Triple-task mutual consistency for semi-supervised 3D medical image segmentation.

Semi-supervised deep learning algorithm is an effective means of medical image segmentation. Among these methods, multi-task learning with consistency regularization has achieved outstanding results. However, most of the existing methods usually simply embed the Signed Distance Map (SDM) task into the network, which underestimates the potential ability of SDM in edge awareness and leads to excessive dependence between tasks. In this work, we propose a novel triple-task mutual consistency (TTMC) framework to enhance shape and edge awareness capabilities, and overcome the task dependence problem underestimated in previous work. Specifically, we innovatively construct the Signed Attention Map (SAM), a novel fusion image with attention mechanism, and use it as an auxiliary task for segmentation to enhance the edge awareness ability. Then we implement a triple-task deep network, which jointly predicts the voxel-wise classification map, the Signed Distance Map and the Signed Attention Map. In our proposed framework, an optimized differentiable transformation layer associates SDM with voxel-wise classification map and SAM prediction, while task-level consistency regularization utilizes unlabeled data in an unsupervised manner. Evaluated on the public Left Atrium dataset and NIH Pancreas dataset, our proposed framework achieves significant performance gains by effectively utilizing unlabeled data, outperforming recent state-of-the-art semi-supervised segmentation methods. Code is available at https://github.com/Saocent/TTMC.

Heart rate detection method based on Ballistocardiogram signal of wearable device：Algorithm development and validation.

Background: Heart rate, as the four vital signs of human body, is a basic indicator to measure a person's health status. Traditional electrocardiography (ECG) measurement, which is routinely monitored, requires subjects to wear lead electrodes frequently, which undoubtedly places great restrictions on participants' activities during the normal test. At present, the boom of wearable devices has created hope for non-invasive, simple operation and low-cost daily heart rate monitoring, among them, Ballistocardiogram signal (BCG) is an effective heart rate measurement method, but in the actual acquisition process, the robustness of non-invasive vital sign collection is limited. Therefore, it is necessary to develop a method to improve the robustness of heart rate monitoring. Objective: Therefore, in view of the problem that the accuracy of untethered monitoring heart rate is not high, we propose a method aimed at detecting the heartbeat cycle based on BCG to accurately obtain the beat-to-beat heart rate in the sleep state. Methods: In this study, we implement an innovative J-wave detection algorithm based on BCG signals. By collecting BCG signals recorded by 28 healthy subjects in different sleeping positions, after preprocessing, the data feature set is formed according to the clustering of morphological features in the heartbeat interval. Finally, a J-wave recognition model is constructed based on bi-directional long short-term memory (BiLSTM), and then the number of J-waves in the input sequence is counted to realize real-time detection of heartbeat. The performance of the proposed heartbeat detection scheme is cross-verified, and the proposed method is compared with the previous wearable device algorithm. Results: The accuracy of J wave recognition in BCG signal is 99.67%, and the deviation rate of heart rate detection is only 0.27%, which has higher accuracy than previous wearable device algorithms. To assess consistency between method results and heart rates obtained by the ECG, seven subjects are compared using Bland-Altman plots, which show no significant difference between BCG and ECG results for heartbeat cycles. Conclusions: Compared with other studies, the proposed method is more accurate in J-wave recognition, which improves the accuracy and generalization ability of BCG-based continuous heartbeat cycle extraction, and provides preliminary support for wearable-based untethered daily monitoring.

The causality between gut microbiome and liver cirrhosis: a bi-directional two-sample Mendelian randomization analysis.

