Radiomics-based distinction of small (≤2 cm) hepatocellular carcinoma and precancerous lesions based on unenhanced MRI

AIM

To assess the feasibility of a radiomics model based on unenhanced magnetic resonance imaging (MRI) to differentiate small hepatocellular carcinoma (S-HCC) (≤2 cm) and pre-hepatocellular carcinoma (Pre-HCC).

MATERIALS AND METHODS

One hundred and fourteen histopathologically confirmed 114 hepatic nodules were analysed retrospectively. All patients had undergone MRI before surgery using a 3 T MRI system. Each nodule was segmented on unenhanced MRI sequences (T1-weighted imaging [T1] and T2WI with fat-suppression [FS-T2]). Radiomics features were extracted and the optimal features were selected using the least absolute shrinkage and selection operator (LASSO). The support vector machine (SVM) was used to establish the radiomics model. One abdominal radiologist performed the conventional qualitative analysis for classification of S-HCC and Pre-HCC. The diagnostic performances of the radiomics and radiologist models were evaluated using receiver operating characteristic (ROC) analysis.

RESULT

Radiomics features (n=1,223) were extracted from each sequence and the optimal features were selected from T1, FS-T2, and T1+FS-T2 to construct the radiomics models. The radiomics model based on T1+FS-T2 showed the best performance among the three models, with areas under the ROC curves (AUCs) of 0.95 (95 % confidence interval [CI], 0.875-0.986) and 0.942 (95 % CI, 0.775-0.985), accuracies of 86 % and 88.5 %, sensitivities of 94.12 % and 100 %, and specificities of 85.48 % and 85.19 %, respectively. The radiomics model on FS-T2 showed better performance on a single sequence than that of the T1-based model. The diagnostic performance for the radiomic model was significantly higher than that for the radiologist (AUC = 0.518, p<0.05).

CONCLUSION

This study suggested that a radiomics model based on unenhanced MRI may serve as a feasible and non-invasive tool to classify S-HCC and Pre-HCC.

miR-26a-5p Attenuates Oxidative Stress and Inflammation in Diabetic Retinopathy through the USP14/NF-κB Signaling Pathway

Purpose

Diabetic retinopathy (DR) is an ocular disease caused by diabetes and may lead to vision impairment and even blindness. Oxidative stress and inflammation are two key pathogenic factors of DR. Recently, regulatory roles of different microRNAs (miRNAs) in DR have been widely verified. miR-26a-5p has been confirmed to be a potential biomarker of DR. Nevertheless, the specific functions of miR-26a-5p in DR are still unclear.

Methods

Primary cultured mouse retinal Müller cells in exposure to high glucose (HG) were used to establish an in vitro DR model. Müller cells were identified via morphology observation under phase contrast microscope and fluorescence staining for glutamine synthetase. The in vivo animal models for DR were constructed using streptozotocin-induced diabetic C57BL/6 mice. Western blotting was performed to quantify cytochrome c protein level in the cytoplasm and mitochondria of Müller cells and to measure protein levels of glial fibrillary acidic protein (GFAP), ubiquitin-specific peptidase 14 (USP14), as well as factors associated with NF-κB signaling (p-IκBα, IκBα, p-p65, and p65) in Müller cells or murine retinal tissues. ROS production was detected by CM-H2DCFDA staining, and the concentration of oxidative stress markers (MDA, SOD, and CAT) was estimated by using corresponding commercial kits. Quantification of mRNA expression was conducted by RT-qPCR analysis. The concentration of proinflammatory factors (TNF-α, IL-1β, and IL-6) was evaluated by ELISA. Hematoxylin-eosin staining for murine retinal tissues was performed for histopathological analysis. Immunofluorescence staining was conducted to determine NF-κB p65 nuclear translocation in Müller cells. Furthermore, the interaction between miR-26a-5p and USP14 was verified via the luciferase reporter assays.

Results

HG stimulation contributed to Müller cell dysfunction by inducing inflammation, oxidative injury, and mitochondrial damage to Müller cells. miR-26a-5p was downregulated in Müller cells under HG condition, and overexpression of miR-26a-5p relieved HG-induced Müller cell dysfunction. Moreover, miR-26a-5p targeted USP14 and inversely regulated USP14 expression. Additionally, HG-evoked activation of NF-κB signaling was suppressed by USP14 knockdown or miR-26a-5p upregulation. Rescue assays showed that the protective impact of miR-26a-5p upregulation against HG-induced Müller cell dysfunction was reversed by USP14 overexpression. Furthermore, USP14 upregulation and activation of NF-κB signaling in the retinas of DR mice were detected in animal experiments. Injection with miR-26a-5p agomir improved retinal histopathological injury and weakened the concentration of proinflammatory cytokines and oxidative stress markers in the retinas of DR mice.

Conclusion

miR-26a-5p inhibits oxidative stress and inflammation in DR progression by targeting USP14 and inactivating the NF-κB signaling pathway.

Metastasis, characteristic, and treatment of breast cancer in young women and older women: A study from the Surveillance, Epidemiology, and End Results registration database

BACKGROUND

Younger age is an independent risk factor for breast cancer (BC) prognosis, and BC in young women is often considered more aggressive. BC patients with different age and molecular subtypes have different metastasis patterns and survival. Herein, we aim to explore the metastasis patterns, characteristics and treatment methods of young patients with BC, and to compare them with older patients.

METHODS

Data of young patients (aged ≤40 years old) and older patients (aged >40 years old) with BC were extracted from the Surveillance, Epidemiology, and End Results (SEER) registration database in 2010-2019 in this retrospective cohort study. Univariate and multivariate competing risk models and proportional hazard models were used to explore the association between different metastasis patterns and treatments and BC prognoses in young and older patients. Kaplan-Meier (KM) curves were drawn to reflect the survival probability of patients with BC who have different metastasis patterns. Also, we performed subgroup analysis of different metastasis patterns to explore the association between different treatments and overall survival (OS)/cancer specific survival (CSS) in patients with BC. The evaluation index was hazard ratios (HRs) with 95% confidence intervals (CIs).

RESULTS

Totally, 5,984 patients died, and 92.56% of them died from BC. There were respectively 1,089 young patients and 9,105 older patients, and we found some differences of characteristics and metastasis patterns between them. After adjusting for covariates, young patients who had brain metastasis and multiple sites metastasis seemed to have high risk of both lower OS and CSS. Among older patients with BC, brain metastasis, liver metastasis, and multiple sites metastasis were all positively associated with both lower OS and CSS. In young and older patients, those who not receive radiotherapy or surgery, or received non-surgery combined with radiotherapy seemed to have high risk of both lower OS and CSS. Breast-conserving surgery (BCS) and surgery combined with radiotherapy were associated with higher OS and CSS in young patients, while only older patients received surgery combined with radiotherapy had higher OS and CSS. Results of subgroup analysis indicated that for patients with different metastasis patterns, developing a personalized treatment plan is necessary.

CONCLUSIONS

Characteristics of BC between young patients and older patients were different. Clinicians should focus on different metastasis sites and choose appropriate treatments in patients with different ages, which may improve the prognoses.

Identification and quantitative evaluation of symptomatic cerebral venous thrombosis using 3D variable flip angle turbo spin echo

PURPOSE

To explore the feasibility of MR 3D T1w Sampling Perfection with Application optimized Contrasts by using different flip angle Evolutions (SPACE) sequence imaging in symptomatic CVT diagnose, extracting the imaging features with quantitative analysis.

