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  1. Book: Emergency ultrasound

    Blaivas, Michael

    (Ultrasound clinics ; 9,2)

    2014  

    Author's details ed. Michael Blaivas
    Series title Ultrasound clinics ; 9,2
    Collection
    Language English
    Size XI S., S. 120 - 312 : zahlr. Ill.
    Publisher Elsevier
    Publishing place Philadelpha, Pa. u.a.
    Publishing country United States
    Document type Book
    HBZ-ID HT018263876
    ISBN 978-0-323-29020-3 ; 0-323-29020-5
    Database Catalogue ZB MED Medicine, Health

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  2. Book ; Online: Emergency Medicine : An International Perspective

    Blaivas, Michael

    2012  

    Keywords Psychotherapy ; Accident & emergency medicine
    Size 1 electronic resource (234 pages)
    Publisher IntechOpen
    Document type Book ; Online
    Note English ; Open Access
    HBZ-ID HT021049918
    ISBN 9789535169161 ; 9535169165
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  3. Article: Machine learning algorithm using publicly available echo database for simplified "visual estimation" of left ventricular ejection fraction.

    Blaivas, Michael / Blaivas, Laura

    World journal of experimental medicine

    2022  Volume 12, Issue 2, Page(s) 16–25

    Abstract: Background: Left ventricular ejection fraction calculation automation typically requires complex algorithms and is dependent of optimal visualization and tracing of endocardial borders. This significantly limits usability in bedside clinical ... ...

    Abstract Background: Left ventricular ejection fraction calculation automation typically requires complex algorithms and is dependent of optimal visualization and tracing of endocardial borders. This significantly limits usability in bedside clinical applications, where ultrasound automation is needed most.
    Aim: To create a simple deep learning (DL) regression-type algorithm to visually estimate left ventricular (LV) ejection fraction (EF) from a public database of actual patient echo examinations and compare results to echocardiography laboratory EF calculations.
    Methods: A simple DL architecture previously proven to perform well on ultrasound image analysis, VGG16, was utilized as a base architecture running within a long short term memory algorithm for sequential image (video) analysis. After obtaining permission to use the Stanford EchoNet-Dynamic database, researchers randomly removed approximately 15% of the approximately 10036 echo apical 4-chamber videos for later performance testing. All database echo examinations were read as part of comprehensive echocardiography study performance and were coupled with EF, end systolic and diastolic volumes, key frames and coordinates for LV endocardial tracing in csv file. To better reflect point-of-care ultrasound (POCUS) clinical settings and time pressure, the algorithm was trained on echo video correlated with calculated ejection fraction without incorporating additional volume, measurement and coordinate data. Seventy percent of the original data was used for algorithm training and 15% for validation during training. The previously randomly separated 15% (1263 echo videos) was used for algorithm performance testing after training completion. Given the inherent variability of echo EF measurement and field standards for evaluating algorithm accuracy, mean absolute error (MAE) and root mean square error (RMSE) calculations were made on algorithm EF results compared to Echo Lab calculated EF. Bland-Atlman calculation was also performed. MAE for skilled echocardiographers has been established to range from 4% to 5%.
    Results: The DL algorithm visually estimated EF had a MAE of 8.08% (95%CI 7.60 to 8.55) suggesting good performance compared to highly skill humans. The RMSE was 11.98 and correlation of 0.348.
    Conclusion: This experimental simplified DL algorithm showed promise and proved reasonably accurate at visually estimating LV EF from short real time echo video clips. Less burdensome than complex DL approaches used for EF calculation, such an approach may be more optimal for POCUS settings once improved upon by future research and development.
    Language English
    Publishing date 2022-03-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2764849-7
    ISSN 2220-315X
    ISSN 2220-315X
    DOI 10.5493/wjem.v12.i2.16
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A Tale of Undiagnosed Coronavirus Disease 2019 and Continued Disabling Exertional Dyspnea in a Previously Healthy and Active Patient.

    Blaivas, Michael

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

    2020  Volume 40, Issue 10, Page(s) 2251–2253

    MeSH term(s) COVID-19 ; Dyspnea/etiology ; Exercise Test ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2020-12-03
    Publishing country England
    Document type Letter
    ZDB-ID 604829-8
    ISSN 1550-9613 ; 0278-4297
    ISSN (online) 1550-9613
    ISSN 0278-4297
    DOI 10.1002/jum.15590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Unexpected finding of myocardial depression in 2 healthy young patients with COVID-19 pneumonia: possible support for COVID-19-related myocarditis.

    Blaivas, Michael

    Journal of the American College of Emergency Physicians open

    2020  Volume 1, Issue 4, Page(s) 375–378

    Abstract: COVID-19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point-of-care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of COVID-19 ... ...

