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Artificial Intelligence (AI) is an important product of the rapid development of computer technology today. It has a far-reaching impact on the development of medical diagnostic technology especially in combination with medical imaging. The aim of this study was to analyze the diagnostic accuracy of AI-assisted diagnosis technology for classification of breast cancer in histopathological images.
A meta-analysis was conducted of published research articles on diagnostic accuracy of AI-assisted diagnosis technology for breast cancer classification between January 2010 and September 2019 in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and China Bio-medicine Database. Statistical analysis was performed with software Meta-Disc 1.4 and Stata 12.0, and the summary receiver operating characteristic (SROC) curve was drawn to evaluate accuracy of the method.
A total of 18 studies with 13,573 breast histopathological images were considered for the analysis. The pooled sensitivity, specificity, diagnostic odds ratio and the area under the curve of the SROC for AI-assisted diagnosis technology for classification of breast cancer respectively, were 0.94 (95% confidence interval [CI]: 0.93–0.85), 0.84 (95% CI: 0.93–0.94), 255.47 (95% CI: 168.33–387.73) and 0.98 (95%CI: 0.96–0.99).
Several limitations should be considered when interpreting the findings of this meta-analysis. First, despite the extensive literature search, the number of included studies was small; however, the number of images enrolled was satisfactory, thereby decreasing type II error. Second, data acquisition is not comprehensive enough because the language of literature search was limited to Chinese and English. Furthermore, the heterogeneity caused due to different sources of data affected the study results. Despite these limitations, our study suggests AI-assisted diagnosis technology for breast cancer classification in histopathological images is a highly accurate and reliable diagnostic method for clinical application.
Quantitative flow ratio (QFR) is a novel approach to derive fractional flow reserve (FFR) from coronary angiography. QFR based on 3-dimensional reconstruction of angiographic images assesses the significance of coronary artery disease (CAD) without using an invasive pressure wire. This study aimed to evaluate the diagnostic accuracy of quantitative flow ratio in myocardial ischemia of coronary artery disease.
A meta-analysis was conducted of published research articles on diagnostic accuracy of QFR between January 2016 and September 2019 in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and China Bio-medicine Database. Statistical analysis was performed with software Meta-Disc 1.4 and Stata 12.0, and the summary receiver operating characteristic (SROC) curve was drawn to evaluate accuracy of the method.
A total of 11 articles were retreived, including 1,782 patients and 2,054 vessels. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for quantitative flow ratio respectively, were 0.86 (95% confidence interval [CI]: 0.85-0.89), 0.89 (95%CI: 0.87–0.91), 7.51(95%CI: 6.40–8.82), 0.15 (95%CI: 0.10–0.23), 54.18 (95%CI: 34.09–86.12), and the pooled AUC was 0.9458.
Several limitations should be considered when interpreting the findings of this meta-analysis. First, despite the extensive literature search, the number of included studies was small; however, the number of patients and vessels enrolled was satisfactory, thereby decreasing type II error. Furthermore, data acquisition is not comprehensive enough because the language of the literature search was limited to Chinese and English. Despite these limitations, our study suggests with a definition of ischemia as FFR ≤ 0.8, the QFR obtains high diagnostic efficacy in myocardial ischemia of CAD. It can be used as a non-invasive novel method to screen CAD patients with myocardial ischemia.
Artificial Intelligence (AI) is an important product of the rapid development of computer technology today. It has a far-reaching impact on the development of medical diagnostic technology especially in combination with medical imaging. The aim of this study was to analyze the diagnostic accuracy of AI-assisted diagnosis technology for classification of benign and malignant lung nodules on Computerized Tomography (CT) images.
A meta-analysis was conducted of published research articles on diagnostic accuracy of AI-assisted diagnosis technology for lung nodules classification between 2010 and 2019 in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and China Bio-medicine Database. Statistical analysis was performed with the software SAS 9.4 and Stata 12.0, and the summary receiver operating characteristic (SROC) curve was drawn to evaluate accuracy of the method.
