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Magnetic Resonance Imaging (MRI) typically recruits multiple sequences (defined here as “modalities”). As each modality is designed to offer different anatomical and functional clinical information, there are evident disparities in the imaging content across modalities. Inter- and intra-modality affine and non-rigid image registration is an essential medical image analysis process in clinical imaging, as for example before imaging biomarkers need to be derived and clinically evaluated across different MRI modalities, time phases and slices. Although commonly needed in real clinical scenarios, affine and non-rigid image registration is not extensively investigated using a single unsupervised model architecture. In our work, we present an unsupervised deep learning registration methodology that can accurately model affine and non-rigid transformations, simultaneously. Moreover, inverse-consistency is a fundamental inter-modality registration property that is not considered in deep learning registration algorithms. To address inverse consistency, our methodology performs bi-directional cross-modality image synthesis to learn modality-invariant latent representations, and involves two factorised transformation networks (one per each encoder-decoder channel) and an inverse-consistency loss to learn topology-preserving anatomical transformations. Overall, our model (named “FIRE”) shows improved performances against the reference standard baseline method (i.e., Symmetric Normalization implemented using the ANTs toolbox) on multi-modality brain 2D and 3D MRI and intra-modality cardiac 4D MRI data experiments. We focus on explaining model-data components to enhance model explainability in medical image registration. On computational time experiments, we show that the FIRE model performs on a memory-saving mode, as it can inherently learn topology-preserving image registration directly in the training phase. We therefore demonstrate an efficient and versatile registration technique that can have merit in multi-modal image registrations in the clinical setting.

Bone marrow adiposity changes in diverse diseases, but the full scope of these, and whether they are directly influenced by marrow adiposity, remains unknown. To address this, we previously measured the bone marrow fat fraction of the femoral head, total hip, femoral diaphysis, and spine of over 48,000 UK Biobank participants. Here, we first use these data for PheWAS to identify diseases associated with marrow adiposity at each site. This reveals associations with 47 incident diseases across 12 disease categories, including osteoporosis, fracture, type 2 diabetes, cardiovascular diseases, cancers, and other conditions that burden public health worldwide. Intriguingly, type 2 diabetes associates positively with spine bone marrow adiposity but negatively with marrow adiposity at femoral sites. We then establish PRSs based on bone-marrow-fat-fraction-associated SNPs and use PRS-PheWAS and Mendelian randomization to explore causal associations between marrow adiposity and disease. PRS-PheWAS reveals that genetic predisposition to increased marrow adiposity is positively associated with osteoporosis and fractures. Mendelian randomization further suggests that increased marrow adiposity at the diaphysis and total hip is causally associated with osteoporosis. Our findings substantially advance understanding of how marrow adiposity impacts human health and highlight its potential as a biomarker and/or therapeutic target for diverse human diseases. Bone marrow adipose tissue accounts for almost 10% of human fat mass, but its roles remain unclear. Here, Xu et al. identify more than 45 diseases linked to marrow adiposity in over 48,000 people, including causal roles in musculoskeletal disease.

Bone marrow adipose tissue is a distinct adipose subtype comprising more than 10% of fat mass in healthy humans. However, the functions and pathophysiological correlates of this tissue are unclear, and its genetic determinants remain unknown. Here, we use deep learning to measure bone marrow adiposity in the femoral head, total hip, femoral diaphysis, and spine from MRI scans of approximately 47,000 UK Biobank participants, including over 41,000 white and over 6300 non-white participants. We then establish the heritability and genome-wide significant associations for bone marrow adiposity at each site. Our meta-GWAS in the white population finds 67, 147, 134, and 174 independent significant single nucleotide polymorphisms, which map to 54, 90, 43, and 100 genes for the femoral head, total hip, femoral diaphysis, and spine, respectively. Transcriptome-wide association studies, colocalization analyses, and sex-stratified meta-GWASes in the white participants further resolve functional and sex-specific genes associated with bone marrow adiposity at each site. Finally, we perform a multi-ancestry meta-GWAS to identify genes associated with bone marrow adiposity across the different bone regions and across ancestry groups. Our findings provide insights into BMAT formation and function and provide a basis to study the impact of BMAT on human health and disease. Bone marrow adipose tissue accounts for over 10% of human fat mass. Here, Xu et al. use deep learning to measure marrow adiposity in over 45,000 people, and identify genes associated with altered bone marrow adiposity.