    Abstract COVID-19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point-of-care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of COVID-19 acute care patients. However, relatively little attention has been paid to POCUS utility in assessing the heart in COVID-19 patients. Anecdotal reports suggest encounters of likely COVID-19 induced pericardial effusions and myocardial electrical dysfunction. This article presents 2 cases of generally healthy patients who were noted to have classic COVID-19 bilateral pneumonia findings on lung ultrasound and incidentally discovered to have unsuspected left ventricular dysfunction likely resulting from myocarditis. POCUS videos are presented as illustrations of this potentially overlooked complication.
    Keywords covid19
    Language English
    Publishing date 2020-06-13
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas.

    Carvalho, Nuno / Blaivas, Michael / Caroselli, Costantino

    Acta medica portuguesa

    2024  Volume 37, Issue 1, Page(s) 42–45

    Abstract: Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and ... ...

    Abstract Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. A total of three puncture attempts were performed until arterial blood was collected. Roughly two weeks upon observation, the patient was readmitted to the emergency department after the insidious appearance of a painful swelling in the left wrist, with progressive worsening since hospital discharge. On physical examination, a painful erythematous pulsatile swelling in the left wrist's volar aspect was observed, and further point-of-care ultrasound evaluation documented a cysticlike collection, communicating with the radial artery's lumen, and suggesting the probable diagnosis of iatrogenic radial pseudoaneurysm. The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications.
    MeSH term(s) Female ; Humans ; Aged, 80 and over ; Radial Artery/diagnostic imaging ; Aneurysm, False/etiology ; Aneurysm, False/surgery ; Punctures/adverse effects ; Ultrasonography ; Pain ; Dyspnea
    Language English
    Publishing date 2024-01-03
    Publishing country Portugal
    Document type Case Reports ; Journal Article
    ZDB-ID 603078-6
    ISSN 1646-0758 ; 0870-399X
    ISSN (online) 1646-0758
    ISSN 0870-399X
    DOI 10.20344/amp.19697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Bedside Ultrasound to Identify and Predict Severity of Dysphagia Following Ischemic Stroke: Human Versus Artificial Intelligence.

    Barron, Keith / Blaivas, Michael / Blaivas, Laura / Sadler, John / Deal, Isadora

    Ultrasound in medicine & biology

    2023  Volume 50, Issue 1, Page(s) 99–104

    Abstract: Objective: Dysphagia is a significant ischemic stroke complication that can lead to aspiration. Identification of at-risk patients can be logistically difficult and costly. Researchers investigated whether quantitative ultrasound assessment of hyoid ... ...

    Abstract Objective: Dysphagia is a significant ischemic stroke complication that can lead to aspiration. Identification of at-risk patients can be logistically difficult and costly. Researchers investigated whether quantitative ultrasound assessment of hyoid bone movement during induced swallowing would predict failure of videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallowing (FEES), as determined by a penetration-aspiration scale (PAS) score. Additionally, ability of a machine learning (ML) algorithm to predict PAS success or failure from real-time ultrasound video recordings was assessed.
    Methods: A prospective, single-blinded, observational pilot study was conducted from June 2019 through March 2020 at a comprehensive stroke center on a convenience sample of patients admitted with diagnosis of acute ischemic stroke undergoing VFS or FEES as part of dysphagia assessment. Researchers performed a midsagittal airway ultrasound during swallowing in patients receiving an objective swallowing assessment by speech language pathologists who were blinded to ultrasound results. Sonologists measured hyoid bone movement, and researchers then constructed an ML algorithm designed for real-time video analysis using a long short-term memory network with an embedded VGG16 convolutional neural network.
    Results: Videos from 69 patients were obtained with their respective PAS results. In total, 90% of available videos were used for algorithm training. After training, the ML algorithm was challenged with the 10% previously unseen videos and then compared with PAS outcomes. Statistical analysis included logistic regression and correlation matrix testing on human ultrasound measurements. Cohen's κ was calculated to compare deep learning algorithm prediction with PAS results. Measurement of hyoid bone elevation, forward displacement, total displacement and mandible length was unable to predict PAS assessment outcome (p values = 0.36, 0.13, 0.11 and 0.32, respectively). The ML algorithm showed substantial agreement with PAS testing results for predicting test outcome (κ = 0.79; 95% confidence interval: 0.52-1.0) CONCLUSION: Manual ultrasound measurement of hyoid movement during swallowing in stroke patients failed to predict PAS swallowing results. However, an ML algorithm showed substantial agreement with PAS results despite a small data set, which could greatly improve access to dysphagia assessment in the future.
    MeSH term(s) Humans ; Deglutition Disorders/etiology ; Deglutition Disorders/complications ; Ischemic Stroke/complications ; Artificial Intelligence ; Prospective Studies ; Deglutition ; Stroke/complications ; Stroke/diagnostic imaging
    Language English
    Publishing date 2023-10-18
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2023.09.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Unexpected finding of myocardial depression in 2 healthy young patients with COVID‐19 pneumonia

