Diagnosis of coronary layered plaque by deep learning

Background/Introduction

Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability and rapid plaque progression. However, the diagnosis of layered plaque requires expertise in OCT image interpretation and is susceptible to interobserver variability.

Purpose

We aimed to develop a deep learning (DL) model for an accurate diagnosis of layered plaque.

Methods

We developed a Visual Transformer (ViT)-based DL model emulating the cardiologists who review consecutive OCT frames to make a diagnosis (Figure 1), and compared it to the standard convolutional neural network (CNN) model. We used 302,415 cross-sectional OCT images from 873 patients collected from 9 sites: 237,021 images from 581 patients for training and internal validation from 8 sites, and 65394 images from 292 patients collected from another site for external validation.

Results

Model performances were evaluated using the area under the receiver operating characteristics (AUC). In the five-fold cross validation, the ViT-based model showed better performance than the standard CNN-based model with AUC of 0.886 (95% confidence interval [CI], 0.882–0.891) compared with 0.797 (95% CI, 0.790–0.804). The ViT-based model also outperformed the standard CNN-based model in the external validation, with an AUC of 0.857 (95% CI, 0.849–0.864) compared to 0.806 (95% CI, 0.797–0.815) (Figure 2).

Conclusion(s)

The ViT-based DL model will help cardiologists to make an accurate diagnosis of layered plaque, which might help to stratify the risk of future adverse cardiac events.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Mrs. Gillian Gray through the Allan Gray Fellowship Fund in Cardiology

Reduced ER-mitochondria connectivity promotes neuroblastoma multidrug resistance

Most cancer deaths result from progression of therapy resistant disease, yet our understanding of this phenotype is limited. Cancer therapies generate stress signals that act upon mitochondria to initiate apoptosis. Mitochondria isolated from neuroblastoma cells were exposed to tBid or Bim, death effectors activated by therapeutic stress. Multidrug‐resistant tumor cells obtained from children at relapse had markedly attenuated Bak and Bax oligomerization and cytochrome c release (surrogates for apoptotic commitment) in comparison with patient‐matched tumor cells obtained at diagnosis. Electron microscopy identified reduced ER–mitochondria‐associated membranes (MAMs; ER–mitochondria contacts, ERMCs) in therapy‐resistant cells, and genetically or biochemically reducing MAMs in therapy‐sensitive tumors phenocopied resistance. MAMs serve as platforms to transfer Ca²⁺ and bioactive lipids to mitochondria. Reduced Ca²⁺ transfer was found in some but not all resistant cells, and inhibiting transfer did not attenuate apoptotic signaling. In contrast, reduced ceramide synthesis and transfer was common to resistant cells and its inhibition induced stress resistance. We identify ER–mitochondria‐associated membranes as physiologic regulators of apoptosis via ceramide transfer and uncover a previously unrecognized mechanism for cancer multidrug resistance.

Machine Learning-Based Single Cell and Integrative Analysis Reveals That Baseline mDC Predisposition Correlates With Hepatitis B Vaccine Antibody Response

Vaccination to prevent infectious disease is one of the most successful public health interventions ever developed. And yet, variability in individual vaccine effectiveness suggests that a better mechanistic understanding of vaccine-induced immune responses could improve vaccine design and efficacy. We have previously shown that protective antibody levels could be elicited in a subset of recipients with only a single dose of the hepatitis B virus (HBV) vaccine and that a wide range of antibody levels were elicited after three doses. The immune mechanisms responsible for this vaccine response variability is unclear. Using single cell RNA sequencing of sorted innate immune cell subsets, we identified two distinct myeloid dendritic cell subsets (NDRG1-expressing mDC2 and CDKN1C-expressing mDC4), the ratio of which at baseline (pre-vaccination) correlated with the immune response to a single dose of HBV vaccine. Our results suggest that the participants in our vaccine study were in one of two different dendritic cell dispositional states at baseline – an NDRG2-mDC2 state in which the vaccine elicited an antibody response after a single immunization or a CDKN1C-mDC4 state in which the vaccine required two or three doses for induction of antibody responses. To explore this correlation further, genes expressed in these mDC subsets were used for feature selection prior to the construction of predictive models using supervised canonical correlation machine learning. The resulting models showed an improved correlation with serum antibody titers in response to full vaccination. Taken together, these results suggest that the propensity of circulating dendritic cells toward either activation or suppression, their “dispositional endotype” at pre-vaccination baseline, could dictate response to vaccination.

Detection of interleukin-33 in serum and carcinoma tissue from patients with hepatocellular carcinoma and its clinical implications

OBJECTIVE

To study the clinical significance of intercellular interleukin (IL)-33 in hepatocellular carcinoma (HCC).

METHODS

Using immunohistochemistry, this prospective study compared IL-33 protein levels in samples of HCC tissue and normal tissue adjacent to the tumour in 60 patients with HCC, and in normal liver tissue from six healthy controls. Interferon (IFN)-α, IFN-γ and IL-33 serum levels were also analysed by enzyme-linked immunosorbent assay in HCC 30 patients and 10 healthy controls. The level of IL-33 immunohistochemical staining was compared with the rate of lymph node metastasis in HCC patients.

RESULTS

IL-33 was strongly positive in the cytoplasm of hepatocytes. The median percentage of IL-33-positive tissue was higher in HCC than in normal liver tissue samples (adjacent to the tumour or from controls). Serum IFN-α, IFN-γ and IL-33 levels were higher in pre- and postoperative samples from HCC patients than in control samples, and in patients with metastasis compared with those without metastasis.

