovery typically depends on the age of organisms or the prevalence of metabolic disorders such as osteoporosis, which is a metabolic condition characterized by decreased bone strength and bone mineral density (BMD). Therefore, low-intensity pulsed ultrasound (LIPUS), a non-invasive method for osteogenic stimulation, presents promising results. However, heterogeneity in animal study designs is a typical characteristic. Hence, we conducted a systematic review to evaluate the effectiveness of LIPUS in the recovery of experimental bone defects using rat models. We examined the areal and volumetric BMD to identify LIPUS doses to be applied and evaluated the accuracy reported by previous studies., Methods: The Virtual Health Library regional portal, PubMed, Embase, EBSCOhost, Scopus and CAPES were reviewed for animal studies that compared fracture treatments based on LIPUS with sham or no treatments using rat models and reported BMD as an outcome. The tool provided by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) and the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist were used to assess the bias and quality of such studies., Results: Of the six studies reviewed, the most frequently used LIPUS dose had an ultrasonic frequency of 1.0 MHz, repetition rate of 0.1 kHz and pulse duration of 2000 μs. An intensity (I SATA ) of 30 mW/cm 2 was the most preferred for bone recovery. However, the BMD could not solely irrefutably evaluate the effectiveness of LIPUS in bone recovery as the results were discordant with each other. The discrepancies in experimental methodologies, low-quality classifications and high risk of bias in the selected studies, however, did not validate the undertaking of a meta-analysis., Conclusion: On the basis of the BMD results, no sufficient evidence was found to recommend the use of LIPUS for bone recovery in rat models. Thus, this systematic review indicates that the accuracy of such reports must be improved to improve their scientific quality to facilitate a transition of LIPUS applications from pre-clinical research to clinic use., Competing Interests: Conflict of interest The authors declare no competing interests., (Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Hyperthermia using High-Intensity Focused Ultrasound (HIFU) is an acoustic therapy for cancer treatment. This technique consists of an increase in the temperature field of the tumor to achieve coagulative necrosis and immediate cell death. Therefore, for having a successful treatment, the physical problem requires to know several properties due to the high variability from individual to individual, or even for the same individual under different physiological conditions. This article presents a numerical simulation of hyperthermia therapy for cancer treatment using HIFU, as well as the estimation of parameters that influence the physical problem. Two mathematical models were considered to solve the forward problem. The acoustic model based on acoustic pressure performs a frequency-domain study, and the bioheat transfer model a time-dependent study. These models were solved using Comsol Multiphysics® software in a 2D-axisymmetric rectangular domain to determine the temperature field. Parameter estimation was coded in Matlab Mathworks® environment using a Bayesian approach. The Markov Chain Monte Carlo method by the Metropolis-Hastings algorithm was implemented, and the simulated temperature measurements were considered. Results suggest that specific HIFU therapy can be performed for each patient by estimating appropriate parameters for cancer treatment and provides the possibility to define procedures before and during the treatment., (© 2022 John Wiley & Sons Ltd.)

Objectives: to understand the practice of the nurse in healthcare management of children with chronic condition in the hospital setting., Methods: analytical study of qualitative approach with theoretical and methodological reference of institutional ethnography. Developed in the pediatric unit of a university hospital, in a municipality in Northeastern Brazil. Data collections techniques were: participant observation, documentary analysis and semi-structured interview. Participants of the study totaled twenty professionals, including nurses, social workers, psychologists, pharmacists, nutritionists, physiotherapists, and doctors. For data analysis, it was used the Bardin's Content Analysis with interface of the Atlas.ti software., Results: categories of analysis were "Nurse as mediator of healthcare management"; "Nursing process as a mechanism of healthcare management"., Final: considerations: the nurse proved to be essential for healthcare management of the child with chronic condition, acting as mediator of the relationship between the doctor, the members of the health team, the user and their family.

