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BACKGROUND: Following the Monro-Kellie doctrine, the Cerebral Blood Volume Changes (CB_VC) should be mirrored by the Cerebrospinal Fluid Volume Changes (CSF_VC) at the spinal canal. Cervical level is often chosen to estimate CB_VC during the cardiac cycle. However, due to the heterogeneity in the anatomy of extracranial internal jugular veins and their high compliance, we hypothesize that the intracranial level could be a better choice to investigate blood and cerebrospinal fluid (CSF) interactions. This study aims to determine which level, intracranial or extracranial, is more suitable for measuring arterial and venous flows to study cerebral blood and CSF dynamics interactions. METHODS: The spinal CSF and cerebral blood flow measured at intracranial and extracranial levels were quantified using cine phase-contrast magnetic resonance imaging (PC-MRI) in 38 healthy young adults. Subsequently, CSF_VC and CB_VC were calculated, and by linear regression analysis (R2 and slope), the relationship between CB_VC at both levels and the spinal CSF_VC was compared. The differences between extracranial and intracranial measurements were assessed using either a paired Student's t-test or Wilcoxon's test, depending on the normality of the data distribution. RESULTS: The CB_VC amplitude was significantly higher at the extracranial level (0.89 ± 0.28 ml/CC) compared to the intracranial level (0.73 ± 0.19 ml/CC; p < 0.001). CSF oscillations through the spinal canal do not completely balance blood volume changes. The R2 and the slope values obtained from the linear regression analysis between CSF and blood flows were significantly higher in magnitude for the intracranial CB_VC (R2: 0.82 ± 0.16; slope: - 0.74 ± 0.19) compared to the extracranial CB_VC (R2: 0.47 ± 0.37; slope: -0.36 ± 0.33; p < 0.001). Interestingly, extracranial CB_VC showed a greater variability compared to intracranial CB_VC. CONCLUSION: Our results confirmed that CSF does not completely and instantaneously balance cerebral blood expansion during the cardiac cycle. Nevertheless, the resting volume is very small compared to the total intracranial volume. To our knowledge, this study is the first to demonstrate these findings using cerebral blood flow measured intracranially below the Circle of Willis. Additionally, our findings show that cerebral arterial and venous flow dynamic measurements during the cardiac cycle obtained by PC-MRI at the intracranial plane strongly correlate with CSF oscillations measured in the spinal canal. Therefore, the intracranial vascular plane is more relevant for analyzing cerebral blood and CSF interactions during the cardiac cycle compared to measurements taken at the cervical vascular level.
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Líquido Cefalorraquídeo , Circulación Cerebrovascular , Humanos , Circulación Cerebrovascular/fisiología , Masculino , Femenino , Adulto , Líquido Cefalorraquídeo/fisiología , Líquido Cefalorraquídeo/diagnóstico por imagen , Adulto Joven , Imagen por Resonancia Magnética/métodos , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Imagen por Resonancia Cinemagnética/métodosRESUMEN
Lithium (Li) metal is an attractive anode material for use in high-energy lithium-sulfur and lithium-air batteries. However, its practical application is severely impeded by excessive dendrite growth, huge volume changes, and severe side reactions. Herein, a novel Li metal anode composed of lithiophilic two dimensional (2D) conjugated microporous polymer (Li-CMP) and reduced graphene oxide (rGO) sandwiches (Li-CMP@rGO) for Li metal batteries (LiMBs) is reported. In the Li-CMP@rGO anode, the conductive rGO facilitates the charge transfer while the functionalized-CMP provides Li nucleation sites within the micropores, thereby preventing dendrite growth. As a result, the Li-CMP@rGO anode can be cycled smoothly at 6 mA cm-2 of current density with a platting capacity of 2 mAh cm-2 for 1000 h. A Coulombic efficiency of 98.4% is achieved over 350 cycles with a low overpotential of 28 mV. In a full cell with LiFePO4 cathode, the Li-CMP@rGO anode also exhibited good cycling stability compared to CMP@rGO and CMP/Super-P. As expected, the simulation results reveal that Li-CMP@rGO has a strong affinity for Li ions compared to CMP@rGO. The strategies adopted in this work can open new avenues for designing hybrid porous host materials for developing safe and stable Li metal anodes.
