Unsupervised shape-and-texture-based generative adversarial tuning of pre-trained networks for carotid segmentation from 3D ultrasound images.

BACKGROUND: Vessel-wall volume and localized three-dimensional ultrasound (3DUS) metrics are sensitive to the change of carotid atherosclerosis in response to medical/dietary interventions. Manual segmentation of the media-adventitia boundary (MAB) and lumen-intima boundary (LIB) required to obtain these metrics is time-consuming and prone to observer variability. Although supervised deep-learning segmentation models have been proposed, training of these models requires a sizeable manually segmented training set, making larger clinical studies prohibitive. PURPOSE: We aim to develop a method to optimize pre-trained segmentation models without requiring manual segmentation to supervise the fine-tuning process. METHODS: We developed an adversarial framework called the unsupervised shape-and-texture generative adversarial network (USTGAN) to fine-tune a convolutional neural network (CNN) pre-trained on a source dataset for accurate segmentation of a target dataset. The network integrates a novel texture-based discriminator with a shape-based discriminator, which together provide feedback for the CNN to segment the target images in a similar way as the source images. The texture-based discriminator increases the accuracy of the CNN in locating the artery, thereby lowering the number of failed segmentations. Failed segmentation was further reduced by a self-checking mechanism to flag longitudinal discontinuity of the artery and by self-correction strategies involving surface interpolation followed by a case-specific tuning of the CNN. The U-Net was pre-trained by the source dataset involving 224 3DUS volumes with 136, 44, and 44 volumes in the training, validation and testing sets. The training of USTGAN involved the same training group of 136 volumes in the source dataset and 533 volumes in the target dataset. No segmented boundaries for the target cohort were available for training USTGAN. The validation and testing of USTGAN involved 118 and 104 volumes from the target cohort, respectively. The segmentation accuracy was quantified by Dice Similarity Coefficient (DSC), and incorrect localization rate (ILR). Tukey's Honestly Significant Difference multiple comparison test was employed to quantify the difference of DSCs between models and settings, where p ≤ 0.05 $p\,\le \,0.05$ was considered statistically significant. RESULTS: USTGAN attained a DSC of 85.7 ± 13.0 $85.7\,\pm \,13.0$ % in LIB and 86.2 ± 10.6 ${86.2}\,\pm \,{10.6}$ % in MAB, improving from the baseline performance of 74.6 ± 30.7 ${74.6}\,\pm \,{30.7}$ % in LIB (p < 10 - 12 $<10^{-12}$ ) and 75.7 ± 28.9 ${75.7}\,\pm \,{28.9}$ % in MAB (p < 10 - 12 $<10^{-12}$ ). Our approach outperformed six state-of-the-art domain-adaptation models (MAB: p ≤ 3.63 × 10 - 7 $p \le 3.63\,\times \,10^{-7}$ , LIB: p ≤ 9.34 × 10 - 8 $p\,\le \,9.34\,\times \,10^{-8}$ ). The proposed USTGAN also had the lowest ILR among the methods compared (LIB: 2.5%, MAB: 1.7%). CONCLUSION: Our framework improves segmentation generalizability, thereby facilitating efficient carotid disease monitoring in multicenter trials and in clinics with less expertise in 3DUS imaging.

Nickel-Catalyzed Enantioselective Carbonyl Addition of Aryl Chlorides and Bromides to Aldehydes.

The Ni-catalyzed enantioselective addition reaction of aryl halides to aldehydes was studied with cyanobis(oxazoline) as chiral ligands and Mn as reductant. Aryl and heteroaryl bromides reacted with phenyl aldehyde at room temperature to produce dibenzyl alcohols in 16-99% yields with 53-92% ees. Moreover, the coupling of phenyl chloride with a variety of aryl, heteroaryl and alkyl aldehydes was demonstrated in the presence of cyanobis(oxazoline)/Ni(II) at 60 oC in generally high yields with moderate enantioselectivities.

Pancreatic cancer cells hijack tumor suppressive microRNA-26a to promote radioresistance and potentiate tumor repopulation.