Background: Outlining lesion contours in Ultra Sound (US) breast images is an important step in breast cancer diagnosis. Malignant lesions infiltrate the surrounding tissue, generating irregular contours, with spiculation and angulated margins, whereas benign lesions produce contours with a smooth outline and elliptical shape. In breast imaging, the majority of the existing publications in the literature focus on using Convolutional Neural Networks (CNNs) for segmentation and classification of lesions in mammographic images. In this study our main objective is to assess the ability of CNNs in detecting contour irregularities in breast lesions in US images., Methods: In this study we compare the performance of two CNNs with Direct Acyclic Graph (DAG) architecture and one CNN with a series architecture for breast lesion segmentation in US images. DAG and series architectures are both feedforward networks. The difference is that a DAG architecture could have more than one path between the first layer and end layer, whereas a series architecture has only one path from the beginning layer to the end layer. The CNN architectures were evaluated with two datasets., Results: With the more complex DAG architecture, the following mean values were obtained for the metrics used to evaluate the segmented contours: global accuracy: 0.956; IOU: 0.876; F measure: 68.77%; Dice coefficient: 0.892., Conclusion: The CNN DAG architecture shows the best metric values used for quantitatively evaluating the segmented contours compared with the gold-standard contours. The segmented contours obtained with this architecture also have more details and irregularities, like the gold-standard contours.

Described here is a novel texture extraction method based on auto-mutual information (AMI) for classifying breast lesions. The objective is to extract discriminating information found in the non-linear relationship of textures in breast ultrasound (BUS) images. The AMI method performs three basic tasks: (i) it transforms the input image using the ranklet transform to handle intensity variations of BUS images acquired with distinct ultrasound scanners; (ii) it extracts the AMI-based texture features in the horizontal and vertical directions from each ranklet image; and (iii) it classifies the breast lesions into benign and malignant classes, in which a support-vector machine is used as the underlying classifier. The image data set is composed of 2050 BUS images consisting of 1347 benign and 703 malignant tumors. Additionally, nine commonly used texture extraction methods proposed in the literature for BUS analysis are compared with the AMI method. The bootstrap method, which considers 1000 bootstrap samples, is used to evaluate classification performance. The experimental results indicate that the proposed approach outperforms its counterparts in terms of area under the receiver operating characteristic curve, sensitivity, specificity and Matthews correlation coefficient, with values of 0.82, 0.80, 0.85 and 0.63, respectively. These results suggest that the AMI method is suitable for breast lesion classification systems., (Copyright © 2019 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Background and Objective: Conventional computer-aided diagnosis (CAD) systems for breast ultrasound (BUS) are trained to classify pathological classes, that is, benign and malignant. However, from a clinical perspective, this kind of classification does not agree totally with radiologists' diagnoses. Usually, the tumors are assessed by using a BI-RADS (Breast Imaging-Reporting and Data System) category and, accordingly, a recommendation is emitted: annual study for category 2 (benign), six-month follow-up study for category 3 (probably benign), and biopsy for categories 4 and 5 (suspicious of malignancy). Hence, in this paper, a CAD system based on BI-RADS categories weighted by pathological information is presented. The goal is to increase the classification performance by reducing the common class imbalance found in pathological classes as well as to provide outcomes quite similar to radiologists' recommendations., Methods: The BUS dataset considers 781 benign lesions and 347 malignant tumors proven by biopsy. Moreover, every lesion is associated to one BI-RADS category in the set {2, 3, 4, 5}. Thus, the dataset is split into three weighted classes: benign, BI-RADS 2 in benign lesions; probably benign, BI-RADS 3 and 4 in benign lesions; and malignant, BI-RADS 4 and 5 in malignant lesions. Thereafter, a random forest (RF) classifier, denoted by RF w , is trained to predict the weighted BI-RADS classes. In addition, for comparison purposes, a RF classifier is trained to predict pathological classes, denoted as RF p ., Results: The ability of the classifiers to predict the pathological classes is measured by the area under the ROC curve (AUC), sensitivity (SEN), and specificity (SPE). The RF w classifier obtained AUC=0.872,SEN=0.826, and SPE=0.919, whereas the RF p classifier reached AUC=0.868,SEN=0.808, and SPE=0.929. According to a one-way analysis of variance test, the RF w classifier statistically outperforms (p < 0.001) the RF p classifier in terms of the AUC and SEN. Moreover, the classification performance of RF w to predict weighted BI-RADS classes is given by the Matthews correlation coefficient that obtained 0.614., Conclusions: The division of the classification problem into three classes reduces the imbalance