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Deng C, Xie Y, Liu F, Tang X, Fan L, Yang X, Chen Y, Zhou Z, Li X. Simplified integration of optimal self-management behaviors is associated with improved HbA1c in patients with type 1 diabetes. J Endocrinol Invest 2024:10.1007/s40618-024-02357-8. [PMID: 38602658 DOI: 10.1007/s40618-024-02357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/04/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE Living with type 1 diabetes requires burdensome and complex daily diabetes self-management behaviors. This study aimed to determine the association between integrated behavior performance and HbA1c, while identifying the behavior with the most significant impact on HbA1c. METHODS A simple and feasible questionnaire was used to collect diabetes self-management behavior in patients with type 1 diabetes (n = 904). We assessed six dimensions of behavior performance: continuous glucose monitor (CGM) usage, frequent glucose testing, insulin pump usage, carbohydrate counting application, adjustment of insulin doses, and usage of apps for diabetes management. We evaluated the association between these behaviors and HbA1c. RESULTS In total, 21.3% of patients performed none of the allotted behavior, while 28.5% of patients had a total behavior score of 3 or more. 63.6% of patients with a behavior score ≥ 3 achieved HbA1c goal, contrasting with only 30.4% of patients with a behavior score of 0-1. There was a mean 0.54% ± 0.05% decrease in HbA1c for each 1-unit increase in total behavior score after adjustment for age, family education and diabetes duration. Each behavior was independently correlated with a lower HbA1c level, with CGM having the most significant effect on HbA1c levels. CONCLUSIONS Six optimal self-management behaviors, especially CGM usage, were associated with improved glycemic control, emphasizing the feasibility of implementing a simplified version of DSMES in the routine clinical care. REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT03610984.
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Affiliation(s)
- C Deng
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Y Xie
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - F Liu
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - X Tang
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - L Fan
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - X Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Y Chen
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Z Zhou
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - X Li
- Department of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China.
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Li J, Yang Y, Xia Y, Luo S, Lin J, Xiao Y, Li X, Huang G, Yang L, Xie Z, Zhou Z. Effect of SIRT1 gene single-nucleotide polymorphisms on susceptibility to type 1 diabetes in a Han Chinese population. J Endocrinol Invest 2024; 47:819-826. [PMID: 37695462 DOI: 10.1007/s40618-023-02190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
AIMS SIRT1 deficiency has been associated with diabetes, and a variant of the SIRT1 gene has been found to be involved in human autoimmune diabetes; however, it is unclear whether this genetic variation exists in Han Chinese with type 1 diabetes (T1D) and whether it contributes to development of T1D. Therefore, we aimed to explore the association of the SIRT1 gene single-nucleotide polymorphisms (SNPs) rs10997866 and rs3818292 in a Han Chinese population with T1D. METHODS This study recruited 2653 unrelated Han Chinese individuals, of whom 1289 had T1D and 1364 were healthy controls. Allelic and genotypic distributions of SIRT1 polymorphisms (rs10997866 and rs3818292) were determined by MassARRAY. Basic characteristics, genotype and allele frequencies of selected SNPs were compared between the T1D patients and healthy controls. Further genotype-phenotype association analysis of the SNPs was performed on the T1D patients divided into three groups according to genotype. Statistical analyses included the chi-square test, Mann‒Whitney U test, Kruskal‒Wallis H test and logistic regression. RESULTS The allelic (G vs. A) and genotypic (GA vs. AA) distributions of SIRT1 rs10997866 were significantly different in T1D patients and healthy controls (P = 0.039, P = 0.027), and rs10997866 was associated with T1D susceptibility under dominant, overdominant and additive models (P = 0.026, P = 0.030 and P = 0.027, respectively). Moreover, genotype-phenotype association analysis showed the GG genotype of rs10997866 and the GG genotype of rs3818292 to be associated with higher titers of IA-2A (P = 0.013 and P = 0.038, respectively). CONCLUSION SIRT1 rs10997866 is significantly associated with T1D susceptibility, with the minor allele G conferring a higher risk of T1D. Moreover, SIRT1 gene rs10997866 and rs3818292 correlate with the titer of IA-2A in Han Chinese individuals with T1D.
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Affiliation(s)
- J Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Y Yang
- Department of Laboratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Y Xia
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - S Luo
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - J Lin
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Y Xiao
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - X Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - G Huang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - L Yang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Z Xie
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Z Zhou
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes, Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
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Zhou Z, Yang Y, Yang ZY, Gong W. [Progress and controversy in minimally invasive approach to radical cholecystectomy for gallbladder cancer]. Zhonghua Wai Ke Za Zhi 2024; 62:278-283. [PMID: 38432668 DOI: 10.3760/cma.j.cn112139-20231215-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Surgical treatment is one of the most important forms of treatment in patients with gallbladder cancer. With the development of minimally invasive technology, the feasibility, safety and efficacy of minimally invasive approaches such as laparoscopic or robotic-assisted radical cholecystectomy for gallbladder cancer have received continuous attention.For patients with an early T-stage (Tis or T1a), laparoscopic simple cholecystectomy is safe and economical, with a good prognosis for postoperative patients, and it has been widely accepted and performed. Radical resection of advanced gallbladder cancer requires resection of the gallbladder, its liver bed, and other neighboring invaded organs, as well as clearance of regional lymph nodes, which requires experienced gallbladder cancer treatment teams to strictly grasp the indications, select appropriate patients, and formulate a good surgical strategy to ensure the therapeutic effect. Meanwhile, robot-assisted radical resection for gallbladder cancer has been performed in a few centers and shows good clinical potential, but more high-quality studies are needed to further evaluate its value in gallbladder cancer treatment.
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Affiliation(s)
- Z Zhou
- Department of General Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Y Yang
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai Research Center of Tract Disease, Research Institute of Biliary Tract Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Z Y Yang
- Department of General Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - W Gong
- Department of General Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Li S, Tsui PH, Wu W, Wu S, Zhou Z. Ultrasound k-nearest neighbor entropy imaging: Theory, algorithm, and applications. Ultrasonics 2024; 138:107256. [PMID: 38325231 DOI: 10.1016/j.ultras.2024.107256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
Ultrasound information entropy is a flexible approach for analyzing ultrasound backscattering. Shannon entropy imaging based on probability distribution histograms (PDHs) has been implemented as a promising method for tissue characterization and diagnosis. However, the bin number affects the stability of entropy estimation. In this study, we introduced the k-nearest neighbor (KNN) algorithm to estimate entropy values and proposed ultrasound KNN entropy imaging. The proposed KNN estimator leveraged the Euclidean distance between data samples, rather than the histogram bins by conventional PDH estimators. We also proposed cumulative relative entropy (CRE) imaging to analyze time-series radiofrequency signals and applied it to monitor thermal lesions induced by microwave ablation (MWA). Computer simulation phantom experiments were conducted to validate and compare the performance of the proposed KNN entropy imaging, the conventional PDH entropy imaging, and Nakagami-m parametric imaging in detecting the variations of scatterer densities and visualizing inclusions. Clinical data of breast lesions were analyzed, and porcine liver MWA experiments ex vivo were conducted to validate the performance of KNN entropy imaging in classifying benign and malignant breast tumors and monitoring thermal lesions, respectively. Compared with PDH, the entropy estimation based on KNN was less affected by the tuning parameters. KNN entropy imaging was more sensitive to changes in scatterer densities and performed better visualizable capability than typical Shannon entropy (TSE) and Nakagami-m parametric imaging. Among different imaging methods, KNN-based Shannon entropy (KSE) imaging achieved the higher accuracy in classification of benign and malignant breast tumors and KNN-based CRE imaging had larger lesion-to-normal contrast when monitoring the ablated areas during MWA at different powers and treatment durations. Ultrasound KNN entropy imaging is a potential quantitative ultrasound approach for tissue characterization.
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Affiliation(s)
- Sinan Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
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Zhao JW, Hou YC, Yang ZY, Zhou Z, Gong W. [Genome-wide Mendelian randomization study of the pathogenic role of gut microbiota in benign biliary tract diseases]. Zhonghua Wai Ke Za Zhi 2024; 62:216-222. [PMID: 38291637 DOI: 10.3760/cma.j.cn112139-20230714-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Objective: To investigate the causal relationship between intestinal flora and benign biliary diseases by genome-wide Mendelian randomization. Methods: This is a retrospective observational study. The data from the genome-wide association study of the gut microbiota from 18 340 samples from the MiBioGen consortium were selected as the exposure group,and the data from the genome-wide association study of biliary tract diseases were obtained from the FinnGen consortium R8 as the outcome group. There were 1 491 cases of primary sclerosing cholangitis,32 894 cases of cholelithiasis,3 770 cases of acalculous cholecystitis,and 34 461 cases of cholecystitis. Single nucleotide polymorphisms were screened as instrumental variables,and the Mendelian randomization method was used to infer the causal relationship between exposures and outcomes. The inverse variance weighting method (IVW) was used as the main basis, supplemented by heterogeneity,pleiotropy and sensitivity tests. Results: Coprococcus 2 was associated with a reduced risk of cholelithiasis (IVW OR=0.88,95%CI:0.80 to 0.97,P=0.012) and cholecystitis (IVW OR=0.88,95%CI:0.80 to 0.97,P=0.011). Coprococcus 3 was associated with cholelithiasis (IVW OR=1.15,95%CI:1.02 to 1.30,P=0.019) and acalculous cholecystitis(IVW OR=1.48, 95%CI: 1.08 to 2.04,P=0.016) and cholecystitis (IVW OR=1.17, 95%CI: 1.02 to 1.33, P=0.020). Peptococcus was associated with an increased risk of cholelithiasis (IVW OR=1.08, 95%CI:1.02 to 1.13, P=0.005) and cholecystitis (IVW CI=1.07, 95%CI:1.02 to 1.13,P=0.010). Clostridiumsensustricto 1 was associated with an increased risk of cholelithiasis (IVW OR=1.16,95%CI:1.02 to 1.31, P=0.020) and cholecystitis (IVW OR=1.16, 95%CI:1.03 to 1.30, P=0.015). Eubacterium hallii was associated with an increased risk of primary sclerosing cholangitis (IVW OR=1.43, 95%CI: 1.03 to 1.99, P=0.033). Eubacterium ruminantium (IVW OR=0.87, 95%CI: 0.76 to 1.00, P=0.043) and Methanobrevibacter (IVW OR=0.81, 95%CI: 0.68 to 0.98, P=0.027) were associated with a reduced risk of acalculous cholecystitis. Conclusions: Eight intestinal bacterial genera maybe play pathogenic roles in benign biliary diseases. Eubacterium hallii can increase the risk of primary sclerosing cholangitis. Peptococcus and Clostridiumsensustricto 1 can increase the risk of cholelithiasis and generalized cholecystitis. Coprococcus 3 have multiple correlations with biliary stones and inflammation.
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Affiliation(s)
- J W Zhao
- Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Biliary Tract Disease Research; Research Institute of Biliary Tract Disease;Shanghai Research Center of Tract Disease,Shanghai 200092,China
| | - Y C Hou
- Department of Cardiovascular Surgery,the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Z Y Yang
- Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Biliary Tract Disease Research; Research Institute of Biliary Tract Disease;Shanghai Research Center of Tract Disease,Shanghai 200092,China
| | - Z Zhou
- Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Biliary Tract Disease Research; Research Institute of Biliary Tract Disease;Shanghai Research Center of Tract Disease,Shanghai 200092,China
| | - W Gong
- Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Biliary Tract Disease Research; Research Institute of Biliary Tract Disease;Shanghai Research Center of Tract Disease,Shanghai 200092,China
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Xiao H, Fang W, Lin M, Zhou Z, Fei H, Chen C. [A multiscale carotid plaque detection method based on two-stage analysis]. Nan Fang Yi Ke Da Xue Xue Bao 2024; 44:387-396. [PMID: 38501425 PMCID: PMC10954526 DOI: 10.12122/j.issn.1673-4254.2024.02.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE To develop a method for accurate identification of multiscale carotid plaques in ultrasound images. METHODS We proposed a two-stage carotid plaque detection method based on deep convolutional neural network (SM-YOLO).A series of algorithms such as median filtering, histogram equalization, and Gamma transformation were used to preprocess the dataset to improve image quality. In the first stage of the model construction, a candidate plaque set was built based on the YOLOX_l target detection network, using multiscale image training and multiscale image prediction strategies to accommodate carotid artery plaques of different shapes and sizes. In the second stage, the Histogram of Oriented Gradient (HOG) features and Local Binary Pattern (LBP) features were extracted and fused, and a Support Vector Machine (SVM) classifier was used to screen the candidate plaque set to obtain the final detection results. This model was compared quantitatively and visually with several target detection models (YOLOX_l, SSD, EfficientDet, YOLOV5_l, Faster R-CNN). RESULTS SM-YOLO achieved a recall of 89.44%, an accuracy of 90.96%, a F1-Score of 90.19%, and an AP of 92.70% on the test set, outperforming other models in all performance indicators and visual effects. The constructed model had a much shorter detection time than the Faster R-CNN model (only one third of that of the latter), thus meeting the requirements of real-time detection. CONCLUSION The proposed carotid artery plaque detection method has good performance for accurate identification of carotid plaques in ultrasound images.