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The data presented in this article are part of a very extensive project on studies of solutions of halogenated compounds with alkanes, esters, alcohols, etc. The contribution presented focuses on original data regarding binaries formed by dibromomethane with a set of 21 alkyl esters and with 6 alkanes. The data show a database on changes in volume and on the energy experienced in the mixing processes, with a contribution of more than 900 points (x 1,y E=h E or v E). The provided information is original and was measured in the laboratory at a constant temperature of 298.15 K and atmospheric pressure. Brominated compounds are of interest in various industrial applications, such as pharmaceutical, chemical, agriculture, and others. As these compounds are typically found in solution the information provided has significant value. In addition, scientists use this information for theoretical purposes to develop behavioural theories.
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Background: The use of free gracilis muscle flaps in reconstructive surgery of the lower leg is common practice to cover defects. However, there is still a lack of understanding of the morphometric changes that occur in the transferred muscle and area of interest over time, particularly the characteristic volume decrease that is observed over the course of the first year. This study aimed to assess volume changes in patients with free gracilis muscle flap reconstruction following infection, trauma, or malignancies of the lower extremity. Methods: Three-dimensional surface imaging was performed intraoperatively after 2 weeks, 6 months, and 12 months with the Vectra H2 system. A total of 31 patients were included in this study and analyzed. Results: There was an average volume increase of 146.67 ± 29.66% 2 weeks after reconstruction. Compared to this volume increase, there was a reduction of 108.44 ± 13.62% after 12 months (p < 0.05). Overall, we found a shrinkage to 85.53 ± 20.14% of the intraoperative baseline volume after 12 months. Conclusions: The use of non-invasive 3D surface imaging is a valuable tool for volume monitoring after free flap reconstruction of the lower extremity. The free gracilis muscle flap undergoes different phases of volume change over the first year, with the greatest influence on overall change being the development and decongestion of edema. Precise initial surgical tailoring is crucial for optimal long-term functional and cosmetic results.
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Background: Based on the results of JCOG0802 and CALGB studies, segmentectomy has considered to be a standard procedure for early-stage non-small cell lung cancer (NSCLC). After lobectomy, the residual cavity is filled with mediastinal and diaphragmatic deviations, and compensatory volume changes are present in the residual lungs. In this study, we examined the efficacy of segmentectomy, a surgical procedure, by focusing on its impact on postoperative lung volume and function. Methods: We enrolled 77 patients who underwent segmentectomy as their initial surgical procedure, excluding those with additional lung resections and those who lacked postoperative computed tomography imaging. The predicted residual volume (mL) was defined as the total lung volume before surgery minus the volume of the resected area. Using the predicted residual volume (mL) and postoperative total lung volume (mL), we calculated the rate of postoperative lung volume increase [(postoperative total lung volume/predicted residual volume) × 100] (%). We also classified 52 cases with a rate of postoperative lung volume increase of ≥100% into a compensatory group, while those with a rate of <100% were classified into a non-compensatory group. Results: The average postoperative lung volume increase was 104.6% among 77 cases. Age ≥65 years, pack year index ≥27.5, ≥3 resected segments, and use of electrocautery for intersegmental plane division were significantly associated with compensatory group classification. In 20 compensatory cases with preoperative and postoperative pulmonary function tests, postoperative vital capacity and forced expiratory volume in one second values exceeded the preoperative predictions. This study further examined the areas responsible for postoperative compensatory lung volume increase. In the compensatory group, significant expansion was observed in the ipsilateral lobes, excluding the resected segment and contralateral lung, while no significant changes were noted in the volume of the lobe, including the resected segment. Conversely, the non-compensatory group showed a significant volume decrease in the resected lobe, but no significant increase in other areas. Conclusions: This study emphasizes the importance of preserving lung segments in segmentectomy. The study demonstrates extensive compensatory volume changes in the ipsilateral lung and contralateral lung. There was no significant volume decrease in any residual segment. This underlines the potential of segmentectomy to maintain lung function and expand treatment options post-surgery. In addition, the compensated group included patients with a lower pack-year index and younger patients. These results suggest that postoperative compensatory lung expansion includes not only hyperinflation of the remaining lung, but also an increase in the functional lung parenchyma.