Background and aim: Previous studies have reported an association between gut microbiota and cirrhosis. However, the causality between intestinal flora and liver cirrhosis still remains unclear. In this study, bi-directional Mendelian randomization (MR) analysis was used to ascertain the potential causal effect between gut microbes and cirrhosis. Methods: Large-scale Genome Wide Association Study (GWAS) data of cirrhosis and gut microbes were obtained from FinnGen, Mibiogen consortium, and a GWAS meta-analysis of Alcoholic cirrhosis (ALC). Two-sample MR was performed to determine the causal relationship between gut microbiota and cirrhosis. Furthermore, a bi-directional MR analysis was employed to examine the direction of the causal relations. Result: In MR analysis, we found that 21 gut microbiotas were potentially associated with cirrhosis. In reverse MR analysis, 11 gut microbiotas displayed potentially associations between genetic liability in the gut microbiome and cirrhosis. We found that the family Lachnospiraceae (OR: 1.59, 95% CI:1.10-2.29) might be harmful in cirrhotic conditions (ICD-10: K74). Furthermore, the genus Erysipelatoclostridium might be a protective factor for cirrhosis (OR:0.55, 95% CI:0.34-0.88) and PBC (OR:0.68, 95% CI:0.52-0.89). Combining the results from the MR analysis and reverse MR analysis, we firstly identified the Genus Butyricicoccus had a bi-directional causal effect on PBC (Forward: OR: 0.37, 95% CI:0.15-0.93; Reverse: OR: 1.03, 95% CI:1.00-1.05). Conclusion: We found a new potential causal effect between cirrhosis and intestinal flora and provided new insights into the role of gut microbiota in the pathological progression of liver cirrhosis.

Identification of major depression patients using machine learning models based on heart rate variability during sleep stages for pre-hospital screening.

With the COVID-19 pandemic causing challenges in hospital admissions globally, the role of home health monitoring in aiding the diagnosis of mental health disorders has become increasingly important. This paper proposes an interpretable machine learning solution to optimise initial screening for major depressive disorder (MDD) in both male and female patients. The data is from the Stanford Technical Analysis and Sleep Genome Study (STAGES). We analyzed 5-min short-term electrocardiogram (ECG) signals during nighttime sleep stages of 40 MDD patients and 40 healthy controls, with a 1:1 gender ratio. After preprocessing, we calculated the time-frequency parameters of heart rate variability (HRV) based on the ECG signals and used common machine learning algorithms for classification, along with feature importance analysis for global decision analysis. Ultimately, the Bayesian optimised extremely randomized trees classifier (BO-ERTC) showed the best performance on this dataset (accuracy 86.32%, specificity 86.49%, sensitivity 85.85%, F1-score 0.86). By using feature importance analysis on the cases confirmed by BO-ERTC, we found that gender is one of the most important factors affecting the prediction of the model, which should not be overlooked in our assisted diagnosis. This method can be embedded in portable ECG monitoring systems and is consistent with the literature results.

Efficacy and Safety of Drug-Eluting Beads Bronchial Arterial Chemoembolization in Treating Patients with Lung Cancer Who Were Complicated with Hemoptysis.

Background: This study explored the effectiveness and safety of drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) in patients with lung cancer who were complicated with hemoptysis. Materials and Methods: In total, 11 patients with lung cancer who were complicated with hemoptysis and underwent DEB-BACE treatment were analyzed. Clinical success was defined as no hemoptysis or reduction of hemoptysis volume >50% after treatment. Hemoptysis recurrence was recorded, and overall survival (OS) was calculated. Results: After DEB-BACE treatment, the clinical and technical success was 100%: in detail, 10 (90.0%) patients presented with no hemoptysis and 1 (9.1%) patient exhibited a reduction of hemoptysis volume >50%. Regarding the prognosis, 1 (9.1%) patient had hemoptysis recurrence at 46 d after DEB-BACE treatment. Furthermore, 4 (36.4%) patients died (1 [9.1%] patient died of nonhemoptysis asphyxia; 1 [9.1%] patient died of massive gastrointestinal hemorrhage; 1 [9.1%] patient died of respiratory failure; and 1 [9.1%] patient died of hemoptysis recurrence). Additionally, the mean OS in total patients was 14.2 (95% confidence interval: 8.2-20.3) months. As to adverse events, 1 (9.1%) patient showed high fever, 2 (18.2%) patients exhibited low fever, and 1 (9.1%) patient suffered from chest pain. Conclusions: DEB-BACE can be considered an effective and safe treatment in treating hemoptysis in patients with lung cancer.

Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world.

Purpose: This study aimed to assess the efficacy and safety of a triple therapy that comprises transarterial chemoembolization (TACE), antiangiogenic-targeted therapy, and programmed death-1 (PD-1) inhibitors in a real-world cohort of patients with unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods: Consecutive patients treated with TACE combined with antiangiogenic therapy and PD-1 inhibitors at the Eastern Hepatobiliary Surgery Hospital between June 2019 and May 2021 were enrolled. The baseline characteristics and treatment course of the patients were recorded. The tumor response was evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and HCC-specific modified RECIST (mRECIST). The overall survival (OS) and progression-free survival (PFS) of the patients were analyzed using the Kaplan-Meier method. Adverse events (AEs) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Results: As of the data cutoff on 30 August 2021, the median follow-up time was 10.0 (3.9-28.4) months. A total of 39 eligible patients were included. The objective response rate (ORR) and the disease control rate (DCR) were 35.9% and 74.4% according to the RECIST 1.1, and 48.7% and 84.6% according to mRECIST criteria, respectively. The median OS and PFS were 14.0 and 9.2 months, respectively. Moreover, 34 (87.2%) patients experienced at least one treatment-related AE and 8 (20.5%) patients experienced grade 3/4 treatment-related AEs. The most common treatment- and laboratory-related AEs were hypertension (46.2%) and decreased albumin (53.8%), respectively. No treatment-related mortality occurred during the study period. Conclusions: TACE combined with antiangiogenic-targeted therapy and immune checkpoint inhibitors may have promising anticancer activity in unresectable HCC patients with PVTT. AEs were manageable, with no unexpected overlapping toxicities.

Circadian stage-dependent and stimulation duration effects of transcutaneous auricular vagus nerve stimulation on heart rate variability.

Transcutaneous auricular vagus nerve stimulation (taVNS) can improve autonomic nerve function and is currently undergoing extensive clinical research; however, its efficacy heterogeneity has caused great controversy. Heart rate variability (HRV), a biomarker reflecting autonomic function, exhibits a time-varying pattern with circadian rhythms, which may be the main reason for the inconsistent stimulation effects. To test this conjecture, we performed isochronous acute stimulation experiments at intervals of 12 h. The results showed that HRV indicators representing vagal nerve activity significantly increased when stimulation was performed in the morning, and the enhancement of high frequency continued into the recovery period. However, the evening stimulation did not yield similar results. In addition, we found that improvements in the measures of autonomic balance were more pronounced in the presence of lower vagal activity. By increasing the stimulation duration, we also found that the effect of taVNS on HRV was not regulated by duration; in other words, HRV changes only had the best effect at the beginning of stimulation. These studies allowed us to determine the optimal stimulation phase and duration and potentially screen the optimal candidates for taVNS.

Efficacy and safety of drug-eluting beads bronchial arterial chemoembolization versus conventional bronchial arterial chemoembolization in lung cancer patients with hemoptysis.

Background: This study aimed to explore the efficacy and safety of drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) compared with conventional bronchial arterial chemoembolization (cBACE) in lung cancer patients with hemoptysis. Materials & methods: Thirty-six lung cancer patients with hemoptysis treated by DEB-BACE or cBACE were retrospectively analyzed. Results: Technical success of BACE and clinical success of hemoptysis treatment were no different between DEB-BACE and cBACE (both p > 0.050), whereas DEB-BACE achieved increased total clinical response (p = 0.021), objective response rate (p = 0.035) and prolonged hemoptysis relapse-free survival (p = 0.013) compared with cBACE. The adverse event rates were similar between these two groups (all p > 0.05). Conclusion: DEB-BACE presents with higher tumor treatment response, prolonged hemoptysis relapse-free survival and comparable safety profiles compared with cBACE in lung cancer patients with hemoptysis.

Efficacy and Safety of Lenvatinib Combined With PD-1 Inhibitors Plus TACE for Unresectable Hepatocellular Carcinoma Patients in China Real-World.

