Prediction of metastases in confusing mediastinal lymph nodes based on flourine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging using machine learning.

Background: For patient management and prognosis, accurate assessment of mediastinal lymph node (LN) status is essential. This study aimed to use machine learning approaches to assess the status of confusing LNs in the mediastinum using positron emission tomography/computed tomography (PET/CT) images; the results were then compared with the diagnostic conclusions of nuclear medicine physicians. Methods: A total of 509 confusing mediastinal LNs that had undergone pathological assessment or follow-up from 320 patients from three centres were retrospectively included in the study. LNs from centres I and II were randomised into a training cohort (N=324) and an internal validation cohort (N=81), while those from centre III patients formed an external validation cohort (N=104). Various parameters measured from PET and CT images and extracted radiomics and deep learning features were used to construct PET/CT-parameter, radiomics, and deep learning models, respectively. Model performance was compared with the diagnostic results of nuclear medicine physicians using the area under the curve (AUC), sensitivity, specificity, and decision curve analysis (DCA). Results: The coupled model of gradient boosting decision tree-logistic regression (GBDT-LR) incorporating radiomic features showed AUCs of 92.2% [95% confidence interval (CI), 0.890-0.953], 84.6% (95% CI, 0.761-0.930) and 84.6% (95% CI, 0.770-0.922) across the three cohorts. It significantly outperformed the deep learning model, the parametric PET/CT model and the physician's diagnosis. DCA demonstrated the clinical usefulness of the GBDT-LR model. Conclusions: The presented GBDT-LR model performed well in evaluating confusing mediastinal LNs in both internal and external validation sets. It not only crossed radiometric features but also avoided overfitting.

nnUNet-based Multi-modality Breast MRI Segmentation and Tissue-Delineating Phantom for Robotic Tumor Surgery Planning.

Segmentation of the thoracic region and breast tissues is crucial for analyzing and diagnosing the presence of breast masses. This paper introduces a medical image segmentation architecture that aggregates two neural networks based on the state-of-the-art nnU-Net. Additionally, this study proposes a polyvinyl alcohol cryogel (PVA-C) breast phantom, based on its automated segmentation approach, to enable planning and navigation experiments for robotic breast surgery. The dataset consists of multimodality breast MRI of T2W and STIR images obtained from 10 patients. A statistical analysis of segmentation tasks emphasizes the Dice Similarity Coefficient (DSC), segmentation accuracy, sensitivity, and specificity. We first use a single class labeling to segment the breast region and then exploit it as an input for three-class labeling to segment fatty, fibroglandular (FGT), and tumorous tissues. The first network has a 0.95 DCS, while the second network has a 0.95, 0.83, and 0.41 for fat, FGT, and tumor classes, respectively. Clinical Relevance-This research is relevant to the breast surgery community as it establishes a deep learning-based (DL) algorithmic and phantomic foundation for surgical planning and navigation that will exploit preoperative multimodal MRI and intraoperative ultrasound to achieve highly cosmetic breast surgery. In addition, the planning and navigation will guide a robot that can cut, resect, bag, and grasp a tissue mass that encapsulates breast tumors and positive tissue margins. This image-guided robotic approach promises to potentiate the accuracy of breast surgeons and improve patient outcomes.

Self-efficacy for self-regulation and fear of failure as mediators between self-esteem and academic procrastination among undergraduates in health professions.

Academic procrastination has been a widespread problem behavior among undergraduates. This study aimed to examine the prevalence of academic procrastination among undergraduates in health professions, and explore the mediation effects of self-efficacy for self-regulation and fear of failure in the relationship between self-esteem and academic procrastination. A cross-sectional design was used to study 1184 undergraduates in health professions from China. Participants completed measures of academic procrastination, self-esteem, self-efficacy for self-regulation and fear of failure. We used Pearson product-moment correlation to examine the bivariate correlations between study variables, and path analysis to examine mediation. Among the 1184 undergraduates, 877 (74.1%) procrastinated on at least one type of academic task. The total score for academic procrastination was negatively correlated with scores for self-esteem and self-efficacy for self-regulation, and positively correlated with the score for fear of failure. Moreover, the relationship between self-esteem and academic procrastination was fully mediated by self-efficacy for self-regulation (indirect effect: ß = - .15, 95% bootstrap CI - .19 to - .11) and fear of failure (indirect effect: ß = - .06, 95% bootstrap CI - .09 to - .04). These findings suggest that interventions targeting the enhancement of self-efficacy for self-regulation and the conquest of fear of failure may prevent or reduce academic procrastination among undergraduates in health professions, especially for those with lower self-esteem.

