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  1. Puyol Anton, E ; Pop, M ; Sermesant, M ; Campello, V ; Lalande, A ; Lekadir, K ; Suinesiaputra, A ; Camara, O ; Young, A (Ed.)
    Cardiac cine magnetic resonance imaging (CMRI) is the reference standard for assessing cardiac structure as well as function. However, CMRI data presents large variations among different centers, vendors, and patients with various cardiovascular diseases. Since typical deep-learning-based segmentation methods are usually trained using a limited number of ground truth annotations, they may not generalize well to unseen MR images, due to the variations between the training and testing data. In this study, we proposed an approach towards building a generalizable deep-learning-based model for cardiac structure segmentations from multi-vendor,multi-center and multi-diseases CMRI data. We used a novel combination of image augmentation and a consistency loss function to improve model robustness to typical variations in CMRI data. The proposed image augmentation strategy leverages un-labeled data by a) using CycleGAN to generate images in different styles and b) exchanging the low-frequency features of images from different vendors. Our model architecture was based on an attention-gated U-Net model that learns to focus on cardiac structures of varying shapes and sizes while suppressing irrelevant regions. The proposed augmentation and consistency training method demonstrated improved performance on CMRI images from new vendors and centers. When evaluated using CMRI data from 4 vendors and 6 clinical center, our method was generally able to produce accurate segmentations of cardiac structures. 
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  4. Computational fluid dynamics (CFD) is increasingly used to study blood flows in patient-specific arteries for understanding certain cardiovascular diseases. The techniques work quite well for relatively simple problems but need improvements when the problems become harder when (a) the geometry becomes complex (eg, a few branches to a full pulmonary artery), (b) the model becomes more complex (eg, fluid-only to coupled fluid-structure interaction), (c) both the fluid and wall models become highly nonlinear, and (d) the computer on which we run the simulation is a supercomputer with tens of thousands of processor cores. To push the limit of CFD in all four fronts, in this paper, we develop and study a highly parallel algorithm for solving a monolithically coupled fluid-structure system for the modeling of the interaction of the blood flow and the arterial wall. As a case study, we consider a patient-specific, full size pulmonary artery obtained from computed tomography (CT) images, with an artificially added layer of wall with a fixed thickness. The fluid is modeled with a system of incompressible Navier-Stokes equations, and the wall is modeled by a geometrically nonlinear elasticity equation. As far as we know, this is the first time the unsteady blood flow in a full pulmonary artery is simulated without assuming a rigid wall. The proposed numerical algorithm and software scale well beyond 10 000 processor cores on a supercomputer for solving the fluid-structure interaction problem discretized with a stabilized finite element method in space and an implicit scheme in time involving hundreds of millions of unknowns. 
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  5. Simulation of blood flows in the pulmonary artery provides some insight into certain diseases by examining the relationship between some continuum metrics, e.g., the wall shear stress acting on the vascular endothelium, which responds to flow-induced mechanical forces by releasing vasodilators/constrictors. V. Kheyfets, in his previous work, studies numerically a patient-specific pulmonary circulation to show that decreasing wall shear stress is correlated with increasing pulmonary vascular impedance. In this paper, we develop a scalable parallel algorithm based on domain decomposition methods to investigate an unsteady model with patient-specific pulsatile waveforms as the inlet boundary condition. 
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  6. Nonlinear fluid–structure interaction (FSI) problems on unstructured meshes in 3D appear in many applications in science and engineering, such as vibration analysis of aircrafts and patient-specific diagnosis of cardiovascular diseases. In this work, we develop a highly scalable, parallel algorithmic and software framework for FSI problems consisting of a nonlinear fluid system and a nonlinear solid system, that are coupled monolithically. 
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