METHODS

Fifty-nine patients with suspected CVT with neurological symptoms were retrospectively included in this study. Of them, 35 patients were enrolled in the comparation of diagnostic accuracy between the contrast-enhanced magnetic resonance venograms (CE-MRV) and 3D T1w SPACE imaging. Forty-five patients with 101 involved segments were identified for the quantitative analysis. All MR images were acquired on a 3.0 T MR scanner. The reference standard used in this study was a comprehensive combination of the imaging techniques and clinical information. CVT patients were grouped as acute (≤48 h), subacute (>48 h and ≤30d), and chronic (>30d) clinical phase. CVT segments were grouped based on pre-contrast T1WI, as type A: hypo intense signal; B: heterogeneously hyper intense signal; C: iso intense signal. The feasibility of 3D T1w SPACE imaging for diagnosing CVT was explored. Diagnostic accuracy of T1w SPACE imaging was analyzed and compared with the CE-MRV. The signal intensity of pre-contrast images (SpreCE), signal intensity of post-contrast images (SpostCE), and contrast enhancement (CE) rate, CE rate relative to that of pituitary gland (PG), white matter (WM), gray matter (GM), and normal vein vessel wall (nVVW) were compared based on both patients and segments. The CE rate grade of CVT segments of different imaging types was compared.

RESULTS

The MR 3D T1w SPACE imaging achieved a higher sensitivity and specificity (100%/94.1% and 100%/100% based on patients/segments separately) than that of the CE-MRV (73.9%/56.9% and 83.3%/98.9% based on patients/segments separately). No statistical correlation was found between the imaging types of CVT segments and onset time of clinical symptoms (χ2 = 6.649, P = 0.171). Quantitative analysis showed that the CE rate relative to PG and that to WM were higher in the chronic CVT patients than that in the other two groups (H = 10.330 and P = 0.006, H = 9.898 and P = 0.007, separately). CE rate relative to GM in the chronic group was higher than that in the subacute group (H = 7.143 and P = 0.028). All of the quantitative parameters were statistically different across CVT segments of three imaging types (all P≤0.001).

CONCLUSION

MR 3D T1w SPACE imaging has the advantage to accurately diagnose CVT of different clinical stages, and identify the involved thrombus segments.

Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]

This corrects the article DOI: 10.1103/PhysRevLett.130.031802.

In Situ Fluorescence Imaging Reveals Contribution of Cerebral Hydroxyl Radicals in Hyperhomocysteinemia-Induced Alzheimer-like Dementia

Elevated plasma level of homocysteine, also termed as hyperhomocysteinemia, is acknowledged as a significant and independent risk factor of Alzheimer's disease. However, the mechanistic insight has not been thoroughly elucidated yet. In this work, 3,5-dihydroxybenzyloxy was explored as the unique reaction trigger and integrated into the naphthalimide fluorophore via a carbamate linker to afford a new probe for ^•OH imaging. ^•OH treatment induced aromatic hydroxylation and subsequent elimination reaction to release the caged fluorophore, accompanied with a highly specific and sensitive turn-on fluorescence response. Cell imaging results revealed that excess homocysteine triggered overwhelming ^•OH production, which was mediated by N-methyl-d-aspartate receptor and NADPH oxidase, and the resultant ^•OH stress further initiated neuronal ferroptosis, also confirmed by western blot analyses. Additionally, hyperhomocysteinemic mouse models were established, and Alzheimer-like dementia of the mice was observed from behavioral tests. Most importantly, with this probe, cerebral ^•OH fluctuation was in situ visualized in live mice, which positively correlated with the severity of Alzheimer-like dementia induced by hyperhomocysteinemia. These results reveal that cerebral ^•OH stress may be the critical nexus linking hyperhomocysteinemia and Alzheimer's disease. This work provides a robust fluorescence probe for in situ visualizing the cerebral ^•OH fluctuations and illuminating critical insights into ^•OH contributions in brain disorders.

Immunized Microspheres Engineered Hydrogel Membrane for Reprogramming Macrophage and Mucosal Repair

The "double-edged sword" effect of macrophages under the influence of different microenvironments determines the outcome and prognosis of tissue injury. Accurate and stable reprogramming macrophages (Mφ) are the key to rapid wound healing. In this study, an immunized microsphere-engineered GelMA hydrogel membrane is constructed for oral mucosa treatment. The nanoporous poly(lactide-co-glycolide) (PLGA) microsphere drug delivery system combined with the photo-cross-linkable hydrogel is used to release the soybean lecithin (SL)and IL-4 complexes (SL/IL-4) sustainedly. In this way, it is realized effective wound fit, improvement of drug encapsulation, and stable triphasic release of interleukin-4 (IL-4). In both in vivo and in vitro experiments, it is demonstrated that the hydrogel membrane can reprogram macrophages in the microenvironment into M2Mφ anti-inflammatory types, thereby inhibiting the local excessive inflammatory response. Meanwhile, high levels of platelet-derived growth factor (PDGF) secreted by M2Mφ macrophages enhanced neovascular maturation by 5.7-fold, which assisted in achieving rapid healing of oral mucosa. These findings suggest that the immuno-engineered hydrogel membrane system can re-modulating the biological effects of Mφ, and potentiating the maturation of neovascularization, ultimately achieving the rapid repair of mucosal tissue. This new strategy is expected to be a safe and promising immunomodulatory biomimetic material for clinical translation.

Smart Magnetic Optical Antenna for Automatic Nanoalignment and Photon Beaming from Prepatterned Single Quantum Dot Nanospot

We present a unidirectional dielectric optical antenna, which can be chemically synthesized and controlled by magnetic fields. By applying magnetic fields, we successfully aligned an optical antenna on a prepatterned quantum dot nanospot with accuracy better than 40 nm. It confined the fluorescence emission into a 16-degree wide beam and enhanced the signal by 11.8 times. Moreover, the position of the antenna, and consequently the beam direction, can be controlled by simply adjusting the direction of the magnetic fields. Theoretical analyses show that this magnetic alignment technique is stable and accurate, providing a new strategy for building high-performance tunable nanophotonic devices.

Sub-differentiation of PI-RADS 3 lesions in TZ by advanced diffusion-weighted imaging to aid the biopsy decision process

Background

Performing biopsy for intermediate lesions with PI-RADS 3 has always been controversial. Moreover, it is difficult to differentiate prostate cancer (PCa) and benign prostatic hyperplasia (BPH) nodules in PI-RADS 3 lesions by conventional scans, especially for transition zone (TZ) lesions. The purpose of this study is sub-differentiation of transition zone (TZ) PI-RADS 3 lesions using intravoxel incoherent motion (IVIM), stretched exponential model, and diffusion kurtosis imaging (DKI) to aid the biopsy decision process.

Methods

A total of 198 TZ PI-RADS 3 lesions were included. 149 lesions were BPH, while 49 lesions were PCa, including 37 non-clinical significant PCa (non-csPCa) lesions and 12 clinical significant PCa (csPCa) lesions. Binary logistic regression analysis was used to examine which parameters could predict PCa in TZ PI-RADS 3 lesions. The ROC curve was used to test diagnostic efficiency in distinguishing PCa from TZ PI-RADS 3 lesions, while one-way ANOVA analysis was used to examine which parameters were statistically significant among BPH, non-csPCa and csPCa.