The sustainability of mariculture depends on adopting green technologies, which can mitigate the negative impacts on the environment and ensure long-term viability. However, existing studies do not comprehensively understand the characteristics and regional differences of green technology progress (GTP) in mariculture. According to data from ten coastal regions from 2008 to 2020, this study adopts the Epsilon-Based Measure (EBM)-Malmquist model to measure the GTP of mariculture, uses the Dagum Gini coefficient to analyze the spatial differences of GTP, and uses convergence models to explore the convergence of GTP. The results showed that: (1) the GTP of China’s mariculture showed a fluctuating upward trend temporally and significant spatial differences. The overall differences showed a dispersion trend over time. The contributions of inter-regional super variable net value difference (Gnb), inter-regional transvariation intensity (Gt), and intra-regional difference (Gw) were 38.813%, 31.256%, and 29.931%, respectively. (2) The degree of dispersion of GTP among different regions has not decreased with time, which means there is no apparent σ convergence. Absolute β convergence and conditional β convergence existed in GTP, and the absolute value of the latter was greater than that of the former. That is, the growth rate of GTP will first reach their respective steady-state levels and then approach a unified steady-state equilibrium level.

•We investigate 18F-flutemetamol pharmacokinetics in probable CAA using PETMR.•We develop a model-based input function (mIF) and assess perfusion and tracer uptake.•We compare measurements from 30 min, against 120 min and SUVR PET-MR.•mIF 1-TC detected impaired perfusion and amyloid load in CAA from both time frames.•Perfusion deficits and amyloid burden were congruent in cases with probable CAA. Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease associated with perivascular β-amyloid deposition. CAA is also associated with strokes due to lobar intracerebral haemorrhage (ICH). 18F-flutemetamol amyloid ligand PET may improve the early detection of CAA. We performed pharmacokinetic modelling using both full (0–30, 90–120 min) and reduced (30 min) 18F-flutemetamol PET-MR acquisitions, to investigate regional cerebral perfusion and amyloid deposition in ICH patients. Dynamic18F-flutemetamol PET-MR was performed in a pilot cohort of sixteen ICH participants; eight lobar ICH cases with probable CAA and eight deep ICH patients. A model-based input function (mIF) method was developed for compartmental modelling. mIF 1-tissue (1-TC) and 2-tissue (2-TC) compartmental modelling, reference tissue models and standardized uptake value ratios were assessed in the setting of probable CAA detection. The mIF 1-TC model detected perfusion deficits and 18F-flutemetamol uptake in cases with probable CAA versus deep ICH patients, in both full and reduced PET acquisition time (all P < 0.05). In the reduced PET acquisition, mIF 1-TC modelling reached the highest sensitivity and specificity in detecting perfusion deficits (0.87, 0.77) and 18F-flutemetamol uptake (0.83, 0.71) in cases with probable CAA. Overall, 52 and 48 out of the 64 brain areas with 18F-flutemetamol-determined amyloid deposition showed reduced perfusion for 1-TC and 2-TC models, respectively. Pharmacokinetic (1-TC) modelling using a 30 min PET-MR time frame detected impaired haemodynamics and increased amyloid load in probable CAA. Perfusion deficits and amyloid burden co-existed within cases with CAA, demonstrating a distinct imaging pattern which may have merit in elucidating the pathophysiological process of CAA.