Purpose: To evaluate the efficacy and safety of lenvatinib combined with programmed death receptor-1 signaling inhibitors plus transarterial chemoembolization (LePD1-TACE) for treatment of unresectable hepatocellular carcinoma (uHCC) in a real-world setting in China. Methods: This was a retrospective study involving consecutive patients with uHCC (n =114) receiving LePD1-TACE treatment from June 2019 to May 2021. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were calculated to evaluate the antitumor efficacy. Treatment-related adverse events (TRAEs) were analyzed to assess the safety profiles. In addition, we also evaluated prognostic factors related to survival and disease progression. Results: A total of 114 patients with a median age of 53 years were analyzed during a median follow-up duration of 10.6 months (95% confidence interval [CI]: 8.5 -12.8). The Kaplan-Meier analysis showed that the median OS was 18.0 months (95% CI: 14.1 - Not reached), the median PFS was 10.4 months (95% CI: 6.6 - 12.4). Based on modified Response Evaluation Criteria in Solid Tumors, the best ORR was 69.3% and DCR was 80.7%. Almost all patients suffered from TRAEs, the most common grade 3-4 TRAEs were hypertension (8.8%), proteinuria (3.6%), hyperbilirubinemia (1.8%), leukopenia (4.4%) and alanine aminotransferase elevation (3.6%) across all patients. The independent treatment factors associated with OS and PFS were tumor number, neutrophil-to-lymphocyte ratio (NLR) and the early tumor response. In the early tumor response (CR+PR) patients, median OS and PFS were 25.1 months (95% CI: 13.8 - Not reached) and 15.2 months (95% CI: 10.5 - 19.1). The patients with tumor number < 3 had a superior median OS and PFS (25.1, 16.4 months) compared to patients with tumor number ≥ 3 (14.1 months, P = 0.012; 6.6 months, P = 0.007). The patients with NLR ≤ 2.165 had a longer median OS and PFS (Not reached, 15.2 months) than those with NLR > 2.165 (17.7 months, P = 0.003; 7.5 months, P = 0.047). Conclusion: In this real-world study, LePD1-TACE triple therapy showed encouraging efficiency and manageable safety in patients with uHCC. The tumor number (< 3), NLR (≤ 2.165) and early tumor response (CR+PR) could be one of the prognostic markers.

Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study.

Background: There is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients. Methods: This study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared. Results: The incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1-30.9) vs. 29.7 (95% CI: 21.4-38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1-16.3) vs. 15.9 (95% CI: 8.3-23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9-9.2) vs. 8.0 (95% CI: 5.1-10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380). Conclusions: Regorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14-22% and 62-60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.

Sleep EEG-Based Approach to Detect Mild Cognitive Impairment.

Mild Cognitive Impairment (MCI) is an early stage of dementia, which may lead to Alzheimer's disease (AD) in older adults. Therefore, early detection of MCI and implementation of treatment and intervention can effectively slow down or even inhibit the progression of the disease, thus minimizing the risk of AD. Currently, we know that published work relies on an analysis of awake EEG recordings. However, recent studies have suggested that changes in the structure of sleep may lead to cognitive decline. In this work, we propose a sleep EEG-based method for MCI detection, extracting specific features of sleep to characterize neuroregulatory deficit emergent with MCI. This study analyzed the EEGs of 40 subjects (20 MCI, 20 HC) with the developed algorithm. We extracted sleep slow waves and spindles features, combined with spectral and complexity features from sleep EEG, and used the SVM classifier and GRU network to identify MCI. In addition, the classification results of different feature sets (including with sleep features from sleep EEG and without sleep features from awake EEG) and different classification methods were evaluated. Finally, the MCI classification accuracy of the GRU network based on features extracted from sleep EEG was the highest, reaching 93.46%. Experimental results show that compared with the awake EEG, sleep EEG can provide more useful information to distinguish between MCI and HC. This method can not only improve the classification performance but also facilitate the early intervention of AD.

Coexistence of situs inversus totalis and hepatocellular carcinoma: A series of nine cases and a literature review.

