Twist-Net: A multi-modality transfer learning network with the hybrid bilateral encoder for hypopharyngeal cancer segmentation

Hypopharyngeal cancer (HPC) is a rare disease. Therefore, it is a challenge to automatically segment HPC tumors and metastatic lymph nodes (HPC risk areas) from medical images with the small-scale dataset. Combining low-level details and high-level semantics from feature maps in different scales can improve the accuracy of segmentation. Herein, we propose a Multi-Modality Transfer Learning Network with Hybrid Bilateral Encoder (Twist-Net) for Hypopharyngeal Cancer Segmentation. Specifically, we propose a Bilateral Transition (BT) block and a Bilateral Gather (BG) block to twist (fuse) high-level semantic feature maps and low-level detailed feature maps. We design a block with multi-receptive field extraction capabilities, M Block, to capture multi-scale information. To avoid overfitting caused by the small scale of the dataset, we propose a transfer learning method that can transfer priors experience from large computer vision datasets to multi-modality medical imaging datasets. Compared with other methods, our method outperforms other methods on HPC dataset, achieving the highest Dice of 82.98%. Our method is also superior to other methods on two public medical segmentation datasets, i.e., the CHASE_DB1 dataset and BraTS2018 dataset. On these two datasets, the Dice of our method is 79.83% and 84.87%, respectively. The code is available at: https://github.com/zhongqiu1245/TwistNet.

Case Report: Thalidomide in the treatment of complicated central nervous system tuberculosis

Central nervous system tuberculosis (CNSTB) is the most fatal type of tuberculosis (TB). Early administration of glucocorticoids can improve the prognosis of CNSTB patients and reduce mortality; however, some CNSTB patients do not respond well to anti-tuberculosis drugs and glucocorticoids. As an immunomodulatory drug, Thalidomide has been used under such circumstances. We retrospectively reviewed the drug to describe its clinical characteristics, efficacy, and safety in the treatment of four complicated CNSTB patients who responded well to thalidomide. Thalidomide may be an effective and well-tolerated drug for the treatment of CNSTB, and therefore requires further study.

Analysis of the directivity of longitudinal waves based on double-fold coil phased EMAT

Longitudinal critically refracted (LCR) waves have already been widely applied for residual stress characterization. Such waves are usually generated using mode-conversion at the first critical angle of the incident longitudinal wave, which gives waves that then propagate at a dip-angle, and this places energy close to the surface of the specimen. The dip-angle needs to be minimized to improve both velocity measurement and residual stress characterization sensitivity. This paper reports a novel double-fold coil phased EMAT that can decrease the dip-angle. The performance of this new EMAT was investigated using both a COMSOL model and experiments. Initial model validation was provided through a comparison with experimental data. The EMAT design also enables scanning of samples, and operation in harsh environments where use of a PZT based transducer and couplants can complicate and limit inspection. The use of the EMAT has the potential to give more accurate time of flight (TOF) data and enhances the reliability and accuracy for residual stress measurement.

SS-31 Modification Inhibits the Proinflammatory Effect on Macrophages Induced by Superparamagnetic Iron Oxide Nanoparticles