Pancreatic cancer is one of the most lethal cancers with significant radioresistance and tumor repopulation after radiotherapy. As a type of short non-coding RNA that regulate various biological and pathological processes, miRNAs might play vital role in radioresistance. We found by miRNA sequencing that microRNA-26a (miR-26a) was upregulated in pancreatic cancer cells after radiation, and returned to normal state after a certain time. miR-26a was defined as a tumor suppressive miRNA by conventional tumor biology experiments. However, transient upregulation of miR-26a after radiation significantly promoted radioresistance, while stable overexpression inhibited radioresistance, highlighting the importance of molecular dynamic changes after treatment. Mechanically, transient upregulation of miR-26a promoted cell cycle arrest and DNA damage repair to promote radioresistance. Further experiments confirmed HMGA2 as the direct functional target, which is an oncogene but enhances radiosensitivity. Moreover, PTGS2 was also the target of miR-26a, which might potentiate tumor repopulation via delaying the synthesis of PGE2. Overall, this study revealed that transient upregulation of miR-26a after radiation promoted radioresistance and potentiated tumor repopulation, highlighting the importance of dynamic changes of molecules upon radiotherapy.

Effectiveness of prognostic nutritional index in predicting overall survival and evaluating immunotherapy response in anaplastic thyroid carcinoma.

BACKGROUND: The prognostic value of nutritional status in anaplastic thyroid carcinoma (ATC) remains unclear. The Prognostic Nutritional Index (PNI) is a reliable indicator of overall nutritional and immune status, and it has emerged as a significant prognostic factor in various malignancies. This study aimed to explore the utility of PNI in ATC. METHODS: We systematically reviewed ATC patients in our institute from January 2000 to June 2023 and categorized them into high and low PNI groups based on the median PNI value. Kaplan-Meier analysis and Cox regression were employed to assess the impact of PNI on overall survival, while ROC curve analysis evaluated the predictive value of PNI. Mimics software was used for three-dimensional reconstruction of pre- and post-immunotherapy tumor volumes, enabling the assessment of treatment response. RESULTS: A total of 77 ATC patients were included in this study. Low baseline PNI was associated with significantly shorter overall survival (1-year survival rate: 5.26% vs 30.77%; median survival time: 5.30 months vs 8.87 months). The 1-year, 2-year, and 3-year AUC values for PNI were 0.82, 0.79, and 0.77, respectively. In the multivariate analysis, both PNI and tumor size emerged as independent prognostic factors for patient overall survival. Among ATC patients receiving 2-3 cycles of immunotherapy, an increase in post-treatment PNI levels was positively correlated with a reduction in tumor volume. CONCLUSION: PNI is an independent predictor of overall survival and holds the potential to serve as a valuable indicator for assessing and predicting immunotherapy efficacy in ATC patients.

Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis.

BACKGROUND: Postoperative hypoparathyroidism (hypoPT) is a common complication following thyroid surgery. However, current research findings on the risk factors for post-thyroid surgery hypoPT are not entirely consistent, and the same risk factors may have different impacts on transient and permanent hypoPT. Therefore, there is a need for a comprehensive study to summarize and explore the risk factors for both transient and permanent hypoPT after thyroid surgery. MATERIALS AND METHODS: Two databases (PubMed and Embase) were searched from inception to 2024. The Newcastle-Ottawa Scale was used to rate study quality. Pooled odds ratios (OR) were used to calculate the relationship of each risk factor with transient and permanent hypoPT. Subgroup analyses were conducted for hypoPT with different definition-time (6 or 12 mo). Publication bias was assessed using Begg's test, and Egger's test. RESULTS: A total of 19 risk factors from the 93 studies were included in the analysis. Among them, sex and parathyroid autotransplantation were the most frequently reported risk factors. Meta-analysis demonstrated that sex (female vs. male), cN stage, central neck dissection, lateral neck dissection, extent of central neck dissection (bilateral vs. unilateral), surgery (total thyroidectomy (TT) vs. lobectomy), surgery type (TT vs. sub-TT), incidental parathyroidectomy, and pathology (cancer vs. benign) were significantly associated with transient and permanent hypoPT. Preoperative calcium and parathyroid autotransplantation were only identified as risk factors for transient hypoPT. Additionally, node metastasis and parathyroid in specimen were associated with permanent hypoPT. CONCLUSION: The highest risk of hypoPT occurs in female thyroid cancer patients with lymph node metastasis undergoing TT combined with neck dissection. The key to preventing postoperative hypoPT lies in the selection of surgical approach and intraoperative protection.