between benign and malignant classes; thus, the sensitivity is increased without degrading the specificity. Therefore, the CAD based on weighted BI-RADS classes improves the classification performance of the conventional CAD systems. Additionally, the proposed approach has the advantage of being capable of providing a multiclass outcome related to radiologists' recommendations., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose: This paper presents an adaptive contrast enhancement method based on sigmoidal mapping function (SACE) used for improving the computerized segmentation of breast lesions on ultrasound., Methods: First, from the original ultrasound image an intensity variation map is obtained, which is used to generate local sigmoidal mapping functions related to distinct contextual regions. Then, a bilinear interpolation scheme is used to transform every original pixel to a new gray level value. Also, four contrast enhancement techniques widely used in breast ultrasound enhancement are implemented: histogram equalization (HEQ), contrast limited adaptive histogram equalization (CLAHE), fuzzy enhancement (FEN), and sigmoid based enhancement (SEN). In addition, these contrast enhancement techniques are considered in a computerized lesion segmentation scheme based on watershed transformation. The performance comparison among techniques is assessed in terms of both the quality of contrast enhancement and the segmentation accuracy. The former is quantified by the measure, where the greater the value, the better the contrast enhancement, whereas the latter is calculated by the Jaccard index, which should tend towards unity to indicate adequate segmentation., Results: The experiments consider a data set with 500 breast ultrasound images. The results show that SACE outperforms its counterparts, where the median values for the measure are: SACE: 139.4, SEN: 68.2, HEQ: 64.1, CLAHE: 62.8, and FEN: 7.9. Considering the segmentation performance results, the SACE method presents the largest accuracy, where the median values for the Jaccard index are: SACE: 0.81, FEN: 0.80, CLAHE: 0.79, HEQ: 77, and SEN: 0.63., Conclusion: The SACE method performs well due to the combination of three elements: (1) the intensity variation map reduces intensity variations that could distort the real response of the mapping function, (2) the sigmoidal mapping function enhances the gray level range where the transition between lesion and background is found, and (3) the adaptive enhancing scheme for coping with local contrasts. Hence, the SACE approach is appropriate for enhancing contrast before computerized lesion segmentation., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Ultrasound (US) is an important tool for diagnosing of many musculoskeletal tissue conditions. Image texture analysis can be used to characterize this tissue. The complexity curve (CC) is a technique commonly used to characterize the number of grey-level transitions in an image. Variability and reliability of US texture measures in the muscle tissue are unavailable in the literature. The aim of this study was to determine the variability and reliability of five CC texture parameters from US images of healthy Biceps Brachialis and Gastrocnemius Lateralis (GL) muscles, with longitudinal and transversal orientations of the probe. Eight images per subject were obtained for 30 men in 2 days. Mean, standard deviation, coefficient of variation and intraclass correlation coefficient for the five parameters were calculated for regions of interest. Results showed that the variability was similar for both muscles and most of the parameters showed satisfactory reliability (r > 0·7) for the Biceps Brachialis with the transverse scan and for the GL with the longitudinal scan., (© 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

Background: Low-intensity physiotherapeutic ultrasound has been used in physical therapy clinics; however, there remain some scientific issues regarding the bone-healing process. The objective of this study was to investigate the influence of low-intensity physiotherapeutic ultrasound on the initial stage of bone healing in rats., Methods: Twenty-two male adult rats were assessed quantitatively and qualitatively using radiographic, biochemical, and histological analyses. Numerical simulations were also performed. Fractures in animals in the ultrasound group ( n  = 11) were treated with low-intensity ultrasound (pulsed mode, duty cycle 20 %) for 10 min daily at an intensity of 40 mW/cm 2 SATA (1.0 MHz) for 10 days. Fractures in animals in the control group ( n  = 11) were not treated., Results: Alkaline phosphatase levels were non-significantly higher in the ultrasound group than in the control group in the time intervals considered ( t (13) = 0.440; 95 % confidence interval (CI) -13.79 to 20.82; p  = 0.67). Between-group serum calcium levels were also not significantly different ( t (13) = -0.842; 95 % CI -0.48 to 0.21; p  = 0.42). Finally, there were no significant differences in radiological scores between the two groups ( U  = 118; 95 % CI -1.99 to 1.99; p  = 0.72). However, the diameter of the newly formed bone tissue was greater and more evident in the ultrasound group., Conclusions: Thirteen days after fracture, there was no significant between-group differences in bone-healing processes, although the increased alkaline phosphatase levels and diameter of new bone tissue need to be further investigated.