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Background and purpose: Introducing moderately hypofractionated salvage radiotherapy (SRT) following prostatectomy obligates investigation of its effects on clinical target volume (CTV) coverage and organ-at-risk (OAR) doses. This study assessed interfractional volume and dose changes in OARs and CTV in moderately hypofractionated SRT and evaluated the 8-mm planning target volume (PTV) margin. Materials and methods: Twenty patients from the PERYTON-trial were included; 10 received conventional SRT (35 × 2 Gy) and 10 hypofractionated SRT (20 × 3 Gy). OARs were delineated on 539 pre-treatment Cone Beam CT (CBCT) scans to compare interfractional OAR volume changes. CTVs for the hypofractionated group were delineated on 199 CBCTs. Dose distributions with 4 and 6 mm PTV margins were generated using voxel-wise minimum robustness evaluation of the original 8-mm PTV plan, and dose changes were assessed. Results: Median volume changes for bladder and rectum were -26 % and -10 %, respectively. OAR volume changes were not significantly different between the two treatment schedules. The 8-mm PTV margin ensured optimal coverage for prostate bed and vesicle bed CTV (V95 = 100 % in >97 % fractions). However, bladder V60 <25 % was not achieved in 5 % of fractions, and rectum V60 <5 % was unmet in 33 % of fractions. A 6-mm PTV margin resulted in CTV V95 = 100 % in 92 % of fractions for prostate bed, and in 86 % for vesicle bed CTV. Conclusions: Moderately hypofractionated SRT yielded comparable OAR volume changes to conventionally fractionated SRT. Interfractional changes remained acceptable with a PTV margin of 6 mm for prostate bed and 8 mm for vesicle bed.
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Purpose: This study assessed the serial volume changes in multiple shoulder muscles simultaneously following arthroscopic rotator cuff repair (ARCR) by a three-dimensional (3D) modeling-based sectional measurement. These volume changes were correlated with background preoperative factors. Methods: Four consecutive magnetic resonance imaging scans (preoperatively and postoperatively at 3, 6, and 12 months) of 33 shoulders from 31 patients who underwent arthroscopic rotator cuff repair were examined. We focused on the sectional volume differences of the supraspinatus, infraspinatus, teres minor, and subscapularis between preoperatively and 3 months postoperatively (Dif.pre.3mo) and between 3 and 12 months postoperatively (Dif.3.12mo). The correlation between volume differences and clinical/demographic parameters was determined by a multivariate analysis. Results: No statistically significant differences were observed for most serial changes in the shoulder muscle volumes. The tear-site muscles (supraspinatus and infraspinatus) showed similar tendencies for volume changes, whereas the non-tear-site muscles (teres minor and subscapularis) differed. A negative correlation was observed between Dif.pre.3mo and Dif.3.12mo for the supraspinatus, infraspinatus, and teres minor. These perioperative volume differences might correlate with tear size and symptom duration in the supraspinatus, as well as with a history of steroid injections and work and sports activity levels in the infraspinatus and teres minor. Conclusion: The serial volume changes in multiple shoulder muscles after ARCR measured using our 3D sectional approach exhibited different tendencies and clinical implications depending on the primary and non-primary site of tears. Our method may serve as a potential indicator to facilitate muscle recovery and prevent the progression of postoperative muscle atrophy.
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Molecular carriers are necessary for the controlled release of drugs and genes to achieve the desired therapeutic outcomes. DNA hydrogels can be a promising candidate in this application with their distinctive sequence-dependent programmability, which allows precise encapsulation of specific cargo molecules and stimuli-responsive release of them at the target. However, DNA hydrogels are inherently susceptible to the degradation of nucleases, making them vulnerable in a physiological environment. To be an effective molecular carrier, DNA hydrogels should be able to protect encapsulated cargo molecules until they reach the target and release them once they are reached. Here, we develop a simple way of controlling the enzyme resistance of DNA hydrogels for cargo protection and release by using cation-mediated condensation and expansion. We found that DNA hydrogels condensed by spermine are highly resistant to enzymatic degradation. They become degradable again if expanded back to their original, uncondensed state by sodium ions interfering with the interaction between spermine and DNA. These controllable condensation, expansion, and degradation of DNA hydrogels pave the way for the development of DNA hydrogels as an effective molecular carrier.