Effects of ambient PM2.5 on non-accidental death: a time-series study in Shenzhen, China during 2014-2019.

This study aims to investigate the impact of PM2.5 on non-accidental death of residents. The single-pollutant model revealed that the influence of PM2.5 on non-accidental death was significant at lag0 and lag4-6, and was greatest at lag5. A 10 µg/m3 increase in PM2.5 was related with a 1.31% increase in non-accidental deaths. The connection between PM2.5 and non-accidental death was stronger in femalesthan males, in people aged ≥ 65 years than people aged < 65 years, and in people below high school education than people with high school education or above. Two-pollutant model revealed that the influence of PM2.5 on non-accidental death was essentially unchanged when CO, SO2, and O3 were included and reduced when NO2 was included. The multiple-pollutant model showed that the effect of ambient PM2.5 on non-accidental death was reduced. An increase in PM2.5 concentrations may cause an increase in non-accidental death.

Development of a nomogram for predicting myopia risk among school-age children: a case-control study.

OBJECTIVES: To analyze the factors influencing myopia and construct a nomogram to forecast the risk of myopia among school-age children, providing a reference for identifying high-risk groups to aid prevention and control. METHODS: This case-control study enrolled 3512 students from three primary schools in Shenzhen using random cluster sampling for a questionnaire survey, myopia screening and ocular biometric parameter measurement. Logistic regression was used to analyze the influencing factors of myopia, and a nomogram was constructed to forecast myopia risk. Bootstrap resampling was used to verify the practicability of the nomogram. RESULTS: Older age (odds ratio[OR] = 1.164; 95% confidence interval [CI]: 1.111-1.219), female sex (OR = 2.405; 95% CI: 2.003-2.887), maternal myopia (OR = 1.331; 95% CI: 1.114-1.589), incorrect posture during reading and writing (OR = 1.283; 95% CI: 1.078-1.528) and axial length (OR = 7.708; 95% CI: 6.044-8.288) are risk factors for myopia, whereas an increase in corneal radius (OR = 0.036; 95% CI: 0.025-0.052) is a protective factor against myopia. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.857, and the net benefit was high when the risk threshold of the decision curve analyses (DCA) ranged from 0.20 to 1.00. The measured values were consistent with the prediction. CONCLUSION: The nomogram was accurate in predicting the risk of myopia among schoolchildren. This study provides a reference for screening high-risk students and for individualized myopia prevention and control.

Older age, female sex, maternal myopia, incorrect posture during reading and writing, and prolonged axial length are risk factors for myopia among primary school students.The nomogram constructed based on age, sex, maternal myopia, incorrect posture during reading and writing, axial length and corneal radius showed good predictive accuracy and practicability.The nomogram constructed in this study can be used for individualized myopia risk assessment.

Human-derived bacterial strains mitigate colitis via modulating gut microbiota and repairing intestinal barrier function in mice.

BACKGROUND: Unbalanced gut microbiota is considered as a pivotal etiological factor in colitis. Nevertheless, the precise influence of the endogenous gut microbiota composition on the therapeutic efficacy of probiotics in colitis remains largely unexplored. RESULTS: In this study, we isolated bacteria from fecal samples of a healthy donor and a patient with ulcerative colitis in remission. Subsequently, we identified three bacterial strains that exhibited a notable ability to ameliorate dextran sulfate sodium (DSS)-induced colitis, as evidenced by increased colon length, reduced disease activity index, and improved histological score. Further analysis revealed that each of Pediococcus acidilactici CGMCC NO.17,943, Enterococcus faecium CGMCC NO.17,944 and Escherichia coli CGMCC NO.17,945 significantly attenuated inflammatory responses and restored gut barrier dysfunction in mice. Mechanistically, bacterial 16S rRNA gene sequencing indicated that these three strains partially restored the overall structure of the gut microbiota disrupted by DSS. Specially, they promoted the growth of Faecalibaculum and Lactobacillus murinus, which were positively correlated with gut barrier function, while suppressing Odoribacter, Rikenella, Oscillibacter and Parasutterella, which were related to inflammation. Additionally, these strains modulated the composition of short chain fatty acids (SCFAs) in the cecal content, leading to an increase in acetate and a decrease in butyrate. Furthermore, the expression of metabolites related receptors, such as receptor G Protein-coupled receptor (GPR) 43, were also affected. Notably, the depletion of endogenous gut microbiota using broad-spectrum antibiotics completely abrogated these protective effects. CONCLUSIONS: Our findings suggest that selected human-derived bacterial strains alleviate experimental colitis and intestinal barrier dysfunction through mediating resident gut microbiota and their metabolites in mice. This study provides valuable insights into the potential therapeutic application of probiotics in the treatment of colitis.