CONCLUSIONS

Increased IL-33 protein levels were observed in serum and liver tissue from HCC patients; IL-33 may be a useful biological marker for monitoring HCC growth and metastasis.

UV light emitting transparent conducting tin-doped indium oxide (ITO) nanowires

Multifunctional single crystalline tin-doped indium oxide (ITO) nanowires with tuned Sn doping levels are synthesized via a vapor transport method. The Sn concentration in the nanowires can reach 6.4 at.% at a synthesis temperature of 840 °C, significantly exceeding the Sn solubility in ITO bulks grown at comparable temperatures, which we attribute to the unique feature of the vapor-liquid-solid growth. As a promising transparent conducting oxide nanomaterial, layers of these ITO nanowires exhibit a sheet resistance as low as 6.4 Ω/[Symbol: see text] and measurements on individual nanowires give a resistivity of 2.4 × 10(-4) Ω cm with an electron density up to 2.6 × 10(20) cm(-3), while the optical transmittance in the visible regime can reach ∼ 80%. Under the ultraviolet excitation the ITO nanowire samples emit blue light, which can be ascribed to transitions related to defect levels. Furthermore, a room temperature ultraviolet light emission is observed in these ITO nanowires for the first time, and the exciton-related radiative process is identified by using temperature-dependent photoluminescence measurements.

Influence of season on some skin properties: winter vs. summer, as experienced by 354 Shanghaiese women of various ages

The facial skin of 354 women, aged 18-80, living in Shanghai, was investigated over two successive 6-month periods, summer and winter. Results from clinical assessments indicate that aging signs, such as wrinkling and sagging, are unaffected over such period. However, physical measurements revealed alterations in some functional criteria of the skin, such as sebum output, skin colour, melanin content of pigmented spots, skin hydration, all being increased during summer. The relationships between all criteria, as well as technical or applied inferences/consequences from this study, are discussed.

PTEN, tau-AP-3, thymidylate synthase immunohistochemistry scoring expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignancy potential and uterine leiomyosarcomas

Uterine smooth muscle tumors are frequently classified as benign and malignant. However, an assortment of mitotic counts and nuclear atypia can be indecisive between uncertain malignant potential, and malignant uterine smooth muscle tumors. We applied three immunohistochemical parameters to distinguish between cases of benign, malignant, and those with uncertain malignant histology.

Atomistic free-volume zones and inelastic deformation of metallic glasses

The amorphous nature of metallic glasses and their mechanical properties make them interesting for structural applications. However, the interplay between the nature of atomic structures in metallic glasses and mechanical properties remains poorly understood. In this study, high-frequency dynamic micropillar tests have been used to probe both atomic clusters and flow defects in metallic glasses. We show that loosely bonded atomistic free-volume zones that are enveloped elastically by tightly bonded atomic clusters show a deformation character similar to supercooled liquids. At room temperature, the effective viscosity of these free-volume zones is of the order of 1 x 10(8) Pa s before the occurrence of shear banding. The confined liquid-like deformation of free-volume zones leads to significant mechanical hysteresis in micropillars under dynamic loading, providing important insight into how atomistic structural features affect the deformation behaviours in metallic glasses in the apparent elastic regime. The inelastic behaviour also serves as the basis for the superior damping resistance of metallic glasses.

Malignant transformation of extragonadal endometriosis: a case report

Though malignant transformation of endometriosis has been documented, malignancy arising from extragonadal endometriosis is rare. We present the case of a 39-year-old woman with abdominal pain and fullness after menstruation. Evaluation revealed a cul-de-sac mass and CA-125 level of 1048 U/ml. A hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. Endometrioid adenocarcinoma with a clearly defined transition zone from endometriosis to adenocarcinoma was noted histologically. Adjuvant chemotherapy and GnRH agonist treatment was administered. Serum CA-125 level was 1.51 U/ml 19 months after completion of treatment. Patients with endometriosis and elevated CA-125 levels should be managed aggressively and CA-125 levels monitored until they have normalized.

Importance of the (nabla) D term in frequency-resolved optical diffusion imaging

The effects of the approximation DD=0 that is often used in frequency-resolved optical diffusion imaging are examined. It is shown that this approximation can affect the performance of integral-equation-based approaches to optical diffusion imaging, such as the Born iterative method and the distorted Born iterative method. The approximation introduces errors into the calculation of data used in simulations, which can lead to misleading evaluations of reconstruction algorithms. Numerical calculations show the magnitude of these effects and the appearance of artifacts in reconstructed images when conventional inversion algorithms are applied to more accurately calculated data.

Pharmacokinetics of weekly transdermal estradiol controlled delivery system in postmenopausal Chinese

AIM

To study Pharmacokinetical profile of weekly transdermal estradiol controlled delivery system (E2-WTCDS) in 18 Chinese postmenopausal women.

METHODS

Single and multiple daily doses of E2-WTCDS were applied to an area of intact skin on the lower abdomen, using Estraderm TTS (E2-TTS) from Ciba-Geigy Company as control. E2 concentration in serum was measured by RIA.

RESULTS

Cmax 38 +/- 5 ng.L-1, Tmax 22 +/- 5 h, AUC 5651 +/- 386 ng.h.L-1, Cmax(SS) 44 +/- 7 ng.L-1, Cmax(SS) 35 +/- 4 ng.L-1, Fl 0.22 +/- 0.10. The relative bioavailability of E2-WTCDS was comparable to E2-TTS during the same period of system application.

CONCLUSION

E2-WTCDS maintained relatively constant and effective serum estradiol concentrations and is suitable for once-weekly application.