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ADN , Hidrogeles , Espermina , Hidrogeles/química , ADN/química , ADN/metabolismo , Espermina/química , Portadores de Fármacos/químicaRESUMEN
Silver (Ag) is deemed a promising anode material for capacitive deionization (CDI) due to its high theoretical capacity and efficient selectivity to Cl-. However, the strong volume change during the conversion reaction significantly undermines the cycling performance of the Ag electrode. Additionally, achieving well-dispersed Ag in the active matrix is challenging, as Ag electrodes prepared by conventional thermal reduction tend to agglomerate. Herein, the organic linker confinement strategy is proposed, applying metal-organic framework (MOF) chemistry between Ag nodes and organic ligands to construct Ag-based MOF. The uniform dispersion of Ag at the molecular level, confined in the organic matrix, efficiently enhances the utilization of active sites, and strengthens the interfacial stability of Ag. Consequently, the Ag-MOF for the CDI anode exhibits an excellent Cl- removal capacity of 121.52 mg g-1 at 20 mA g-1 in 500 mg L-1 NaCl solution, and a high Ag utilization rate of 60.54%. After 100 cycles, a capacity retention of 96.93% is achieved. Furthermore, the Cl- capture mechanism of Ag-MOF is elucidated through density functional theory (DFT) calculations, ex situ XRD, ex situ Raman and XPS. This ingenious electrode design can offer valuable insights for the development of high-performance conversion electrodes for CDI applications.
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Binders are crucial for stabilizing the cycling performance of silicon (Si) materials by preventing Si particle pulverization during lithiation and delithiation. Poly(acrylic acid) (PAA) and carboxymethyl cellulose (CMC) are the two most studied binders for Si electrodes, with PAA being an elastic polymer and CMC a rigid polymer. Starting with the elastic PAA, in this work the impact of binder content on the cycling performance of Si electrodes is studied. It is found that regardless of Si particle size, there is an optimal binder content between 20 % and 25 % for the cycling stability of Si electrodes. On the other hand, the rigid CMC binder results in lower capacity and faster capacity fading for Si electrodes compared with the elastic PAA. AC-impedance analysis reveals that the lower capacity is due to higher grain boundary resistance (Rgb) in CMC-coated electrodes, leading to high charge-transfer resistance (Rct) and increased polarization. This high polarization triggers premature termination during the discharging process (i. e., the lithiation) of Li/Si cells, underutilizing the Si active material. Additionally, the rapid capacity fading of CMC-coated electrodes is attributed to the rigid binder's inferior ability to prevent Si particle pulverization.
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Aqueous potassium-ion batteries (AKIBs) are considered promising electrochemical energy storage systems owing to their high safety and cost-effectiveness. However, the structural degradation resulting from the repeated accommodation of large K-ions and the dissolution of active electrode materials in highly dielectric aqueous electrolytes often lead to unsatisfactory electrochemical performance. This study introduces a high-entropy Prussian blue analog (HEPBA) cathode material for AKIBs, demonstrating significantly enhanced structural stability and reduced dissolution. The HEPBA exhibits a highly reversible specific capacity of 102.4 mAh g-1, with 84.4% capacity retention after undergoing 3448 cycles over a duration of 270 days. Mechanistic insights derived from comprehensive experimental investigations, supported by theoretical calculations, reveal that the HEPBA features a robust structure resistant to dissolution, a solid-solution reaction pathway with negligible volume variation during charge-discharge, and efficient ion transport kinetics characterized by a reduced band gap and a low energy barrier. This study represents a measurable step forward in the development of long-lasting electrode materials for aqueous AKIBs.
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PURPOSE: An accurate, reproducible method to calculate post-operative facial swelling in patients who have undergone orthognathic surgery is important to evaluate the effects of different therapies and surgical techniques on edema. The purpose of this study was to describe such a method and assess its reliability. MATERIALS AND METHODS: A prospective study of patients undergoing orthognathic surgery was conducted. 3D facial photographs were taken on these patients immediately postoperatively, and again at least 21 days later using the 3DMD face system (3DMD LLC., Atlanta, GA, USA). These were cropped using specific anatomic points and the difference in facial volume between the photographs was calculated. Intra-rater reliability and inter-rater reliability were assessed using the Intraclass Correlation Coefficient (ICC). RESULTS: 30 patients were included in the study for analysis. When the difference in facial swelling was calculated twice by the same rater, the mean difference between the two measurements was 4.0 ± 4.2 mL. When calculated by two separate raters, the mean difference was found to be 5.0 ± 3.8 mL. The ICCs for intra-rater and inter-rater reliability were excellent at 0.979 and 0.981 respectively. CONCLUSION: This method allows for reproducible calculation of post-operative facial swelling and could be useful to evaluate the effects of different therapies used to limit swelling and to track the resolution of swelling. It can also potentially be used as a visual aid for patient counseling during the pre-surgical visits.
