肾细胞癌（RCC）是一种常见的癌症，随着临床行为的变化。懒惰的RCC通常是低级的，没有坏死，可以在没有治疗的情况下监测。激进的RCC通常是高级的，如果未及时检测和治疗，可能会导致转移和死亡。虽然大多数肾脏癌在CT扫描中都检测到，但分级是基于侵入性活检或手术的组织学。确定对CT图像的侵略性在临床上很重要，因为它促进了风险分层和治疗计划。这项研究旨在使用机器学习方法来识别与病理学特征相关的放射学特征，以促进评估CT图像而不是组织学上的癌症侵略性。本文提出了一种新型的自动化方法，即按区域（Corrfabr）相关的特征聚集，用于通过利用放射学和相应的不对齐病理学图像之间的相关性来对透明细胞RCC进行分类。 CORRFABR由三个主要步骤组成：（1）特征聚集，其中从放射学和病理图像中提取区域级特征，（2）融合，放射学特征与病理特征相关的放射学特征在区域级别上学习，并且（3）在其中预测的地方学到的相关特征用于仅使用CT作为输入来区分侵略性和顽固的透明细胞RCC。因此，在训练过程中，Corrfabr从放射学和病理学图像中学习，但是在没有病理图像的情况下，Corrfabr将使用CORFABR将侵略性与顽固的透明细胞RCC区分开。 Corrfabr仅比放射学特征改善了分类性能，二进制分类F1分数从0.68（0.04）增加到0.73（0.03）。这证明了将病理疾病特征纳入CT图像上透明细胞RCC侵袭性的分类的潜力。

Artificial Intelligence (AI) is having a tremendous impact across most areas of science. Applications of AI in healthcare have the potential to improve our ability to detect, diagnose, prognose, and intervene on human disease. For AI models to be used clinically, they need to be made safe, reproducible and robust, and the underlying software framework must be aware of the particularities (e.g. geometry, physiology, physics) of medical data being processed. This work introduces MONAI, a freely available, community-supported, and consortium-led PyTorch-based framework for deep learning in healthcare. MONAI extends PyTorch to support medical data, with a particular focus on imaging, and provide purpose-specific AI model architectures, transformations and utilities that streamline the development and deployment of medical AI models. MONAI follows best practices for software-development, providing an easy-to-use, robust, well-documented, and well-tested software framework. MONAI preserves the simple, additive, and compositional approach of its underlying PyTorch libraries. MONAI is being used by and receiving contributions from research, clinical and industrial teams from around the world, who are pursuing applications spanning nearly every aspect of healthcare.

Generalization is an important attribute of machine learning models, particularly for those that are to be deployed in a medical context, where unreliable predictions can have real world consequences. While the failure of models to generalize across datasets is typically attributed to a mismatch in the data distributions, performance gaps are often a consequence of biases in the 'ground-truth' label annotations. This is particularly important in the context of medical image segmentation of pathological structures (e.g. lesions), where the annotation process is much more subjective, and affected by a number underlying factors, including the annotation protocol, rater education/experience, and clinical aims, among others. In this paper, we show that modeling annotation biases, rather than ignoring them, poses a promising way of accounting for differences in annotation style across datasets. To this end, we propose a generalized conditioning framework to (1) learn and account for different annotation styles across multiple datasets using a single model, (2) identify similar annotation styles across different datasets in order to permit their effective aggregation, and (3) fine-tune a fully trained model to a new annotation style with just a few samples. Next, we present an image-conditioning approach to model annotation styles that correlate with specific image features, potentially enabling detection biases to be more easily identified.