Superparamagnetic iron oxide nanoparticles can induce macrophage polarization into the proinflammatory M1-type. This adverse effect is very likely to restrict the applications of superparamagnetic iron oxide nanoparticles in various inflammatory medical conditions. To inhibit the proinflammatory effect, the mitochondrial-targeted antioxidant peptide SS-31 was physically adsorbed on superparamagnetic iron oxide nanoparticles to develop superparamagnetic iron oxide nanoparticles@SS-31. The macrophages (RAW 264.7) were incubated with superparamagnetic iron oxide nanoparticles or superparamagnetic iron oxide nanoparticles@SS-31 at a concentration of 50 μg Fe3O4/mL for 24 hours. Compared to the superparamagnetic iron oxide nanoparticles group, the superparamagnetic iron oxide nanoparticles@SS-31 group demonstrated significantly reduced cell damage, as evidenced by the inhibition of cell viability loss, early cell apoptosis and the production of reactive oxygen species. Moreover, the proinflammatory factor TNF-α and M1-type cell surface markers CD86 and CD80 were significantly downregulated in the superparamagnetic iron oxide nanoparticles@SS-31 group as shown by enzyme-linked immunosorbent assay and flow cytometric analysis. Notably, compared with the superparamagnetic iron oxide nanoparticles group, levels of the anti-inflammatory factors IL-10, TGF-β and the M2-type cell surface marker CD163 were markedly upregulated in the superparamagnetic iron oxide nanoparticles@SS-31 group. In addition, severe disruption of the mitochondrial ultrastructure was observed by transmission electron microscopy in the superparamagnetic iron oxide nanoparticles group, but the superparamagnetic iron oxide nanoparticles@SS-31 group displayed structurally intact mitochondria. All of these results suggest that superparamagnetic iron oxide nanoparticles can promote macrophage M1-type polarization by inducing oxidative stress and mitochondrial damage, while superparamagnetic iron oxide nanoparticles@SS-31 can significantly inhibit superparamagnetic iron oxide nanoparticles-induced toxicity by releasing SS-31 to exert mitochondrial-targeted antioxidant and anti-inflammatory effects, indicating that the strategy of coloading the SS-31 peptide into superparamagnetic iron oxide nanoparticles has the potential to alleviate superparamagnetic iron oxide nanoparticles-induced proinflammatory effects.

CCS-Net: Cascade Detection Network with the Convolution Kernel Switch Block and Statistics Optimal Anchors Block in Hypopharyngeal Cancer MRI

Magnetic resonance imaging (MRI) is a common diagnostic method for hypopharyngeal cancer (HPC). It is a challenge to automatically detect HPC tumors and swollen lymph nodes (HPC risk areas) from MRI slices because of the small size and irregular shape of HPC risk areas. Herein, we propose a cascade detection network with Convolution Kernel Switch (CKS) Block and Statistics Optimal Anchors (SOA) Block in HPC MRI (CCS-Net). CKS Block can adaptively switch standard convolution to deformable convolution in some appropriate layers to detect irregular objects more efficiently without taking up too much computing resources. SOA Block can automatically generate the optimal anchors based on the size distribution of objects. Compared with other methods, our method achieves splendid detection performance and outperforms other methods on the HPC dataset (more than 1800 T2 MRI slices), achieving the highest AP₅₀ of 78.90%. Experiments show that the proposed network can be the basis of a computer aided diagnosis utility that helps achieve faster and more accurate diagnostic decisions for HPC.

Analysis of the directivity of Longitudinal Critically Refracted (LCR) waves

The use of ultrasonic longitudinal critically refracted (LCR) waves is one approach used for near surface material characterization. It has been shown to be sensitive to stress and, in general, less sensitive to the effects of the texture of the material. Although the LCR wave is increasingly widely applied, in experiments the factors that influence the formation of the LCR beam are seldom discussed. This paper reports a new numerical model used to investigate the transducers' parameters that can contribute to the directionality of the LCR wave and hence enable performance optimization when used for industrial applications. An orthogonal experimental method is used to study the sensitivity to the transducer parameters which influence the LCR wave beam characteristics. This method provides a design tool used to study and optimize multiple parameter experiments and it can identify which parameter or parameters are of most significance. The effects of incident angle, the aperture and the center frequency of the transducer were all studied. It is shown that the aperture of the transducer, the center frequency and the incident angle are the most important factors in controlling the directivity of the resulting LCR wave fields. The model was validated by comparision of data to those obtained with a finite element model. Experiments were also performed to confirm the numerical results. The model and experimental data provided improve understanding of the transducer selection and positioning in the optimization of LCR wave fields in experiments, which can be used to give signals which exhibit higher sensitivity for near-surface stress characterization.