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Cara , Imagenología Tridimensional , Procedimientos Quirúrgicos Ortognáticos , Humanos , Imagenología Tridimensional/métodos , Cara/anatomía & histología , Estudios Prospectivos , Reproducibilidad de los Resultados , Procedimientos Quirúrgicos Ortognáticos/métodos , Femenino , Masculino , Adulto , Fotograbar , Edema/diagnóstico , Edema/etiología , Edema/patología , Adulto Joven , Adolescente , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Variaciones Dependientes del ObservadorRESUMEN
Dual-ion batteries (DIBs) represent a promising energy storage technology, offering a cost-effective safe solution with impressive electrochemical performance. The large combinatorial configuration space of the electrode-electrolyte leads to design challenges. We present a machine learning (ML) approach for accurately predicting the voltage and volume changes of polycyclic aromatic hydrocarbon (PAH) cathodes upon intercalation with a variety of DIB salts following different mechanisms. Gradient Boosting and XGBoost Regression models trained on the data set demonstrate exceptional performance in voltage and volume change prediction, respectively. The models are further cross-validated and utilized to predict the properties for â¼700 combinations of PAH and DIB salt intercalations, a subset of which is further validated by density functional theory. Using average voltage and volume change for all combinations of PAHs and salts, preferable combinations for high/low voltage requirements along with long-term stability are obtained. Overall, the study shows the applicability of PAHs in DIBs exhibiting good electrochemical performance with low volume change compared to graphite indicative of its potential to overcome the cycling stability issues of DIBs. This research establishes a reliable and broadly applicable ML-based workflow for efficient screening and accelerated design of advanced PAH cathodes and salts, thus driving progress in the field of DIBs.
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BACKGROUND: Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT. METHODS: The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23. RESULTS: Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change. CONCLUSIONS: The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation.
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PURPOSE: Bio-impedance analysis (BIA) has been widely investigated for hemodynamic monitoring. However, previous works rarely modelled two synchronously pulsatile arteries (representing the radial and ulnar arteries) in the wrist/forearm model. This work aims to clarify and quantify the influences of two pulsatile arteries on BIA. METHODS: First, two blood-filled arteries were structured in a 3D wrist segment using the finite element method (FEM). Afterwards, an easy-to-produce two-arteries artificial wrist was fabricated with two components: gelatine-based surrounding tissue phantom and saline blood phantom. A syringe driver was utilised to constrict the arteries, and the impedance signals were measured using a Multi-frequency Impedance Analyser (MFIA). RESULTS: Both simulation and experimental results demonstrated the non-negligible influences of the ulnar artery on the overall BIA, inducing unwanted resistance changes to the acquired signals from the radial artery. The phantom experiments revealed the summation of the individual resistance changes caused by a single pulsatile artery was approximately equal to the measured resistance change caused by two synchronously pulsatile arteries, confirming the measured impedance signal at the wrist contains the pulsatile information from both arteries. CONCLUSION: This work is the first simulation and phantom investigation into two synchronously pulsatile arteries under BIA in the distal forearm, providing a better insight and understanding in the morphology of measured impedance signals. Future research can accordingly select either a small spacing 4-spot electrode configuration for a single artery sensing or a band electrode configuration for overall pulsatile arteries sensing. A more accurate estimation of blood volume change and pulse wave analysis (PWA) could help to develop cuffless blood pressure measurement (BPM).
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Arteria Radial , Muñeca , Muñeca/fisiología , Impedancia Eléctrica , Determinación de la Presión SanguíneaRESUMEN
In the setting where breast cancer-related lymphedema (BCRL) remains a feared and common complication of breast cancer, here we review important factors for the development, diagnosis, prevention, and treatment of BCRL. We find that race/ethnicity affect BCRL development risk, that future studies should focus on understanding the biological reasons behind the increased susceptibility of certain racial minorities to BCRL, that surveillance, early detection, exercise programs, and arm compression can reduce the risk of BCRL, and that surgical techniques to preserve and restore lymphatic drainage being evaluated in randomized trials may become transformative in reducing BCRL risk for high-risk patients.