To analyze this characteristic of vulnerability, we developed an automated deep learning method for detecting microvessels in intravascular optical coherence tomography (IVOCT) images. A total of 8,403 IVOCT image frames from 85 lesions and 37 normal segments were analyzed. Manual annotation was done using a dedicated software (OCTOPUS) previously developed by our group. Data augmentation in the polar (r,{\theta}) domain was applied to raw IVOCT images to ensure that microvessels appear at all possible angles. Pre-processing methods included guidewire/shadow detection, lumen segmentation, pixel shifting, and noise reduction. DeepLab v3+ was used to segment microvessel candidates. A bounding box on each candidate was classified as either microvessel or non-microvessel using a shallow convolutional neural network. For better classification, we used data augmentation (i.e., angle rotation) on bounding boxes with a microvessel during network training. Data augmentation and pre-processing steps improved microvessel segmentation performance significantly, yielding a method with Dice of 0.71+/-0.10 and pixel-wise sensitivity/specificity of 87.7+/-6.6%/99.8+/-0.1%. The network for classifying microvessels from candidates performed exceptionally well, with sensitivity of 99.5+/-0.3%, specificity of 98.8+/-1.0%, and accuracy of 99.1+/-0.5%. The classification step eliminated the majority of residual false positives, and the Dice coefficient increased from 0.71 to 0.73. In addition, our method produced 698 image frames with microvessels present, compared to 730 from manual analysis, representing a 4.4% difference. When compared to the manual method, the automated method improved microvessel continuity, implying improved segmentation performance. The method will be useful for research purposes as well as potential future treatment planning.

医疗人工智能（AI）的最新进展已提供了可以达到临床专家水平绩效的系统。但是，当在与训练环境不同的临床环境中评估时，这种系统往往会证明次优的“分布式”性能。一种常见的缓解策略是使用特定地点数据为每个临床环境开发单独的系统[1]。但是，这很快变得不切实际，因为医疗数据很耗时，可以注释且昂贵[2]。因此，“数据有效概括”的问题给医学AI开发带来了持续的困难。尽管代表性学习的进展显示出希望，但并未对其好处进行严格的研究，特别是用于分布的设置。为了应对这些挑战，我们提出了RESEDIS，这是一种统一的代表学习策略，以提高医学成像AI的鲁棒性和数据效率。雷雷迪斯使用大规模监督转移学习与自我监督学习的通用组合，几乎不需要特定于任务的自定义。我们研究各种医学成像任务，并使用回顾性数据模拟三个现实的应用程序场景。 RESEDIS表现出明显改善的分布性能，而在强有力的基线上，诊断准确性相对相对提高了11.5％。更重要的是，我们的策略会导致对医学成像AI的强大数据有效的概括，并使用跨任务的1％至33％的重新培训数据匹配强有力的监督基线。这些结果表明，Repedis可以显着加速医学成像AI开发的生命周期，从而为医学成像AI提供了重要的一步，以产生广泛的影响。

Thin-cap fibroatheroma (TCFA) and plaque rupture have been recognized as the most frequent risk factor for thrombosis and acute coronary syndrome. Intravascular optical coherence tomography (IVOCT) can identify TCFA and assess cap thickness, which provides an opportunity to assess plaque vulnerability. We developed an automated method that can detect lipidous plaque and assess fibrous cap thickness in IVOCT images. This study analyzed a total of 4,360 IVOCT image frames of 77 lesions among 41 patients. To improve segmentation performance, preprocessing included lumen segmentation, pixel-shifting, and noise filtering on the raw polar (r, theta) IVOCT images. We used the DeepLab-v3 plus deep learning model to classify lipidous plaque pixels. After lipid detection, we automatically detected the outer border of the fibrous cap using a special dynamic programming algorithm and assessed the cap thickness. Our method provided excellent discriminability of lipid plaque with a sensitivity of 85.8% and A-line Dice coefficient of 0.837. By comparing lipid angle measurements between two analysts following editing of our automated software, we found good agreement by Bland-Altman analysis (difference 6.7+/-17 degree; mean 196 degree). Our method accurately detected the fibrous cap from the detected lipid plaque. Automated analysis required a significant modification for only 5.5% frames. Furthermore, our method showed a good agreement of fibrous cap thickness between two analysts with Bland-Altman analysis (4.2+/-14.6 micron; mean 175 micron), indicating little bias between users and good reproducibility of the measurement. We developed a fully automated method for fibrous cap quantification in IVOCT images, resulting in good agreement with determinations by analysts. The method has great potential to enable highly automated, repeatable, and comprehensive evaluations of TCFAs.

