LI-RADS version 2018 treatment response algorithm on extracellular contrast-enhanced MRI in patients treated with transarterial chemoembolization for hepatocellular carcinoma: diagnostic performance and the added value of ancillary features.

BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Algorithm (TRA) (LI-RADS TRA) is used for assessing response of HCC to locoregional therapy (LRT), however, the value of ancillary features (AFs) for TACE-treated HCCs has not been extensively investigated on extracellular agent MRI (ECA-MRI). PURPOSE: To evaluate the diagnostic performance of LI-RADS v2018 TRA on ECA-MRI for HCC treated with transarterial chemoembolization (TACE) and the value of ancillary features. METHODS: This retrospective study included patients who underwent TACE for HCC and then followed by hepatic surgery between January 2019 and June 2023 with both pre- and post-TACE contrast-enhanced MRI available. Two radiologists independently evaluated the post-treated lesions on MRI using LI-RADS treatment response (TR) (LR-TR) algorithm and modified LR-TR (mLR-TR) algorithm in which ancillary features (restricted diffusion and intermediate T2-weighted hyperintensity) were added, respectively. Lesions were categorized as complete pathologic necrosis (100%, CPN) and non-complete pathologic necrosis (< 100%, non-CPN) on the basis of surgical pathology. The diagnostic performance in predicting viable and non-viable tumors based on LR-TR and mLR-TR algorithms was compared using the McNemar test. Interreader agreement was calculated by using Cohen's weighted and unweighted κ. RESULTS: A total of 61 patients [mean age 59 years ± 10 (standard deviation); 47 men] with 79 lesions (57 pathologically viable) were included. For non-CPN prediction, the sensitivity, specificity of LR-TR viable and mLR-TR viable category were 75% (43 of 57), 82% (18 of 22) and 88% (50 of 57), 77% (17 of 22), respectively, the sensitivity of mLR-TR was significantly higher than that of LR-TR (P = 0.016) without difference in specificity (P = 1.000). Interreader agreement for LR-TR and mLR-TR category was moderate (k = 0.50, 95% confidence interval 0.33, 0.67, k = 0.42, 95% confidence interval 0.20, 0.63). The sensitivity of both LR-TR and mLR-TR algorithms in predicting viable tumors between conventional TACE (cTACE) and drug-eluting beads TACE (DEB-TACE) did not have significant difference (cTACE: 76%, 89% vs. DEB-TACE: 73%, 82%). CONCLUSIONS: On ECA-MRI, applying ancillary features to LI-RADS v2018 TRA can improve the sensitivity in predicting pathologic tumor viability in patients treated with TACE for hepatocellular carcinoma with no significant difference in specificity.

Intra- and Peri-tumoral Radiomics Based on Dynamic Contrast Enhanced-MRI to Identify Lymph Node Metastasis and Prognosis in Intrahepatic Cholangiocarcinoma.

BACKGROUND: Lymph node metastasis (LNM) in patients with intrahepatic cholangiocarcinoma (iCCA) affects treatment strategies and prognosis. However, preoperative imaging is not reliable enough for identifying LNM. PURPOSE: To develop and validate a radiomics nomogram based on dynamic contrast enhanced (DCE)-MR images for identifying LNM and prognosis in iCCA. STUDY TYPE: Retrospective. SUBJECTS: Two hundred four patients with pathologically proven iCCA who underwent curative-intent resection and lymphadenectomy (training cohort: N = 107, internal test cohort: N = 46, and external test cohort: N = 51). FIELD STRENGTH/SEQUENCE: T1- and T2-weighted imaging, diffusion-weighted imaging and DCE imaging at 1.5 T or 3.0 T. ASSESSMENT: Radiomics features were extracted from intra- and peri-tumoral regions on preoperative DCE-MR images. Imaging features were evaluated by three radiologists, and significant variables in univariable and multivariable regression analysis were included in clinical model. The best-performing radiomics signature and clinical characteristics (intrahepatic duct dilatation, MRI-reported LNM) were combined to build a nomogram. Patients were divided into high-risk and low-risk groups based on their nomogram scores (cutoff = 0.341). Patients were followed up for 1-102 months (median 12) after surgery, the overall survival (OS) and recurrence-free survival (RFS) were calculated. STATISTICAL TESTS: Receiver operating characteristic (ROC) curve, calibration, decision curve, Delong test, Kaplan-Meier curves, log rank test. Two tailed P < 0.05 was considered statistically significant. RESULTS: The nomogram incorporating intra- and peri-tumoral radiomics features, intrahepatic duct dilatation and MRI-reported LNM obtained the best discrimination for LNM, with areas under the ROC curves of 0.946, 0.913, and 0.859 in the training, internal, and external test cohorts. In the entire cohort, high-risk patients had significantly lower RFS and OS than low-risk patients. High-risk of LNM was an independent factor of unfavorable OS and RFS. DATA CONCLUSION: The nomogram integrating intra- and peri-tumoral radiomics signatures has potential to identify LNM and prognosis in iCCA. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