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Neoplasias de la Mama , Linfedema , Humanos , Femenino , Linfedema/diagnóstico , Linfedema/etiología , Linfedema/terapia , Morbilidad , Neoplasias de la Mama/complicaciones , Medición de Riesgo , Extremidad SuperiorRESUMEN
Volume change plays an important role in biological cells to regulate their internal microenvironment. To adapt to the rapid variation of the surface area during the volume change, the lipid membrane is dynamically modulated via membrane folding invagination, or spontaneous uptake or release of lipid molecules under osmotic pressure. Here, we demonstrate an alternative approach to design a functional protocellular system capable of dynamically adjusting its volume and intracellular microenvironment in response to the alteration of pH. By assembling and subsequently cross-linking pH-responsive caseinate at the water-oil interface, the caseinate-based protocell with more than ten thousand caseinate units in its membrane was established and showed a reversible volume and pore size change to pH variation due to the collective response of the caseinate in the membrane, which could be used to control the spatial distribution of proto-organelle by regulating of the viscosity inside the protocell.
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Células Artificiales , Caseínas/química , Agua/química , LípidosRESUMEN
Lobectomy is an effective and well-established therapy for localized lung cancer. This study aimed to assess the lung and lobe change after lobectomy and predict the postoperative lung volume. The study included 135 lung cancer patients from two hospitals who underwent lobectomy (32, right upper lobectomy (RUL); 31, right middle lobectomy (RML); 24, right lower lobectomy (RLL); 26, left upper lobectomy (LUL); 22, left lower lobectomy (LLL)). We initially employ a convolutional neural network model (nnU-Net) for automatically segmenting pulmonary lobes. Subsequently, we assess the volume, effective lung volume (ELV), and attenuation distribution for each lobe as well as the entire lung, before and after lobectomy. Ultimately, we formulate a machine learning model, incorporating linear regression (LR) and multi-layer perceptron (MLP) methods, to predict the postoperative lung volume. Due to the physiological compensation, the decreased TLV is about 10.73%, 8.12%, 13.46%, 11.47%, and 12.03% for the RUL, RML, RLL, LUL, and LLL, respectively. The attenuation distribution in each lobe changed little for all types of lobectomy. LR and MLP models achieved a mean absolute percentage error of 9.8% and 14.2%, respectively. Radiological findings and a predictive model of postoperative lung volume might help plan the lobectomy and improve the prognosis.
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Neoplasias Pulmonares , Pulmón , Neumonectomía , Humanos , Pulmón/diagnóstico por imagen , Pulmón/cirugía , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Pronóstico , Tórax , Tomografía Computarizada por Rayos XRESUMEN
Introduction: Brain atrophy is a critical biomarker of disease progression and treatment response in neurodegenerative diseases such as multiple sclerosis (MS). Confounding factors such as inconsistent imaging acquisitions hamper the accurate measurement of brain atrophy in the clinic. This study aims to develop and validate a robust deep learning model to overcome these challenges; and to evaluate its impact on the measurement of disease progression. Methods: Voxel-wise pseudo-atrophy labels were generated using SIENA, a widely adopted tool for the measurement of brain atrophy in MS. Deformation maps were produced for 195 pairs of longitudinal 3D T1 scans from patients with MS. A 3D U-Net, namely DeepBVC, was specifically developed overcome common variances in resolution, signal-to-noise ratio and contrast ratio between baseline and follow up scans. The performance of DeepBVC was compared against SIENA using McLaren test-retest dataset and 233 in-house MS subjects with MRI from multiple time points. Clinical evaluation included disability assessment with the Expanded Disability Status Scale (EDSS) and traditional imaging metrics such as lesion burden. Results: For 3 subjects in test-retest experiments, the median percent brain volume change (PBVC) for DeepBVC and SIENA was 0.105 vs. 0.198% (subject 1), 0.061 vs. 0.084% (subject 2), 0.104 vs. 0.408% (subject 3). For testing consistency across multiple time points in individual MS subjects, the mean (± standard deviation) PBVC difference of DeepBVC and SIENA were 0.028% (± 0.145%) and 0.031% (±0.154%), respectively. The linear correlation with baseline T2 lesion volume were r = -0.288 (p < 0.05) and r = -0.249 (p < 0.05) for DeepBVC and SIENA, respectively. There was no significant correlation of disability progression with PBVC as estimated by either method (p = 0.86, p = 0.84). Discussion: DeepBVC is a deep learning powered brain volume change estimation method for assessing brain atrophy used T1-weighted images. Compared to SIENA, DeepBVC demonstrates superior performance in reproducibility and in the context of common clinical scan variances such as imaging contrast, voxel resolution, random bias field, and signal-to-noise ratio. Enhanced measurement robustness, automation, and processing speed of DeepBVC indicate its potential for utilisation in both research and clinical environments for monitoring disease progression and, potentially, evaluating treatment effectiveness.