Results

The logistic model was statistically significant (χ2 = 181.410, p<0.001) and could correctly classify 89.39% of the subjects. Parameters of fractional anisotropy (FA) (p=0.004), mean diffusion (MD) (p=0.005), mean kurtosis (MK) (p=0.015), diffusion coefficient (D) (p=0.001), and distribute diffusion coefficient (DDC) (p=0.038) were statistically significant in the model. ROC analysis showed that AUC was 0.9197 (CI 95%: 0.8736-0.9659). Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 80.4%, 93.9% and 75.5%, respectively. FA and MK of csPCa were higher than those of non-csPCa (all p<0.05), while MD, ADC, D, and DDC of csPCa were lower than those of non-csPCa (all p<0.05).

Conclusion

FA, MD, MK, D, and DDC can predict PCa in TZ PI-RADS 3 lesions and inform the decision-making process of whether or not to perform a biopsy. Moreover, FA, MD, MK, D, DDC, and ADC may have ability to identify csPCa and non-csPCa in TZ PI-RADS 3 lesions.

Measurement of the ν_{e}-Nucleus Charged-Current Double-Differential Cross Section at ⟨E_{ν}⟩=2.4 GeV Using NOvA

The inclusive electron neutrino charged-current cross section is measured in the NOvA near detector using 8.02×10^{20} protons-on-target in the NuMI beam. The sample of GeV electron neutrino interactions is the largest analyzed to date and is limited by ≃17% systematic rather than the ≃7.4% statistical uncertainties. The double-differential cross section in final-state electron energy and angle is presented for the first time, together with the single-differential dependence on Q^{2} (squared four-momentum transfer) and energy, in the range 1  GeV≤E_{ν}<6  GeV. Detailed comparisons are made to the predictions of the GENIE, GiBUU, NEUT, and NuWro neutrino event generators. The data do not strongly favor a model over the others consistently across all three cross sections measured, though some models have especially good or poor agreement in the single differential cross section vs Q^{2}.

Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande

We report a search for cosmic-ray boosted dark matter with protons using the 0.37  megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1  MeV/c^{2} to 300  MeV/c^{2}.

Radiomics signatures based on contrast-enhanced CT for preoperative prediction of the Ki-67 proliferation state in gastrointestinal stromal tumors

PURPOSE

This study aimed to evaluate the Ki-67 proliferation state in patients with gastrointestinal stromal tumors (GISTs) using radiomics prediction signatures based on contrast-enhanced computed tomography (CE-CT).

MATERIALS AND METHODS

This single-center, retrospective study involved 103 patients (48 men and 55 women, mean age 61.1 ± 10.6 years) who had pathologically confirmed GISTs after curative resection, including 63 with low Ki-67 proliferation level (Ki-67 labeling index ≤ 6%) and 40 with high Ki-67 proliferation level (Ki-67 labeling index > 6%). Radiomics features of the delineated lesions were preoperatively extracted from three-phase CE-CT images, including the arterial, venous, and delayed phases. The most relevant features were selected to construct the radiomics signatures using a logistic regression algorithm. Significant demographic characteristics and semantic features on CT were selected to develop a nomogram along with the optimal radiomics feature. We calculated the sensitivity, specificity, accuracy, F1 score, and area under the receiver operating characteristic (ROC) curve to evaluate the predictive performance of radiomics signatures.

RESULTS

Ten quantitative radiomics features (two first-order and eight texture features) were selected to construct radiomics signatures. The radiomics signature based on the three-phase CE-CT images showed better predictive performance than that based on the single-phase CE-CT images, with an area under the curve (AUC) of 0.83 (95% CI 0.73-0.92) and F1 score of 82% in the training dataset and an AUC of 0.80 (95% CI 0.63-0.95) and F1 score of 75% in the testing dataset. The nomogram showed good calibration.

CONCLUSION

Radiomics signatures using CE-CT images are generalizable and could be used in clinical practice to determine the proliferation state of Ki-67 in GISTs.

CalliSpheres® microsphere transarterial chemoembolization combined with 125I brachytherapy for patients with non–small‐cell lung cancer liver metastases

Objective

Poor prognosis and limited treatments of liver metastases from non–small‐cell lung cancer (NSCLC) after radical surgery are critical issues. The current study aimed to evaluate the efficacy and safety of CalliSpheres^® microsphere transarterial chemoembolization (CSM-TACE) plus ¹²⁵I brachytherapy in these patients.

Methods

A total of 23 patients with liver metastases from NSCLC after radical surgery were included. All patients received CSM-TACE 1–3 times, then ¹²⁵I brachytherapy was carried out following the last CSM-TACE. Complete response (CR), objective response rate (ORR), disease control rate (DCR), survival, and adverse events were evaluated.

Results

CR, ORR and DCR were 43.5%, 87.0%, and 100%, respectively, at three months; furthermore, they were 78.3%, 100%, and 100% accordingly at six months. Moreover, most European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) subscales of functions (including physical and emotional function) and symptoms (including pain, nausea, and vomiting) were generally improved at three months (all P < 0.05). Furthermore, median progression-free survival (PFS) was 14.0 [95% confidence interval (CI): 10.4–17.6] months, with a 1-year PFS rate of 62.9%, but the 2-year PFS rate was not reached. Moreover, the median overall survival (OS) was 22.0 (95% CI: 16.8–27.2) months, with a 1-year OS rate of 91.3% and a 2-year OS rate of 43.5%. Additionally, the main adverse events included fever (100%), pain (65.2%), liver function impairment (65.2%), fatigue (56.5%), and nausea and vomiting (52.2%), which were all categorized as grade 1–2.

Conclusion

CSM-TACE plus ¹²⁵I brachytherapy is effective and safe in patients with liver metastases from NSCLC after radical surgery, providing a potentially optimal option in these patients.

Early changes in peripheral blood cytokine levels after the treatment of metastatic hepatic carcinoma with CalliSpheres microspheres drug-eluting beads transcatheter arterial chemoembolization

Objective

To observe the early changes in peripheral blood cytokine levels after treatment of metastatic hepatic carcinoma (MHC) with CalliSpheres microspheres drug-eluting beads (DEB) transcatheter arterial chemoembolization (CSM-TACE).

Methods

Twenty-eight patients with refractory MHC who underwent CSM-TACE were selected prospectively, and 5mL of peripheral blood was collected before CSM-TACE and on the 2nd and 5th day after CSM-TACE. Flow cytometry was used to detect immunological indicators. The early changes in levels of peripheral blood cell inflammatory factors Th1 (interleukin 2 (IL-2), tumor necrosis factor-α (TNF-a), interferon (IFN-r)), Th2 (IL-4, IL-6, IL-10), and Th17 (IL-17A) were observed after CSM-TACE, as well as the ratio of CD4+/CD8+.

Results

All the 28 patients underwent CSM-TACE successfully. CT at 4 days after CSM-TACE showed clear outline low-density changes in liver tumors, and honeycomb necrosis was observed in the tumors in some cases. After CSM-TACE, the IL-6 and IL-10 levels were increased and then decreased again. After CSM-TACE, IL-2 showed a trend of transient increase and then decreased again, and the TNF-a level decreased temporarily, and then decreased. After CSM-TACE, the IFN-r level showed a continuous and slowly increasing trend. The IL-17 level showed a continuous downward trend, and the CD4+/CD8+ ratio showed a gradual and continuous upward trend, and there was a negative correlation between them.