Introduction: Syphilis is one of the known transfusion-transmissible infections and causes 100,000 deaths yearly, with around 90% of these deaths occurring in the developing world. Little data is available regarding the prevalence of syphilis among Saudi blood and stem cell donors. We conducted a survey on the incidence of syphilis among all blood and stem cell donors., Methods: This study was conducted at the Prince Sultan Military Medical City in Riyadh, Saudi Arabia in the 10 years period data during 2006-2015. Data were analyzed about full history, physical examination, age, sex, weight, profession, marital status, number of the donations, data of last donation, having a relation who received blood transfusion, as well as the screening test results of the donated blood. We determined the seroprevalence of infection and compared by sex and other variable through frequency analysis, Chi square, Fisher, and prevalence ratios., Results: Approximately 240,000 blood donors were screened and studied in the period of study. Most of the blood donors were male (98.3%) and 89% of them were citizens of Saudi Arabia. According to our findings, we estimated that, in the last 10 years, approximately 0.044% of all the blood donors were syphilis positive cases. No cases were detected as positive for syphilis among stem cell donors. Only 60 blood donors tested positive for syphilis. In addition, we studied 202 stem cell transplant donors during the same period, of which 59% were male and none texted positive for syphilis., Conclusions: A concerted effort between the government, health care providers, regulatory bodies and accreditation agencies have all contributed in eliminating the risk of spreading syphilis among blood donors., Competing Interests: There is no conflict of interest to be declared.

Ultrasonic phantoms are objects that mimic some features of biological tissues, allowing the study of their interactions with ultrasound (US). In the diagnostic-imaging field, breast phantoms are an important tool for testing performance and optimizing US systems, as well as for training medical professionals. This paper describes the design and manufacture of breast lesions by using polyvinyl chloride plastisol (PVCP) as the base material. Among the materials available for this study, PVCP was shown to be stable, durable, and easy to handle. Furthermore, it is a nontoxic, nonpolluting, and low-cost material. The breast's glandular tissue (image background) was simulated by adding graphite powder with a concentration of 1% to the base material. Mixing PVCP and graphite powder in differing concentrations allows one to simulate lesions with different echogenicity patterns (anechoic, hypoechoic, and hyperechoic). From this mixture, phantom materials were obtained with speed of sound varying from 1379.3 to 1397.9ms(-1) and an attenuation coefficient having values between 0.29 and 0.94dBcm(-1) for a frequency of 1MHz at 24°C. A single layer of carnauba wax was added to the lesion surface in order to evaluate its applicability for imaging. The images of the phantoms were acquired using commercial ultrasound equipment; a specialist rated the images, elaborating diagnoses representative of both benign and malignant lesions. The results indicated that it was possible to easily create a phantom by using low-cost materials, readily available in the market and stable at room temperature, as the basis of ultrasonic phantoms that reproduce the image characteristics of fatty breast tissue and typical lesions of the breast., (Copyright © 2016 Elsevier B.V. All rights reserved.)