Mechanism of Strength Formation of Unfired Bricks Composed of Aeolian Sand-Loess Composite.

Aeolian sand and loess are both natural materials with poor engineering-related properties, and no research has been devoted to exploring aeolian sand-loess composite materials. In this study, we used aeolian sand and loess as the main raw materials to prepare unfired bricks by using the pressing method, along with cement, fly ash, and polypropylene fiber. The effects of different preparation conditions on the physical properties of the unfired bricks were investigated based on compressive strength, water absorption, and softening tests and a freeze-thaw cycle test combined with X-ray diffraction and scanning electron microscope analysis to determine the optimal mixing ratio for unfired bricks, and finally, the effects of fibers on the durability of the unfired bricks were investigated. The results reveal that the optimal mixing ratio of the masses of aeolian sand-loess -cement -fly ash-polypropylene fiber-alkali activator-water was 56.10:28.05:9.17:2.40:0.4:0.003:4.24 under a forming pressure of 20 MPa. The composite unfired bricks prepared had a compressive strength of 14.5 MPa at 14 d, with a rate of water absorption of 8.8%, coefficient of softening of 0.92, and rates of the losses of frozen strength and mass of 15.93% and 1.06%, respectively, where these satisfied the requirements of environmentally protective bricks with strength grades of MU10-MU15. During the curing process, silicate and sodium silicate gels tightly connected the particles of aeolian sand and the loess skeleton, and the spatial network formed by the addition of the fibers inhibited the deformation of soil and improved the strength of the unfired bricks.

Development and Preliminary Validation of a Novel Convolutional Neural Network Model for Predicting Treatment Response in Patients with Unresectable Hepatocellular Carcinoma Receiving Hepatic Arterial Infusion Chemotherapy.

The goal of this study was to evaluate the performance of a convolutional neural network (CNN) with preoperative MRI and clinical factors in predicting the treatment response of unresectable hepatocellular carcinoma (HCC) patients receiving hepatic arterial infusion chemotherapy (HAIC). A total of 191 patients with unresectable HCC who underwent HAIC in our hospital between May 2019 and March 2022 were retrospectively recruited. We selected InceptionV4 from three representative CNN models, AlexNet, ResNet, and InceptionV4, according to the cross-entropy loss (CEL). We subsequently developed InceptionV4 to fuse the information from qualified pretreatment MRI data and patient clinical factors. Radiomic information was evaluated based on several constant sequences, including enhanced T1-weighted sequences (with arterial, portal, and delayed phases), T2 FSE sequences, and dual-echo sequences. The performance of InceptionV4 was cross-validated in the training cohort (n = 127) and internally validated in an independent cohort (n = 64), with comparisons against single important clinical factors and radiologists in terms of receiver operating characteristic (ROC) curves. Class activation mapping was used to visualize the InceptionV4 model. The InceptionV4 model achieved an AUC of 0.871 (95% confidence interval [CI] 0.761-0.981) in the cross-validation cohort and an AUC of 0.826 (95% CI 0.682-0.970) in the internal validation cohort; these two models performed better than did the other methods (AUC ranges 0.783-0.873 and 0.708-0.806 for cross- and internal validations, respectively; P < 0.01). The present InceptionV4 model, which integrates radiomic information and clinical factors, helps predict the treatment response of unresectable HCC patients receiving HAIC treatment.