Conclusions

There are complex dynamic changes in TH1/Th2 in the early stage of CSM-TACE, and the acute inflammatory response and the enhancement of the body’s immune anti-tumor response coexist.

Photocontrollable Fluorescence Imaging of Mitochondrial Peroxynitrite during Ferroptosis with High Fidelity

Ferroptosis, a new regulatory cell death modality, underlies the pathogenesis of a broad range of disorders. Although much efforts have been made to uncover the molecular mechanisms, some mechanistic details of ferroptosis still remain poorly understood. Particularly, the functional relevance of mitochondrial reactive oxygen species (ROS) in ferroptosis is still highly controversial, which is partially due to the fact that it still remains puzzled how the mitochondrial ROS level varies during ferroptosis. The conventional mitochondria-targeted probes may react with cytosolic ROS and show fluorescence variation before entering mitochondria, thus probably giving a false result on the mitochondrial ROS level and leading to the misjudgment on its biofunction. To circumvent this issue, we rationally designed a photocontrollable and mitochondria-targeted fluorescent probe to in situ visualize the mitochondrial peroxynitrite (ONOO^-), which is the ROS member and mediator of ferroptosis. The photoactivated probe was endowed with a highly specific and sensitive fluorescence response to ONOO^-. Notably, the response activity could be artificially regulated with light irradiation, which ensured that all the probe molecules passed through the cytosol in the locked status and were then photoactivated after reaching mitochondria. This photocontrolled fluorescence imaging strategy eliminated the interference of ONOO^- outside the mitochondria, thus potentially afforded improved fidelity for mitochondrial ONOO^- bioimaging in live cells and animal models. With this probe, for the first time, we revealed the mitochondrial ONOO^- flux and its probable biological source during erastin-induced ferroptosis. These results suggest a tight correlation between mitochondrial ONOO^-/ROS and ferroptotic progression, which will further facilitate the comprehensive exploration and manipulation of ferroptosis.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Assessment of efficacy and prognostic factors by Gelfoam for DEB-TACE in unresectable large hepatocellular carcinoma with portal vein tumor thrombus: a multi-center retrospective study

OBJECTIVE

To explore the clinical efficacy and prognostic factors of the use of Gelfoam for drug-eluting bead (DEB) transarterial chemoembolization (GMD-TACE) in patients with unresectable large hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

METHODS

A retrospective analysis was conducted using the mRECIST standard to evaluate tumor response after GMD-TACE. Overall survival time, median survival time, time to progression (TTP) after the first intervention, and other treatment methods were recorded.

RESULTS

The follow-up time was 2-110 months (mean 17.97 + 19.12 months), the median follow-up time was 12.5 months, and the first TTP after the first GMD-TACE was 4 months (95% CI 3.020-4.980). The median overall survival (OS) time was 14 months (95% CI 9.801-18.199). The 1-, 3-, and 5-year survival rates were 53.6%, 32.3%, and 8.9%, respectively. Multivariate analysis showed that the type of tumor thrombus was an independent factors affecting prognosis, and combination therapy was a protective factor affecting prognosis.

CONCLUSIONS

GMD-TACE can be used as the core treatment for unresectable large HCC combined with a PVTT. This can improve the quality of life and further improve the median OS, and is worthy of clinical promotion and application.

Polarization-dispersive imaging spectrometer for scattering circular dichroism spectroscopy of single chiral nanostructures

Circular dichroism spectroscopy is one of the most important tools in nanoscopic chiroptics. However, there is lack of simple, fast and reliable method for measuring the circular dichroism responses of single nanostructures. To tackle this issue, we report a polarization-dispersive imaging spectrometer which is capable of measuring the scattering circular dichroism response of a single chiral nanostructure with a single shot. Using this technique, we studied the scattering circular dichroism spectra of a model system, the vertically coupled plasmonic nanorod pair. Both experimental and theoretical results indicate that the polarization-dispersive spectrometer measures the imaginary part of nonlocal susceptibility of the structure. We further applied the technique to 3-dimensional Au nanorod structures assembled on DNA origami templates together with correlated scanning electron microscopic measurements. Rich chiroptical phenomena were unveiled at the single nanostructure level.

Clinical application of gelatin sponge microparticles-transcatheter arterial chemoembolization combined with synchronous antigen-presenting dendritic cell sequential reinfusion for treatment of advanced large liver cancer: A single-center, prospective, non-randomized, controlled trial

To assess the clinical efficacy and safety of gelatin sponge microparticles-transcatheter arterial chemoembolization (GSMs-TACE) plus synchronous antigen-presenting dendritic cell (DC) sequential reinfusion for advanced large liver cancer (LC).Patients with large LC were assigned to the experimental (combined sequential DC therapy) or control group. All patients received standardized GSMs-TACE. In the experimental group, 60 mL of peripheral blood was collected for in vitro culture of DCs (10-14 days). Then, intravenous reinfusion was conducted 3 times within 10, 20, and 30 days after surgery. Adverse reactions during the treatment were recorded and evaluated. The overall survival, transcatheter arterial chemoembolization frequency, and physical score (PS) were calculated.The median survival time of the experimental group was significantly longer than that of the control group. There were significant differences in median progression-free survival between the 2 groups (P < .05) and the objective effective rate at 1 and 6 months and 1 year (P < .05), but not 2 years (P > .05). The PSs of 2 groups were significantly improved at 1 month after GSMs-TACE, with more obvious improvement in the experimental group (P < .05).GSMs-TACE plus synchronous DC sequential reinfusion significantly prolonged the median survival time, improved the tumor response rate and PS, prolonged progression-free survival, and reduced intervention frequency. GSMs-TACE plus synchronous DC sequential reinfusion treatment is suitable for comprehensive treatment of patients with advanced larger LC in China.

Mechanical Shunt Resonators-Based Piezoelectric Metamaterial for Elastic Wave Attenuation

The conventional piezoelectric metamaterials with operational-amplifier-based shunt circuits have limited application due to the voltage restriction of the amplifiers. In this research, we report a novel piezoelectric metamaterial beam that takes advantage of mechanical shunt resonators. The proposed metamaterial beam consisted of a piezoelectric beam and remote mechanical piezoelectric resonators coupled with electrical wires. The local resonance of the remote mechanical shunt resonators modified the mechanical properties of the beam, yielding an elastic wave attenuation capability. A finite-length piezoelectric metamaterial beam and mechanical shunt resonators were considered for conceptual illustration. Significant elastic wave attenuation can be realized in the vicinity of the resonant frequency of the shunt resonators. The proposed system has the potential in the application of wave attenuation under large-amplitude excitations.

Bacteria-engineered porous sponge for hemostasis and vascularization

Background

Hemostasis and repair are two essential processes in wound healing, yet early hemostasis and following vascularization are challenging to address in an integrated manner.