Hepatocellular carcinoma (HCC) is the most commonly diagnosed carcinoma and one of the leading causes of cancer-related deaths worldwide. Situs inversus totalis (SIT) is a congenital condition where in the internal organs of the abdomen and thorax lie in mirror images of their normal position. Thus far, there are very few reports on cases of SIT coexisting with HCC. Our case series is probably the largest series in world literature. The cohort of this retrospective study included a total of nine patients diagnosed with SIT-HCC and treated in our hospital between January 2013 and May 2018. Clinical characteristics, prognostic factors, and outcomes were summarized. Treatment strategies included surgery, transarterial chemoembolization, and microwave ablation. The diagnosis and treatment of patients with SIT are challenging because of organ reversion. The current treatment strategies for different stages of liver cancer are safe and feasible for patients with SIT-HCC.

Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients.

BACKGROUND: The present study aimed to compare the efficacy and safety profiles of microspheres versus (vs.) polyvinyl alcohol (PVA) for bronchial artery embolization (BAE) treatment in patients with hemoptysis. METHODS: Totally, 152 patients with hemoptysis who were about to receive BAE treatment were consecutively enrolled and divided into microspheres group (N = 62) and PVA group (N = 90). Technical success and clinical success were assessed after BAE procedure, and the hemoptysis-recurrence status, survival status and adverse events were recorded during follow-up. RESULTS: Technical success rates were both 100% in microspheres group and PVA group; clinical success rate (96.8% vs. 100.0%, P = 0.165), 6-month (9.7% vs. 7.8%, P = 0.681) and 1-year (9.7% vs. 8.9%, P = 0.869) hemoptysis recurrence rate, 6-month (4.8% vs. 2.2%, P = 0.374) and 1-year (4.8% vs. 3.3%, P = 0.639) mortality were similar between microspheres group and PVA group. Furthermore, hemoptysis-free survival (P = 0.488) and overall survival (P = 0.321) were of no difference between two groups. In addition, all adverse events were mild, and there was no difference of adverse events between two groups (all P > 0.05). These data were validated by further multivariate regression analysis. CONCLUSIONS: Microspheres present comparable efficacy and safety profiles compared with PVA for the BAE treatment in patients with hemoptysis, providing evidence for embolic agent selection.

Vibrio vulnificus infection attributed to bee sting: a case report.

Vibrio vulnificus is a pathogenic marine bacteria associated with high mortality. Changes in climate and the global seafood trade have increased the prevalence of marine and freshwater systems affected by V. vulnificus. As a result, the incidence of land animals, plants, and insects contacting V. vulnificus and acting as disease vectors is on the rise. We report the case of a 53-year-old male who was infected with V. vulnificus as the result of a bee sting. The patient had no history of contact with the sea or fresh water or aquatic organisms or products. Due to bacterial pathogenicity and the patient's underlying diseases, his condition deteriorated rapidly and eventually resulted in death. Here, we review the pathogenic mechanisms and treatment of V. vulnificus. We determined that V. vulnificus has spread from seawater to freshwater and that individuals may become infected from insects, even in the absence of direct contact with infected water. This case report will inform clinicians about the possible sources of V. vulnificus infection and indicates the possibility that more insects may transmit V. vulnificus in the future.

Lenvatinib in combination with transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma (uHCC): a retrospective controlled study.