Comparative effectiveness of warfarin in cirrhotic patients with non-symptomatic portal vein thrombosis: a multicenter, randomized controlled trial.

The effectiveness and risks of anticoagulant therapy in cirrhotic patients with non-symptomatic portal vein thrombosis (PVT) remain unclear. We conducted a multicenter, Zelen-designed randomized controlled trial to determine the effectiveness of warfarin in cirrhotic patients with non-symptomatic PVT during a one-year follow-up. In brief, 64 patients were 1:1 randomly divided into the anticoagulation group or the untreated group. The probability of recanalization was significantly higher in the anticoagulation group than those untreated in both ITT analysis (71.9% vs 34.4%, p = 0.004) and PP analysis (76.7% vs 32.4%, p < 0.001). Anticoagulation treatment was the independent predictor of recanalization (HR 2.776, 95%CI 1.307-5.893, p = 0.008). The risk of bleeding events and mortality were not significantly different. A significantly higher incidence of ascites aggravation was observed in the untreated group (3.3% vs 26.5%, p = 0.015). In conclusion, warfarin was proved to be an effective and safe as an anticoagulation therapy for treating non-symptomatic PVT in cirrhotic patients.

MRI-based radiomics signature: a potential imaging biomarker for prediction of microvascular invasion in combined hepatocellular-cholangiocarcinoma.

PURPOSE: To investigate the potential of radiomics analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in preoperatively predicting microvascular invasion (MVI) in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC) before surgery. METHODS: A cohort of 91 patients with histologically confirmed cHCC-CC who underwent preoperative liver DCE-MRI were enrolled and divided into a training cohort (27 MVI-positive and 37 MVI-negative) and a validation cohort (11 MVI-positive and 16 MVI-negative). Clinical characteristics and MR features of the patients were evaluated. Radiomics features were extracted from DCE-MRI, and a radiomics signature was built using the least absolute shrinkage and selection operator (LASSO) algorithm in the training cohort. Prediction performance of the developed radiomics signature was evaluated by utilizing the receiver operating characteristic (ROC) analysis. RESULTS: Larger tumor size and higher Radscore were associated with the presence of MVI in the training cohort (p = 0.026 and < 0.001, respectively), and theses findings were also confirmed in the validation cohort (p = 0.040 and 0.001, respectively). The developed radiomics signature, composed of 4 stable radiomics features, showed high prediction performance in both the training cohort (AUC = 0.866, 95% CI 0.757-0.938, p < 0.001) and validation cohort (AUC = 0.841, 95% CI 0.650-0.952, p < 0.001). CONCLUSIONS: The radiomics signature developed from DCE-MRI can be a reliable imaging biomarker to preoperatively predict MVI in cHCC-CC.

Prognostic value of LI-RADS category on MRI in patients with primary hepatic lymphoepithelioma-like carcinoma.

OBJECTIVES: To compare the clinical and MRI features of primary hepatic lymphoepithelioma-like carcinoma (LELC) categorized as LR-M or LR-4/5 using the Liver Imaging Reporting and Data System (LI-RADS) version 2018 and to determine the prognostic factors for recurrence-free survival (RFS). METHODS: In this retrospective study, 37 patients with surgically confirmed LELC were included. Two independent observers evaluated preoperative MRI features according to the LI-RADS version 2018. Clinical and imaging features were compared between two groups. RFS and the associated factors were evaluated using Cox proportional hazards regression analysis, Kaplan-Meier analysis, and log-rank test. RESULTS: In total, 37 patients (mean age, 58.5 ± 10.3 years) were evaluated. Sixteen (43.2%) LELCs were categorized as LR-M and twenty-one (56.8%) LELCs were categorized as LR-4/5. In the multivariate analysis, the LR-M category was an independent factor for RFS (HR 7.908, 95% CI 1.170-53.437; p = 0.033). RFS rates were significantly lower in patients with LR-M LELCs than in patients with LR-4/5 LELCs (5-year RFS rate, 43.8% vs.85.7%; p = 0.002). CONCLUSION: The LI-RADS category was significantly associated with postsurgical prognosis of LELC, with tumor categorized as LR-M having a worse RFS than those categorized as LR-4/5. KEY POINTS: • Lymphoepithelioma-like carcinoma patients categorized as LR-M have worse recurrence-free survival than those categorized as LR-4/5. • MRI-based LI-RADS categorization was an independent factor for postoperative prognosis of primary hepatic lymphoepithelioma-like carcinoma.