深度学习（DL）模型为各种医学成像基准挑战提供了最先进的性能，包括脑肿瘤细分（BRATS）挑战。然而，局灶性病理多隔室分割（例如，肿瘤和病变子区）的任务特别具有挑战性，并且潜在的错误阻碍DL模型转化为临床工作流程。量化不确定形式的DL模型预测的可靠性，可以实现最不确定的地区的临床审查，从而建立信任并铺平临床翻译。最近，已经引入了许多不确定性估计方法，用于DL医学图像分割任务。开发指标评估和比较不确定性措施的表现将有助于最终用户制定更明智的决策。在本研究中，我们探索并评估在Brats 2019-2020任务期间开发的公制，以对不确定量化量化（Qu-Brats），并旨在评估和排列脑肿瘤多隔室分割的不确定性估计。该公制（1）奖励不确定性估计，对正确断言产生高置信度，以及在不正确的断言处分配低置信水平的估计数，（2）惩罚导致更高百分比的无关正确断言百分比的不确定性措施。我们进一步基准测试由14个独立参与的Qu-Brats 2020的分割不确定性，所有这些都参与了主要的Brats细分任务。总体而言，我们的研究结果证实了不确定性估计提供了分割算法的重要性和互补价值，因此突出了医学图像分析中不确定性量化的需求。我们的评估代码在HTTPS://github.com/ragmeh11/qu-brats公开提供。

模型的可解释性对于许多实际应用是必不可少的，例如临床决策支持系统。在本文中，提出了一种新的可解释机学习方法，可以模拟人类理解规则中的输入变量与响应之间的关系。该方法是通过将热带几何形状应用于模糊推理系统构建的，其中通过监督学习可以发现可变编码功能和突出规则。进行了使用合成数据集的实验，以研究所提出的算法在分类和规则发现中的性能和容量。此外，将所提出的方法应用于鉴定心力衰竭患者的临床应用，这些患者将受益于心脏移植或耐用的机械循环支撑等先进的疗法。实验结果表明，该网络在分类任务方面取得了很大的表现。除了从数据集中学习人类可理解的规则外，现有的模糊域知识可以很容易地转移到网络中，并用于促进模型培训。从我们的结果，所提出的模型和学习现有领域知识的能力可以显着提高模型的概括性。所提出的网络的特征使其在需要模型可靠性和理由的应用中承诺。

The recent increase in public and academic interest in preserving biodiversity has led to the growth of the field of conservation technology. This field involves designing and constructing tools that utilize technology to aid in the conservation of wildlife. In this article, we will use case studies to demonstrate the importance of designing conservation tools with human-wildlife interaction in mind and provide a framework for creating successful tools. These case studies include a range of complexities, from simple cat collars to machine learning and game theory methodologies. Our goal is to introduce and inform current and future researchers in the field of conservation technology and provide references for educating the next generation of conservation technologists. Conservation technology not only has the potential to benefit biodiversity but also has broader impacts on fields such as sustainability and environmental protection. By using innovative technologies to address conservation challenges, we can find more effective and efficient solutions to protect and preserve our planet's resources.

A Digital Twin (DT) is a simulation of a physical system that provides information to make decisions that add economic, social or commercial value. The behaviour of a physical system changes over time, a DT must therefore be continually updated with data from the physical systems to reflect its changing behaviour. For resource-constrained systems, updating a DT is non-trivial because of challenges such as on-board learning and the off-board data transfer. This paper presents a framework for updating data-driven DTs of resource-constrained systems geared towards system health monitoring. The proposed solution consists of: (1) an on-board system running a light-weight DT allowing the prioritisation and parsimonious transfer of data generated by the physical system; and (2) off-board robust updating of the DT and detection of anomalous behaviours. Two case studies are considered using a production gas turbine engine system to demonstrate the digital representation accuracy for real-world, time-varying physical systems.