Gradiently Foaming Ultrasoft Hydrogel with Stop Holes for Highly Deformable, Crack-Resistant and Sensitive Conformal Human-Machine Interfaces.

Hydrogels are considered as promising materials for human-machine interfaces (HMIs) owing to their merits of tailorable mechanical and electrical properties; nevertheless, it remains challenging to simultaneously achieve ultrasoftness, good mechanical robustness and high sensitivity, which are the pre-requisite requirements for wearable sensing applications. Herein, for the first time, this work proposes a universal phase-transition-induced bubbling strategy to fabricate ultrasoft gradient foam-shaped hydrogels (FSHs) with stop holes for high deformability, crack-resistance and sensitive conformal HMIs. As a typical system, the FSH based on polyacrylamide/sodium alginate system shows an ultralow Young's modulus (1.68 kPa), increased sustainable strain (1411%), enhanced fracture toughness (915.6 J m-2), improved tensile sensitivity (21.77), and compressive sensitivity (65.23 kPa-1). The FSHs are used for precisely acquiring and identifying gesture commands of the operator to remotely control a surgical robot for endoscopy and an electric ship in a first-person perspective for cruising, feeding crabs and monitoring the environmental change in real-time.

Insulin Use Is Associated With Improved Outcomes in Critically Ill Patients With Acute Pancreatitis: A Retrospective Matched Cohort Study.

BACKGROUND: Severe acute pancreatitis (SAP) has a mortality of 30% with no current targeted therapy. The potential protective effect of insulin on AP has been reported and needs to be confirmed. Thus, we aim to examine the effect of insulin treatment on the outcome of AP patients. METHODS: A retrospective study was performed using data from the Medical Information Mart for Intensive Care (MIMIC) database. Kruskal-Wallis test, t-tests, and Pearson's chi-squared test were used to compare differences between groups. Propensity score matching and further nearest neighbor matching were used to construct a matched cohort. Cox proportional hazards regression analyses, logistic regression analyses, and the doubly robust estimation method were used to assess the relationship between insulin use and mortality. RESULTS: Nine hundred patients were enrolled in the final analysis. Insulin was associated with better outcomes in AP patients admitted to ICU, and could act as an independent predictor for 30-day mortality (HR = 0.36, 95% CI = 0.24-0.55). Subgroup analysis showed that AP patients with heart failure or without kidney disease or respiratory failure may not benefit from insulin treatment. CONCLUSIONS: Insulin treatment is independently associated with lower 30-day mortality in AP patients, except for those with heart failure or without kidney disease or respiratory failure.

Spatial epidemiological characteristics and driving factors of myopia among school-age children based on geographical detector: a national study.

The present study aimed to examine the spatial characteristics of myopia and identify the socioeconomic and environmental factors influencing its prevalence. Myopia prevalence among children of school age of Han ethnicity in China was 56.6% in 2019, with the highest and lowest prevalence's in Shandong (66.8%) and Guizhou (47.3%), respectively. There was a spatial aggregation of myopia prevalence in China. Environmental factors (atmospheric PM2.5 concentration and forest coverage) and socioeconomic factors (gross domestic product per capita, per capita disposable income, hospital beds per thousand people, and Engel coefficient) have significant influences on myopia prevalence. The interaction of each factor on myopia showed nonlinear enhancement. Myopia prevalence among children of school age was spatially clustered, and environmental and socioeconomic conditions are associated with myopia prevalence. Our findings provide novel perspectives for the comprehensive prevention and control of myopia.

The effect of Ge doping concentration on the electrochemical performance of silicene anode for lithium-ion batteries: a first-principles study.