Untargeted GC/TOFMS unravel metabolic profiles in cerebrospinal fluid of Chinese people living with HIV

Background

Metabolic syndrome becomes a focus of clinical cares to people living with HIV (PLHIV) globally. This study aimed to explore the metabolic profiles in cerebrospinal fluid (CSF) of Chinese people living with HIV (PLHIV).

Methods

Cerebrospinal fluid samples from PLHIV and healthy controls were collected from our hospital. Then, the metabolic profiles of CSFs were analyzed PLHIV with healthy individual as the normal controls using the untargeted GC/TOFMS. Following this, kyoto encyclopedia of genes and genomes annotation and pathway analysis were performed to further explore the underlying mechanism of these metabolic alterations in cognitive impairment of PLHIV.

Results

Both PCA analysis and OPLS‐DA had presented that most samples were localized in 95% CI and the gap between control and HIV could significantly separate from each other. Upon this quality control, a total of 82 known metabolites were identified in CSF between PLHIV and healthy controls. Clustering of these metabolites presented that these differentially expressed metabolites could markedly distinguish HIV from healthy controls. Further pathway analyses showed that TCA cycle (citric acid, fumaric acid, lactate, et al.), amino acid (arginine, proline, alanine, aspartate, glutamine, et al.), lipid (cholesterol, butyrate, et al.) metabolisms were significantly changed in CSF of PLHIV, which might affect the cognitive status of PLHIV via affecting neuron energy support, signaling transduction, and neuroinflammation.

Conclusion

Metabolic profiles were significantly altered in CSF and might play key roles in the etiology of cognitive impairment of PHLIV. Further explore the exact mechanism for these metabolic changes might be useful for cognitive impairment management of PHLIV.

Thalidomide in the treatment of human immunodeficiency virus-negative tuberculous meningitis: A case report

INTRODUCTION

Tuberculous meningitis (TBM) is the most fatal type of tuberculosis in which corticosteroids are added with antitubercular therapy to prevent permanent brain damage. However, this treatment may produce paradoxical reactions. In such cases, thalidomide use might reduce central nervous system inflammation and improve the outcome. We present the case of a human immunodeficiency virus-negative patient with TBM who developed paradoxical reactions manifesting as multiple intracranial tuberculomas that were resistant to standard care (antitubercular drugs and corticosteroids) but responded well to thalidomide.

PATIENT'S MAIN CONCERN AND CLINICAL FINDINGS

The patient was a 40-year-old Chinese female, who was admitted with a 10-day history of headaches, night sweats, and cough. She was healthy before contracting the infection and had no history of contact with tuberculosis patients.

DIAGNOSES, INTERVENTION, AND OUTCOME

We diagnosed the patient with TBM complicated by the occurrence of pulmonary tuberculosis. Positive results were obtained from Gram and Ziehl-Neelsen staining of the sputum and acid-fast bacilli sputum culture. Standard treatment was initiated with antitubercular drugs (daily isoniazid, rifampicin, ethionamide, and pyrazinamide) and corticosteroids (dexamethasone). However, 3 months later the magnetic resonance imaging of the head revealed some new tuberculoma lesion. Thus, a specific therapy of antitubercular drugs and thalidomide was introduced. On completion of a 12-month course of antitubercular drugs with 2 months of thalidomide, the patient showed favorable outcomes without neurologic sequelae. Moreover, thalidomide appeared safe and well tolerated in the patient.

CONCLUSION

In addition to the specific anti-tubercular and adjuvant corticosteroid therapies for TBM, thalidomide can be used as a "salvage" antitubercular drug in cases that are unresponsive to corticosteroids.

Pharmacologic ascorbate as a pro-drug for hydrogen peroxide release to kill mycobacteria

BACKGROUND AND PURPOSE

Tuberculosis is one of the most highly fatal diseases worldwide, and one-third of the world's population has been infected with Mycobacterium tuberculosis (M. tuberculosis). A previous study showed that M. tuberculosis was highly susceptible to being killed by ascorbate (i.e. vitamin C, VC), but the molecular mechanisms of the bactericidal activity of VC against M. tuberculosis are still not well understood.