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Affiliation(s)
- H Xiao
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - W Fang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - M Lin
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Z Zhou
- Guangzhou Shangyi Network Information Technology Co., Ltd., Guangzhou 510515, China
| | - H Fei
- Guangdong Provincial People's Hospital Affiliated to Southern Medical University, Guangzhou 510180, China
| | - C Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
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Liu J, Zhou Z, Zhang X, Huang L, Luo Z, Chen S, Zhang Y, Li S. [Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2024; 35:545-556. [PMID: 38413015 DOI: 10.16250/j.32.1374.2023176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. METHODS A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. RESULTS The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators "external environment", "internal support" and "comprehensive control" were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator "external environment", the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator "internal support", the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator "comprehensive control", the weight was 16.67% for each indicator. CONCLUSIONS An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.
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Affiliation(s)
- J Liu
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
- Co-first authors
| | - Z Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- Co-first authors
| | - X Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
| | - L Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Z Luo
- Beijing Center for Disease Control and Prevention, China
| | - S Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Y Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - S Li
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
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Qi J, Liu H, Zhou Z, Jiang Y, Fan W, Hu J, Li J, Guo Z, Xie M, Huang W, Zhang Q, Hou S. Genome-wide association study identifies multiple loci influencing duck serum biochemical indicators in the laying period. Br Poult Sci 2024; 65:8-18. [PMID: 38284741 DOI: 10.1080/00071668.2023.2272982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/12/2023] [Indexed: 01/30/2024]
Abstract
1. Laying performance is an important economic trait in poultry. The blood is essential in transporting nutrients to the yolk and albumen and is necessary for egg formation.2. This study calculated the phenotypic relationships of duck egg quality, egg production efficiency and 22 serum parameters in the egg-laying stage. Using a variety of methodologies, a genome-wide association study (GWAS) was carried out to uncover the genetic foundations of the 22 serum biochemical markers of laying ducks.3. Spearman correlation coefficients between the egg production (226-329 per day) and the serum parameters were all weak, being less than 0.3. This analysis was done on 22 serum parameters, with total protein (TP), total triglycerides (TG), calcium (Ca) and phosphorous (P) having the highest correlation coefficients (r = 0.56-0.88). The coefficients for blood markers, such as total cholesterol (CHOL), total bilirubin (TBIL), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) varied from 0.70-0.94.4. Based on single-marker single-trait genome-wide analyses by a mixed linear model program of EMMAX, nine candidate genes were associated with enzyme traits (AST/ALT aspartate transaminase/glutamic-pyruvic transaminase, creatine kinase) and 19 candidate genes were associated with metabolism and protein-related serum parameters (glucose, total bile acid, uric acid (UA), albumin (ALB).5. The mvLMM (multivariate linear mixed model) of GEMMA software was used to carry out multiple trait integrated GWAS. Two candidate genes were found in the TP-TG-CA-P analysis and seven candidate genes in the CHOL_LDL-C_HDL-C_TBIL study. There was a high genetic correlation between the two groups.
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Affiliation(s)
- J Qi
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, China
| | - H Liu
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Z Zhou
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Y Jiang
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - W Fan
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - J Hu
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - J Li
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, China
| | - Z Guo
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - M Xie
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - W Huang
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Q Zhang
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - S Hou
- State Key Laboratory of Animal Nutrition, Ministry of Agriculture and Rural Affairs, Beijing, China
- Key Laboratory of Animal (Poultry) Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Beijing, China
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
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9
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Wei P, Lamont B, He T, Xue W, Wang PC, Song W, Zhang R, Keyhani AB, Zhao S, Lu W, Dong F, Gao R, Yu J, Huang Y, Tang L, Lu K, Ma J, Xiong Z, Chen L, Wan N, Wang B, He W, Teng M, Dian Y, Wang Y, Zeng L, Lin C, Dai M, Zhou Z, Xiao W, Yan Z. Vegetation-fire feedbacks increase subtropical wildfire risk in scrubland and reduce it in forests. J Environ Manage 2024; 351:119726. [PMID: 38052142 DOI: 10.1016/j.jenvman.2023.119726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/07/2023]
Abstract
Climate dictates wildfire activity around the world. But East and Southeast Asia are an apparent exception as fire-activity variation there is unrelated to climatic variables. In subtropical China, fire activity decreased by 80% between 2003 and 2020 amid increased fire risks globally. Here, we assessed the fire regime, vegetation structure, fuel flammability and their interactions across subtropical Hubei, China. We show that tree basal area (TBA) and fuel flammability explained 60% of fire-frequency variance. Fire frequency and fuel flammability, in turn, explained 90% of TBA variance. These results reveal a novel system of scrubland-forest stabilized by vegetation-fire feedbacks. Frequent fires promote the persistence of derelict scrubland through positive vegetation-fire feedbacks; in forest, vegetation-fire feedbacks are negative and suppress fire. Thus, we attribute the decrease in wildfire activity to reforestation programs that concurrently increase forest coverage and foster negative vegetation-fire feedbacks that suppress wildfire.
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Affiliation(s)
- P Wei
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Lamont
- Ecology Section, School of Molecular and Life Sciences, Curtin University, Perth, WA 6845, Australia.
| | - T He
- College of Science Engineering & Education, Murdoch University, Murdoch, WA 6150, Australia.
| | - W Xue
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - P C Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Song
- College of Agronomy, Northwest Agriculture & Forestry University, Xianyang, 712100, China.
| | - R Zhang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - A B Keyhani
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - S Zhao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Lu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - F Dong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - R Gao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - J Yu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Huang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Tang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - K Lu
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - J Ma
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Xiong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Chen
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - N Wan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W He
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - M Teng
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Dian
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Zeng
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - C Lin
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - M Dai
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Zhou
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Xiao
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - Z Yan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
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10
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Wang Z, Wu W, Wu S, Zhou Z, Zhang H. An Automatic Needle Puncture Path-Planning Method for Thermal Ablation of Lung Tumors. Diagnostics (Basel) 2024; 14:215. [PMID: 38275462 PMCID: PMC10814031 DOI: 10.3390/diagnostics14020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Computed tomography (CT)-guided thermal ablation is an emerging treatment method for lung tumors. Ablation needle path planning in preoperative diagnosis is of critical importance. In this work, we proposed an automatic needle path-planning method for thermal lung tumor ablation. First, based on the improved cube mapping algorithm, binary classification was performed on the surface of the bounding box of the patient's CT image to obtain a feasible puncture area that satisfied all hard constraints. Then, for different clinical soft constraint conditions, corresponding grayscale constraint maps were generated, respectively, and the multi-objective optimization problem was solved by combining Pareto optimization and weighted product algorithms. Finally, several optimal puncture paths were planned within the feasible puncture area obtained for the clinicians to choose. The proposed method was evaluated with 18 tumors of varying sizes (482.79 mm3 to 9313.81 mm3) and the automatically planned paths were compared and evaluated with manually planned puncture paths by two clinicians. The results showed that over 82% of the paths (74 of 90) were considered reasonable, with clinician A finding the automated planning path superior in 7 of 18 cases, and clinician B in 9 cases. Additionally, the time efficiency of the algorithm (35 s) was much higher than that of manual planning. The proposed method is expected to aid clinicians in preoperative path planning for thermal ablation of lung tumors. By providing a valuable reference for the puncture path during preoperative diagnosis, it may reduce the clinicians' workload and enhance the objectivity and rationality of the planning process, which in turn improves the effectiveness of treatment.
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Affiliation(s)
- Zhengshuai Wang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing 100054, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Honghai Zhang
- Beijing Youan Hospital, Capital Medical University, Beijing 100054, China
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11
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Gao R, Tsui PH, Wu S, Tai DI, Bin G, Zhou Z. Ultrasound Entropy Imaging Based on the Kernel Density Estimation: A New Approach to Hepatic Steatosis Characterization. Diagnostics (Basel) 2023; 13:3646. [PMID: 38132230 PMCID: PMC10742695 DOI: 10.3390/diagnostics13243646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
In this paper, we present the kernel density estimation (KDE)-based parallelized ultrasound entropy imaging and apply it for hepatic steatosis characterization. A KDE technique was used to estimate the probability density function (PDF) of ultrasound backscattered signals. The estimated PDF was utilized to estimate the Shannon entropy to construct parametric images. In addition, the parallel computation technique was incorporated. Clinical experiments of hepatic steatosis were conducted to validate the feasibility of the proposed method. Seventy-two participants and 204 patients with different grades of hepatic steatosis were included. The experimental results show that the KDE-based entropy parameter correlates with log10 (hepatic fat fractions) measured by magnetic resonance spectroscopy in the 72 participants (Pearson's r = 0.52, p < 0.0001), and its areas under the receiver operating characteristic curves for diagnosing hepatic steatosis grades ≥ mild, ≥moderate, and ≥severe are 0.65, 0.73, and 0.80, respectively, for the 204 patients. The proposed method overcomes the drawbacks of conventional histogram-based ultrasound entropy imaging, including limited dynamic ranges and histogram settings dependence, although the diagnostic performance is slightly worse than conventional histogram-based entropy imaging. The proposed KDE-based parallelized ultrasound entropy imaging technique may be used as a new ultrasound entropy imaging method for hepatic steatosis characterization.
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Affiliation(s)
- Ruiyang Gao
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; (R.G.); (S.W.)
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; (R.G.); (S.W.)
| | - Dar-In Tai
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan 333423, Taiwan;
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; (R.G.); (S.W.)
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; (R.G.); (S.W.)
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12
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Wang Q, Lai MW, Bin G, Ding Q, Wu S, Zhou Z, Tsui PH. MBR-Net: A multi-branch residual network based on ultrasound backscattered signals for characterizing pediatric hepatic steatosis. Ultrasonics 2023; 135:107093. [PMID: 37482038 DOI: 10.1016/j.ultras.2023.107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/18/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023]
Abstract
The evaluation of pediatric hepatic steatosis and early detection of fatty liver in children are of critical importance. In this paper, a deep learning model based on the convolutional neural network (CNN) of ultrasound backscattered signals, multi-branch residual network (MBR-Net), was proposed for characterizing pediatric hepatic steatosis. The MBR-Net was composed of three convolutional branches. Each branch used different sizes of convolution blocks to enhance the capability of local feature acquisition, and leveraged the residual mechanism with skip connections to guide the network to effectively capture features. A total of 393 frames of ultrasound backscattered signals collected from 131 children were included in the experiments. The hepatic steatosis index was used as the reference standard for diagnosing the steatosis grade, G0-G3. The ultrasound backscattered signals within the liver region of interests (ROIs) were normalized and augmented using a sliding gate method. The gated ROI signals were randomly divided into training, validation, and test sets with the ratio of 8:1:1. The area under the operating characteristic curve (AUC), accuracy (ACC), sensitivity (SEN), and specificity (SPE) were used as the evaluation metrics. Experimental results showed that the MBR-Net yields AUCs for diagnosing pediatric hepatic steatosis grade ≥G1, ≥G2, and ≥G3 of 0.94 (ACC: 93.65%; SEN: 89.79%; SPE: 84.48%), 0.93 (ACC: 90.48%; SEN: 87.75%; SPE: 82.65%), and 0.93 (ACC: 87.76%; SEN: 84.84%; SPE: 86.55%), respectively, which were superior to the conventional one-branch CNNs without residual mechanisms. The proposed MBR-Net can be used as a new deep learning method for ultrasound backscattered signal analysis to characterize pediatric hepatic steatosis.
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Affiliation(s)
- Qian Wang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Ming-Wei Lai
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Qiying Ding
- Department of Ultrasound, BJUT Hospital, Beijing University of Technology, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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13
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Zhou Z, Tong C, Tian L, Zhang X, Li Y, Xiao Y, Yan L. Retraction Note: Retrospective study of preservation and transection of the round ligament of uterus during laparoscopic transabdominal preperitoneal inguinal hernia repair in adult women. Hernia 2023; 27:1627. [PMID: 37792104 DOI: 10.1007/s10029-023-02906-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Z Zhou
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
- Yan'an University, Yan'an, China
| | - C Tong
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - L Tian
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - X Zhang
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - Y Li
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - Y Xiao
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - L Yan
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China.