Results

In this study, we constructed a hemostatic sponge OBNC-DFO by fermentation of Komagataeibacterxylinus combined with TEMPO oxidation to obtain oxidized bacterial nanocellulose (OBNC). Then angiogenetic drug desferrioxamine (DFO) was grafted through an amide bond, and it promoted clot formation and activated coagulation reaction by rapid blood absorption due to the high total pore area (approximately 42.429 m2/g measured by BET). The further release of DFO stimulated the secretion of HIF-1α and the reconstruction of blood flow, thus achieving rapid hemostasis and vascularization in damaged tissue. This new hemostatic sponge can absorb water at a rate of approximate 1.70 g/s, rapidly enhancing clot formation in the early stage of hemostasis. In vitro and in vivo coagulation experiments (in rat tail amputation model and liver trauma model) demonstrated superior pro-coagulation effects of OBNC and OBNC-DFO to clinically used collagen hemostatic sponges (COL). They promoted aggregation and activation of red blood cells and platelets with shorter whole blood clotting time, more robust activation of endogenous coagulation pathways and less blood loss. In vitro cellular assays showed that OBNC-DFO prevailed over OBNC by promoting the proliferation of human umbilical vein endothelial cells (HUVECs). In addition, the release of DFO enhanced the secretion of HIF-1α, further strengthening vascularization in damaged skin. In the rat skin injury model, 28 days after being treated with OBNC-DFO, skin appendages (e.g., hair follicles) became more intact, indicating the achievement of structural and functional regeneration of the skin.

Conclusion

This hemostatic and vascularization-promoting oxidized bacterial nanocellulose hemostatic sponge, which rapidly activates coagulation pathways and enables skin regeneration, is a highly promising hemostatic and pro-regenerative repair biomaterial.

Graphical Abstract

Search for Active-Sterile Antineutrino Mixing Using Neutral-Current Interactions with the NOvA Experiment

This Letter reports results from the first long-baseline search for sterile antineutrinos mixing in an accelerator-based antineutrino-dominated beam. The rate of neutral-current interactions in the two NOvA detectors, at distances of 1 and 810 km from the beam source, is analyzed using an exposure of 12.51×10^{20} protons-on-target from the NuMI beam at Fermilab running in antineutrino mode. A total of 121 of neutral-current candidates are observed at the far detector, compared to a prediction of 122±11(stat.)±15(syst.) assuming mixing only between three active flavors. No evidence for ν[over ¯]_{μ}→ν[over ¯]_{s} oscillation is observed. Interpreting this result within a 3+1 model, constraints are placed on the mixing angles θ_{24}<25° and θ_{34}<32° at the 90% C.L. for 0.05  eV^{2}≤Δm_{41}^{2}≤0.5  eV^{2}, the range of mass splittings that produces no significant oscillations at the near detector. These are the first 3+1 confidence limits set using long-baseline accelerator antineutrinos.

Clinical application of gelatin sponge microparticles combined with pirarubicin for hepatic transcatheter arterial chemoembolization in breast cancer liver metastasis treatment: results of a single-center long-term study

Objective

To retrospectively analyze the safety and long-term clinical efficacy of gelatin sponge microparticles combined with the chemotherapy drug pirarubicin for hepatic transcatheter arterial chemoembolization (GSMs-TACE) in order to treat breast cancer liver metastasis (BCLM).

Methods

Twenty-seven BCLM patients who underwent GSMs-TACE from July 2010 to July 2016 were enrolled. Tumor target blood vessels were slowly and regionally embolized with absorbable gelatin sponge particles and pirarubicin injections. Plain computed tomography (CT) scans and biochemical indexes were re-examined at 4 days after treatment, and enhanced CT scans or magnetic resonance images and biochemical indexes, 1 month later. For patients with stable tumors, the follow-up period was 2 to 3 months, and the tumor response was evaluated using Modified Response Evaluation Criteria in Solid Tumors. Adverse reactions, survival time, and prognostic factors were assessed.

Results

By October 2019, 27 patients with BCLM had undergone GSMs-TACE, with an average of 2.44 ± 1.58 treatments. The 1-, 3-, and 5-year survival rates were 62.96%, 22.22%, and 14.81%, respectively, and the mOS was 22.0 months. No serious complications, such as acute liver failure and liver abscess, had occurred. There were two cases of acute cholecystitis that recovered after symptomatic treatment. Multivariate analysis of the prognosis showed that the primary tumor size, number of metastatic lymph nodes, estrogen receptor/progesterone receptor (ER/PR) status, and time to postoperative liver metastasis and combination therapy were statistically significant.

Conclusions

The overall prognosis of BCLM was poor. GSMs-TACE was safe and effective for BCLM treatment and could prolong the median survival time of patients. Therefore, it is worthy of widespread clinical application.

Overall diagnostic accuracy of different MR imaging sequences for detection of dysplastic nodules: a systematic review and meta-analysis

OBJECTIVE

To assess the overall diagnostic accuracy of different MR imaging sequences in the detection of the dysplastic nodule (DN).

METHODS

PubMed, Cochrane Library, and Web of Science were systematically searched. Study selection and data extraction were conducted by two authors independently. Quality assessment of diagnostic accuracy studies (QUADAS) 2 in RevMan software was used to score the included studies and assess their methodological quality. A random-effects model was used for statistical pooling by Meta-Disc. Subgroup analysis and sensitivity analysis were used to explore potential sources of heterogeneity.

RESULTS

Fourteen studies (335 DN lesions in total) were included in our meta-analysis. The area under the curve (AUC) of summary receiver operating characteristic (SROC) of T₂WI was 0.87. Pooled sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of DWI were 0.81 (95%CI, 0.73-0.87), 0.90 (95%CI, 0.86-0.93), 7.04 (95%CI, 4.49-11.04), and 0.24 (95%CI, 0.17-0.33) respectively. In the arterial phase, pooled sensitivity, specificity, PLR, and NLR were 0.89 (0.84-0.93), 0.75 (0.72-0.79), 3.72 (2.51-5.51), and 0.17 (0.12-0.25), respectively. Pooled sensitivity, specificity, PLR, and NLR of the delayed phase were 0.78 (0.72-0.83), 0.60 (0.55-0.65), 2.19 (1.55-3.10), and 0.36 (0.23-0.55) separately. Pooled sensitivity, specificity, PLR, and NLR of the hepatobiliary phase were 0.77 (0.71-0.82), 0.92 (0.89-0.94), 8.74 (5.91-12.92), and 0.24 (0.14-0.41) respectively. Pooled sensitivity, specificity, and PLR were higher on DWI and hepatobiliary phase in diagnosing LGDN than HGDN.

CONCLUSION

MR sequences, particularly DWI, arterial phase, and hepatobiliary phase imaging demonstrate high diagnostic accuracy for DN.

KEY POINTS

• MRI has dramatically improved the detection and accurate diagnosis of DNs and their differentiation from hepatocellular carcinoma. • Overall diagnostic accuracy of different MRI sequences in the detection of DN has not been studied before. • Our meta-analysis demonstrates that MRI achieves a high diagnostic value for DN, especially when using DWI, arterial phase imaging, and hepatobiliary phase imaging.

Irinotecan eluting beads-transarterial chemoembolization using Callispheres® microspheres is an effective and safe approach in treating unresectable colorectal cancer liver metastases

Background

Callispheres® microspheres (CSM) are the first drug-eluting bead (DEB) product developed in China; meanwhile, DEB-transarterial chemoembolization (TACE) with CSM is effective and safe in the treatment of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, the data regarding the role of irinotecan-eluting beads-TACE (DEBIRI-TACE) using CSM for colorectal cancer liver metastases (CRLM) treatment is limited. Therefore, the present study aimed to investigate the efficacy and safety of DEBIRI-TACE using CSM in the patients with unresectable CRLM.