[Treatment of transplantation of NT-3 gene modified olfactory ensheathing cells on experimental autoimmune encephalomyelitis in rats].

OBJECTIVE: To explore the effects of transplantation of NT-3 gene modified olfactory ensheathing cells (OECs) on nerve function of rats with experimental autoimmune encephalomyelitis (EAE). METHODS: The experimental autoimmune encephalomyelitis model was established in Lewis rats. The animals were randomly divided into 3 group: blank control group (transplantation of saline), OECs transplanted group (transplantation of OECs), and OECs-NT-3 transplanted group (transplantation of NT-3 modified OECs). The neurological function was assessed and recorded every day. The migration and distribution of transplanted cells were observed. The nerve regeneration was valued in the aspect of morphological structure by means of immunohistochemistry and retrograde tracing technique of horseradish peroxidase (HRP). RESULTS: The neurological functional score of OECs-NT-3 transplanted group was obviously inferior to OECs transplanted group after transplantation (P < 0.05). A large number of OECs-NT-3 survived and migrated with axon in OECs-NT-3 transplanted group at Day 28. The number of nerve fibers in one microscopic field was much more in OECs-NT-3 transplanted group (38.8 ± 3.4, Day 28) than those in OECs transplanted group (32.5 ± 2.8, Day 28) (P < 0.05). The number of cortex neurons labeled by HRP in OECs-NT-3 transplanted group were significantly higher than those in OECs transplanted group, (P < 0.01). CONCLUSION: NT-3 gene modified OECs have better capacities of survival and migration in EAE rats. The transplanted OECs-NT-3 can promote the regeneration of axon, reduce the injury of cortical neurons and improve the motor functions of EAE rats.

Lycopene attenuates insulin signaling deficits, oxidative stress, neuroinflammation, and cognitive impairment in fructose-drinking insulin resistant rats.

Fructose intake is linked with the increasing prevalence of insulin resistance, and insulin resistance links Alzheimer's disease with impaired insulin signaling, oxidative damage, neuroinflammation, and cognitive impairment. As a member of the carotenoid family of phytochemicals, lycopene is used as a potent free scavenger, and has been demonstrated to be effective in anti-oxidative stress and anti-inflammatory reaction in the models of AD and other neurodegenerative diseases. Here, we investigated the effect of lycopene on learning and memory impairment and the possible underlying molecular events in fructose-drinking insulin resistant rats. We found that long-term fructose-drinking causes insulin resistance, impaired insulin signaling, oxidative stress, neuroinflammation, down-regulated activity of cholinergic system, and cognitive impairment, which could be significantly ameliorated by oral lycopene administration. The results from this study provide experimental evidence for using lycopene in the treatment of brain damage caused by fructose-drinking insulin resistance.

AGEs induce cell death via oxidative and endoplasmic reticulum stresses in both human SH-SY5Y neuroblastoma cells and rat cortical neurons.

Advanced glycation endproducts (AGEs) are elevated in aging and neurodegenerative diseases such as Alzheimer's disease (AD), and they can stimulate the generation of reactive oxygen species (ROSs) via NADPH oxidase, induce oxidative stress that lead to cell death. In the current study, we investigated the molecular events underlying the process that AGEs induce cell death in SH-SY5Y cells and rat cortical neurons. We found: (1) AGEs increase intracellular ROSs; (2) AGEs cause cell death after ROSs increase; (3) oxidative stress-induced cell death is inhibited via the blockage of AGEs receptor (RAGE), the down-regulation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, and the increase of scavenging by anti-oxidant alpha-lipoic acid (ALA); (4) endoplasmic reticulum (ER) stress was triggered by AGE-induced oxidative stress, resulting in the activation of C/EBP homologous protein (CHOP) and caspase-12 that consequently initiates cell death, taurine-conjugated ursodeoxycholic acid (TUDCA) inhibited AGE-induced ER stress and cell death. Blocking RAGE-NADPH oxidase, and RAGE-NADPH oxidase-ROSs and ER stress scavenging pathways could efficiently prevent the oxidative and ER stresses, and consequently inhibited cell death. Our results suggest a new prevention and or therapeutic approach in AGE-induced cell death.