Risk factors associated with failure of endoscopic combined treatment to prevent varices rebleeding in patients with liver cirrhosis.

BACKGROUND: The aim of this study is to investigate risk factors associated with gastroesophageal variceal rebleeding after endoscopic combined treatment. RESEARCH DESIGN AND METHODS: Patients who had liver cirrhosis and underwent endoscopic treatment to prevent variceal rebleeding were retrospectively recruited. Hepatic venous pressure gradient (HVPG) measurement and CT examination of portal vein system were performed before endoscopic treatment. Endoscopic obturation for gastric varices and ligation for esophageal varices were performed simultaneously at the first treatment. RESULTS: One hundred and sixty-five patients were enrolled, and after the first endoscopic treatment, recurrent hemorrhage occurred in 39 patients (23.6%) during 1-year follow-up. Compared to the non-rebleeding group, HVPG was significantly higher (18 mmHg vs.14 mmHg, P = 0.024) and more patients had HVPG exceeding 18 mmHg (51.3% vs.31.0%, P = 0.021) in the rebleeding group. No significant difference was found in other clinical and laboratory data between two groups (P > 0.05 for all). By a logistic regression analysis, high HVPG was the only risk factor associated with failure of endoscopic combined therapy (OR = 1.071, 95%CI, 1.005-1.141, P = 0.035). CONCLUSIONS: The poor efficacy of endoscopic treatment to prevent variceal rebleeding was associated with high HVPG. Therefore, other therapeutic options should be considered for the rebleeding patients with high HVPG.

Prognostic role of aortic distensibility in patients with bicuspid aortic valve: a CMR study.

To evaluate the prognostic value of aortic distensibility measured by cardiovascular magnetic resonance (CMR) as predictors of prophylactic aortic valve or aortic surgery in patients with bicuspid aortic valve (BAV). 110 patients with BAV were included. Distensibility of middle ascending aorta (AscAo) and proximal descending aorta (DescAo) at baseline was determined using CMR. The association between aortic distensibility and primary endpoint of aortic valve and/or aortic surgery was investigated with Cox proportional hazard regression analyses. The receiver operating characteristics curves (ROC) of the area under receiver-operator (AUC) and DeLong test were used to evaluate and compare the performance of different models. During a median follow-up of 66.5 months [IQR 13-75 months], 42 patients experienced surgical treatments. After adjusting for traditional risk factors, aortic distensibility (P = 0.003) and severe valve dysfunction (P < 0.001) were found significantly associated with aortic valve and/or aortic surgery. The model 2 (aortic distensibility and severe valve dysfunction) is slightly better in predicting primary endpoint than the model 1 (aortic diameter and severe valve dysfunction) (AUC: 0.893 vs. 0.842, P = 0.106). In BAV patients, aortic distensibility and severe valve dysfunction are valuable predictors for final aortic valve and/or aortic surgery.

A Novel Thoracoabdominal Aorta CTA-based Nomogram Model to Identify Ideal Candidates for Transradial Approach Chemoembolization in Patients with Liver Cancer.

Background: High technical complexity limits the wide use of transradial approach (TRA) chemoembolization in the management of liver cancer. We sought to construct a thoracoabdominal aorta CTA-based nomogram model to identify ideal candidates for TRA chemoembolization in patients with liver cancer. Methods: Patients who had received thoracoabdominal aorta CTA before TRA chemoembolization from 2018 to 2020 were retrospectively enrolled and randomly divided into a training set and a validation set. The clinical characteristics and CTA features were collected to build a clinical model. Univariate and multivariate analyses were used to identify significant clinical-radiological variables. A CTA-based nomogram model was constructed by using multivariate logistic regression analysis. The predictive performance, as well as discrimination efficacy of the model, was evaluated by ROC analysis and calibration plot. Results: Vascular variation (P=0.028), Myla classification (P=0.030), length from left subclavian artery to the left subclavian artery (P=0.017), and angle between common hepatic artery and abdominal aorta (P=0.017) were identified as important factors associated with the technical complexity of TRA chemoembolization, indicated by fluoroscopy time of the total procedure. The CTA-based nomogram model was established by these abovementioned variables, which demonstrated good predictive ability in both the training cohort (AUC=0.929) and validation cohort (AUC= 0.769), with a high C-index of 0.928 and 0.827 respectively. Moreover, satisfactory calibrations were confirmed by the Hosmer-Lemeshow test with P values of 0.618 and 0.299 in the training cohort and validation cohort. Conclusion: Our study constructs a novel CTA-based nomogram, which can serve as a useful tool to identify ideal candidates for TRA chemoembolization in patients with liver cancer.