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14
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Hsieh CS, Lai MW, Chen CC, Chao HC, Wang CY, Wan YL, Zhou Z, Tsui PH. Quantitative ultrasound envelope statistics imaging as a screening approach for pediatric hepatic steatosis and liver fibrosis: using biomarker and transient elastography as reference standards. Heliyon 2023; 9:e22743. [PMID: 38213577 PMCID: PMC10782159 DOI: 10.1016/j.heliyon.2023.e22743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/13/2024] Open
Abstract
Quantitative ultrasound (QUS) envelope statistics imaging is an emerging technique for the assessment of hepatic steatosis in adults. Blood tests are currently recommended as the screening tool for pediatric hepatic steatosis, a condition that can lead to liver fibrosis in children. This study examined the utility of QUS envelope statistics imaging in grading biomarker-diagnosed hepatic steatosis and detecting liver fibrosis in a pediatric population. A total of 173 subjects was enrolled (Group A) for QUS envelope statistics imaging using two statistical distributions, Nakagami and homodyned K (HK) models, and information entropy. QUS parameter values were compared with the hepatic steatosis index (HSI) and steatosis grade (G0: HSI <30; G1: 30 ≤ HSI <36; G2: 36 ≤ HSI <41.6; G3: ≥41.6). An additional cohort of 63 subjects (Group B) was recruited to undergo both QUS envelope statistics imaging and liver stiffness measurements (LSM) obtained from the transient elastography (Fibroscan), with a cutoff value set at 5 kPa to indicate liver fibrosis. The diagnostic performances were evaluated using the area under the receiver operating characteristic curve (AUROC). QUS envelope statistics imaging generated the AUROC values for steatosis grading at levels ≥ G1, ≥ G2, and ≥ G3 ranged from 0.94 to 0.97, 0.91 to 0.93, and 0.83 to 0.87, respectively, and produced an AUROC range of between 0.82 and 0.84 for identifying liver fibrosis. QUS envelope statistics imaging integrates the benefits of both biomarkers and elastography, enabling the screening of hepatic steatosis and detection of liver fibrosis in a pediatric population.
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Affiliation(s)
- Chiao-Shan Hsieh
- Department of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Wei Lai
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chien-Chang Chen
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsun-Chin Chao
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiao-Yin Wang
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Liang Wan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Po-Hsiang Tsui
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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15
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Xiong X, Zhu Q, Zhou Z, Qian X, Hong R, Dai Y, Hu C. Discriminating minimal residual disease status in multiple myeloma based on MRI: utility of radiomics and comparison of machine-learning methods. Clin Radiol 2023; 78:e839-e846. [PMID: 37586967 DOI: 10.1016/j.crad.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023]
Abstract
AIM To explore the possibility of discriminating minimal residual disease (MRD) status in multiple myeloma (MM) based on magnetic resonance imaging (MRI) and identify optimal machine-learning methods to optimise the clinical treatment regimen. MATERIALS AND METHODS A total of 83 patients were analysed retrospectively. They were divided randomly into training and validation cohorts. The regions of interest were segmented and radiomics features were extracted and analysed on two sequences, including T1-weighted imaging (WI) and fat saturated (FS)-T2WI, and then radiomics models were built in the training cohort and evaluated in the validation cohort. Clinical characteristics were calculated to build a traditional model. A combined model was also built using the clinical characteristics and radiomics features. Classification accuracy was assessed using area under the curve (AUC) and F1 score. RESULTS In the training cohort, only the bone marrow (BM) infiltrate ratio (p=0.005) was retained after univariate and multivariable logistic regression analysis. In T1WI, the linear support vector machine (SVM) achieved the best performance compared to other classifiers, with AUCs of 0.811 and 0.708 and F1 scores of 0.792 and 0.696 in the training and validation cohorts, respectively. Similarly, in FS-T2WI sequence, linear SVM achieved the best performance with AUCs of 0.833 and 0.800 and F1 score of 0.833 and 0.800. The combined model constructed by the FS-T2WI-linear SVM and BM infiltrate ratio outperformed the traditional model (p=0.050 and 0.012, Delong test), but showed no significant difference compared with the radiomics model (p=0.798 and 0.855). CONCLUSION The linear SVM-based machine-learning method can offer a non-invasive tool for discriminating MRD status in MM.
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Affiliation(s)
- X Xiong
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Q Zhu
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Z Zhou
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, 215163, China
| | - X Qian
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, 215163, China; School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - R Hong
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Y Dai
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, 215163, China
| | - C Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
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16
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Bao Y, Men Y, Yang X, Sun S, Yuan M, Ma Z, Liu Y, Wang J, Deng L, Wang W, Zhai Y, Bi N, Lv J, Liang J, Feng Q, Chen D, Xiao Z, Zhou Z, Wang L, Hui Z. Efficacy of Postoperative Radiotherapy for Patients with New N2 Descriptors of Subclassification in Completely Resected Non-Small Cell Lung Cancer: A Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:e5. [PMID: 37785570 DOI: 10.1016/j.ijrobp.2023.06.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with N2 non-small cell lung cancer (NSCLC) were heterogeneous groups and required further stratification. The International Society for the Study of Lung Cancer (IASLC) added new descriptors of three sub-stages for stage N2 NSCLC: N2 at a single station without N1 involvement (N2a1), N2 at a single station with N1 involvement (N2a2), and N2 at multiple stations (N2b). This study aimed to investigate the efficacy of postoperative radiotherapy (PORT) for patients with these N2 descriptors. MATERIALS/METHODS Patients with histologically confirmed NSCLC after complete resection and divided into PORT group and non-PORT group. The primary endpoint was DFS. The second endpoints were overall survival (OS) and locoregional recurrence-free survival (LRFS). Propensity-score matching (PSM) of baseline characteristics between the PORT and non-PORT groups was used for validation. RESULTS Totally 1832 patients were enrolled, including 308 N2a1 patients, 682 N2a2 patients, and 842 N2b patients. The median follow-up time was 50.1 months. The survival outcomes of the PORT and non-PORT groups before PSM were shown in Table 1. For patients with N2a1, PORT could not improve the DFS (median DFS of the PORT group and the non-PORT group: not reached vs. 46.8 months, P = 0.41), OS (P = 0.85), or LRFS (P = 0.32), which were consistent with the multivariate analysis and data after the PSM. For patients with N2a2, PORT significantly improved the DFS (median DFS 29.7 vs. 22.2 months, P = 0.02), OS (P = 0.03), and LRFS (P = 0.01). The multivariate analysis and data after the PSM confirmed the benefits in DFS and LRFS, but no benefit was observed in OS (multivariate analysis: HR 0.79, P = 0.18; median OS after PSM: 103.7 vs. 63.1 months, P = 0.34). For patients with N2b, PORT could not improve the DFS (median DFS 20.6 vs. 21.2 months, P = 0.39) but significantly improved the OS (P<0.001) and LRFS (P<0.001). However, the multivariate analysis showed that PORT significantly improved DFS (HR 0.81, P = 0.03), consistent with the data after the PSM (median DFS 20.6 and 17.6 months, P = 0.04). CONCLUSION PORT significantly improved the DFS and LRFS in patients with N2a2 and significantly improved the DFS, LRFS, and OS in patients with N2b. Patients with N2a1 could not benefit from PORT.
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Affiliation(s)
- Y Bao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Men
- Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Yang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - M Yuan
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Ma
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - L Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - W Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Zhai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Lv
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Liang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Q Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - D Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - L Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China, Shenzhen, China
| | - Z Hui
- Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhou Z, Wang Y, Zhao F, Yao G, Yu H, Yu H, Bu L, Lu Z, Yan S. Radiation Induced Lung Injury in Rats after Pre-Oxygenation Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e279-e280. [PMID: 37785046 DOI: 10.1016/j.ijrobp.2023.06.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Deep inspiratory breath holding (DIBH) has been widely used during the radiotherapy of thoracic tumors. The main disadvantage of voluntary DIBH is the short duration of each breath hold. The hypocapnia induced by hyperoxia (oxygen concentration > 50%) pre-oxygenation (PreO2) combined with mechanical hyperventilation has been reported to prolong the duration of single breath hold, but its safety remains controversial, especially the sensitivity of lung tissue to radiation damage under hyperoxia exposure has not been elucidated. In this study, we aim to investigate the changes of radiation induced lung injury in rats after PreO2 radiation. MATERIALS/METHODS We evaluated the lung tissue of rats at different time points (48h, 2w, 4w, 8w, 12w) after thoracic radiation (15Gy single fraction to the right lung), and sequenced the transcriptome of lung tissue at 48 hours after irradiation. Rat cohorts (n = 7/group): 1. Control (Con); 2. Radiation group (RT); 3. Pre-oxygenation (oxygen concentration > 90%) for 8 hours before thoracic radiation (PreO2). RESULTS The inflammatory exudation emerged in the pulmonary interstitium at 48 hours, and reached the most serious alveolitis after four weeks of irradiation (the comparison of alveolitis scores in RT4w vs Con4w and PreO2(4w) vs Con4w, P<0.001) on hematoxylin-eosin staining. While the alveolitis scores in RT group and PreO2 group were not statistically different at each time point. Masson staining showed that the pulmonary fibrosis in the RT group and the PreO2 group reached an obvious pathological change at 12 weeks after irradiation, but the difference between the two groups was not significant. Transcriptome sequencing showed that the number of differential genes in PreO2 vs Con was 559 (302 up-regulated genes and 257 down-regulated genes). The GO enrichment analysis indicated that chromosome segregation was the most significant functional item with P value in the comparative analysis, and the KEGG enrichment analysis suggested that cell division was the most significant enrichment pathway of these differential genes. While there was a small quantity of differential genes in PreO2 vs RT group (3 up-regulated genes and 12 down-regulated genes). Pentose and glucuronate conversions were the most significant enrichment pathway of these differential genes. CONCLUSION This study demonstrated that PreO2 radiotherapy did not increase the severity of radiation induced lung injury in rats compared to conventional radiotherapy. Further study should be conducted to confirm these results and to investigate the regulatory mechanism of pneumonia caused by PreO2 radiotherapy.
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Affiliation(s)
- Z Zhou
- Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y Wang
- Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - F Zhao
- Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - G Yao
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - H Yu
- The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - H Yu
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - L Bu
- Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Z Lu
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - S Yan
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Ma Y, Bi N, Ying J, Li C, Xiao J, Tian Y, Ma X, Deng L, Zhang T, Wang J, Zhou Z. Inter-fraction Dynamics during Adaptive Hypofractionated Radiotherapy for Brain Metastases with a MR LINAC. Int J Radiat Oncol Biol Phys 2023; 117:e133. [PMID: 37784696 DOI: 10.1016/j.ijrobp.2023.06.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study examined the displacement and deformation in brain metastases (BMs) during adaptive hypofractionated radiotherapy (HFRT) on a magnetic resonance imaging linear accelerator (MR LINAC). In addition, the contouring variability between enhanced T1 (T1+c) and T2/FLAIR (T2f) sequence to define gross tumor volume (GTV) was compared. MATERIALS/METHODS Patients with 1-3 BMs and treated with MR LINAC were enrolled. T1+c sequence was acquired at initial planning, while T2/T2f was acquired during each fraction. GTV at initial planning (GTVi) and fraction 1-n (GTV1-n) were contoured in all images. Dice similarity coefficient (DSC) was used to quantify the contouring variability between different sequences at initial planning. The three-dimensional coordinate values of geometric centers of GTVi and GTV1-n were recorded and the distance was calculated. Statistical analysis was performed using two-sided paired t-test. RESULTS Between December 2019 and October 2022, 19 patients with 22 BMs were analyzed. The median age was 64 y (37-84 y) and the major primary tumor was lung cancer (89.5%). The median dose was 52 Gy in 13 fractions (30 Gy/5f- 60 Gy/20 f). The median GTVi on T1c, T2f and T2 sequences were 6.70cc (0.41-84.85 cc), 6.70 cc (0.35-84.14 cc, p = 0.924) and 6.16 cc (0.32-79.44 cc, p = 0.117), respectively. The mean DSC was 0.95 (0.76-1.00) and 0.86 (0.64-0.97) when comparing GTVi on T1c/T2f and T1c/T2, respectively. All of the lesions achieved volume reduction during HFRT and the mean reduction rate was 28.8% (4.8%-71.0%) at the end of HFRT. 54.5% of the BMs were reduced by more than 20%. The median treatment course and BED to get 20% reduction was 2/3 (40%-93%) and 40.8 Gy (24.5-67.5 Gy), respectively. The median shift of center of GTV1-n was 0.8 mm (0-2.5mm). The center of 7 lesions (31.8%) deviated more than 1mm from GTVi. CONCLUSION GTV contouring variability was seen between T1c, T2f and T2 sequences. The coincidence of T1+c and T2f was better than T1+c and T2 in BMs. Since reductions in volume and changes of lesion center was observed during HFRT, the use of MR-guided radiation therapy (RT) and treatment adaptation is needed. The optimal timing for treatment plan modification might be when the course of treatment reaches 2/3 for most large BMs. Further research to find out patients who may benefit form MR-guided adaptive RT is ongoing.