A total of 27 studies with 5,701 lung nodules were considered. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the curve of SROC for AI-assisted diagnosis technology for lung nodules classification respectively were 0.892 (95% confidence interval [CI]: 0.854–0.920), 0.876 (95% CI: 0.833–0.909), 7.190 (95% CI: 5.194–9.955), 0.124 (95% CI: 0.089–0.171), 58.102 (95% CI: 32.391–104.219) and 0.95 (95%CI: 0.92–0.96).
Of note, several limitations should be considered when interpreting the findings of this meta-analysis. Data acquisition is not comprehensive enough because the language of the literature search was limited to Chinese and English. Furthermore,heterogeneity caused due to the difference of lung nodule size affected the study results. Despite these limitations, our study suggests that AI-assisted diagnosis technology for benign-malignant lung nodule classification on CT images obtains high diagnostic accuracy, and it can be used as a novel method to differentiate benign and malignant pulmonary nodules.
Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.
Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).
PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.
A simple, compact, double-pass pumped Nd:YVO4 thin disk laser is demonstrated. Its continuous-wave performance with different Nd doping concentrations and thicknesses is investigated experimentally. The maximum output power of 17.7 W is achieved by employing a 0.5 at.% doped sample, corresponding to an optical-to-optical efficiency of 46% with respect to the absorbed pump power. In addition, a numerical analysis and an experimental study of the temperature distribution, and thermal lens effect of the Nd:YVO4 thin disk, are presented considering the influence of the energy transfer upconversion effect and the temperature dependence of the thermal conductivity tensor. The simulated results are in good agreement with the experimental results.
Using ethanol adsorption calorimetry, the surface energetics of two carbon substrates and two products in microwave-assisted carbon nanotube (CNT) growth was studied. In this study, the ethanol adsorption enthalpies of the two graphene-based samples at 25 °C were measured successfully. Specifically, the near-zero differential enthalpies of ethanol adsorption are −75.7 kJ/mol for graphene and −63.4 kJ/mol for CNT-grafted graphene. Subsequently, the differential enthalpy curve of each sample becomes less exothermic until reaching a plateau, −55.8 kJ/mol for graphene and −49.7 kJ/mol for CNT-grafted graphene, suggesting favorable adsorbate–adsorbent binding. Moreover, the authors interpreted and discussed the partial molar entropy and chemical potential of adsorption as the ethanol surface coverage (loading) increases. Due to the low surface areas of carbon black–based samples, adsorption calorimetry could not be performed. This model study demonstrates that using adsorption calorimetry as a fundamental tool and ethanol as the molecular probe, the overall surface energetics of high–surface area carbon materials can be estimated.
Enthalpies of water adsorption on amorphous and crystalline oxides and peroxides of uranium are reported. Despite substantial structural and computational research on reactions between actinides and water, understanding their surface interactions from the energetic perspective remains incomplete. Direct calorimetric measurements of hydration energetics of nano-sized, bulk-sized UO2, U3O8, anhydrous γ-UO3, amorphous UO3, and U2O7 were carried out, and their integral adsorption enthalpies were determined to be −67.0, −70.2, −73.0, −84.1, −61.6, and −83.6 kJ/mol water, with corresponding water coverages of 4.6, 4.5, 4.1, 5.2, 4.4, and 4.1 H2O per nm2, respectively. These energetic constraints are important for understanding the interfacial phenomena between water and U-containing phases. Additionally, this set of data also helps predict the absorption and desorption behavior of water from nuclear waste forms or used nuclear fuels under repository conditions. There are also underlying relations for water coverage among different U compounds. These experimentally determined data can be used as benchmark values for future computational investigations.
The dynamics of spreading of a macroscopic liquid droplet over a wetting surface is often described by a power-law relaxation, namely, the droplet radius increases as
, which is known as Tanner’s law. Here we show, by both experiments and theory, that when the liquid spreading takes place between a thin soap film and a glass fibre penetrating the film, the spreading is significantly slowed down. When the film thickness
becomes smaller than the fibre diameter
, the strong hydrodynamic confinement effect of the soap film gives rise to a logarithmic relaxation with fibre creeping time
. Such a slow dynamics of spreading is observed for hours both in the measured time-dependent height of capillary rise
on the fibre surface and viscous friction coefficient
felt by the glass fibre in contact with the soap film. A new theoretical approach based on the Onsager variational principle is developed to describe the dynamics of thin film spreading along a fibre. The newly derived equations of motion provide the analytical solutions of
and contact angle
, which are found to be in good agreement with the experimental results. Our work thus provides a common framework for understanding the confinement effect of thin soap films on the dynamics of spreading along a fibre.