Methods

Totally, 42 unresectable CRLM patients treated with DEBIRI-TACE using CSM were continuously enrolled in this study. Postoperative treatment response (including complete response rate (CR), objective response rate (ORR), and disease control rate (DCR)), survival data (overall survival (OS)), liver function, and adverse events were documented during the follow-up.

Results

CR, ORR, and DCR were 19.0%, 92.9%, and 100.0%, respectively, at month (M) 1; were 23.8%, 92.9%, and 97.6%, respectively, at M3; then were 14.3%, 78.6%, and 90.5%, respectively at M6. Regarding survival profiles, 1-year OS was 81.0%; 2-year OS was 58.5%; median OS was 25.0 months (95%CI: 19.3–30.7 months). Additionally, ALT and AST experienced an obviously increased trend at 4 days, but a declined trend at 7 days, while ALB and TBIL had no obvious change. No grade 3 or grade 4 adverse event was observed, and main adverse events included fever (95.3%), pain (57.1%), fatigue (50.0%), and nausea/vomiting (42.8%).

Conclusion

DEBIRI-TACE with CSM achieves high treatment response, acceptable survival benefits, and good toleration in unresectable CRLM treatment.

Case Report: An Undefined Liver Lesion in a Young Man With Severe Aplastic Anemia: A Teachable Moment

In this work, we reported a young man complaining of asthenia and intermittent fever for 10 days, and an ultrasound showed an undefined lesion on his liver. Facing the patient's situation with severe agranulocytosis, anemia, and thrombocytopenia, we passed through a tough diagnostic process for choosing an appropriate treatment for him with an ambiguous result of pathological biopsy. The undefined liver lesion was successfully solved by withdrawing the androgen for observation, without lobectomy. The lesion gradually diminished over 2 years of follow-up.

Assessment of efficacy and safety by CalliSpheres versus HepaSpheres for drug-eluting bead transarterial chemoembolization in unresectable large hepatocellular carcinoma patients

This study aimed to compare efficacy and safety of HepaSpheres and CalliSpheres in unresectable large hepatocellular carcinoma (HCC) patients. One hundred and twenty-seven unresectable large HCC patients receiving drug-eluting bead transarterial chemoembolization (DEB-TACE) treatment with CalliSpheres or HepaSpheres microspheres were analyzed. Treatment response, Karnofsky performance status (KPS) score, adverse events, main liver function indexes, time to progression (TTP), and overall survival (OS) were analyzed. Objective response rate (82.7% vs. 63.8%, p=.030) and disease control rate (100.0% vs. 91.5%, p=.030) were increased in CalliSpheres group compared to HepaSpheres group at 1 month after treatment, while no difference was found between the two groups regarding treatment response at 3 or 6 months post treatment (all p>.05). The KPS score at 1, 3, and 6 months was similar between the two groups (all p>.05). As for the liver function, the ALT, AST, ALB, and TBIL levels at 7 and 30 days were of no difference between the two groups (all p>.05). In addition, the adverse events including nausea/vomiting, pain, fever, myelosuppression, biloma, and abscess were of no difference between the two groups, either (all p>.05). In terms of survival profile, there was no difference regarding TTP (6.3 months (95%CI: 5.9-6.6 months) vs. 6.0 months (95%CI: 5.6-6.4 months), p=.082) or OS (23.0 months (95%CI: 20.1-25.9 months) vs. 22.0 months (95%CI: 20.2-23.8 months), p=.571) between the two groups. In conclusion, CalliSpheres seems to be superior in short-term efficacy and equal in long-term efficacy as well as safety compared to HepaSpheres for DEB-TACE treatment in unresectable large HCC patients.

Sensing of mercury and silver ions using branched Au nanoparticles prepared by hyperbranched polyethylenimine fabricated and capped AuNPs seeds

Branched AuNPs usually have two or more local surface plasmon resonance (LSPR) absorption bands due to their structural anisotropy, and the LSPR performance is more sensitive to the changes of environmental refractive index than that of spherical AuNPs. The design and preparation of branched AuNPs as colorimetric probes is expected to improve the selectivity and sensitivity of detection of targets. In this paper, branched AuNPs were innovatively synthesized via hyperbranched polyethylenimine (HPEI) fabricated and capped AuNPs as seeds and cetyltrimethylammonium bromide (CTAB) as template agent. The branched AuNPs were characterized by TEM, DLS, zeta potentials and UV-vis spectra. Using the branched AuNPs as a colorimetric probe, the detection system for Hg²⁺and Ag⁺showed bright color changes from blue to orange and blue to green based on the morphological evolution of branched AuNPs. The branched AuNPs could selectively detect Hg²⁺and Ag⁺at concentrations as low as 77 and 140 nM, respectively. Moreover, this unusual colorimetric method has been successfully used in real water samples and has great potential as a simple, rapid, sensitive and selective method for the detection of Hg²⁺and Ag⁺.

Application and significance of PiCCO monitoring technique combined with troponin I detection in fluid resuscitation of elderly patients with septic myocardial dysfunction

OBJECTIVE

This study was designed to demonstrate the predictive value of Pulse indicate Contour Cardiac Output (PiCCO) monitoring technique combined with troponin I (cTnI) detection in septic myocardial dysfunction (SMD) of the elderly.

METHODS

One hundred and nineteen elderly patients with SMD treated in our hospital from March 2016 to September 2019 were enrolled and allocated into the joint group (JG; 64 cases) for capacity management of fluid resuscitation under the guidance of PiCCO monitoring technique and cTnI detection, and the control group (CG; 55 cases) for conventional capacity management. Clinical indicators, hemodynamics, improvement of myocardial injury markers and inflammatory factors 6 h and 36 h post intervention, fluid balance 6 h, 12 h and 36 h post intervention, drug consumption (norepinephrine), treatment effect and 28-day hospitalization mortality were compared between the two groups.

RESULTS

After resuscitation, the urine volume per hour and the fluid resuscitation volume were higher while the blood lactic acid (BLA) expression was lower in JG as compared to CG. JG presented a remarkably lower central venous pressure (CVP) than CG after resuscitation, with notably higher mean arterial pressure (MAP) and central venous oxygen saturation (ScvO2). In comparison with CG, JG displayed dramatically lower cTnI and N-terminal pro-brain natriuretic peptide (NT-ProBNP) 6 h and 36 h post intervention, as well as evidently reduced interleukin-6 (IL-6), procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP). After 36 h of intervention, the fluid balance was evidently lower in JG than in CG. JG showed statistically less use of norepinephrine, less time of mechanical ventilation and ICU stay, and noticeably lower incidence of multiple organ dysfunction syndrome (MODS), as well as dramatically lower 28-day hospitalization mortality than CG post intervention.

CONCLUSIONS

PiCCO monitoring technique combined with cTnI detection is high-performing in fluid resuscitation of elderly patients with SMD, which can meliorate the myocardial function of patients, reduce medication and facilitate disease recovery.