In this study, we put forward a new approach to classify early stages of fibrosis based on a multiparametric characterization using backscatter ultrasonic signals. Ultrasonic parameters, such as backscatter coefficient (Bc), speed of sound (SoS), attenuation coefficient (Ac), mean scatterer spacing (MSS), and spectral slope (SS), have shown their potential to differentiate between healthy and pathologic samples in different organs (eye, breast, prostate, liver). Recently, our group looked into the characterization of stages of hepatic fibrosis using the parameters cited above. The results showed that none of them could individually distinguish between the different stages. Therefore, we explored a multiparametric approach by combining these parameters in two and three, to test their potential to discriminate between the stages of liver fibrosis: F0 (normal), F1, F3, and/without F4 (cirrhosis), according to METAVIR Score. Discriminant analysis showed that the most relevant individual parameter was Bc, followed by SoS, SS, MSS, and Ac. The combination of (Bc, SoS) along with the four stages was the best in differentiating between the stages of fibrosis and correctly classified 85% of the liver samples with a high level of significance (p<0.0001). Nevertheless, when taking into account only stages F0, F1, and F3, the discriminant analysis showed that the parameters (Bc, SoS) and (Bc, Ac) had a better classification (93%) with a high level of significance (p<0.0001). The combination of the three parameters (Bc, SoS, and Ac) led to a 100% correct classification. In conclusion, the current findings show that the multiparametric approach has great potential in differentiating between the stages of fibrosis, and thus could play an important role in the diagnosis and follow-up of hepatic fibrosis., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Bioheat models have been proposed to predict heat distribution in multilayered biological tissues after therapeutic ultrasound (TUS) stimulation. However, evidence on its therapeutic benefit is still controversial for many clinical conditions. The aim of this study was to evaluate and to compare the TUS heating distribution on commercially available bone phantoms and in vitro femur and tibia human samples, at 1 MHz and several ultrasonic pulse regimens, by means of a thermographic image processing technique., Methods: An infrared camera was used to capture an image after each 5-min 1-MHz TUS stimulation on bone phantoms, as well as in vitro femur and tibia samples (N = 10). An intensity-based processing algorithm was applied to estimate temperature distribution. Sections of five femurs in the coronal plane were also used for the evaluation of heat distribution inside the medullar canal., Results: Temperature increased up to 8.2 and 9.8 °C for the femur and tibia, respectively. Moreover, the temperature increased up to 10.8 °C inside the medullar canal. Although temperature distributions inside the region of interest (ROI) were significantly different (p < 0.001), the average and standard deviation values for bone phantoms were more similar to the femur than to the tibia samples. Pulsed regimens caused lower increments in temperature than continuous sonication, as expected., Conclusions: Commercially available bone phantoms could be used in research focusing on thermal effects of ultrasound. Small differences in mean and standard deviation temperatures were observed between bone samples and phantoms. Temperature can reach more than 10 °C inside the medullar canal on a fixed probe position which may lead to severe cellular damage.

This study explores the effect of ultrasound scattering on the temperature increase in phantoms and in samples of ex-vivo biological tissue through the calculation of the thermal dose (TD). Phantoms with different weight percentages of graphite powder (0-1%w/w, different scattering mean free paths, ℓS) and ex-vivo bovine muscle tissue were isonified by therapeutic ultrasound (1 MHz). The TD values were calculated from the first 4 min of experimental temperature curves obtained at several depths and were compared with those acquired from the numerical solution of the bio-heat transfer equation (simulated with 1 MHz and 0.5-2.0 W cm(-2)). The temperature curves suggested that scattering had an important role because the temperature increments were found to be higher for higher percentages of graphite powder (lower ℓS). For example, at a 30-mm depth and a 4-min therapeutic ultrasound application (0.5 W cm(-2)), the TDs (in equivalent minutes at 43 °C) were 7.2, 17.8, and 58.3 for the phantom with ℓS of 4.35, 3.85, and 3.03 mm, respectively. In tissue, the inclusion of only absorption or full attenuation in the bio-heat transfer equation (BHTE) heat source term of the simulation leads to under- or overestimation of the TD, respectively, as compared to the TD calculated from experimental data. The experiments with phantoms (with different scatterer concentrations) and ex-vivo samples show that the high values of TD were caused by the increase of energy absorption due to the lengthening of the propagation path caused by the changing in the propagation regime., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Thermochromic test bodies are promising tools for qualitatively evaluating the acoustic output of ultrasound physiotherapy systems. Here, a novel phantom, made of silicone mixed with thermochromic powder material, was developed. Additionally, a procedure was developed to evaluate the stability and homogeneity of the phantom in a metrologic and statistical base. Twelve phantoms were divided into three groups. Each group was insonated by a different transducer. An effective intensity of 1.0 W/cm(2) was applied to each phantom; two operators performed the procedure three times in all phantoms. The heated area was measured after image processing. No statistical difference was observed in the heated areas for different samples or in the results for different operators. The heated areas obtained using each transducer were statistically different, indicating that the thermochromic phantom samples had sufficient sensitivity to represent the heated areas of different ultrasonic transducers. Combined with the evaluation procedure, the phantom provides an approach not previously described in the literature. The proposed approach can be used to quickly assess changes in ultrasonic beam cross-sectional shape during the lifetime of ultrasound physiotherapy systems., (Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Purpose: To determine the effectiveness of low-intensity therapeutic ultrasound (LITUS) on wound healing in rats with third-degree burns., Methods: Twenty rats were divided into the Control Group that comprised four rats without third-degree burns that did not undergo LITUS, the Burned Group (BG), comprising eight rats with third-degree burns that did not undergo LITUS, and the Burned with Treatment Group (BTG), comprising eight rats with third-degree burns that were administered LITUS. LITUS began 24 h after injury and involved daily applications for 8 min at 0.1 W/cm2 for 14 days., Results: The BTG lost less weight than the BG (Q=2.75; p<0.05). No visible differences were apparent among the groups' lesions on day 4. By the end of treatment, wound healing was more evident in the BTG. No statistically significant differences were found between the BG and the BTG in relation to the parameters measured using the histological changes in burn wound healing scoring system., Conclusion: The LITUS protocol applied to the animals with third-degree burns accelerated the formation of fibrin-leukocyte crusts and significantly reduced weight loss. However, burn wound healing was not accelerated.