Several epidemiological studies have investigated that Na or K intakes might be associated with the metabolic syndrome (MetS). However, little evidence has evaluated the association between Na:K ratio and the MetS. In this study, we assessed the association between the dietary Na:K ratio and the MetS. The cross-sectional study was conducted among adults aged 18 years and older in Nanjing, using a multi-stage random sampling method, which resulted in a sample size of 1993 participants. Dietary Na and K intakes were assessed by 3 consecutive days of dietary recollection combined with condiments weighing method. Health-related data were obtained by standardised questionnaires, as well as physical examinations and laboratory assessments. The prevalence rate of the MetS was 36·5 % (728/1993). After adjusting for various lifestyle and dietary factors of the MetS, participants in the highest quartile of dietary Na:K ratio were at a higher risk of developing MetS (OR=1·602; 95 % CI 1·090, 2·353) compared with those in the lowest quartile. Each 1-sd increase in dietary Na:K ratio was associated with a higher risk of prevalent MetS (OR=1·166; 95 % CI: 1·018, 1·336). Among the components of the MetS, dietary Na:K ratio was positively associated with high blood pressure (quartile 3 v. quartile 1: OR=1·656; 95 % CI 1·228, 2·256) and hypertriacylglycerolaemia (quartile 4 v. quartile1: OR=1·305; 95 % CI 1·029, 1·655) in multivariate analysis. These results revealed that higher dietary Na:K ratio significantly increased the risk of the MetS in Chinese adults. Further studies are needed to verify this association.
Little is known about the joint mental health effects of air pollution and tobacco smoking in low- and middle-income countries.
To investigate the effects of exposure to ambient fine particulate matter pollution (PM2.5) and smoking and their combined (interactive) effects on depression.
Multilevel logistic regression analysis of baseline data of a prospective cohort study (n=41785). The 3-year average concentrations of PM2.5 were estimated using US National Aeronautics and Space Administration satellite data, and depression was diagnosed using a standardised questionnaire. Three-level logistic regression models were applied to examine the associations with depression.
The odds ratio (OR) for depression was 1.09 (95% CI 1.01–1.17) per 10 μg/m3 increase in ambient PM2.5, and the association remained after adjusting for potential confounding factors (adjusted OR = 1.10, 95% CI 1.02–1.19). Tobacco smoking (smoking status, frequency, duration and amount) was also significantly associated with depression. There appeared to be a synergistic interaction between ambient PM2.5 and smoking on depression in the additive model, but the interaction was not statistically significant in the multiplicative model.
Our study suggests that exposure to ambient PM2.5 may increase the risk of depression, and smoking may enhance this effect.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
In this paper, a double-passage shape correction (DPSC) method is presented for simulation of unsteady flows around vibrating blades and aeroelastic prediction. Based on the idea of phase-lagged boundary conditions, the shape correction method was proposed aimed at efficiently dealing with unsteady flow problems in turbomachinery. However, the original single-passage shape correction (SPSC) may show the disadvantage of slow convergence of unsteady solutions and even produce nonphysical oscillation. The reason is found to be related with the disturbances on the circumferential boundaries that can not be damped by numerical schemes. To overcome these difficulties, the DPSC method is adopted here, in which the Fourier coefficients are computed from flow variables at implicit boundaries instead of circumferential boundaries in the SPSC method. This treatment actually reduces the interaction between the calculation of Fourier coefficients and the update of flow variables. Therefore a faster convergence speed could be achieved and also the solution stability is improved. The present method is developed to be suitable for viscous and turbulent flows. And for real three-dimensional (3D) problems, the rotating effects are also considered. For validation, a 2D oscillating turbine cascade, a 3D oscillating flat plate cascade and a 3D practical transonic fan rotor are investigated. Comparisons with experimental data or other solutions and relevant discussions are presented in detail. Numerical results show that the solution accuracy of DPSC method is favorable and at least comparable to the SPSC method. However, fewer iteration cycles are needed to get a converged and stable unsteady solution, which greatly improves the computational efficiency.