Background Primary immunodeficiency (PI) is a group of heterogeneous disorders resulting from immune system defects. Over 70% of PI is undiagnosed, leading to increased mortality, co-morbidity and healthcare costs. Among PI disorders, combined immunodeficiencies (CID) are characterized by complex immune defects. Common variable immunodeficiency (CVID) is among the most common types of PI. In light of available treatments, it is critical to identify adult patients at risk for CID and CVID, before the development of serious morbidity and mortality. Methods We developed a deep learning-based method (named “TabMLPNet”) to analyze clinical history from nationally representative medical claims from electronic health records (Optum® data, covering all US), evaluated in the setting of identifying CID/CVID in adults. Further, we revealed the most important CID/CVID-associated antecedent phenotype combinations. Four large cohorts were generated: a total of 47,660 PI cases and (1:1 matched) controls. Results The sensitivity/specificity of TabMLPNet modeling ranges from 0.82-0.88/0.82-0.85 across cohorts. Distinctive combinations of antecedent phenotypes associated with CID/CVID are identified, consisting of respiratory infections/conditions, genetic anomalies, cardiac defects, autoimmune diseases, blood disorders and malignancies, which can possibly be useful to systematize the identification of CID and CVID. Conclusions We demonstrated an accurate method in terms of CID and CVID detection evaluated on large-scale medical claims data. Our predictive scheme can potentially lead to the development of new clinical insights and expanded guidelines for identification of adult patients at risk for CID and CVID as well as be used to improve patient outcomes on population level. Plain language summary Primary immunodeficiencies (PI) are disorders that weaken the immune system, increasing the incident of life-threatening infections, organ damage and the development of cancer and autoimmune diseases. Although PI is estimated to affect 1-2% of the global population, 70-90% of these patients remain undiagnosed. Many patients are diagnosed during adulthood, after other serious diseases have already developed. We developed a computational method to analyze the clinical history from a large group of people with and without PI. We focused on combined (CID) and common variable immunodeficiency (CVID), which are among the least studied and most common PI subtypes, respectively. We could identify people with CID or CVID and combinations of diseases and symptoms which could make it easier to identify CID or CVID. Our method could be used to more readily identify adults at risk of CID or CVID, enabling treatment to start earlier and their long-term health to be improved. Papanastasiou et al. develop a deep learning-based method to identify combined immunodeficiencies (CID) and common variable immunodeficiencies (CVID) from large-scale electronic health record data. Distinctive combinations of antecedent phenotypes associated with CID/CVID are identified that could improve early diagnosis.

The rapid spread of coronavirus 2019 disease (COVID-19) has manifested a global public health crisis, and chest CT has been proven to be a powerful tool for screening, triage, evaluation and prognosis in COVID-19 patients. However, CT is not only costly but also associated with an increased incidence of cancer, in particular for children. This study will question whether clinical symptoms and laboratory results can predict the CT outcomes for the pediatric patients with positive RT-PCR testing results in order to determine the necessity of CT for such a vulnerable group. Clinical data were collected from 244 consecutive pediatric patients (16 years of age and under) treated at Wuhan Children's Hospital with positive RT-PCR testing, and the chest CT were performed within 3 days of clinical data collection, from January 21 to March 8, 2020. This study was approved by the local ethics committee of Wuhan Children's Hospital. Advanced decision tree based machine learning models were developed for the prediction of CT outcomes. Results have shown that age, lymphocyte, neutrophils, ferritin and C-reactive protein are the most related clinical indicators for predicting CT outcomes for pediatric patients with positive RT-PCR testing. Our decision support system has managed to achieve an AUC of 0.84 with 0.82 accuracy and 0.84 sensitivity for predicting CT outcomes. Our model can effectively predict CT outcomes, and our findings have indicated that the use of CT should be reconsidered for pediatric patients, as it may not be indispensable.

Multiview based learning has generally returned dividends in performance because additional information can be extracted for the representation of the diversity of different views. The advantage of multiview based learning fits the purpose of segmenting cardiac anatomy from multiview echocardiography, which is a non-invasive, low-cost and low-risk imaging modality. Nevertheless, it is still challenging because of limited training data, a poor signal-to-noise ratio of the echocardiographic data, and large variances across views for a joint learning. In addition, for a better interpretation of pathophysiological processes, clinical decision-making and prognosis, such cardiac anatomy segmentation and quantitative analysis of various clinical indices should ideally be performed for the data covering the full cardiac cycle. To tackle these challenges, a multiview recurrent aggregation network (MV-RAN) has been developed for the echocardiographic sequences segmentation with the full cardiac cycle analysis. Experiments have been carried out on multicentre and multi-scanner clinical studies consisting of spatio-temporal (2D + t) datasets. Compared to other state-of-the-art deep learning based methods, the MV-RAN method has achieved significantly superior results (0.92 ± 0.04 Dice scores) for the segmentation of the left ventricle on the independent testing datasets. For the estimation of clinical indices, our MV-RAN method has also demonstrated great promise and will undoubtedly propel forward the understanding of pathophysiological processes, computer-aided diagnosis and personalised prognosis using echocardiography. [Display omitted] •MV-RAN provides a unified framework for both MV echocardiographic sequences segmentation and full cardiac cycle analysis.•Multi-level and multiscale spatial-temporal information can be captured by PDDConvs and hConvLSTMs.•Double-branch aggregation performs both segmentation and classification, mitigating the differences across MV data.•MV-RAN exploits spatial-temporal information in end-to-end manner without any deformable model or pretrained models.