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Affiliation(s)
- Y Ma
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - N Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - J Ying
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - C Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - J Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Y Tian
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - X Ma
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - L Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - T Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Z Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
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Li M, Ao Y, Peng P, Bahmani H, Han L, Zhou Z, Li Q. Resource allocation of rural institutional elderly care in China's new era: spatial-temporal differences and adaptation development. Public Health 2023; 223:7-14. [PMID: 37572563 DOI: 10.1016/j.puhe.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES In the new era of China, to ensure that rural residents can get the corresponding institutional elderly services equally, it is necessary to investigate the current situation of resource allocation of rural institutional elderly care and make corresponding adaptation suggestions. STUDY DESIGN This research discusses the characteristics and evolution pattern of rural aging, the resource allocation of rural elderly care institutions, and the adaptation degree of rural institutional elderly care resource and aging. METHODS The research methodology consists of the following stages: entropy-based Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), kernel density estimation, coupling coordination, spatial autocorrelation, and Theil index decomposition. RESULTS The degree of aging in rural areas of China is rising, and the whole population has entered a moderate aging society, showing the spatial characteristics of 'high in the east and low in the west'. The resource allocation of rural institutional elderly care in China is at a low level, and the absolute differences among provinces tend to reduce over time, and the overall resource allocation level tends to decline. The provinces that were in the mismatched adaptation relationship in the early stage have improved; however, the number of provinces with mismatched adaptability has continued to increase. The local spatial autocorrelation of resource adaptation verifies that the middle and lower reaches of the Yangtze River as the core form a hot spot, and during the observation period, the spatial agglomeration effect of the core is strengthened. The Theil index decomposition of resource adaptation indicates that the within-group differences between the eastern and western regions is significantly higher than that between the northeastern and central regions. CONCLUSIONS First, special attention should be paid to preventing the resource allocation of rural institutional elderly care in the eastern and western regions from falling again. Second, to avoid more and more low-adapted provinces falling into the 'mismatch dilemma' with the deepening of the aging degree. Third, strengthen cooperation among regions and promote the coordinated development of resource allocation of institutional elderly care in various regions. Fourth, the priority of institutional elderly care balanced development should be given to the eastern region and western region, thus weakening the overall difference.
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Affiliation(s)
- M Li
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
| | - Y Ao
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China; College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China.
| | - P Peng
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - H Bahmani
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - L Han
- School of Civil Engineering, Hexi University, Zhangye, 734000, China
| | - Z Zhou
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
| | - Q Li
- School of Continuing Education, Southwest University, Chongqing 400000, China
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Yu N, Li J, Chen X, Wang Z, Kang X, Zhang R, Qin J, Zheng Q, Feng G, Deng L, Zhang T, Wang W, Liu W, Wang J, Feng Q, Lv J, Chen D, Zhou Z, Xiao Z, Li Y, Bi N, Li Y, Wang X. Chemoradiotherapy Combined with Nab-Paclitaxel plus Cisplatin in Patients with Locally Advanced Borderline Resectable or Unresectable Esophageal Squamous Cell Carcinoma: A Phase I/II Study. Int J Radiat Oncol Biol Phys 2023; 117:e354. [PMID: 37785224 DOI: 10.1016/j.ijrobp.2023.06.2433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus cisplatin as the regimen of conversional chemoradiotherapy (cCRT) in locally advanced borderline resectable or unresectable esophageal squamous cell carcinoma (ESCC). MATERIALS/METHODS Patients with locally advanced ESCC (cT3-4, Nany, M0-1, M1 was limited to lymph node metastasis in the supraclavicular area) were enrolled. All the patients received the cCRT of nab-PTX plus cisplatin. After the cCRT, those resectable patients received esophagectomy; those unresectable patients continued to receive the definitive chemoradiotherapy (dCRT). The locoregional control (LRC), overall survival (OS), progression-free survival (PFS), distant metastasis free survival (DMFS), pathological complete response (pCR), R0 resection rate and adverse events (AEs) were calculated. RESULTS A total of 45 patients with ESCC treated from October 2019 to May 2021 were finally included. The median follow-up time was 30.3 months. The LRC, OS, EFS, DMFS at 1and 2 years were 81.5%, 86.6%, 64.3%, 73.2% and 72.4%, 68.8%, 44.8%, 52.7% respectively. 21 patients (46.7%) received conversional chemoradiotherapy plus surgery (cCRT+S). The pCR rate and R0 resection rate were 47.6% and 84.0%. The LRC rate at 1 and 2 years were 95.0%, 87.1% in cCRT+S patients and 69.3%, 58.7% in dCRT patients respectively (HR, 5.14; 95% CI, 1.10-23.94; P = 0.021). The OS rate at 1 and 2 years were 95.2% and 84.2% in resectable patients compared to 78.8% and 54.4% in unresectable patients (HR, 3.41; 95% CI, 1.10-10.61; P = 0.024). The toxicities during chemoradiotherapy were tolerated, the most common grade 3-4 toxicities were radiation esophagitis (15.6%). CONCLUSION Nab-PTX plus cisplatin were effective and safe as the regimen of conversional chemoradiotherapy of ESCC. The patients receiving conversional chemoradiotherapy plus surgery (cCRT+S) were prone to have a better survival.
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Affiliation(s)
- N Yu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Chen
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Kang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - R Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Qin
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Q Zheng
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - G Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - L Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - W Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - W Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Q Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Lv
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - D Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Z Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhang C, Zhou Z, Deng L, Bi N, Wang W, Xiao Z, Wang J, Jr WL, Wang X, Zhang T, Lv J. Clinical Outcomes with Thoracic Radiotherapy for Extensive-Stage Small-Cell Lung Cancer in the Era of Immunotherapy: A Retrospective Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e80. [PMID: 37786186 DOI: 10.1016/j.ijrobp.2023.06.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Chemo-immunotherapy has shown significant benefits for extensive-stage small-cell lung cancer (ES-SCLC), which prolonged overall survival (OS) of nearly 2-4.5 months compared with platinum-based chemotherapy alone. However, thoracic radiotherapy (TRT), was not allowed to be used in previous trials. This retrospective study aimed to evaluate the safety and efficiency of TRT for ES-SCLC patients in the era of Immunotherapy. MATERIALS/METHODS We retrospectively reviewed ES-SCLC patients treated with chemo-immunotherapy between 2017 and 2021 in our center. Patients who accepted consolidative or salvage TRT were included. The overall survival, progression-free survival (PFS), local progression-free survival (LPFS), and distant progression free-survival (DPFS) were calculated using the Kaplan-Meier method. Toxicity was recorded based on CTCAE 5.0 scale. RESULTS We finally enrolled 30 patients in our study. The median follow-up time was 26.0 months (95% confidence interval, 18.2-33.8 months). 26(86.7%) patients have undergone first-line chemotherapy and immunotherapy, while 4(13.3%) have undergone immunotherapy as a second-line agent. 23(76.6%) patients achieved CR/PR/SD to initial systematic therapy. All patients were treated with TRT with a median dose of 51 Gy (24-60.2 Gy). The median interval between TRT and immunotherapy was 35 days. Median OS was 26 months (95% confidence interval, 17.8-34.2 months) and median PFS was 8 months (95% confidence interval, 5.3-10.7 months). 2-year OS, PFS, and DPFS were 51.4%, 21.4%, and 27.4%, respectively. 18 months LPFS was 59.6%. There was no ≥ G3 radiation-related adverse event except 2(6.7%) G3 esophagitis. G1-2 pneumonitis was reported in 8(26.7%) patients. CONCLUSION TRT is well-tolerated and effective for selected ES-SCLC patients in the modern era of immunotherapy. Prospective trials are still needed to further evaluate the combination of TRT and immunotherapy for patients with ES-SCLC.
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Affiliation(s)
- C Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - L Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - W Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - W Liu Jr
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, China
| | - J Lv
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Weidhaas JB, Harris J, Gillison M, Blakaj DM, Krempl GA, Higgins KA, Phan J, Dunlap NE, Mahmood S, Dorth JA, Caudell JJ, Desai AB, Galloway TJ, Pennington JDD, Zhou Z, Lathrop J, Torres-Saavedra P, Hayes DN, Yom SS, Le QT. The KRAS-Variant and Cetuximab in HPV-Positive Oropharyngeal Cancer in NRG/RTOG 1016. Int J Radiat Oncol Biol Phys 2023; 117:S151. [PMID: 37784383 DOI: 10.1016/j.ijrobp.2023.06.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) NRG/RTOG 1016 was a non-inferiority phase III trial comparing radiation with cisplatin versus cetuximab monotherapy for patients with HPV-positive oropharyngeal squamous cell carcinoma (SCC). The trial did not meet the non-inferiority criteria for overall survival (OS) and had significantly worse progression-free survival (PFS) and locoregional failure (LRF) in patients treated with cetuximab. Based on prior evidence that HNSCC patients with a germ-line mutation in KRAS (the KRAS-variant) had a positive response to radiation with cisplatin plus cetuximab without increased toxicity, samples from RTOG 1016 were used to test the protocol-specified hypothesis that KRAS-variant patients will have better outcomes when receiving IMRT + cetuximab monotherapy compared to IMRT + cisplatin. MATERIALS/METHODS The KRAS-variant was tested in 562 samples at MiraDx, a CLIA-certified laboratory. OS, PFS, LRF, and distant metastases (DM) were as defined per the RTOG 1016 protocol, and hazard ratios (HRs) were estimated by (cause-specific) Cox models. Negative binomial regression was used to model the number of treatment-related acute and late (≤ and > 180 days from end of treatment, respectively) grade 3-5 adverse events. To assess the predictive role of the KRAS-variant, all models included KRAS, assigned treatment, and their interaction, with the interaction tested at two-sided 0.05. HRs and toxicity ratios are expressed as IMRT + cetuximab / IMRT + cisplatin. RESULTS The prevalence of the KRAS-variant was 16% with similar patient and tumor characteristics and well-balanced treatment arms for variant and non-variant patients. Median follow-up was 8.6 years. There was no significant interaction between KRAS and treatment for OS (p = 0.99), PFS (p = 0.56), LRF (p = 0.09), or DM (p = 0.19) (Table 1). In KRAS-variant patients the mean acute and late toxicity ratios were 0.53 (95% CI 0.36, 0.80) and 1.62 (95% CI 0.57, 4.62). In non-variant patients, the mean acute and late toxicity ratios were 0.80 (95% CI 0.67, 0.95) and 0.55 (95% CI 0.35, 0.87), respectively. The interaction of KRAS and treatment was not significant for acute (p = 0.07) or late toxicity (p = 0.07). CONCLUSION While this study does not directly refute prior evidence that KRAS-variant patients benefit from radiation + cisplatin and cetuximab, this study does not support the hypothesis that the KRAS-variant is a predictive biomarker of improved outcome in HPV+ oropharyngeal SCC patients treated with IMRT + cetuximab alone, and suggests that for KRAS-variant patients, potential benefits in LRF and acute toxicity with cetuximab may be offset by worse DM and worse late toxicity.