Zn3(VO4)2 nanorods with visible light-driven photocatalytic activity were prepared by hydrothermal reaction and characterized by x-ray diffraction, Fourier transform infrared, scanning electron microscopy, x-ray photoelectron spectroscopy, UV–vis diffuse reflectance spectra, and Brunauer–Emmett–Teller surface area and pore size analyzer. The Zn3(VO4)2 nanorods consisted of rods with a thickness of approximately 30 nm, length in the range 400–600 nm, and width in the range 150–250 nm. The photocatalytic degradation activities for methylene blue (MB) and 4-nitrophenol (4-NP) over the Zn3(VO4)2 nanorods were studied in detail. The photocatalytic activity of the as-prepared photocatalyst for MB and 4-NP in visible light under the same conditions was about 3.5 times and 2.5 times higher than that of N–TiO2, respectively. The main active species in the photodegradation come from •OH, and the photogenerated electrons also partly involved in the photocatalytic degradation process, in which the •OH radicals formed were in proportional to the light illumination time obeying zero-order reaction rate kinetics.
This study presented a novel fabrication process for TiNi thin films by vacuum diffusion technology using reactive Ni/Ti/Ni multilayer thin films. The sandwiched thin films were prepared by chemical nickel plating. Ni/Ti/Ni multilayer films were heat treated for various diffusion times and temperatures and the influences of the temperature and diffusion time on the interdiffusion behavior of the Ti–Ni system were researched in detail. The results showed that a homogeneous TiNi thin film was obtained at 1173 K with a diffusion time of 4 h. Moreover, the formation sequence of the intermetallics in the Ti–Ni diffusion system was investigated by thermodynamic analysis and experiment. It was found that three compounds – TiNi3, Ti2Ni, and TiNi – formed in the diffusion process at the Ti/Ni interfaces. More importantly, the nucleation of TiNi3 and Ti2Ni was prior to that of TiNi because of the lower reaction Gibbs free energy and increasing interface energy of TiNi3 and Ti2Ni.
The aluminothermic reduction and nitridation method using microsized Al powder and nanosized alumina powder was employed to fabricate AlON powder under N2 atmosphere. Single-phase aluminum oxynitride (AlON) can be prepared at a relatively low temperature (1700 °C) with a holding time of 3 h. The powder is ball milled, doped with different amounts of Y2O3 (0.1–0.9 wt%) as a sintering additive, and then shaped into pellets. The pellet sintering is carried out at two relatively low temperatures (1860 and 1880 °C) for 10 h. The transmittance and hardness of the obtained samples varies as the amount of Y2O3 varies. The sample sintered under optimal conditions can reach an ultimate transmittance of 65% with 2 mm thickness. The Vickers hardness of highly transparent AlON ceramic is about 15.95 ± 0.17 GPa, indicating that our method has a promising future in transparent AlON ceramic production. The sintering promoting mechanisms of Y2O3 are also discussed in detail.
Systemic Fe overload can contribute to abnormal glucose metabolism and the onset of type 2 diabetes (T2D). Although hepcidin is the master regulator of systemic Fe homeostasis, few studies have systematically evaluated the associations of serum hepcidin concentrations with Fe metabolism parameters and risks for the development of T2D. In this regard, whether hepcidin concentrations are associated with T2D remains controversial. We measured serum hepcidin and ferritin concentrations in a case–control study of 1259 Han Chinese participants to evaluate the possible associations of serum hepcidin concentrations with Fe metabolism parameters and risks of T2D. Individuals with diabetes (n 555) and control participants (n 704) were recruited and serum hepcidin and ferritin concentrations were quantified. Additionally, selected biochemical and anthropometric variables were determined. A logistic regression analysis was performed to evaluate the association of serum hepcidin and ferritin concentrations with T2D. A linear regression analysis was used to test for associations between serum hepcidin and ferritin concentrations and a number of clinical, demographic and diabetes-associated variables. We found that serum hepcidin concentrations correlated with Hb and serum ferritin concentrations. No differences in hepcidin concentrations were found between the group with diabetes and the control group. Hepcidin concentrations were not significantly correlated with T2D risk factors. We also found that serum ferritin concentrations were elevated in individuals with diabetes and were positively correlated with both Hb concentrations and T2D risk factors. The present findings suggest that serum ferritin concentrations correlate with T2D risk factors, while serum hepcidin concentrations are positively associated with Hb and serum ferritin concentrations, but do not correlate with T2D.