The design of a novel arthroscopy shaver.

Cases of arthroscopic surgery have increased over the past two decades, and arthroscopic shaver systems have become a commonly used orthopedic tool. Nevertheless, most shavers generally have problems such as the cutting edge is not sharp enough and easy to wear. This paper aims to discuss the structural characteristics of BJKMC's (Bojin◊ Kinetic Medical) novel arthroscopic shaver, the double serrated blade. The product's design and verification process are outlined. BJKMC's articular arthroscopy shaver has a "tube in a tube" structure, comprising a stainless steel outer sleeve and a rotating hollow inner tube. The outer sleeve and inner tube have corresponding suction and cutting windows, and there are serrated teeth on the inner and outer casing. To verify the design rationality, it was compared to Dyonics◊'s equivalent product, the Incisor◊ Plus Blade. The appearance, cutting tool hardness, metal pipe roughness, cutting tool wall thickness, tooth profile, and angle, overall structure, and the key dimensions were examined and compared. Compared with Dyonics◊'s Incisor◊ Plus Blade, BJKMC's Double Serrated Blade had a smoother working surface, harder and thinner blade head. Therefore, BJKMC's product may have satisfactory performance when it comes to surgery.

Association of aortic distensibility and left ventricular function in patients with stenotic bicuspid aortic valve and preserved ejection fraction: a CMR study.

To determine the relationship between aortic distensibility and left ventricular (LV) remodeling, myocardial strain and blood biomarkers in patients with stenotic bicuspid aortic valve (BAV) and preserved ejection fraction (EF) by cardiovascular magnetic resonance (CMR). 43 stenotic BAV patients were prospectively selected for 3.0 T CMR. Patients were divided into LV remodeling group (LV mass/volume ≥ 1.15, n = 21) and non-remodeling group (LV mass/volume < 1.15, n = 22). Clinical characteristics, biochemical data including cardiac troponin T(cTNT), N-terminal pro-B type natriuretic peptide (NT-proBNP) and creatine kinase isoenzyme (CK-MB) were noted. Distensibility of middle ascending aorta (mid-AA) and proximal descending aorta, LV structural and functional parameters, global and regional myocardial strain were measured. Compared to non-remodeling group, LV remodeling group had significantly decreased LV global strain (radial: 26.04 ± 8.70% vs. 32.92 ± 7.81%, P = 0.009; circumferential: - 17.20 ± 3.38% vs. - 19.65 ± 2.34%, P = 0.008; longitudinal: - 9.13 ± 2.34% vs. - 11.63 ± 1.99%, P < 0.001) and decreased mid-AA distensibility (1.22 ± 0.24 10-3 mm/Hg vs 1.60 ± 0.41 10-3 mm/Hg, P = 0.001). In addition, mid-AA distensibility was independently associated with LV remodeling (ß = - 0.282, P = 0.003), and it was also significantly correlated with LV global strain (radial: r = 0.392, P = 0.009; circumferential: r = - 0.348, P = 0.022; longitudinal: r = - 0.333, P = 0.029), cTNT (r = - 0.333, P = 0.029) and NT-proBNP (r = - 0.440, P = 0.003). In this cohort with stenotic BAV and preserved EF, mid-AA distensibility is found significantly associated with LV remolding, which encouraging to better understand mechanism of ventricular vascular coupling.

DCE-MRI based radiomics nomogram for preoperatively differentiating combined hepatocellular-cholangiocarcinoma from mass-forming intrahepatic cholangiocarcinoma.