EXPERIMENTAL APPROACH

We assayed the effects of VC as an anti-tuberculosis drug against mycobacteria (i.e. M. bovis BCG or M. tuberculosis H37Rv) in macrophages (i.e. RAW 264.7 cells). Relative global protein expression changes in 5 mM VC-treated and control samples of H37Rv were investigated by Tandem mass tag (TMT)-based quantitative proteomic analysis. qRT-PCR was also used to measure the differential expression of six intracellular stress response mycobacteria genes.

KEY RESULTS

Quantitative proteomic analysis showed that 11 peptide components including rip3, fdxA, Rv2028c, mtp, LH57_00670, hspX, pfkB, Rv1824, Rv1813c, LH57_08410 and Rv2030c were up-regulated and 17 peptide components were down-regulated in 5 mM VC-treated H37Rv compared with the control samples. qRT-PCR also verified that VC could induce the expression of six genes (hsp, fdxD, furA, devR, hspX, and dnaB) in BCG and H37Rv. We also found that exosomes from RAW 264.7 cells treated with pharmacologic VC could kill M. bovis BCG in vitro.

CONCLUSION AND IMPLICATIONS

Our results demonstrated that the bactericidal activity of VC against mycobacteria, as a pro-drug for hydrogen peroxide formation (H₂O₂), was dependent on reactive oxygen species production and the activated oxidative stress pathway, which suggested that pharmaceutical VC and exosomes from macrophages treated with VC could be used as potential anti-tuberculosis drugs.

Uniform magnetic targeting of magnetic particles attracted by a new ferromagnetic biological patch

A new non-toxic ferromagnetic biological patch (MBP) was designed in this paper. The MBP consisted of two external layers that were made of transparent silicone, and an internal layer that was made of a mixture of pure iron powder and silicon rubber. Finite-element analysis showed that the local inhomogeneous magnetic field (MF) around the MBP was generated when MBP was placed in a uniform MF. The local MF near the MBP varied with the uniform MF and shape of the MBP. Therefore, not only could the accumulation of paramagnetic particles be adjusted by controlling the strength of the uniform MF, but also the distribution of the paramagnetic particles could be improved with the different shape of the MBP. The relationship of the accumulation of paramagnetic particles or cells, magnetic flux density, and fluid velocity were studied through in vitro experiments and theoretical considerations. The accumulation of paramagnetic particles first increased with increment in the magnetic flux density of the uniform MF. But when the magnetic flux density of the uniform MF exceeded a specific value, the magnetic flux density of the MBP reached saturation, causing the accumulation of paramagnetic particles to fall. In addition, the adsorption morphology of magnetic particles or cells could be improved and the uniform distribution of magnetic particles could be achieved by changing the shape of the MBP. Also, MBP may be used as a new implant to attract magnetic drug carrier particles in magnetic drug targeting. Bioelectromagnetics. 39:98-107, 2018. © 2017 Wiley Periodicals, Inc.

Comparison of acoustoelastic Lamb wave propagation in stressed plates for different measurement orientations

High order Lamb waves are investigated for the effects of stress on both symmetrical and anti-symmetrical modes in an aluminum plate for wave propagation and load parallel. Data are compared with those for the case of load and measurement axis perpendicular. It is the S₁ mode which exhibits significantly higher sensitivity to stress than other Lamb modes. For aluminum the use of the S₁ mode for stress measurement is found to be about six times more sensitive, than bulk waves, for the load-measurement axes parallel case and this compares with about ten times for the case of load-measurement axes perpendicular.