Two-dimensional materials have been considered as novel anode materials for LIBs because of their large surface area, small volume change, and low Li diffusion barrier. Among them, the two-dimensional material SixGey has many excellent properties as an anode. However, Ge is expensive and not suitable for mass production. Therefore, proper Ge doping is of great significance to improve performance and reduce cost. Herein, we systematically study the effect of Ge doping and its concentration on the structure and electrochemical performance of two-dimensional SixGey by density functional theory (DFT) calculations. The incorporation of low concentration Ge can improve the horizontal and vertical diffusion ability of Li atoms compared to silicene. However, excessive Ge will increase the horizontal diffusion energy barrier of Li and reduce the theoretical capacity, where Si6Ge2 has a relatively high theoretical capacity and a low diffusion energy barrier. In addition, fully lithiated 2D SixGey shows poor electrical conductivity and increasing Ge concentration seems to be effective in improving the electrical conductivity of the material. This study will provide significant theoretical guidance for the design and preparation of two-dimensional silicon-based materials.

FAFuse: A Four-Axis Fusion framework of CNN and Transformer for medical image segmentation.

Medical image segmentation is crucial for accurate diagnosis and treatment in the medical field. In recent years, convolutional neural networks (CNNs) and Transformers have been frequently adopted as network architectures in medical image segmentation. The convolution operation is limited in modeling long-range dependencies because it can only extract local information through the limited receptive field. In comparison, Transformers demonstrate excellent capability in modeling long-range dependencies but are less effective in capturing local information. Hence, effectively modeling long-range dependencies while preserving local information is essential for accurate medical image segmentation. In this paper, we propose a four-axis fusion framework called FAFuse, which can exploit the advantages of CNN and Transformer. As the core component of our FAFuse, a Four-Axis Fusion module (FAF) is proposed to efficiently fuse global and local information. FAF combines Four-Axis attention (height, width, main diagonal, and counter diagonal axial attention), a multi-scale convolution, and a residual structure with a depth-separable convolution and a Hadamard product. Furthermore, we also introduce deep supervision to enhance gradient flow and improve overall performance. Our approach achieves state-of-the-art segmentation accuracy on three publicly available medical image segmentation datasets. The code is available at https://github.com/cczu-xiao/FAFuse.

Development of a Three-Dimensional Carotid Ultrasound Image Segmentation Workflow for Improved Efficiency, Reproducibility and Accuracy in Measuring Vessel Wall and Plaque Volume and Thickness.

Automated segmentation of carotid lumen-intima boundary (LIB) and media-adventitia boundary (MAB) by deep convolutional neural networks (CNN) from three-dimensional ultrasound (3DUS) images has made assessment and monitoring of carotid atherosclerosis more efficient than manual segmentation. However, training of CNN still requires manual segmentation of LIB and MAB. Therefore, there is a need to improve the efficiency of manual segmentation and develop strategies to improve segmentation accuracy by the CNN for serial monitoring of carotid atherosclerosis. One strategy to reduce segmentation time is to increase the interslice distance (ISD) between segmented axial slices of a 3DUS image while maintaining the segmentation reliability. We, for the first time, investigated the effect of ISD on the reproducibility of MAB and LIB segmentations. The intra-observer reproducibility of LIB and MAB segmentations at ISDs of 1 mm and 2 mm was not statistically significantly different, whereas the reproducibility at ISD = 3 mm was statistically lower. Therefore, we conclude that segmentation with an ISD of 2 mm provides sufficient reliability for CNN training. We further proposed training the CNN by the baseline images of the entire cohort of patients for automatic segmentation of the follow-up images acquired for the same cohort. We validated that segmentation with this time-based partitioning approach is more accurate than that produced by patient-based partitioning, especially at the carotid bifurcation. This study forms the basis for an efficient, reproducible, and accurate 3DUS workflow for serial monitoring of carotid atherosclerosis useful in risk stratification of cardiovascular events and in evaluating the efficacy of new treatments.

Intratumor microbiome: selective colonization in the tumor microenvironment and a vital regulator of tumor biology.