OBJECTIVE: To establish a radiomics nomogram based on dynamic contrast-enhanced (DCE) MR images to preoperatively differentiate combined hepatocellular-cholangiocarcinoma (cHCC-CC) from mass-forming intrahepatic cholangiocarcinoma (IMCC). METHODS: A total of 151 training cohort patients (45 cHCC-CC and 106 IMCC) and 65 validation cohort patients (19 cHCC-CC and 46 IMCC) were enrolled. Findings of clinical characteristics and MR features were analyzed. Radiomics features were extracted from the DCE-MR images. A radiomics signature was built based on radiomics features by the least absolute shrinkage and selection operator algorithm. Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical model. The radiomics signature and significant clinicoradiological variables were then incorporated into the radiomics nomogram by multivariate logistic regression analysis. Performance of the radiomics nomogram, radiomics signature, and clinical model was assessed by receiver operating characteristic and area under the curve (AUC) was compared. RESULTS: Eleven radiomics features were selected to develop the radiomics signature. The radiomics nomogram integrating the alpha fetoprotein, background liver disease (cirrhosis or chronic hepatitis), and radiomics signature showed favorable calibration and discrimination performance with an AUC value of 0.945 in training cohort and 0.897 in validation cohort. The AUCs for the radiomics signature and clinical model were 0.848 and 0.856 in training cohort and 0.792 and 0.809 in validation cohort, respectively. The radiomics nomogram outperformed both the radiomics signature and clinical model alone (p < 0.05). CONCLUSION: The radiomics nomogram based on DCE-MRI may provide an effective and noninvasive tool to differentiate cHCC-CC from IMCC, which could help guide treatment strategies. KEY POINTS: • The radiomics signature based on dynamic contrast-enhanced magnetic resonance imaging is useful to preoperatively differentiate cHCC-CC from IMCC. • The radiomics nomogram showed the best performance in both training and validation cohorts for differentiating cHCC-CC from IMCC.

Contrast-enhanced magnetic resonance imaging perfusion can predict microvascular invasion in patients with hepatocellular carcinoma (between 1 and 5 cm).

PURPOSE: To evaluate the role of perfusion parameters with MR imaging of the liver in diagnosing MVI in hepatocellular carcinoma (HCC) (between 1 and 5 cm). MATERIALS AND METHODS: This retrospective study was approved by the institutional review board. In 80 patients with 43 MVI( +) and 42 MVI( -) HCC, whole-liver perfusion MR imaging with Cartesian k-space undersampling and compressed sensing reconstruction was performed after injection of 0.1 mmol/kg gadopentetate dimeglumine. Parameters derived from a dual-input single-compartment model of arterial flow (Fa), portal venous flow (Fp), total blood flow (Ft = Fa + Fp), arterial fraction (ART), distribution volume (DV), and mean transit time (MTT) were measured. The significant parameters between the two groups were included to correlate with the presence of MVI at simple and multiple regression analysis. RESULTS: In MVI-positive HCC, Fp was significantly higher than in MVI-negative HCC, whereas the reverse was seen for ART (p < 0.001). Tumor size (ß = 1.2, p = 0.004; odds ratio, 3.20; 95% CI 1.45, 7.06), Fp (ß = 1.1, p = 0.004; odds ratio, 3.09; 95% CI 1.42, 6.72), and ART (ß = - 3.1, p = 0.001; odds ratio, 12.13; 95% CI 2.85, 51.49) were independent risk factors for MVI. The AUC value of the combination of all three metrics was 0.931 (95% CI 0.855, 0.975), with sensitivity of 97.6% and specificity of 76.2%. CONCLUSION: The combination of Fp, ART, and tumor size demonstrated a higher diagnostic accuracy compared with each parameter used individually when evaluating MVI in HCC (between 1 and 5 cm).

Open-Air Dual-Diamination of Aromatic Aldehydes: Direct Synthesis of Azolo-Fused 1,3,5-Triazines Facilitated by Ammonium Iodide.

A new and practical protocol for the synthesis of medicinally privileged azolo[1,3,5]triazines by simply heating under air has been presented. The in situ generated N-azolo amidines from commercially available aromatic aldehydes and 3-aminoazoles with ammonium iodide undergo the second diamination to accomplish the [3 + 1 + 1 + 1] heteroannulation reaction. This convenient process is appreciated by high efficiency, broad substrate scope, gram-scale synthesis, and operational simplicity under reagent-free conditions.