Higher order acoustoelastic Lamb wave propagation in stressed plates

Modeling and experiments are used to investigate Lamb wave propagation in the direction perpendicular to an applied stress. Sensitivity, in terms of changes in velocity, for both symmetrical and anti-symmetrical modes was determined. Codes were developed based on analytical expressions for waves in loaded plates and they were used to give wave dispersion curves. The experimental system used a pair of compression wave transducers on variable angle wedges, with set separation, and variable frequency tone burst excitation, on an aluminum plate 0.16 cm thick with uniaxial applied loads. The loads, which were up to 600 με, were measured using strain gages. Model results and experimental data are in good agreement. It was found that the change in Lamb wave velocity, due to the acoustoelastic effect, for the S₁ mode exhibits about ten times more sensitive, in terms of velocity change, than the traditional bulk wave measurements, and those performed using the fundamental Lamb modes. The data presented demonstrate the potential for the use of higher order Lamb modes for online industrial stress measurement in plate, and that the higher sensitivity seen offers potential for improved measurement systems.

Aggregation process of paramagnetic particles in fluid in the magnetic field

Magnetic targeting is a promising therapeutic strategy for localizing systemically delivered magnetic responsive drugs or cells to target tissue, but excessive aggregation of magnetic particles could result in vascular embolization. To analyze the reason for embolization, the attractive process of magnetic particles in magnetic field (MF) was studied in this paper by analyzing the form of the aggregated paramagnetic particles while the particle suspension flowed through a tube, which served as a model of blood vessels. The effects of magnetic flux density and fluid velocity on the formation of aggregated paramagnetic particles were investigated. The number of large aggregated clusters dramatically increased with increment in the magnetic flux density and decreased with increment in the fluid velocity. The analysis of accumulative process demonstrates the MF around initially attracted particles was focused, which induced the formation of clusters and increased the possibility of embolism. Bioelectromagnetics. 37:323-330, 2016. © 2016 Wiley Periodicals, Inc.

Comparison of Magnetic Intensities for Mesenchymal Stem Cell Targeting Therapy on Ischemic Myocardial Repair: High Magnetic Intensity Improves Cell Retention but Has no Additional Functional Benefit

Magnetic targeting has the potential to enhance the therapeutic effects of stem cells through increasing retention of transplanted cells. To investigate the effects of magnetic targeting intensities on cell transplantation, we performed different magnetic intensities for mesenchymal stem cell (MSC)-targeting therapy in a rat model of ischemia/reperfusion. Rat MSCs labeled with superparamagnetic oxide nanoparticles (SPIOs) were injected into the left ventricular (LV) cavity of rats during a brief aorta and pulmonary artery occlusion. The 0.15 Tesla (T), 0.3 T, and 0.6 T magnets were placed 0∼1 mm above the injured myocardium during and after the injection of 1 × 10(6) MSCs. Fluorescence imaging and quantitative PCR revealed that magnetic targeting enhanced cell retention in the heart at 24 h in a magnetic field strength-dependent manner. Compared with the 0 T group, three magnetic targeting groups enhanced varying cell engraftment at 3 weeks, at which time LV remodeling was maximally attenuated, and the therapeutic benefit (LV ejection fraction) was also highest in the 0.3 T groups. Interestingly, due to the low MSC engraftment resulting from microvascular embolisms, the 0.6 T group failed to translate into additional therapeutic outcomes, though it had the highest cell retention. Magnetic targeting enhances cell retention in a magnetic field strength-dependent manner. However, too high of a magnetic intensity may result in microembolization and consequently undermine the functional benefits of cell transplantation.

Magnetic targeting enhances retrograde cell retention in a rat model of myocardial infarction

Introduction

Retrograde coronary venous infusion is a promising delivery method for cellular cardiomyoplasty. Poor cell retention is the major obstacle to the establishment of this method as the preferred route for cell delivery. Here, we explored whether magnetic targeting could enhance retrograde cell retention in a rat model of myocardial infarction.