PURPOSE: To compare the efficacy and safety of combined treatment with lenvatinib and transarterial chemoembolization (TACE) versus TACE only in patients with unresectable hepatocellular carcinoma (uHCC). METHODS: Of the 120 patients enrolled in this study, 60 patients received treatment with TACE only, and 60 patients received TACE plus lenvatinib. We retrospectively compared the clinical outcomes including overall survival (OS), progression-free survival (PFS), and tumor response between the two groups. Both PFS and tumor response were based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Adverse events were analyzed to assess the safety profiles. RESULTS: The 1-year and 2-year OS rates were significantly higher in the TACE + lenvatinib group (88.4% and 79.8%) than that in the TACE group (79.2% and 49.2%, p = 0.047). A similar PFS benefit was observed in the TACE + lenvatinib group (1-y PFS rate: 78.4% vs. 64.7%, 2-y PFS rate: 45.5% vs. 38.0%, p < 0.001). The best overall objective response rate (ORR) was also better with TACE + lenvatinib treatment (ORR: 68.3% vs. 31.7%, p < 0.001) and disease control rate (DCR) numerically increased in the TACE + lenvatinib treatment (93.3% vs. 86.7%, p = 0.224). Patients' liver function remained comparable to baseline in the TACE + lenvatinib group. The most common adverse events were decreased albumin (55.0%), hypertension (48.3%) and decreased platelet count (46.7%) in the TACE + lenvatinib group. CONCLUSIONS: Combination treatment with TACE and lenvatinib may significantly improve clinical outcomes over TACE monotherapy with a manageable safety profile for unresectable HCC. The efficacy of the combination treatment should be validated in prospective studies with a large sample size.

Diagnostic Evaluation of 18F-FDG PET/CT Imaging in Recurrent or Residual Urinary Bladder Cancer: A Meta-Analysis.

PURPOSE: To assess the diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography combined with the computed tomography (18F-FDG PET/CT) in the detection of recurrent or residual urinary bladder cancer with meta-analysis. METHODS: We searched PubMed/MEDLINE, Embase, Web of Science, CBM, CNKI, VIP, and Wanfang databases through October 2019. Two reviewers independently screened the full articles. The imaging findings were confirmed by either histopathology or clinical follow-up. Sensitivity, specificity likelihood ratio and diagnostic odds ratio were pooled with 95 % confidence intervals (CI). Overall test performance was summarized by a summary receiver operating characteristic (ROC) curve. The Meta-DiSc software (version 1.4) was used to perform the meta-analysis. RESULTS: The meta-analysis included 7 studies. The pooled sensitivity and specificity of PET/CT for the detection of recurrent or residual urinary bladder cancer was 94.0% (95% CI: 91.0%-96.0%) and 92.0% (95% CI: 88.0%- 95.0%), respectively. Positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 9.77 (95% CI: 4.91-19.41), 0.99(95% CI: 0.06-0.13) and 95.09 (95% CI: 47.96-188.53), respectively. When residual urinary bladder cancer was excluded, sensitivity changed slightly. CONCLUSION: This meta-analysis suggested that the diagnostic accuracy of PET/CT was good in detecting recurrent or residual urinary bladder cancer.

Improving the analysis accuracy of components in blood by SSP-MCSD and multi-mode spectral data fusion.

In recent years, spectral quantitative analysis for blood components has been a research hotspot in biomedical engineering. But researches have been limited to the application of high-sensitivity spectroscopy instruments and the complexity of blood components-the overlapping of absorption curves for many components is severe. This has led to the difficulty in achieving satisfactory results when using spectroscopy to quantify components in blood. In order to enhance the model robustness and improve the model performance, this paper proposed a sample set partitioning strategy based on multi-component spatial distance (SSP-MCSD). Different from the other sample set partitioning strategies, which only consider the uniformity of the concentration distribution of the target component, this strategy also concerns to the concentration distribution of non-target components. The concentration of the target component and non-target components are used to construct a multi-dimensional space, and the Euclidean Distance of sample points in this space is used as the criterion to partition the sample set. At the same time, the spectra collected in multi-modes are fused for increasing the amount of information. So as to enhance the model robustness and to improve the analysis accuracy of the target components. In order to verify the effectiveness of this strategy, the serum of 101 volunteers was analyzed. Taking total protein in serum as the non-target component, the regression model for bilirubin concentration was established by transmission spectra, fluorescence spectra, and the joint spectra after fusion of the above two spectra, respectively. The experimental results showed that the prediction accuracy of the model established by SSP-MCSD combined with multi-mode spectral fusion is obviously higher than that of other methods. It can effectively improve the analysis accuracy of blood components.

Accuracy improvement of quantitative analysis in VIS-NIR spectroscopy using the GKF-WTEF algorithm.