The polymorphic microbiome has been proposed as a new hallmark of cancer. Intratumor microbiome has been revealed to play vital roles in regulating tumor initiation and progression, but the regulatory mechanisms have not been fully uncovered. In this review, we illustrated that similar to other components in the tumor microenvironment, the reside and composition of intratumor microbiome are regulated by tumor cells and the surrounding microenvironment. The intratumor hypoxic, immune suppressive, and highly permeable microenvironment may select certain microbiomes, and tumor cells may directly interact with microbiome via molecular binding or secretions. Conversely, the intratumor microbiomes plays vital roles in regulating tumor initiation and progression via regulating the mutational landscape, the function of genes in tumor cells and modulating the tumor microenvironment, including immunity, inflammation, angiogenesis, stem cell niche, etc. Moreover, intratumor microbiome is regulated by anti-cancer therapies and actively influences therapy response, which could be a therapeutic target or engineered to be a therapy weapon in the clinic. This review highlights the intratumor microbiome as a vital component in the tumor microenvironment, uncovers potential mutual regulatory mechanisms between the tumor microenvironment and intratumor microbiome, and points out the ongoing research directions and drawbacks of the research area, which should broaden our view of microbiome and enlighten further investigation directions.

miR-30e-5p-mediated FOXD1 promotes cell proliferation by blocking cellular senescence and apoptosis through p21/CDK2/Rb signaling in head and neck carcinoma.

Forkhead box D1 (FOXD1) belongs to the FOX protein family, which has been found to function as a oncogene in multiple cancer types, but its role in head and neck squamous cell carcinoma (HNSCC) requires further investigation. Our research aimed to investigate the function of FOXD1 in HNSCC. Bioinformatics analysis indicated that mRNA level of FOXD1 was highly expressed in HNSCC tissues, and over-expressed FOXD1 was related to poor prognosis. Moreover, FOXD1 knockdown increased the ratio of senescent cells but decreased the proliferation ability, while FOXD1 overexpression obtained the opposite results. In vitro experiments revealed that FOXD1 bound to the p21 promoter and inhibited its transcription, which blocked the cyclin dependent kinase 2 (CDK2)/retinoblastoma (Rb) signaling pathway, thus preventing senescence and accelerating proliferation of tumor cells. CDK2 inhibitor could reverse the process to some extent. Further research has shown that miR-3oe-5p serves as a tumor suppressant by repressing the translation of FOXD1 through combining with the 3'-untranslated region (UTR). Thus, FOXD1 resists cellular senescence and facilitates HNSCC cell proliferation by affecting the expression of p21/CDK2/Rb signaling, suggesting that FOXD1 may be a potential curative target for HNSCC.

Association between serum-free thyroxine level and all-cause mortality in critically ill patients: a retrospective study from MIMIC-IV.

Background: Low thyroxine (T4) levels have been observed in critically ill patients; however, controversial results regarding T4 supplemental therapy are reported. The association between serum free T4 (FT4) levels and mortality in critically ill patients has not been fully established and needs to be clarified. Methods: Data from the Medical Information Mart for Intensive Care (MIMIC)-IV were collected and analyzed. The association between FT4 level and 30-day mortality after ICU admission was analyzed using Kaplan-Meier curves, spline smoothing fitting, martingale residuals of the null Cox model, and restricted cubic spline (RCS). Logistic regression, Cox regression, and receiver operating characteristic curve (ROC) were used to uncover the relationship and predictive value of serum FT4 and 30-day mortality in critically ill patients. Results: In the final analysis, 888 patients were enrolled, and the serum FT4 levels were divided into four groups. A significant difference in 30-day mortality was observed between the four groups. Kaplan-Meier curves also presented significantly higher 30-day mortality in groups 1 and 2 (p < 0.0001). Further multivariance logistic regression showed that group 1 with FT4 levels lower than 0.7 µg/dl can predict 30-day mortality (odds ratio (OR) = 3.30, 95% confidence interval (CI) = 1.04-11.31). Spline smoothing fitting analysis showed a "V"-shaped line between 30-day mortality and FT4 level within 0-3 µg/dl. Further RCS analysis showed that the risk of death decreased rapidly as FT4 levels increased when serum FT4 levels were lower than 1.2 µg/dl and started to become flat afterward. The area under the ROC of the lower FT4 level to predict 30-day mortality was 0.833 (95% CI = 0.788-0.878). Both multivariant Cox regression and logistic regression showed that FT4 levels lower than 1.2 µg/dl can independently predict 30-day mortality when adjusted for other potential confounders (HR = 0.34, 95% CI = 0.14-0.82; OR = 0.21, 95% CI = 0.06-0.79, respectively), but its predictive power disappeared when adjusted for T3 or total T4. Conclusion: Serum FT4 levels were significantly negatively associated with 30-day mortality when they were lower than 1.2 µg/dl and could predict the risk of 30-day mortality. A higher FT4 level is potentially related to increased 30-day mortality.