Methods

Rat mesenchymal stem cells were labeled with superparamagnetic oxide nanoparticles. The magnetic responsiveness of MSCs was observed while cells flowed through a tube that served as a model of blood vessels in a 0.6-Tesla magnetic field. In a Sprague–Dawley rat model of acute myocardial infarction, 1 × 10⁶ magnetic mesenchymal stem cells were transjugularly injected into the left cardiac vein while a 0.6-Tesla magnet was placed above the heart. The cardiac retention of transplanted cells was assessed by using quantitative Y chromosome-specific polymerase chain reaction, cardiac magnetic resonance imaging, and optical imaging. Cardiac function was measured by using echocardiography, and histologic analyses of infarct morphology and angiogenesis were obtained.

Results

The flowing iron oxide-labeled mesenchymal stem cells were effectively attracted to the area where the magnet was positioned. Twenty-four hours after cellular retrocoronary delivery, magnetic targeting significantly increased the cardiac retention of transplanted cells by 2.73- to 2.87-fold. Histologic analyses showed that more transplanted cells were distributed in the anterior wall of the left ventricle. The enhanced cell engraftment persisted for at least 3 weeks, at which time, left ventricular remodeling was attenuated, and cardiac function benefit was improved.

Conclusions

These results suggest that magnetic targeting offers new perspectives for retrograde coronary venous delivery to enhance cell retention and subsequent functional benefit in heart diseases.

Ion solvation and association in LiClO4/sulfolane solution: a vibrational spectroscopic and molecular orbital study

Solvation interaction and ion association in solutions of lithium perchlorate/sulfolane have been studied by using infrared and Raman spectra as a function of concentration of lithium perchlorate. The band changes of antisymmetric OSO stretch, antisymmetric CSC stretch, -SO2 wag and twist suggest that there is an interaction between Li+ and sulfolane molecules, and the site of solvation is the oxygen atom of -SO2 group. The molecular orbital calculation supports this suggestion. On the other hand, the apparent solvation number was calculated, and the band fitting for the ClO4- band reveals the presence of contact ion pair, solvent separated ion pair and free ClO4- anion in the concentrated solutions.

A Vibrational Spectroscopic Study of Ion Solvation and Association in Lithium Perchlorate/γ-Butyrolactone Electrolyte

The Raman and infrared (IR) spectra of γ-butyrolactone (BL) containing various concentrations of LiClO

[Surface enhanced Raman scattering of thiourea in acidic solution]

Surface enhanced Raman scattering of thiourea adsorbed on the plated silver surface in an acidic solution has been studied. The results show that the thiourea molecules are inclined to adsorbed on the silver surface via sulphur. When the concentration of HCl in the solution is increased, the plane of the thiourea molecule deviates more from the normal line of the silver surface. The experimental results also suggest that the rather strong chemical enhanced mechanism would exist in this system.

Legal and ethical issues in genetic testing and counseling for susceptibility to breast, ovarian and colon cancer

The prediction of susceptibility to heritable breast, ovarian and colon cancer raises important legal and ethical concerns. Health care professionals have a duty to disclose sufficient information to enable patients to make informed decisions. They must also safeguard the confidentiality of patient data. These duties may come into conflict if a positive finding in one patient implies that family members are also at risk. A legal distinction is made between a breach of confidentiality and the legitimate sharing of information in a patient's interest or to prevent harm to a third party. Physicians also have a fiduciary duty to warn. Other issues concern the legal liability assumed by genetic counsellors, whose disclosures may influence decisions about childbearing, for example, and the risk of socioeconomic discrimination faced by people with a known genetic susceptibility. Traditional ethical orientations and principals may be applied to these and other questions, but feminist ethics will likely have particular importance in the development of an ethical stance toward testing and counseling for heritable breast and ovarian cancer.

[Ambulatory anesthesia in arthroscopy of the knee: proposal of an intravenous general anesthesia technique]

The Authors propose a technique completely i.v. for arthroscopy of the knee by means of proposal discontinuous infusion. The advantage underlined are tolerability, efficaciousness, features of awakening and a few collateral effects verified, and this leads to be conclusion that this anaesthesia system must be considered of choice in this type of surgery.