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Affiliation(s)
- J B Weidhaas
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - J Harris
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | | | - D M Blakaj
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - G A Krempl
- University of Oklahoma Health Sciences Center, OKLAHOMA CITY, OK
| | - K A Higgins
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - J Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N E Dunlap
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - S Mahmood
- Allan Blair Cancer Centre, Saskatchewan, SK, Canada
| | - J A Dorth
- Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH
| | | | | | - T J Galloway
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | | | - P Torres-Saavedra
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | | | - S S Yom
- University of California, San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Zhou Z, Tong C, Tian L, Zhang X, Li Y, Xiao Y, Yan L. Retrospective study of preservation and transection of the round ligament of uterus during laparoscopic transabdominal preperitoneal inguinal hernia repair in adult women. Hernia 2023; 27:1195-1202. [PMID: 36949269 PMCID: PMC10533639 DOI: 10.1007/s10029-023-02765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE The processing of the round ligament of uterus in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia in women has contended. This study aimed to explore whether there is any difference in the surgical outcome and postoperative complications between the two processing modalities, preservation, and transection of the round ligament of uterus, in adult female inguinal hernia patients undergoing TAPP. METHODS Retrospective analysis of 84 female patients (117 sides) who underwent TAPP in XXX Hospital from July 2013 to August 2022. Patient characteristics and technical details of the surgical procedure were collected and divided into two groups according to whether the round ligament of uterus was severed intraoperatively or not. There were 52 cases (77 sides) in the group with preservation of the round ligament of uterus and 32 cases (40 sides) in the group with transection of the round ligament of uterus, comparing the general condition, surgical condition, and the occurrence of postoperative related complications between the 2 groups. RESULTS The operative time for unilateral primary inguinal hernia was (129.2 ± 35.1) and (89.5 ± 42.6) minutes in the preservation and transection groups, respectively. There were no statistical differences between the two groups in terms of age, length of hospital stay, ASA, BMI, history of lower abdominal surgery, type and side of hernia, intraoperative bleeding, and time to surgery for primary bilateral hernia (P > 0.05). In addition, there was likewise no statistical difference in the occurrence of postoperative Clavien-Dindo classification, VAS, seroma, mesh infection, labia majora edema, chronic pain or abnormal sensation in the inguinal region, and hernia recurrence in the two groups as well (P > 0.05). CONCLUSION There is no evidence that the transection of the round ligament of the uterus during TAPP has an impact on postoperative complications in patients. However, given the important role of the uterine round ligament in the surgical management of patients with uterine prolapse and the high incidence of uterine prolapse in older women, hernia surgeons should also be aware of the need to protect the round ligament of uterus in older women.
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Affiliation(s)
- Z Zhou
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
- Yan'an University, Yan'an, China
| | - C Tong
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - L Tian
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - X Zhang
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - Y Li
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - Y Xiao
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China
| | - L Yan
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China.
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Wu H, Zhao J, Li J, Zeng Y, Wu W, Zhou Z, Wu S, Xu L, Song M, Yu Q, Song Z, Chen L. One-Stage Detection without Segmentation for Multi-Type Coronary Lesions in Angiography Images Using Deep Learning. Diagnostics (Basel) 2023; 13:3011. [PMID: 37761378 PMCID: PMC10528585 DOI: 10.3390/diagnostics13183011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
It is rare to use the one-stage model without segmentation for the automatic detection of coronary lesions. This study sequentially enrolled 200 patients with significant stenoses and occlusions of the right coronary and categorized their angiography images into two angle views: The CRA (cranial) view of 98 patients with 2453 images and the LAO (left anterior oblique) view of 176 patients with 3338 images. Randomization was performed at the patient level to the training set and test set using a 7:3 ratio. YOLOv5 was adopted as the key model for direct detection. Four types of lesions were studied: Local Stenosis (LS), Diffuse Stenosis (DS), Bifurcation Stenosis (BS), and Chronic Total Occlusion (CTO). At the image level, the precision, recall, mAP@0.1, and mAP@0.5 predicted by the model were 0.64, 0.68, 0.66, and 0.49 in the CRA view and 0.68, 0.73, 0.70, and 0.56 in the LAO view, respectively. At the patient level, the precision, recall, and F1scores predicted by the model were 0.52, 0.91, and 0.65 in the CRA view and 0.50, 0.94, and 0.64 in the LAO view, respectively. YOLOv5 performed the best for lesions of CTO and LS at both the image level and the patient level. In conclusion, the one-stage model without segmentation as YOLOv5 is feasible to be used in automatic coronary lesion detection, with the most suitable types of lesions as LS and CTO.
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Affiliation(s)
- Hui Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Jing Zhao
- Department of Geriatrics, The Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Jiehui Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Yan Zeng
- Department of Research Center, Shanghai United Imaging Intelligence Co., Ltd., Shanghai 201807, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Liang Xu
- State Key Laboratory of Cardiovascular Disease, Department of Structural Heart Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Min Song
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qibin Yu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ziwei Song
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Lin Chen
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
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25
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Ma JL, Zhou Z, Li Y, Zhang C, Duan FH, Wang GM. [Genetic analysis of a family with hereditary hemorrhagic telangiectasia caused by endoglin gene mutation]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:916-920. [PMID: 37670645 DOI: 10.3760/cma.j.cn112147-20230530-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Objective: To explore the genetic characteristics of a family with hereditary hemorrhagic telangiectasia (HHT) caused by endoglin (ENG) gene mutations. Methods: A total of 17 individuals from a 3-generation HHT family attending the First Affiliated Hospital of Dali University were selected as the research subjects. Clinical data and familial disease status of the HHT family proband were collected. Whole exome sequencing technology was used to screen for suspected pathogenic genes in the proband, and Sanger sequencing was used for family validation. Results: The proband and her mother had recurrent epistaxis and skin mucosal telangiectasia, and enhanced CT scans of the chest of the proband and her mother, daughter, and cousin indicated the presence of varying degrees of pulmonary arteriovenous malformations. The results of the full exon sequencing results showed that the proband carried the ENG gene c.579_599del non-shift deletion mutation, and Sanger sequencing showed that the mother, daughter, and cousin carried the same mutation. Conclusion: ENG gene c.579_ 599del mutation may be the genetic basis of HHT in this family.
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Affiliation(s)
- J L Ma
- Department of School of Clinical Medicine, Dali University, Dali 671000, China
| | - Z Zhou
- Department of Radiology, First Affiliated Hospital of Dali University, Dali 671000, China
| | - Y Li
- Department of Radiology, First Affiliated Hospital of Dali University, Dali 671000, China
| | - C Zhang
- Department of Radiology, First Affiliated Hospital of Dali University, Dali 671000, China
| | - F H Duan
- Center of Genetic Testing, The First Affiliated Hospital of Dali University, Dali, 671000, China
| | - G M Wang
- Department of School of Clinical Medicine, Dali University, Center of Genetic Testing, The First Affiliated Hospital of Dali University, Dali, 671000, China
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26
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Lu S, Qin S, Zhou Z, Chen J, Gu K, Sun P, Pan Y, Yu G, Ma K, Shi J, Sun Y, Yang L, Chen P, Liu A, He J. Bevacizumab biosimilar candidate TAB008 compared to Avastin ® in patients with locally advanced, metastatic EGFR wild-type non-squamous non-small cell lung cancer: a randomized, double-blind, multicenter study. J Cancer Res Clin Oncol 2023; 149:5907-5914. [PMID: 36595042 DOI: 10.1007/s00432-022-04563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Bevacizumab (Avastin®) is a monoclonal antibody targeting the vascular endothelial growth factor (VEGF). Used alone or in combination with chemotherapy and/or immunotherapy, Avastin® has shown promising efficacy in many cancers. This study compared the efficacy and safety of TAB008 with Avastin® sourced from the EU (bevacizumab-EU), in patients with non-squamous non-small cell lung cancer (nsNSCLC). METHOD In this randomized, double-blind, multicenter, phase III similarity study, treatment naïve for metastatic lung cancer., EGFR wild-type, locally advanced, metastatic, or recurrent non-squamous, non-small cell, lung cancer (nsNSCLC) patients were enrolled and randomized (1:1) into TAB008 or Avastin® groups. Patients received TAB008 or Avastin® 15 mg/kg intravenously plus paclitaxel/carboplatin for 4-6 cycles followed by TAB008 or Avastin® 7.5 mg/kg until disease progression, unacceptable toxicity or death. The primary endpoint compared the objective response rate (ORR) within 6 cycles as read by an independent radiological review committee (IRRC). Secondary endpoints compared disease control rate (DCR) Within 6 cycles, duration of response (DoR), progression-free survival (PFS), a year overall survival rate (OSR), overall survival (OS), safety, immunogenicity, and steady-state pharmacokinetics. RESULTS A total of 549 nsNSCLC patients were enrolled (277 in TAB008 group and 272 in Avastin® group). In the full analysis set, ORRs were 55.957% for TAB008 and 55.720% for Avastin®, and the ORR ratio was 1 (90% CI 0.89-1.14), well within the predefined equivalence margin of 0.75-1.33. No significant differences were found in DCR within 6 cycles (95.703% vs 95.367%, p = 0.8536), DoR (8.17 vs 7.3 months, p = 0.3526), PFS (9.10 vs. 7.97 months, p = 0.9457), 1 year overall survival rate (66.2% vs 68%, p = 0.6793), or OS (20.4 vs 17.6 months, p = 0.6549). Serious adverse events (SAEs) occurred in 37.55% (104/277) of patients in the TAB008 group and 34.32% (93/271) in the Avastin® group. Anti-drug antibodies were reported in 3 of 277 (1.08%) TAB008 patients, and 5 of 271 (1.85%) Avastin® patients, neutralizing antibody (Nab) was positive in 1 patient on Avastin®, which became negative upon follow-up. The steady-state trough concentrations (Cssmin) were 106.13 μg/mL in TAB008 group and 96.03 μg/mL in Avastin® groups, with the treatment group ratio of LS geometric means fully contained within the bioequivalence limits of 80.00-125.00% (90% CI was 101.74-120.05%). CONCLUSIONS TAB008 is similar to Avastin® in terms of efficacy, safety, and pharmacokinetic parameters, with comparable immunogenicity. TRIAL REGISTRATION ClinicalTrials.gov number; NCT05427305.
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Affiliation(s)
- S Lu
- Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - S Qin
- Cancer Center, Nanjing Jinling Hospital, Nanjing, China.
| | - Z Zhou
- Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - J Chen
- Oncology, Hunan Cancer Hospital, Changsha, China
| | - K Gu
- Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - P Sun
- Oncology, Yantai Yuhuangding Hospital, Yantai, China
| | - Y Pan
- Oncology, Anhui Provincial Hospital, Hefei, China
| | - G Yu
- Oncology, Weifang People's Hospital, Weifang, China
| | - K Ma
- Oncology, Jilin University First Hospital, Jilin, China
| | - J Shi
- Oncology, Linyi Cancer Hospital, Linyi, China
| | - Y Sun
- Oncology, Jinan Central Hospital, Jinan, China
| | - L Yang
- Cancer Center, Nanjing Jinling Hospital, Nanjing, China
| | - P Chen
- Oncology, Yancheng First People's Hospital, Yancheng, China
| | - A Liu
- Oncology, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - J He
- Statistics, The Second Military Medical University, Shanghai, China
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Wu X, Lv K, Wu S, Tai DI, Tsui PH, Zhou Z. Parallelized ultrasound homodyned-K imaging based on a generalized artificial neural network estimator. Ultrasonics 2023; 132:106987. [PMID: 36958066 DOI: 10.1016/j.ultras.2023.106987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 05/29/2023]
Abstract
The homodyned-K (HK) distribution model is a generalized backscatter envelope statistical model for ultrasound tissue characterization, whose parameters are of physical meaning. To estimate the HK parameters is an inverse problem, and is quite complicated. Previously, we proposed an artificial neural network (ANN) estimator and an improved ANN (iANN) estimator for estimating the HK parameters, which are fast and flexible. However, a drawback of the conventional ANN and iANN estimators consists in that they use Monte Carlo simulations under known values of HK parameters to generate training samples, and thus the ANN and iANN models have to be re-trained when the size of the test sets (or of the envelope samples to be estimated) varies. In addition, conventional ultrasound HK imaging uses a sliding window technique, which is non-vectorized and does not support parallel computation, so HK image resolution is usually sacrificed to ensure a reasonable computation cost. To this end, we proposed a generalized ANN (gANN) estimator in this paper, which took the theoretical derivations of feature vectors for network training, and thus it is independent from the size of the test sets. Further, we proposed a parallelized HK imaging method that is based on the gANN estimator, which used a block-based parallel computation method, rather than the conventional sliding window technique. The gANN-based parallelized HK imaging method allowed a higher image resolution and a faster computation at the same time. Computer simulation experiments showed that the gANN estimator was generally comparable to the conventional ANN estimator in terms of HK parameter estimation performance. Clinical experiments of hepatic steatosis showed that the gANN-based parallelized HK imaging could be used to visually and quantitatively characterize hepatic steatosis, with similar performance to the conventional ANN-based HK imaging that used the sliding window technique, but the gANN-based parallelized HK imaging was over 3 times faster than the conventional ANN-based HK imaging. The parallelized computation method presented in this work can be easily extended to other quantitative ultrasound imaging applications.