Wavelength-dependent laser-induced dynamic nano-annealing of single plasmonic antennas

In this work, we studied the wavelength-dependent laser-induced dynamic annealing of single plasmonic nano-antennas using in situ white light spectroscopy. Unexpected back-and-forth motions of rapidly melted single nano-antennas were observed upon excitation with a 532 nm laser, while only gradual opening of nanogaps was found in the case of a 405 nm laser. Theoretical analyses indicate that the dramatic nano-annealing phenomenon was caused by a series of laser-induced multiphysical processes at the nanoscale. It not only leads to the local heating effect, but also induces complex behaviors such as self-accelerated melting, asymmetry-induced nano-photophoretic forces and optical forces. Our work demonstrates the complexity of light-matter interactions at the nanoscale, and provides new possibilities for shaping and manipulating plasmonic nanostructures.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Unexpected Coulomb Interactions in Nonpolar Solvent for Highly Efficient Nanoxerography of Perovskite Quantum Dots

In this work, an unexpected sign-dependent electrostatic assembly, also known as nanoxerography, of perovskite quantum dots was observed in nonpolar solutions. Electrical force microscope measurements showed that CsPbBr₃ quantum dots carry negative charges and tend to aggregate at the positively charged nanospots via Coulomb interactions despite that they are synthesized and dispersed in a neutral nonpolar solvent. The result was further confirmed by a statistical method developed in this work based on the Gibbs-Boltzmann distribution. More interestingly, we found that the existence of net charges is a common phenomenon for widely used oil-phase synthesized nanoparticles, including Au, Fe₂O₃, and CdSe/ZnS nanoparticles. This is contrary to the common belief and indicates the possibility of highly efficient nanoxerography for functional nanoparticles synthesized in nonpolar solvents.

Magnet-targeted delivery of bone marrow-derived mesenchymal stem cells improves therapeutic efficacy following hypoxic-ischemic brain injury

Stem cell transplantation may represent a feasible therapeutic option for the recovery of neurological function in children with hypoxic-ischemic brain injury; however, the therapeutic efficacy of bone marrow-derived mesenchymal stem cells largely depends on the number of cells that are successfully transferred to the target. Magnet-targeted drug delivery systems can use a specific magnetic field to attract the drug to the target site, increasing the drug concentration. In this study, we found that the double-labeling using superparamagnetic iron oxide nanoparticle and poly-L-lysine (SPIO-PLL) of bone marrow-derived mesenchymal stem cells had no effect on cell survival but decreased cell proliferation 48 hours after labeling. Rat models of hypoxic-ischemic brain injury were established by ligating the left common carotid artery. One day after modeling, intraventricular and caudal vein injections of 1 × 10⁵ SPIO-PLL-labeled bone marrow-derived mesenchymal stem cells were performed. Twenty-four hours after the intraventricular injection, magnets were fixed to the left side of the rats’ heads for 2 hours. Intravoxel incoherent motion magnetic resonance imaging revealed that the perfusion fraction and the diffusion coefficient of rat brain tissue were significantly increased in rats treated with SPIO-PLL-labeled cells through intraventricular injection combined with magnetic guidance, compared with those treated with SPIO-PLL-labeled cells through intraventricular or tail vein injections without magnetic guidance. Hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining revealed that in rats treated with SPIO-PLL-labeled cells through intraventricular injection under magnetic guidance, cerebral edema was alleviated, and apoptosis was decreased. These findings suggest that targeted magnetic guidance can be used to improve the therapeutic efficacy of bone marrow-derived mesenchymal stem cell transplantation for hypoxic-ischemic brain injury. This study was approved by the Animal Care and Use Committee of The Second Hospital of Dalian Medical University, China (approval No. 2016-060) on March 2, 2016.

Deterministic Assembly of Single Sub-20 nm Functional Nanoparticles Using a Thermally Modified Template with a Scanning Nanoprobe

A deterministic assembly technique for single sub-20 nm functional nanoparticles is developed based on nanostructured templates fabricated by hot scanning nanoprobes. With this technique, single nanoparticles including quantum dots, polystyrene fluorescent nanobeads, and gold nanoparticles are successfully assembled into 2D arrays with high yields. Experimental and theoretical analyses show that the key for the high yields is the hot-probe-based template fabrication technique, which creates geometrical nanotraps and modifies their surface energy simultaneously. In addition to single nanoparticle patterning, further experiments demonstrate that this technique is also capable of building complex nanostructures, such as nanoparticle clusters with well-defined shapes and heterogeneously integrated nanostructures consisting of quantum dots and silver nanowires. It opens the door to many important applications.

[Application of aldosterone/direct renin ratio before drug washout in the screening of primary aldosteronism]

Objective: To explore the cut-off point of aldosterone/direct renin ratio (ADRR) before drug washout in the screening for primary aldosteronism (PA) in the Chinese population and reduce the potential risk caused by drug washout during PA screening. Methods: Hospitalized hypertensive patients in the Hypertension Ward of Fuwai Hospital, Chinese Academy of Medical Sciences from January 2017 to October 2019 were enrolled. PA was diagnosed according to the criterion of 2016 American Guideline and 2016 Chinese Consensus for PA. The plasma aldosterone concentration (PAC), direct renin concentration (DRC) and ADRR before and after drug washout were measured. The receiver operating characteristic (ROC) curve of ADRR was drawn and the maximal Youden index was used to determine the best cut-off value. Results: A total of 542 hypertensive patients were included, with 467 patients diagnosed with essential hypertension (EHT) (297 males and 170 females), and 75 patients diagnosed with PA (51 males and 24 females). Patients with PA had higher PAC and ADRR before and after drug washout than those with EHT(150.0 (130.0, 210.0) vs 120.0 (80.0, 170.0) ng/L, 170.0 (120.0, 260.0) vs 130.0 (90.0, 180.0) ng/L; 28.9 (15.9, 63.5) vs 4.3 (1.9, 11.8) (ng/L) / (mU/L) , 55.6 (39.0, 109.0) vs 9.8 (4.5, 21.3) (ng/L) /(mU/L), all P<0.001). However, DRC of PA patients before and after washout were lower than those with EHT (4.0 (2.0, 10.0) vs 27.0 (10.0, 64.0) mU/L, 3.0 (2.0, 4.0) vs 12.2 (5.0, 27.0) mU/L, P<0.001). In EHT and PA groups, PAC and ADRR significantly increased (P=0.001, P<0.001) , but DRC significantly decreased after drug washout (all P<0.001) . The area under the ROC curve of ADRR before drug washout was 0.868 (95%CI 0.836-0.895) with the best cut-off value of 7.8 (ng/L) / (mU/L) for the screening of PA .The sensitivity and specificity was 94.7% and 66.8%, respectively, with the maximal Youden index of 0.615. Conclusion: ADRR before drug washout > 7.8 (ng/L) / (mU/L) can be used as an alternative cut-off point to screen PA when drug washout is not available.

Relationship embedding and environmental governance performance research of pollution in a mining area, China

The aim of this study was to explore the enterprises in the mining area, in the face of environmental pollution, to use relationship embedding to acquire new key knowledge from the external network, and to improve environmental governance performance. In this paper, a model between relationship embedding and environmental governance performance was established, and five main hypotheses were proposed. Luliang Mountain Area is a typical mining area in China. And this study used 310 sample datum and regression analysis to empirically test the mechanism, taking Luliang Mountain Area as an example. First, SPSS statistical software was used for reliability and validity analysis of the questionnaire, and the results showed good. Then regression analysis was performed to test the hypothesis. The results showed that relationship embedding has a significant positive impact on environmental governance performance, and enterprises in the mining area use relationship embedding to obtain key knowledge, which can enhance environmental governance performance. Internal social capital has a positive adjustment effect on the relationship between relationship embedding and knowledge acquisition. In order to control environmental pollution in the mining area, enterprises should make full use of the relationship embedding, acquire new key knowledge, improve environmental governance capacity, and improve the environmental governance performance of enterprises.