[Impact of Pollutant Emission Reduction on Air Quality During the COVID-19 Pandemic Control in Early 2020 Based on RAMS-CMAQ].

In this work, the relationships between air quality and pollutant emissions were investigated during the COVID-19 pandemic in Shandong Province. During the quarantine period (from January 24 to February 7, 2020), the concentrations of atmospheric pollutants decreased significantly relative to the period before controls were imposed (from January 15 to 23, 2020). Specifically, except for an increase in the concentration of O3, concentrations of PM10, PM2.5, NO2, SO2, and CO decreased for 72.6 µg·m-3 (45.86%), 47.4 µg·m-3(41.24%), 25.6 µg·m-3 (58.00%), 3.0 µg·m-3 (17.71%), and 0.5 mg·m-3 (31.40%), respectively. RAMS-CMAQ simulation showed that meteorological diffusion had an essential role in improving air quality. Influenced by meteorological factors, emissions of PM10, PM2.5, NO2, SO2, and CO were reduced 26.04%, 33.03%, 28.35%, 43.27%, and 23.29%, respectively. Furthermore, the concentrations of PM10, PM2.5, NO2, SO2, and CO were reduced by 19.82%, 8.21%, 29.65%, -25.56%, and 8.12%, respectively, due to pollution emissions reductions during the quarantine period. O3 concentrations increased by 20.51% during quarantine, caused by both meteorological factors (10.47%) and human activities (10.04%). These results indicate that primary pollutants were more sensitive to emissions reductions; however, secondary pollutants demonstrated a lagged response the emissions reduction and were significantly affected by meteorological factors. The linear relationship between ozone and the emissions reduction was not significant, and was inverse overall. Further investigation are now required on the impact of emissions reduction on ozone pollution control.

Radiomics signature on dynamic contrast-enhanced MR images: a potential imaging biomarker for prediction of microvascular invasion in mass-forming intrahepatic cholangiocarcinoma.

OBJECTIVE: To develop a radiomics signature based on dynamic contrast-enhanced (DCE) MR images for preoperative prediction of microvascular invasion (MVI) in patients with mass-forming intrahepatic cholangiocarcinoma (IMCC). METHODS: One hundred twenty-six patients with surgically resected single IMCC (34 MVI-positive and 92 MVI-negative) were enrolled and allocated to training and validation cohorts (7:3 ratio). Findings of clinical characteristics and MR features were analyzed. A radiomics signature was built on the basis of reproducible features by using the least absolute shrinkage and selection operator (LASSO) regression algorithm in the training cohort. The prediction performance of radiomics signature was evaluated by receiver operating characteristics curve (ROC) analysis. Internal validation was performed on an independent cohort containing 38 patients. RESULTS: Larger tumor size and higher radiomics score were positively correlated with MVI in both training cohort (p < 0.001, < 0.001, respectively) and validation cohort (p = 0.008, 0.001, respectively). The radiomics signature, consisting of seven wavelet features, showed optimal prediction performance in both training (AUC = 0.873) and validation cohorts (AUC = 0.850). CONCLUSION: A radiomics signature derived from DCE-MRI of the liver can be a reliable imaging biomarker for predicting MVI of IMCC, which could aid in tailoring treatment strategies. KEY POINTS: • The radiomics signature based on dynamic contrast-enhanced magnetic resonance imaging can be a useful tool to preoperatively predict MVI of IMCC. • Larger tumor size is positively correlated with MVI of IMCC.

Research on the Impact and Mechanism for the Inhibition of Micrococcus Catalase Activity by Typical Tetracyclines.