The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.
We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.
Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9–6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.
This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
Hypoxia inducible factor 1 (HIF-1) is a key transcriptional factor activated during cerebral ischemia, which regulates a great number of downstream genes, including those associated with cell death. In the present study, we aimed to test the hypothesis that post-ischemic HIF-1α up-regulation might promote autophagy activation; thereby, HIF-1α inhibitor 2ME2 might prevent neurons from ischemic injury through inhibiting autophagy.
Global ischemia was induced using the four-vessel occlusion model (4-VO) in Sprague-Dawley rats (male, 250-280g). 2-Methoxyestradiol (2ME2, 5mg/kg, i.p.) was administrated to down-regulate HIF-1α expression. Post-ischemic beclin-1 and LC3 protein expression was determined at different time points through Western blot assay. Neuronal injury was determined by cresyl violet staining and TUNEL staining in coronal histological sections.
The expression of beclin-1 and the ratio of LC3-II/LC3-I increased significantly at 12 and 24 h after ischemia. 2ME2 could remarkably inhibit the up-regulation of beclin-1 and the increase of LC3-II/LC3-I ratio during reperfusion. Moreover, 2ME2 and 3-MA exhibited powerful protective effects against ischemic/reperfusion induced neuronal injury.
This study confirmed that autophagy participated in post-ischemic neuronal injury. 2ME2, a HIF-1α inhibitor, might significantly decrease autophagy activation after cerebral ischemia and relieve post-ischemic neuronal injury. Our findings demonstrate that autophagy could be a potential target for neuronal protection after cerebral ischemia.
The nucleus diameter/cell diameter (N/C) ratio and morphological characteristics of the haemocytes of the snail Babylonia areolata were studied using microscopy. Our results revealed two major types of haemocytes, namely granulocytes and hyalinocytes. In granulocytes, the cytoplasm was purplish red with Wright's staining, but it was blue in hyalinocytes. Hyalinocytes were smaller than granulocytes and had a higher N/C ratio. The granulocytes were sub-categorized into type I granulocytes and type II granulocytes based on the shape and the number of granules. Hyalinocytes were sub-categorized into large and small hyalinocytes based on the diameter and N/C ratio. Snails with a shell length from 2.7 to 3.3 cm showed no differences in the abundance of haemocytes.
Transgenes integrated into mammalian cells are silenced rapidly. This phenomenon correlates with repressed chromatin structure marked by histone hypoacetylation. This study investigated the effect of trichostatin A (TSA; a histone-deacetylase inhibitor) on EGFP expression in transfected cells and embryonic development after somatic cell nuclear transfer (SCNT). Porcine adult fibroblasts were transfected with a pEGFP-C1 vector. Then transfected cells, donor cells for SCNT, were pretreated with TSA, with the untreated cells being used as the control. Expression of EGFP in donor cells and reconstructed embryos was detected when exposed to blue light. Results showed that the percentage of EGFP-positive cells significantly increased when the transfected cells were treated with TSA and the increased expression of EGFP was sustained to at least the morula stage. In addition, the cytotoxic effect of TSA on the transfected cells was dose dependent. In conclusion, TSA can rescue the silenced EGFP gene. Even after transferring the TSA-treated cells to enucleated recipient oocytes, TSA retained the ability to rescue a silenced EGFP gene. In addition, TSA had an impact on cell proliferation.