The extraction of effective information in visible-near-infrared (VIS-NIR) spectroscopy is crucial and difficult for spectral analysis. In this research, an algorithm of wavelet feature extraction based on the Gaussian kernel function (GKF-WTEF) was developed to suppress the influence of external interference on VIS-NIR spectroscopy and improve the accuracy of quantitative analysis. This algorithm takes the root-mean-square error of the prediction set (RMSEP) of the model, which is established by partial least-squares regression, as the optimization criteria. First, the optimal type of wavelet function, the decomposition level, and the Gauss kernel function central frequency band are determined according to the RMSEP. Second, the Gauss kernel function bandwidth is determined by Newton's method. Then, the Hadamard product of the Gaussian kernel function and the wavelet coefficient is obtained. Finally, the wavelet coefficients after the Hadamard product can be reconstructed to obtain the spectral data after feature extraction. In order to verify the effectiveness of this algorithm, the difference in the optical parameters of the polyvinyl chloride material container was used as an external interference source. And the spectrum of Intra-lipid and India-ink mixed solution with different concentrations was collected therein. The volume fraction of India-ink in complex mixed solution was quantitatively analyzed by using the RMSEP and the average relative error of the prediction set as the evaluation criteria. The research results demonstrated that the Gaussian-wavelet transform feature extraction algorithm is an effective pretreatment method, it can satisfactorily suppress the influence of external interference on the spectrum, and it can improve the analytical accuracy of VIS-NIR spectroscopy.

Safety and efficacy of transcatheter embolization in patients with massive hemoptysis due to intercostal pulmonary venous shunts.

PURPOSE: Bronchial hemoptysis induced by intercostal pulmonary venous shunt (IPVS) is clinically rare. Pulmonary lesions on pleural surface may facilitate opening of vascular network. This retrospective study investigated safety and efficacy of embolization agents with small-particle embolization treating patients with massive hemoptysis due to IPVS. METHODS: Patients with massive hemoptysis (n = 207) underwent computed tomography angiography of bronchial artery. Depending on results, selective or superselective digital subtraction angiography and embolization were performed. Polyvinyl alcohol (300-500 µm), or microcoils combined with polyvinyl alcohol, was utilized according to IPVS volume. Vital signs of each patient were closely monitored. RESULTS: Of 207 patients with massive hemoptysis, 24 (11.6%) had IPVS syndrome. Patients with IPVS had concomitant bronchiectasis (54.2%), followed by tuberculosis (25.0%). Embolizations were performed in 39 culprit intercostal arteries; 37 (94.9%) of these were successfully embolized. Of the latter, 30 and 7 arteries were embolized, respectively, by polyvinyl alcohol alone or polyvinyl alcohol particles combined with microcoils. Embolization failed in one case because the agents could not enter the intercostal artery. If artery dissection occurred during procedure, microcoils were utilized to embolize the main artery. No skin necrosis, spinal artery embolization, or death occurred. Immediate clinical success was achieved in 22 patients (91.7%) after embolization. Two patients (8.3%) experienced recurrence of hemoptysis. Only four patients experienced mild hemoptysis during the 24-month follow-up with the efficiency of 75.0%. CONCLUSIONS: Intercostal artery embolization with 300-500 µm alone or combined with microcoils is a safe and effective procedure in patients with IPVS-induced bronchial hemoptysis.

A method to eliminate the influence of incident light variations in spectral analysis.

The intensity of the light source and consistency of the spectrum are the most important factors influencing the accuracy in quantitative spectrometric analysis. An efficient "measuring in layer" method was proposed in this paper to limit the influence of inconsistencies in the intensity and spectrum of the light source. In order to verify the effectiveness of this method, a light source with a variable intensity and spectrum was designed according to Planck's law and Wien's displacement law. Intra-lipid samples with 12 different concentrations were prepared and divided into modeling sets and prediction sets according to different incident lights and solution concentrations. The spectra of each sample were measured with five different light intensities. The experimental results showed that the proposed method was effective in eliminating the influence caused by incident light changes and was more effective than normalized processing.