Transforming cancer cells for long-term living with cancer: An inspiring new approach.

Cancer is the leading cause of human death and imposes a huge health burden. Currently, no matter what advanced therapeutic modalities or technologies are applied, it is still peculiarly rare for most cancers to be radically cured whereas therapy resistance and tumor recurrence are ever so common. The long-standing cytotoxic therapy is hard to achieve long-term tumor control, and produces side-effects or even promotes cancer progression. With growing understandings of tumor biology, we came to realize that it is possible to transform but not kill cancer cells to achieve long-term living with cancer, and directly altering cancer cells is a promising way. Remarkably, tissue microenvironment is involved in the fate determination of cancer cells. Of note, leveraging cell competition to combat malignant or therapy-resistant cells shows some therapeutic potentials. Furthermore, modulating tumor microenvironment to restore a normal state might help to transform cancer cells. Especially, reprogramming cancer-associated fibroblasts, and tumor-associated macrophages, or normalization of tumor vessel, tumor immune microenvironment, and tumor extracellular matrix or their combinations, et al., revealed some long-term therapeutic benefits. Despite the massive challenges ahead, it would be possible to transform cancer cells for long-term cancer control and living with cancer longevously. The related basic researches and corresponding therapeutic strategies are also ongoing.

A Dual-Stream Centerline-Guided Network for Segmentation of the Common and Internal Carotid Arteries From 3D Ultrasound Images.

Segmentation of the carotid section encompassing the common carotid artery (CCA), the bifurcation and the internal carotid artery (ICA) from three-dimensional ultrasound (3DUS) is required to measure the vessel wall volume (VWV) and localized vessel-wall-plus-plaque thickness (VWT), shown to be sensitive to treatment effect. We proposed an approach to combine a centerline extraction network (CHG-Net) and a dual-stream centerline-guided network (DSCG-Net) to segment the lumen-intima (LIB) and media-adventitia boundaries (MAB) from 3DUS images. Correct arterial location is essential for successful segmentation of the carotid section encompassing the bifurcation. We addressed this challenge by using the arterial centerline to enhance the localization accuracy of the segmentation network. The CHG-Net was developed to generate a heatmap indicating high probability regions for the centerline location, which was then integrated with the 3DUS image by the DSCG-Net to generate the MAB and LIB. The DSCG-Net includes a scale-based and a spatial attention mechanism to fuse multi-level features extracted by the encoder, and a centerline heatmap reconstruction side-branch connected to the end of the encoder to increase the generalization ability of the network. Experiments involving 224 3DUS volumes produce a Dice similarity coefficient (DSC) of 95.8±1.9% and 92.3±5.4% for CCA MAB and LIB, respectively, and 93.2±4.4% and 89.0±10.0% for ICA MAB and LIB, respectively. Our approach outperformed four state-of-the-art 3D CNN models, even after their performances were boosted by centerline guidance. The efficiency afforded by the framework would allow it to be incorporated into the clinical workflow for improved quantification of plaque change.

Epidemiological Characteristics and Influencing Factors of Myopia Among Primary School Students in Southern China: A Longitudinal Study.

Objectives: To study the epidemiological characteristics and influencing factors of myopia to provide a scientific basis for the prevention and control of myopia. Methods: 7,597 students studying in grades 1-3 were followed up. Eye examinations and questionnaire surveys were conducted annually from 2019 to 2021. The influencing factors of myopia were analyzed by logistic regression model. Results: The prevalence of myopia among students in grades 1-3 in 2019 was 23.4%, which increased to 41.9% and 51.9% after the 1-and 2-year follow-up, respectively. The incidence of myopia and change in the spherical equivalent refraction (SER) were higher in 2020 than in 2021. The 2-year cumulative incidences of myopia were 2.5%, 10.1%, 15.5%, 36.3%, and 54.1% in students with a baseline SER >+1.50D, +1.00D to +1.50D, +0.50D to +1.00D, 0.00D to +0.50D, and -0.50D to 0.00D, respectively. Outdoor activities, sex, age, baseline SER, parental myopia, sleep time, and digital device exposure were associated with myopia. Conclusion: The prevalence of myopia demonstrated a rapid increase; thus, healthy habits and outdoor activities should be promoted for the prevention and control of myopia.