    Michael Blaivas

    Journal of the American College of Emergency Physicians Open, Vol 1, Iss 4, Pp 375-

    possible support for COVID‐19‐related myocarditis

    2020  Volume 378

    Abstract: Abstract COVID‐19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point‐of‐care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of ... ...

    Abstract Abstract COVID‐19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point‐of‐care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of COVID‐19 acute care patients. However, relatively little attention has been paid to POCUS utility in assessing the heart in COVID‐19 patients. Anecdotal reports suggest encounters of likely COVID‐19 induced pericardial effusions and myocardial electrical dysfunction. This article presents 2 cases of generally healthy patients who were noted to have classic COVID‐19 bilateral pneumonia findings on lung ultrasound and incidentally discovered to have unsuspected left ventricular dysfunction likely resulting from myocarditis. POCUS videos are presented as illustrations of this potentially overlooked complication.
    Keywords COVID‐19 ; point‐of‐care ultrasound ; emergency medicine ; myocarditis ; COVID‐19 pneumonia ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Subject code 610
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Are Convolutional Neural Networks Trained on ImageNet Images Wearing Rose-Colored Glasses?: A Quantitative Comparison of ImageNet, Computed Tomographic, Magnetic Resonance, Chest X-Ray, and Point-of-Care Ultrasound Images for Quality.

    Blaivas, Laura / Blaivas, Michael

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

    2020  Volume 40, Issue 2, Page(s) 377–383

    Abstract: Objectives: Deep learning for medical imaging analysis uses convolutional neural networks pretrained on ImageNet (Stanford Vision Lab, Stanford, CA). Little is known about how such color- and scene-rich standard training images compare quantitatively to ...

    Abstract Objectives: Deep learning for medical imaging analysis uses convolutional neural networks pretrained on ImageNet (Stanford Vision Lab, Stanford, CA). Little is known about how such color- and scene-rich standard training images compare quantitatively to medical images. We sought to quantitatively compare ImageNet images to point-of-care ultrasound (POCUS), computed tomographic (CT), magnetic resonance (MR), and chest x-ray (CXR) images.
    Methods: Using a quantitative image quality assessment technique (Blind/Referenceless Image Spatial Quality Evaluator), we compared images based on pixel complexity, relationships, variation, and distinguishing features. We compared 5500 ImageNet images to 2700 CXR, 2300 CT, 1800 MR, and 18,000 POCUS images. Image quality results ranged from 0 to 100 (worst). A 1-way analysis of variance was performed, and the standardized mean-difference effect size value (d) was calculated.
    Results: ImageNet images showed the best image quality rating of 21.7 (95% confidence interval [CI], 0.41) except for CXR at 13.2 (95% CI, 0.28), followed by CT at 35.1 (95% CI, 0.79), MR at 31.6 (95% CI, 0.75), and POCUS at 56.6 (95% CI, 0.21). The differences between ImageNet and all of the medical images were statistically significant (P ≤ .000001). The greatest difference in image quality was between ImageNet and POCUS (d = 2.38).
    Conclusions: Point-of-care ultrasound (US) quality is significantly different from that of ImageNet and other medical images. This brings considerable implications for convolutional neural network training with medical images for various applications, which may be even more significant in the case of US images. Ultrasound deep learning developers should consider pretraining networks from scratch on US images, as training techniques used for CT, CXR, and MR images may not apply to US.
    MeSH term(s) Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Spectroscopy ; Neural Networks, Computer ; Point-of-Care Systems ; Tomography, X-Ray Computed ; X-Rays
    Language English
    Publishing date 2020-08-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 604829-8
    ISSN 1550-9613 ; 0278-4297
    ISSN (online) 1550-9613
    ISSN 0278-4297
    DOI 10.1002/jum.15413
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Unexpected finding of myocardial depression in 2 healthy young patients with COVID‐19 pneumonia

    Blaivas, Michael

    Journal of the American College of Emergency Physicians Open

    possible support for COVID‐19‐related myocarditis

    2020  Volume 1, Issue 4, Page(s) 375–378

    Keywords covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    ISSN 2688-1152
    DOI 10.1002/emp2.12098
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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