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Affiliation(s)
- Xining Wu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Lv
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Dar-In Tai
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
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Zhou Z, Lv K, Tsui PH. Editorial: Recent advances in artificial intelligence-empowered ultrasound tissue characterization for disease diagnosis, intervention guidance, and therapy monitoring. Front Physiol 2023; 14:1234611. [PMID: 37457028 PMCID: PMC10338850 DOI: 10.3389/fphys.2023.1234611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Ke Lv
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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29
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Shao Y, Dang Y, Cheng Y, Gui Y, Chen X, Chen T, Zeng Y, Tan L, Zhang J, Xiao M, Yan X, Lv K, Zhou Z. Predicting the Efficacy of Neoadjuvant Chemotherapy for Pancreatic Cancer Using Deep Learning of Contrast-Enhanced Ultrasound Videos. Diagnostics (Basel) 2023; 13:2183. [PMID: 37443577 DOI: 10.3390/diagnostics13132183] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Contrast-enhanced ultrasound (CEUS) is a promising imaging modality in predicting the efficacy of neoadjuvant chemotherapy for pancreatic cancer, a tumor with high mortality. In this study, we proposed a deep-learning-based strategy for analyzing CEUS videos to predict the prognosis of pancreatic cancer neoadjuvant chemotherapy. Pre-trained convolutional neural network (CNN) models were used for binary classification of the chemotherapy as effective or ineffective, with CEUS videos collected before chemotherapy as the model input, and with the efficacy after chemotherapy as the reference standard. We proposed two deep learning models. The first CNN model used videos of ultrasound (US) and CEUS (US+CEUS), while the second CNN model only used videos of selected regions of interest (ROIs) within CEUS (CEUS-ROI). A total of 38 patients with strict restriction of clinical factors were enrolled, with 76 original CEUS videos collected. After data augmentation, 760 and 720 videos were included for the two CNN models, respectively. Seventy-six-fold and 72-fold cross-validations were performed to validate the classification performance of the two CNN models. The areas under the curve were 0.892 and 0.908 for the two models. The accuracy, recall, precision and F1 score were 0.829, 0.759, 0.786, and 0.772 for the first model. Those were 0.864, 0.930, 0.866, and 0.897 for the second model. A total of 38.2% and 40.3% of the original videos could be clearly distinguished by the deep learning models when the naked eye made an inaccurate classification. This study is the first to demonstrate the feasibility and potential of deep learning models based on pre-chemotherapy CEUS videos in predicting the efficacy of neoadjuvant chemotherapy for pancreas cancer.
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Affiliation(s)
- Yuming Shao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yingnan Dang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Yuejuan Cheng
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yang Gui
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xueqi Chen
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Tianjiao Chen
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yan Zeng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Li Tan
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jing Zhang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Mengsu Xiao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaoyi Yan
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ke Lv
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
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30
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Zhang SC, Li RP, Chen JC, Yang ZG, She YL, Zhou Z, Ouyang P. [Pulmonary vein stenosis with pulmonary infarction secondary to primary mediastinal seminoma: a case report]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:592-594. [PMID: 37278174 DOI: 10.3760/cma.j.cn112147-20221026-00847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pulmonary vein stenosis is a rare condition that is often underdiagnosed and misdiagnosed. The clinical and radiologic manifestations are unspecific such as cough, hemoptysis and pulmonary lesions and are therefore difficult to distinguished with pneumonia and tuberculosis. The present study is a successful case report of pulmonary vein stenosis and pulmonary infraction secondary to mediastinal seminoma. This case suggested that pulmonary vein stenosis should be considered when a mediastinal mass is accompanied by pulmonary opacites that cannot be explained by common causes such as infection.
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Affiliation(s)
- S C Zhang
- Department of Respiratory, Xiangya Changde Hospital, Changde 415000, China
| | - R P Li
- Department of Respiratory, Xiangya Changde Hospital, Changde 415000, China
| | - J C Chen
- Department of Radiology, Xiangya Changde Hospital, Changde 415000, China
| | - Z G Yang
- Department of Respiratory, Xiangya Changde Hospital, Changde 415000, China
| | - Y L She
- Department of Radiology, Xiangya Changde Hospital, Changde 415000, China
| | - Z Zhou
- Department of Respiratory, Xiangya Changde Hospital, Changde 415000, China
| | - P Ouyang
- Department of Respiratory, Xiangya Changde Hospital, Changde 415000, China
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Cao F, Guo Y, Guo S, Zhou Z, Cao J, Tong L, Mi W. [Activation of GABAergic neurons in the zona incerta accelerates anesthesia induction with sevoflurane and propofol without affecting anesthesia maintenance or awakening in mice]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:718-726. [PMID: 37313812 DOI: 10.12122/j.issn.1673-4254.2023.05.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore the regulatory effects of GABAergic neurons in the zona incerta (ZI) on sevoflurane and propofol anesthesia. METHODS Forty-eight male C57BL/6J mice divided into 8 groups (n=6) were used in this study. In the study of sevoflurane anesthesia, chemogenetic experiment was performed in 2 groups of mice with injection of either adeno-associated virus carrying hM3Dq (hM3Dq group) or a virus carrying only mCherry (mCherry group). The optogenetic experiment was performed in another two groups of mice injected with an adeno-associated virus carrying ChR2 (ChR2 group) or GFP only (GFP group). The same experiments were also performed in mice for studying propofol anesthesia. Chemogenetics or optogenetics were used to induce the activation of GABAergic neurons in the ZI, and their regulatory effects on anesthesia induction and arousal with sevoflurane and propofol were observed; EEG monitoring was used to observe the changes in sevoflurane anesthesia maintenance after activation of the GABAergic neurons. RESULTS In sevoflurane anesthesia, the induction time of anesthesia was significantly shorter in hM3Dq group than in mCherry group (P < 0.05), and also shorter in ChR2 group than in GFP group (P < 0.01), but no significant difference was found in the awakening time between the two groups in either chemogenetic or optogenetic tests. Similar results were observed in chemogenetic and optogenetic experiments with propofol (P < 0.05 or 0.01). Photogenetic activation of the GABAergic neurons in the ZI did not cause significant changes in EEG spectrum during sevoflurane anesthesia maintenance. CONCLUSION Activation of the GABAergic neurons in the ZI promotes anesthesia induction of sevoflurane and propofol but does not affect anesthesia maintenance or awakening.
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Affiliation(s)
- F Cao
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
- Department of Anesthesia, Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Y Guo
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - S Guo
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Z Zhou
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - J Cao
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - L Tong
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - W Mi
- Department of Anesthesia, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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Lin G, Zhang Z, Lu Y, Geng J, Zhou Z, Lu L, Cao L. [A region-level contrastive learning-based deep model for glomerular ultrastructure segmentation on electron microscope images]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:815-824. [PMID: 37313824 DOI: 10.12122/j.issn.1673-4254.2023.05.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We propose a novel region- level self-supervised contrastive learning method USRegCon (ultrastructural region contrast) based on the semantic similarity of ultrastructures to improve the performance of the model for glomerular ultrastructure segmentation on electron microscope images. METHODS USRegCon used a large amount of unlabeled data for pre- training of the model in 3 steps: (1) The model encoded and decoded the ultrastructural information in the image and adaptively divided the image into multiple regions based on the semantic similarity of the ultrastructures; (2) Based on the divided regions, the first-order grayscale region representations and deep semantic region representations of each region were extracted by region pooling operation; (3) For the first-order grayscale region representations, a grayscale loss function was proposed to minimize the grayscale difference within regions and maximize the difference between regions. For deep semantic region representations, a semantic loss function was introduced to maximize the similarity of positive region pairs and the difference of negative region pairs in the representation space. These two loss functions were jointly used for pre-training of the model. RESULTS In the segmentation task for 3 ultrastructures of the glomerular filtration barrier based on the private dataset GlomEM, USRegCon achieved promising segmentation results for basement membrane, endothelial cells, and podocytes, with Dice coefficients of (85.69 ± 0.13)%, (74.59 ± 0.13)%, and (78.57 ± 0.16)%, respectively, demonstrating a good performance of the model superior to many existing image-level, pixel-level, and region-level self-supervised contrastive learning methods and close to the fully- supervised pre-training method based on the large- scale labeled dataset ImageNet. CONCLUSION USRegCon facilitates the model to learn beneficial region representations from large amounts of unlabeled data to overcome the scarcity of labeled data and improves the deep model performance for glomerular ultrastructure recognition and boundary segmentation.
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Affiliation(s)
- G Lin
- School of Biomedical Engineering//Guangdong Provincial Key Laboratory of Medical Image Processing//Guangdong Provincial Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou 510515, China
| | - Z Zhang
- School of Biomedical Engineering//Guangdong Provincial Key Laboratory of Medical Image Processing//Guangdong Provincial Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou 510515, China
| | - Y Lu
- Central Laboratory, Southern Medical University, Guangzhou 510515, China
| | - J Geng
- School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
- Guangzhou Huayin Medical Laboratory Center, Guangzhou 510515, China
| | - Z Zhou
- Central Laboratory, Southern Medical University, Guangzhou 510515, China
| | - L Lu
- School of Biomedical Engineering//Guangdong Provincial Key Laboratory of Medical Image Processing//Guangdong Provincial Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou 510515, China
| | - L Cao
- School of Biomedical Engineering//Guangdong Provincial Key Laboratory of Medical Image Processing//Guangdong Provincial Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou 510515, China
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Li S, Zhou Z, Wu S, Wu W. Ultrasound Homodyned-K Contrast-Weighted Summation Parametric Imaging Based on H-scan for Detecting Microwave Ablation Zones. Ultrason Imaging 2023; 45:119-135. [PMID: 36995065 DOI: 10.1177/01617346231162928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The homodyned-K (HK) distribution is a generalized model of envelope statistics whose parameters α (the clustering parameter) and k (the coherent-to-diffuse signal ratio) can be used to monitor the thermal lesions. In this study, we proposed an ultrasound HK contrast-weighted summation (CWS) parametric imaging algorithm based on the H-scan technique and investigated the optimal window side length (WSL) of the HK parameters estimated by the XU estimator (an estimation method based on the first moment of the intensity and two log-moments, which was used in the proposed algorithm) through phantom simulations. H-scan diversified ultrasonic backscattered signals into low- and high-frequency passbands. After envelope detection and HK parameter estimation for each frequency band, the α and k parametric maps were obtained, respectively. According to the contrast between the target region and background, the (α or k) parametric maps of the dual-frequency band were weighted and summed, and then the CWS images were yielded by pseudo-color imaging. The proposed HK CWS parametric imaging algorithm was used to detect the microwave ablation coagulation zones of porcine liver ex vivo under different powers and treatment durations. The performance of the proposed algorithm was compared with that of the conventional HK parametric imaging and frequency diversity and compounding Nakagami imaging algorithms. For two-dimensional HK parametric imaging, it was found that a WSL equal to 4 pulse lengths of the transducer was sufficient for estimating the α and k parameters in terms of both parameter estimation stability and parametric imaging resolution. The HK CWS parametric imaging provided an improved contrast-to-noise ratio over conventional HK parametric imaging, and the HK αcws parametric imaging achieved the best accuracy and Dice score of coagulation zone detection.
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Affiliation(s)
- Sinan Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing, China
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Gu LG, Zheng YM, Xu C, Gao X, Zhou Z, Huang Y, Chu X, Zhao J, Su J, Song WN. [Analysis of the pathogenesis and risk factors of gallstone]. Zhonghua Wai Ke Za Zhi 2023; 61:389-394. [PMID: 36987673 DOI: 10.3760/cma.j.cn112139-20220927-00410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Objective: To explore the pathogenesis and risk factors of gallstone formation. Methods: The findings of hepatobiliary ultrasound and related data were collected from healthy subjects who underwent a physical examination at Xuanwu Hospital of Capital Medical University from January 2012 to December 2021. A total of 98 344 healthy subjects were included in the study,including 48 241 males and 50 103 females,with a ratio of 1∶1.03,aged (42.0±15.6)years(range:14 to 97 years). The gender,age,body mass index,waist circumference,systolic pressure,diastolic pressure,ALT,AST,total bilirubin,fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein,high-density lipoprotein were collected.Healthy subjects were required to sit for at least 10 minutes before blood pressure was measured.Rresults of fasting venous blood were collected after 8 to 12 hours on an empty stomach.According to the presence of gallstones by ultrasound results, healthy subjects were divided into study group and control group. Data were analyzed by rank-sum tests and χ2 test, and risk factors for gallstone formation were explored by Logistic regression analysis. Results: The incidence of gallstones in this group was 5.42%(5 333/98 344). Among them,the incidence of gallstones in people aged 60 years and above was significantly higher than that in people under 60 years old(15.31%(2 348/15 334) vs. 3.60%(2 985/83 010), χ2=3 473.46,P<0.05).The healthy subjects were divided by age for every 10 years,and the results showed that the incidence of gallstones increased with age. The incidence of gallstones in females was 5.68%(2 844/50 103),greater than 5.16%(2 489/48 241) in males(χ2=11.81,P<0.05). Among them,1 478 cases underwent gallbladder surgical resection due to gallstones,and the operation rate was 27.71%. The operation rate reached the peak between 60 and <70 years old,and decreased after 70 years old. The results of the multivariate analysis showed that,female(OR=1.38, P<0.01),age(OR=1.58, P<0.01),body mass index≥24 kg/m2(OR=1.31, P<0.01),waist circumference≥85 cm(OR=1.24, P<0.01),fasting blood glucose>6.1 mmol/L(OR=1.18,P<0.01),total cholesterol≥5.18 mmol/L(OR=0.87, P=0.019),low-density lipoprotein≥3.37 mmol/L(OR=1.15,P=0.001) were the risk factors for gallstone formation;high-density lipoprotein≥1.55 mmol/L(OR=0.87, P<0.01) was a protective factor for gallstone formation. Conclusions: The incidence of gallstones increases with age in male and female. Gender,age,body mass index,waist circumferenc,fasting blood glucose,total cholesterol,LDL,and HDL are related factors with gallstone formation.