As potential inhibitors target to biological enzymes, antibiotics may have certain impacts on the biochemical treatment process. With micrococcus catalase (CAT) served as the target molecule, the impact and inhibition mechanism for typical tetracyclines (TCs) were evaluated. Toxicity experiments showed that TCs had significant inhibition on CAT in the sequence of tetracycline>chlortetracycline>oxytetracycline>doxycycline. To clarify the inhibition mechanism between TCs and CAT which was explored with the assistance of fluorescence spectroscopy and MOE molecule simulation. According to fluorescence analysis, TCs quenched the fluorescence signal of CAT by the mode of static quenching. Combined with toxicity data, it could be presumed that TCs combined with the catalytic active center and thus inhibited CAT. Above presumption was further verified by the molecular simulation data. When TCs combined with the catalytic center of CAT, the compounds have increased combination areas and prominent energy change (compared with the compounds formed by TCs and noncatalytic center recommend by MOE software). IBM SPSS statistics showed that TC toxicity positively correlated with the hydrogen bonds such as O13→Glu252, O1←Arg195, and O6→Asp249, but negatively correlated with the hydrogen bonds such as O10→Pro363, O10→Lys455, and O12 â†’ Asn127. TC toxicity also positively correlated with the ion bonds ofN4-Glu252, but negatively correlated with the ion bonds of N4-Asp379. Hydrogen bonds and ion bonds for above key sites were closely related to the inhibition effect of TCs on CAT.

A Novel Pre-treatment Model Predicting Risk of Developing Refractoriness to Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma.

Background and aim: Refractoriness to transarterial chemoembolization is common during the therapeutic process of hepatocellular carcinoma, which is an intractable issue and may compromise the prognosis. We aim to establish a pre-treatment model to identify patients with high risks of refractoriness. Methods: From 2010 to 2016, 824 treatment-naive patients who had initially underwent at least two sessions of transarterial chemoembolization in Zhongshan Hospital, Fudan University were retrospectively enrolled. These patients were randomly allocated into a training cohort and a validation cohort. The pre-treatment scoring model was established based on the clinical and radiological variables using logistic regression and nomogram. The discrimination and calibration of the model were also evaluated. Results: Logistic regression identified vascularization pattern, ALBI grade, serum alpha-fetoprotein level, serum γ-glutamyl transpeptidase level and major tumor size as the key parameters related to refractoriness. The p-TACE model was established using these variables (risk score range: 0-19.5). Patients were divided into six risk subgroups based on their scores (<4, ≥4, ≥7, ≥10, ≥13, ≥16). The discriminative ability, as determined by the area under receiver operating characteristic curve was 0.784 (95% confidence interval: 0.741-0.827) in the training cohort and 0.743 (95% confidence interval: 0.696-0.789) in the validation cohort. Moreover, satisfactory calibration was confirmed by Hosmer-Lemeshow test with P values of 0.767 and 0.913 in the training cohort and validation cohort. Conclusions: This study presents a pre-treatment model to identify patients with high risks of refractoriness after transarterial chemoembolization and shed light on clinical decision making.

Pollution characteristics of bioaerosols in PM2.5 during the winter heating season in a coastal city of northern China.

Frequent heavy air pollution occurred during the winter heating season of northern China. In this study, PM2.5 (particles with an aerodynamic diameter less than 2.5 µm) was collected from a coastal city of China during the winter heating season from January 1 to March 31, 2018, and the soluble ions, organic carbon (OC), elemental carbon (EC), bacterial, endotoxin, and fungal concentration in PM2.5 were analyzed. During the winter heating season, PM2.5 and bioaerosols increased on polluted days, and the secondary inorganic ions, including NO3-, NH4+, and SO42-, increased significantly. Meteorological factors, such as wind direction and wind speed, had major impacts on the distributions of PM2.5 and bioaerosols. Pollutant concentration was high when there was a westerly wind with the speed of 3-6 m/s from inland area. Using the air mass backward trajectories and principal component analysis, we elucidate the potential origins of bioaerosol in PM2.5. The backward trajectory suggested that air mass for polluted samples (PM2.5 > 75 µg/m3) commonly originated from continent (9.62%), whereas air masses for clean samples (PM2.5 < 35 µg/m3) were mainly from marine (56.73%). The interregional transport of pollutants from continental area contributed most to PM2.5. Principal component analysis of the water-soluble ions and bioaerosol indicated that air pollution of the coastal city was greatly affected by coal combustion, biomass burning, and regional transmission of high-intensity pollutants from continent. Among that, interregional transport, biomass burning, and dust from soil and plants were main sources of bioaerosol. Our findings provide important insights into the origins and characteristics of bioaerosol in PM2.5 during the winter heating season of the coastal city in northern China.