Breast cancer is the most commonly occurring type of cancer among women, and it is the major cause of female cancer-related deaths worldwide. Its incidence is increasing in developed as well as developing countries. Efficient strategies to reduce the high death rates due to breast cancer include early detection and tumor removal in the initial stages of the disease. Clinical and mammographic examinations are considered the best methods for detecting the early signs of breast cancer; however, these techniques are highly dependent on breast characteristics, equipment quality, and physician experience. Computer-aided diagnosis (CADx) systems have been developed to improve the accuracy of mammographic diagnosis; usually such systems may involve three steps: (i) segmentation; (ii) parameter extraction and selection of the segmented lesions and (iii) lesions classification. Literature considers the first step as the most important of them, as it has a direct impact on the lesions characteristics that will be used in the further steps. In this study, the original contribution is a microcalcification segmentation method based on the geodesic active contours (GAC) technique associated with anisotropic texture filtering as well as the radiologists' knowledge. Radiologists actively participate on the final step of the method, selecting the final segmentation that allows elaborating an adequate diagnosis hypothesis with the segmented microcalcifications presented in a region of interest (ROI). The proposed method was assessed by employing 1000 ROIs extracted from images of the Digital Database for Screening Mammography (DDSM). For the selected ROIs, the rate of adequately segmented microcalcifications to establish a diagnosis hypothesis was at least 86.9%, according to the radiologists. The quantitative test, based on the area overlap measure (AOM), yielded a mean of 0.52±0.20 for the segmented images, when all 2136 segmented microcalcifications were considered. Moreover, a statistical difference was observed between the AOM values for large and small microcalcifications. The proposed method had better or similar performance as compared to literature for microcalcifications with maximum diameters larger than 460μm. For smaller microcalcifications the performance was limited., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: Hematopoietic stem cell transplantation (HSCT) involves the infusion of hematopoietic stem cells from a suitable donor to a patient who has undergone chemotherapy. Stem Cell transplantation is used for the treatment for a wide variety of diseases, including leukemia and lymphoma., Purpose: This study highlights prevention strategies of infectious diseases among HSCT donors and recipients in our institute as guided by International guidelines. We aim to highlight the strategy for extensive screening of HIV, Hepatitis B and C, CMV infection and syphilis cases in all the stem cell units stored in our facility., Methods: We searched the institutional database to identify cases of infectious diseases among HSC transplants. Extensive donor evaluation was conducted through screening and laboratory infectious disease testing for HIV, Hepatitis B and C, CMV infection and syphilis., Results: Between 1996 and 2014, 263 consecutive adult HSCT were performed. An approximate equal number of autologous and allogeneic HSC collections were undertaken. The median age for autologous donors was 35 years, whereas that of allogeneic donors is 25 years. Of the 263 stem cell donors, we found 18 patients (autologous) and 2 donors (allogeneic) to be infected. We did not find any of the donors infected with HIV by the serology as well as the NAT testing protocol., Conclusion: Donor screening and testing is the most critical parameter in stem cell transplantation in order to ensure the safety of the product to be transplanted. Modifications in the regulations related to donor screening are aimed at providing safe transplantation and negate the risk of accidental infection of the donor.