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Affiliation(s)
- L G Gu
- Department of General Surgery, Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - Y M Zheng
- Department of General Surgery, Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - C Xu
- Department of General Surgery, Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - X Gao
- Department of General Surgery, Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - Z Zhou
- School of Biomedical Engineering, Capital Medical University, Beijing 100069,China
| | - Y Huang
- Information Center, Xuanwu Hospital,Capital Medical University,Beijing 100053,China
| | - X Chu
- Health Management Department,Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - J Zhao
- Health Management Department,Xuanwu Hospital, Capital Medical University,Beijing 100053,China
| | - J Su
- The First Clinical Medical College, Xuanwu Hospital, Capital Medical University, Beijing 100053,China
| | - W N Song
- The First Clinical Medical College, Xuanwu Hospital, Capital Medical University, Beijing 100053,China
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Zhu Z, Tang T, He Z, Wang F, Chen H, Chen G, Zhou J, Liu S, Wang J, Tian W, Chen D, Wu X, Liu X, Zhou Z, Liu S. Uniaxial cyclic stretch enhances osteogenic differentiation of OPLL-derived primary cells via YAP-Wnt/β-catenin axis. Eur Cell Mater 2023; 45:31-45. [PMID: 36749152 DOI: 10.22203/ecm.v045a03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The pathogenesis of posterior longitudinal ligament ossification (OPLL) remains inadequately understood. Mechanical stimulation is one of the important pathogenic factors in OPLL. As one of the mechanical stimulation transduction signals, the yes-associated protein (YAP) interacts with the Wnt/β-catenin signalling pathway, which plays an important role in osteogenic differentiation. This study aimed to demonstrate the role of YAP-Wnt/β-catenin axis in cell differentiation induced by mechanical stress. Primary cells extracted from posterior longitudinal ligament tissues from OPLL or non-OPLL patients were subjected to sinusoidal uniaxial cyclic stretch (5 %, 0.5 Hz, 3 d). The expression of runt-related transcription factor 2, collagen I, osterix, osteocalcin and alkaline phosphatase were compared between the static and the experimental groups. In addition, the cytoskeleton was detected using phalloidin staining while YAP phosphorylation states and nuclear location were identified using immunofluorescence. The results showed that mechanical stretching loading increased the expression of osteogenic genes and proteins in the OPLL group, while it had no significant effect on the control group. When OPLL cells were stretched, YAP exhibited an obvious nuclear translocation and the Wnt/β-catenin pathway was activated. Knocking down YAP or β-catenin could weaken the impact upon osteogenic differentiation induced by mechanical stimulation. YAP-mediated mechanical stimulation promoted osteogenic differentiation of OPLL cells through Wnt/β-catenin pathway and this progress was independent of the Hippo pathway.
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Zhang J, Zhou Y, Guo J, Li J, Wu Y, Zhou Z, Zhu H, Luo X, Chen D, Li Q, Liu X, Li W. [Prevalence and molecular characterization of Cryptosporidium in captive-bred Mustela putorius furo in Jiangsu Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:73-77. [PMID: 36974018 DOI: 10.16250/j.32.1374.2022159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To investigate the prevalence and molecular features of Cryptosporidium in captive-bred Mustela putorius furo in Jiangsu Province. METHODS A total of 290 fresh stool samples were collected from a ferret farm in Jiangsu Province on May 2017, and the small subunit rRNA (SSU rRNA) gene of Cryptosporidium was amplified in stool samples using nested PCR assay. The actin, cowp and gp60 genes were amplified in positive samples and sequenced to characterize Cryptosporidium species/genotypes. RESULTS A total of 18 stool samples were tested positive for Cryptosporidium SSU rRNA gene, with a detection rate of 6.2%. Sequence and phylogenetic analyses of SSU rRNA, actin and cowp genes characterized Cryptosporidium isolated from captive-bred ferrets as Cryptosporidium sp. ferret genotype. In addition, gp60 gene was amplified in 10 out of 18 stool samples tested positive for Cryptosporidium. CONCLUSIONS Cryptosporidium is widely prevalent in captive-bred ferrets in Jiangsu Province, and Cryptosporidium sp. ferret genotype is the only Cryptosporidium genotype in ferrets.
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Affiliation(s)
- J Zhang
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Y Zhou
- Jiangsu Institute of Parasitic Diseases, Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, China
| | - J Guo
- Animal Husbandry Development Center of Lu'an City, China
| | - J Li
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Y Wu
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Z Zhou
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - H Zhu
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - X Luo
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - D Chen
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Q Li
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - X Liu
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - W Li
- Anhui Province Key Laboratory of Animal Nutritional Regulation and Health, College of Animal Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
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Zeng Y, Tsui PH, Pang K, Bin G, Li J, Lv K, Wu X, Wu S, Zhou Z. MAEF-Net: Multi-attention efficient feature fusion network for left ventricular segmentation and quantitative analysis in two-dimensional echocardiography. Ultrasonics 2023; 127:106855. [PMID: 36206610 DOI: 10.1016/j.ultras.2022.106855] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/03/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
The segmentation of cardiac chambers and the quantification of clinical functional metrics in dynamic echocardiography are the keys to the clinical diagnosis of heart disease. Identifying the end-diastolic frames (EDFs) and end-systolic frames (ESFs) and manually segmenting the left ventricle in the echocardiographic cardiac cycle before obtaining the left ventricular ejection fraction (LVEF) is a time-consuming and tedious task for clinicians. In this work, we proposed a deep learning-based fully automated echocardiographic analysis method. We proposed a multi-attention efficient feature fusion network (MAEF-Net) to automatically segment the left ventricle. Then, EDFs and ESFs in all cardiac cycles were automatically detected to compute LVEF. The MAEF-Net method used a multi-attention mechanism to guide the network to capture heartbeat features effectively, while suppressing noise, and incorporated deep supervision mechanism and spatial pyramid feature fusion to enhance feature extraction capabilities. The proposed method was validated on the public EchoNet-Dynamic dataset (n = 1226). The Dice similarity coefficient (DSC) of the left ventricular segmentation reached (93.10 ± 2.22)%, and the mean absolute error (MAE) of cardiac phase detection was (2.36 ± 2.23) frames. The MAE for predicting LVEF was 6.29 %. The proposed method was also validated on a private clinical dataset (n = 22). The DSC of the left ventricular segmentation reached (92.81 ± 2.85)%, and the MAE of cardiac phase detection was (2.25 ± 2.27) frames. The MAE for predicting LVEF was 5.91 %, and the Pearson correlation coefficient r reached 0.96. The proposed method may be used as a new method for automatic left ventricular segmentation and quantitative analysis in two-dimensional echocardiography. Our code and trained models will be made available publicly at https://github.com/xiaojinmao-code/MAEF-Net.
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Affiliation(s)
- Yan Zeng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; Institute for Radiological Research, Chang Gung University, Taoyuan 333323, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan
| | - Kunjing Pang
- Department of Echocardiography, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Jiehui Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ke Lv
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xining Wu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China.
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China.
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Yu R, Zhou Z, Wu S, Gao X, Bin G. MRASleepNet: a multi-resolution attention network for sleep stage classification using single-channel EEG. J Neural Eng 2022; 19. [PMID: 36379059 DOI: 10.1088/1741-2552/aca2de] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/15/2022] [Indexed: 11/16/2022]
Abstract
Objective. Computerized classification of sleep stages based on single-lead electroencephalography (EEG) signals is important, but still challenging. In this paper, we proposed a deep neural network called MRASleepNet for automatic sleep stage classification using single-channel EEG signals.Approach. The proposed MRASleepNet model consisted of a feature extraction (FE) module, a multi-resolution attention (MRA) module, and a gated multilayer perceptron (gMLP) module, as well as a direct pathway for computing statistical features. The FE, MRA, and gMLP modules were used to extract features, establish feature attention, and obtain temporal relationships between features, respectively. EEG signals were normalized and cut into 30 s segments, and enhanced by incorporating contextual information from adjacent data segments. After data enhancement, the 40 s data segments were input to the MRASleepNet model. The model was evaluated on the SleepEDF and the cyclic alternating pattern (CAP) databases, using such metrics as the accuracy, Kappa, and macro-F1 (MF1).Main results.For the SleepEDF-20 database, the proposed model had an accuracy of 84.5%, an MF1 of 0.789, and a Kappa of 0.786. For the SleepEDF-78 database, the model had an accuracy of 81.4%, an MF1 of 0.754, and a Kappa of 0.743. For the CAP database, the model had an accuracy of 74.3%, an MF1 of 0.656, and a Kappa of 0.652. The proposed model achieved satisfactory performance in automatic sleep stage classification tasks.Significance. The time- and frequency-domain features extracted by the FE module and filtered by the MRA module, together with the temporal features extracted by the gMLP module and the statistical features extracted by the statistical highway, enabled the proposed model to obtain a satisfying performance in sleep staging. The proposed MRASleepNet model may be used as a new deep learning method for automatic sleep stage classification. The code of MRASleepNet will be made available publicly onhttps://github.com/YuRui8879/.
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Affiliation(s)
- Rui Yu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Xiaorong Gao
- Department of Biomedical Engineering, Tsinghua University, 100084 Beijing, People's Republic of China
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
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Yang J, Wang H, Zhou Z, Niu X, Qu C, Guo X, Wu J, Lu S, Xu Q. 54P Oncolytic virus combined PD-1 antibody toripalimab in advanced lung cancer with liver metastases: An early stage, single arm, study (TROJAN 2201). Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Baitei E, Zhang M, Poile C, Luo JL, Dzialo J, Zhou Z, Harber J, Pritchard C, Kamata T, King A, Branson A, Barber S, Thomas A, Yang H, Fennell D. 28P Epithelial mesenchymal transition confers resistance to dual PDL1-VEGF inhibition in relapsed mesothelioma. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Li S, Wang Z, Zhang Y, Wang Y, Wang H, Su Y, Zhou Z. 70: A NOVEL MULTIPLEX PCR ASSAY FOR RAPID DETECTION OF CLINICALLY RELEVANT ASPERGILLUS SPECIES. J Glob Antimicrob Resist 2022. [DOI: 10.1016/s2213-7165(22)00349-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Xu Y, Li H, Huang Z, Xie M, Zhou Z, Fan Y. 33P Changes in serum cytokine CXCL12 level can predict the survival of patients with non-small cell lung cancer receiving anti-PD-1 treatment. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ren HQ, Zhong S, Lei Y, Zhou Z. [Analysis of risk factors for decompensated cirrhosis complicated with sepsis]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1163-1169. [PMID: 36891692 DOI: 10.3760/cma.j.cn501113-20210913-00469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Objective: To investigate the related risk factors in patients with decompensated cirrhosis complicated with sepsis. Methods: 1 098 cases with decompensated cirrhosis were collected from January 2018 to December 2020. A total of 492 cases with complete data meeting the inclusion criteria were included. Among them, the sepsis group (240 cases) was complicated with sepsis and the non-sepsis group (252 cases) was not complicated with sepsis. Albumin, cholinesterase, total bilirubin, prothrombin activity, urea, creatinine, international normalized ratio and other indicators of the two groups of patients were collected. Child-Pugh classification and MELD score were performed on two groups of patients. Mann-Whitney U test was used for non-normally distributed measurement data, and rank sum test for grade data. Logistic regression analysis was performed on sepsis-related factors that may affect patients with decompensated cirrhosis complicated with sepsis. Results: 162 cases of gram negative bacteria, 76 cases of gram positive bacteria and 2 cases of Candida were detected. Child-Pugh grade C was mainly in the sepsis group, and Child- Pugh grade A and B was mainly in the non-sepsis group (z=-13.01, P<0.05). MELD score was significantly higher in patients with sepsis than that of patients without sepsis (z=-12.30, P<0.05). Neutrophils percentage, C-reactive protein, procalcitonin, and total bilirubin in patients with decompensated cirrhosis complicated with sepsis were 86.90% (79.00%, 91.05%), 48.48 (17.63, 97.55) mg/l,1.34 (0.40, 4.52) ng/l, and 78.50 (32.75149.80) μmol/L, which were significantly higher than that of patients without sepsis [69.55% (58.58%, 75.90%), 5.34 (5.00, 14.94) mg/l, 0.11(0.06,0.24) ng/l, 22.50(15.10,37.55) respectively] μmol/L, P<0.05], while the albumin level, prothrombin activity level, and the cholinesterase level in sepsis patients were 27.30 (24.45, 30.60) g/L, 46.00% (33.50%, 59.00%), and 1.87 (1.29, 2.66) kU/L, respectively, which was significantly lower than the non-sepsis group [32.65 (28.95, 37.23) g/l, 73.00(59.75~84.85)%, 3.13(2.23~4.59) kU/L, P<0.05]. Logistic regression analysis showed that serum total bilirubin, albumin, prothrombin activity level and diabetes mellitus were the independent risk factors for complicated sepsis. Conclusion: Patients with decompensated cirrhosis with poor liver function and higher MELD scores are more likely to be complicated with sepsis. Therefore, during the clinical diagnosis and treatment course, patients with decompensated cirrhosis with poor liver reserve function should be actively and dynamically monitored for infection-related indicators such as neutrophil percentage, procalcitonin, C-reactive protein, in an attempt to detect possible potential infections and sepsis, and improve early treatment and prognosis.