Diagnosis of Invasive Lung Adenocarcinoma Based on Chest CT Radiomic Features of Part-Solid Pulmonary Nodules: A Multicenter Study

Background Solid components of part-solid nodules (PSNs) at CT are reflective of invasive adenocarcinoma, but studies describing radiomic features of PSNs and the perinodular region are lacking. Purpose To develop and to validate radiomic signatures diagnosing invasive lung adenocarcinoma in PSNs compared with the Brock, clinical-semantic features, and volumetric models. Materials and Methods This retrospective multicenter study (https://ClinicalTrials.gov, NCT03872362) included 291 patients (median age, 60 years; interquartile range, 55-65 years; 191 women) from January 2013 to October 2017 with 297 PSN lung adenocarcinomas split into training (n = 229) and test (n = 68) data sets. Radiomic features were extracted from the different regions (gross tumor volume [GTV], solid, ground-glass, and perinodular). Random-forest models were trained using clinical-semantic, volumetric, and radiomic features, and an online nodule calculator was used to compute the Brock model. Performances of models were evaluated using standard metrics such as area under the curve (AUC), accuracy, and calibration. The integrated discrimination improvement was applied to assess model performance changes after the addition of perinodular features. Results The radiomics model based on ground-glass and solid features yielded an AUC of 0.98 (95% confidence interval [CI]: 0.96, 1.00) on the test data set, which was significantly higher than the Brock (AUC, 0.83 [95% CI: 0.72, 0.94]; P = .007), clinical-semantic (AUC, 0.90 [95% CI: 0.83, 0.98]; P = .03), volumetric GTV (AUC, 0.87 [95% CI: 0.78, 0.96]; P = .008), and radiomics GTV (AUC, 0.88 [95% CI: 0.80, 0.96]; P = .01) models. It also achieved the best accuracy (93% [95% CI: 84%, 98%]). Both this model and the model with added perinodular features showed good calibration, whereas adding perinodular features did not improve the performance (integrated discrimination improvement, -0.02; P = .56). Conclusion Separating ground-glass and solid CT radiomic features of part-solid nodules was useful in diagnosing the invasiveness of lung adenocarcinoma, yielding a better predictive performance than the Brock, clinical-semantic, volumetric, and radiomics gross tumor volume models. Online supplemental material is available for this article. See also the editorial by Nishino in this issue. Published under a CC BY 4.0 license.

Significant Day-time Ionospheric Perturbation by Thunderstorms along the West African and Congo Sector of Equatorial Region

The equatorial Congo has been recognized as the most active lightning chimney region in the Globe. Although the perturbation of tropospheric thunderstorms on the lower ionosphere has been noticed in the middle latitudes through their transient lightning electric fields or convective gravity waves, the effects on equatorial ionosphere and the horizontal extent of this perturbation remains a mystery because of the difficulties in extracting the effects due to the sporadic nature of the equatorial ionosphere. Here we present observational results showing solid evidence of deviations in ionospheric total electron content (TEC) and its direction of propagation associated with thunderstorms using the method of polynomial filtering, by utilizing the TEC measured from equatorial Global Positioning System (GPS) Receiver stations along the West African region-Congo Basin. The TEC deviations due to the thunderstorms were found to be mostly propagated in a specific direction from the point of the event, with the highest absolute peak TEC at ~±1.5 TECUs. The internal dynamics of the equatorial ionosphere have been found to be suppressed by large thunderstorm effects during the daytime, with negligible impact at night.

Preoperative CT-based radiomics combined with intraoperative frozen section is predictive of invasive adenocarcinoma in pulmonary nodules: a multicenter study

Objectives

Develop a CT-based radiomics model and combine it with frozen section (FS) and clinical data to distinguish invasive adenocarcinomas (IA) from preinvasive lesions/minimally invasive adenocarcinomas (PM).

Methods

This multicenter study cohort of 623 lung adenocarcinomas was split into training (n = 331), testing (n = 143), and external validation dataset (n = 149). Random forest models were built using selected radiomics features, results from FS, lesion volume, clinical and semantic features, and combinations thereof. The area under the receiver operator characteristic curves (AUC) was used to evaluate model performances. The diagnosis accuracy, calibration, and decision curves of models were tested.

Results

The radiomics-based model shows good predictive performance and diagnostic accuracy for distinguishing IA from PM, with AUCs of 0.89, 0.89, and 0.88, in the training, testing, and validation datasets, respectively, and with corresponding accuracies of 0.82, 0.79, and 0.85. Adding lesion volume and FS significantly increases the performance of the model with AUCs of 0.96, 0.97, and 0.96, and with accuracies of 0.91, 0.94, and 0.93 in the three datasets. There is no significant difference in AUC between the FS model enriched with radiomics and volume against an FS model enriched with volume alone, while the former has higher accuracy. The model combining all available information shows minor non-significant improvements in AUC and accuracy compared with an FS model enriched with radiomics and volume.

Conclusions

Radiomics signatures are potential biomarkers for the risk of IA, especially in combination with FS, and could help guide surgical strategy for pulmonary nodules patients.

Key Points

• A CT-based radiomics model may be a valuable tool for preoperative prediction of invasive adenocarcinoma for patients with pulmonary nodules.

• Radiomics combined with frozen sections could help in guiding surgery strategy for patients with pulmonary nodules.

Electronic supplementary material

The online version of this article (10.1007/s00330-019-06597-8) contains supplementary material, which is available to authorized users.

Association of obesity with chronic kidney disease in elderly patients with nonalcoholic fatty liver disease

BACKGROUND/AIMS

This study investigated an association between obesity and impaired renal functions in elderly patients with nonalcoholic fatty liver disease (NAFLD) and evaluated the risk factors for chronic kidney disease (CKD) in these patients.

MATERIALS AND METHODS

A cross-sectional study was performed involving 515 elderly patients (≥ 60 years old) with NAFLD. Demographics, body mass index (BMI), medical history, and laboratory parameters were compared for groups stratified by obesity (≥ 28 kg/m2) or CKD. An association between obesity and CKD was analyzed, and a multivariate logistic regression analysis was conducted for risk factors associated with CKD.

RESULTS

In the overall population, 28.7% were obese and 54.8% had CKD; there were more women (58.8%) than men. The prevalence of hypertension and diabetes was similar between the obese and nonobese groups and between the CKD and non-CKD groups. Obese patients had significantly higher levels of serum uric acid and estimated glomerular filtration rates when compared with the nonobese group. When compared with those without CKD, patients with CKD were significantly older in addition to having higher BMI and serum uric acid levels. The multivariate logistic regression analysis indicated that CKD was positively associated with age, BMI, and serum uric acid levels.

CONCLUSION

Elderly obese patients with NAFLD are at a higher risk of CKD. NAFLD patients with advanced age, greater BMI, or higher serum uric acid levels are more prone to developing CKD. The renal function of NAFLD patients should be closely monitored.