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Affiliation(s)
- H Q Ren
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - S Zhong
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Y Lei
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Z Zhou
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Huang Y, Zeng Y, Bin G, Ding Q, Wu S, Tai DI, Tsui PH, Zhou Z. Evaluation of Hepatic Fibrosis Using Ultrasound Backscattered Radiofrequency Signals and One-Dimensional Convolutional Neural Networks. Diagnostics (Basel) 2022; 12:diagnostics12112833. [PMID: 36428892 PMCID: PMC9689172 DOI: 10.3390/diagnostics12112833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
The early detection of hepatic fibrosis is of critical importance. Ultrasound backscattered radiofrequency signals from the liver contain abundant information about its microstructure. We proposed a method for characterizing human hepatic fibrosis using one-dimensional convolutional neural networks (CNNs) based on ultrasound backscattered signals. The proposed CNN model was composed of four one-dimensional convolutional layers, four one-dimensional max-pooling layers, and four fully connected layers. Ultrasound radiofrequency signals collected from 230 participants (F0: 23; F1: 46; F2: 51; F3: 49; F4: 61) with a 3-MHz transducer were analyzed. Liver regions of interest (ROIs) that contained most of the liver ultrasound backscattered signals were manually delineated using B-mode images reconstructed from the backscattered signals. ROI signals were normalized and augmented by using a sliding window technique. After data augmentation, the radiofrequency signal segments were divided into training sets, validation sets and test sets at a ratio of 80%:10%:10%. In the test sets, the proposed algorithm produced an area under the receive operating characteristic curve of 0.933 (accuracy: 91.30%; sensitivity: 92.00%; specificity: 90.48%), 0.997 (accuracy: 94.29%; sensitivity: 94.74%; specificity: 93.75%), 0.818 (accuracy: 75.00%; sensitivity: 69.23%; specificity: 81.82%), and 0.934 (accuracy: 91.67%; sensitivity: 88.89%; specificity: 94.44%) for diagnosis liver fibrosis stage ≥F1, ≥F2, ≥F3, and ≥F4, respectively. Experimental results indicated that the proposed deep learning algorithm based on ultrasound backscattered signals yields a satisfying performance when diagnosing hepatic fibrosis stages. The proposed method may be used as a new quantitative ultrasound approach to characterizing hepatic fibrosis.
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Affiliation(s)
- Yong Huang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Yan Zeng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Qiying Ding
- Department of Ultrasound, BJUT Hospital, Beijing University of Technology, Beijing 100124, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Dar-In Tai
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan 333423, Taiwan
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Institute for Radiological Research, Chang Gung University, Taoyuan 333323, Taiwan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan
- Correspondence: (P.-H.T.); (Z.Z.)
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
- Correspondence: (P.-H.T.); (Z.Z.)
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Ali M, Thomas S, Zhou Z. Correlating Cytologic and Histologic Features of Hepatic Epithelioid Hemangioendothelioma. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Epithelioid hemangioendothelioma (EHE) is a rare malignant vascular tumor composed of epithelioid and dendritic tumor cells embedded in myxoid or hyalinized stroma. It can occur in various organs and has nonspecific clinical and radiologic presentation. We report a case of EHE in the liver with correlation of cytologic and histological findings.
Methods/Case Report
A 68-year-old female presented for evaluation of a right hepatic lobe lesion that was noted on Imaging. MRI abdomen with contrast showed a well-circumscribed hypointense nodule with no contrast enhancement. CT-guided fine needle aspiration showed scattered atypical epithelioid cells in a background of benign hepatocytes which were positive for vascular markers (CD31 and CD34) as well as keratins and SMA. A diagnosis of atypical vascular neoplasm was rendered. A partial hepatectomy was performed a month later which showed a 3.2 cm mass with solid tan-white cut surface. Histologically, the mass was composed of epithelioid tumor cells with focal intracytoplasmic vacuoles which were partly solid and partly forming vascular-like spaces, embedded in a background of hyalinized stroma. Immunohistochemically, in addition to the vascular markers the tumor was positive for CAMTA1 confirming the presence of WWTR1-CAMTA1 gene fusion which is characteristic for epithelioid hemangioendothelioma. The patient was discharged in good condition.
Results (if a Case Study enter NA)
NA.
Conclusion
Diagnosis of EHE on FNA is challenging. It is characterized by discohesive atypical large polygonal cells with abundant dense cytoplasm in a background of benign hepatocytes. Characteristically, the tumor cells have intracytoplasmic vacuoles containing red blood cells, which resemble signet ring-like structures. Immunohistochemically, positivity for vascular markers and CAMTA1 is diagnostic.
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Affiliation(s)
- M Ali
- Pathology, Robert Wood Johnson Medical School Rutgers University , New Brunswick, New Jersey , United States
| | - S Thomas
- Pathology, Robert Wood Johnson Medical School Rutgers University , New Brunswick, New Jersey , United States
| | - Z Zhou
- Pathology, Robert Wood Johnson Medical School Rutgers University , New Brunswick, New Jersey , United States
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Ali M, Zhou Z. Elastotic Mass-Forming Lesion of the Omentum; A New Pathological Entity. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction/Objective
Elastotic lesions are rare benign mass-forming entity. Although, few reports of mucosal and submucosal elastotic lesions have been previously described, localization of these lesions in the omentum is not previously described in the literature.
Methods/Case Report
We report a case of 60-year-old man with medical history of obesity, hypertension, diabetes mellitus, and a remote abdominal surgery in 1980s who presented to the emergency room complaining of abrupt severe constant epigastric pain that started few hours before. The pain was not relieved by antiacid or analgesic medications. CT of the abdomen showed multiple distended fluid-filled loops of small bowel in mid abdomen with infiltrative changes of mesentery. A diagnosis of small bowel obstruction was made, and patient proceed to have an exploratory laparotomy. During the procedure, extensive adhesions between small bowel and omentum and small bowel obstruction due to a phytobezoar were noted for which he underwent lysis of adhesion, excision of thickened omentum, and enterotomy for removal of significant food bezoar. Grossly, the omentum has multiple chalky tan-gray masses ranging between 1.2 and 1.0 cm in greatest dimension surrounded by indurated fatty tissue. Microscopically, multiple hypocellular foci are seen that are composed almost entirely of truncated elastic fibers, with sparse delicate bands of collagen and scattered prominent thick-walled vessels. Elastic stain highlights these elastic fibers while trichrome stains the elastic fibers pale gray in contrast to the bright blue color of the collagen fibers. Mucicarmine, and Congo red are negative. Patient tolerated the procedure well however, postoperatively he had local wound infection leading to prolonged skin dehiscence.
Results (if a Case Study enter NA)
NA.
Conclusion
Elastotic mass-forming lesions in the omentum is a new entity that has not been described before in this location that can clinically manifest with signs and symptoms of bowel obstruction. We suggested the name of elastomatosis omentum.
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Affiliation(s)
- M Ali
- Pathology, Robert Wood Johnson Medical School Rutgers University , New Brunswick, New Jersey , United States
| | - Z Zhou
- Pathology, Robert Wood Johnson Medical School Rutgers University , New Brunswick, New Jersey , United States
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Li S, Zhou Z, Wu S, Wu W. A Review of Quantitative Ultrasound-Based Approaches to Thermometry and Ablation Zone Identification Over the Past Decade. Ultrason Imaging 2022; 44:213-228. [PMID: 35993226 DOI: 10.1177/01617346221120069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Percutaneous thermal therapy is an important clinical treatment method for some solid tumors. It is critical to use effective image visualization techniques to monitor the therapy process in real time because precise control of the therapeutic zone directly affects the prognosis of tumor treatment. Ultrasound is used in thermal therapy monitoring because of its real-time, non-invasive, non-ionizing radiation, and low-cost characteristics. This paper presents a review of nine quantitative ultrasound-based methods for thermal therapy monitoring and their advances over the last decade since 2011. These methods were analyzed and compared with respect to two applications: ultrasonic thermometry and ablation zone identification. The advantages and limitations of these methods were compared and discussed, and future developments were suggested.
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Affiliation(s)
- Sinan Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing, China
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Zhou Z, Zhang Z, Gao A, Tai DI, Wu S, Tsui PH. Liver Fibrosis Assessment Using Radiomics of Ultrasound Homodyned-K imaging Based on the Artificial Neural Network Estimator. Ultrason Imaging 2022; 44:229-241. [PMID: 36017590 DOI: 10.1177/01617346221120070] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The homodyned-K distribution is an important ultrasound backscatter envelope statistics model of physical meaning, and the parametric imaging of the model parameters has been explored for quantitative ultrasound tissue characterization. In this paper, we proposed a new method for liver fibrosis characterization by using radiomics of ultrasound backscatter homodyned-K imaging based on an improved artificial neural network (iANN) estimator. The iANN estimator was used to estimate the ultrasound homodyned-K distribution parameters k and α from the backscattered radiofrequency (RF) signals of clinical liver fibrosis (n = 237), collected with a 3-MHz convex array transducer. The RF data were divided into two groups: Group I corresponded to liver fibrosis with no hepatic steatosis (n = 94), and Group II corresponded to liver fibrosis with mild to severe hepatic steatosis (n = 143). The estimated homodyned-K parameter values were then used to construct k and α parametric images using the sliding window technique. Radiomics features of k and α parametric images were extracted, and feature selection was conducted. Logistic regression classification models based on the selected radiomics features were built for staging liver fibrosis. Experimental results showed that the proposed method is overall superior to the radiomics method of uncompressed envelope images when assessing liver fibrosis. Regardless of hepatic steatosis, the proposed method achieved the best performance in staging liver fibrosis ≥F1, ≥F4, and the area under the receiver operating characteristic curve was 0.88, 0.85 (Group I), and 0.85, 0.86 (Group II), respectively. Radiomics has improved the ability of ultrasound backscatter statistical parametric imaging to assess liver fibrosis, and is expected to become a new quantitative ultrasound method for liver fibrosis characterization.
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Affiliation(s)
- Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zijing Zhang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Fan Gongxiu Honors College, Beijing University of Technology, Beijing, China
| | - Anna Gao
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Dar-In Tai
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan
- Institute for Radiological Research, Chang Gung University, Taoyuan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan
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Zhang C, Liu X, Zhou Z, Deng L, Xiao Z, Feng Q, Chen D, Lv J, Bi N, Wang X, Zhang T, Wang W. Prophylactic Cranial Irradiation in Patients with Limited-Stage Small-Cell Lung Cancer without Brain Metastases: A Retrospective Cohort Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Yu N, Wan Y, Zuo L, Cao Y, Qu D, Liu W, Deng L, Zhang T, Wang W, Wang J, Feng Q, Zhou Z, Xiao Z, BI N, Niu T, Wang X. MRI and CT Radiomics Features to Predict Overall Survival of Locally Advanced Esophageal Cancer after Definite Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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