Cost-effectiveness of tirofiban for acute ischemic stroke without large or medium-sized vessel occlusion: A Markov modelling analysis from the Chinese and United States perspectives.

BACKGROUND: The RESCUE BT2 trial recently showcased the efficacy of tirofiban in treating acute ischemic stroke (AIS) without large or medium-sized vessel occlusion. To further assess the value of tirofiban from the perspectives of Chinese and US healthcare system, a study was conducted to evaluate its cost-effectiveness. METHODS: A hybrid model, integrating a short-term decision tree with a long-term Markov model, was developed to assess cost-effectiveness between tirofiban and aspirin for stroke patients without large or medium-sized vessel occlusion. Efficacy data for tirofiban was sourced from the RESCUE BT2 trial, while cost information was derived from published papers. Outcomes measured included respective cost, effectiveness, and incremental cost-effectiveness ratio (ICER). We conducted a one-way sensitivity analysis to assess the robustness of the results. Additionally, we performed probabilistic sensitivity analysis (PSA) through 10,000 Monte Carlo simulations to evaluate the uncertainties associated with the results. RESULTS: The study revealed that tirofiban treatment in AIS patients without large or medium-sized vessel occlusion led to a considerable reduction of 2141 Chinese Yuan (CNY) in total cost, along with a lifetime gain of 0.14 quality-adjusted life years (QALYs). In the US settings, tirofiban also exhibited a lower cost ($197,055 versus $201,984) and higher effectiveness (4.15 QALYs versus 4.06 QALYs) compared to aspirin. One-way sensitivity analysis revealed that post-stroke care costs and stroke utility had the greatest impact on ICER fluctuation in both Chinese and US settings. However, these variations did not exceed the willingness-to-pay threshold. PSA demonstrated tirofiban's superior acceptability over aspirin in over 95% of potential scenarios. CONCLUSION: Tirofiban treatment for AIS without large or medium-sized vessel occlusion appeared dominant compared to aspirin in both China and the US.

Enhancing gland segmentation in colon histology images using an instance-aware diffusion model.

In pathological image analysis, determination of gland morphology in histology images of the colon is essential to determine the grade of colon cancer. However, manual segmentation of glands is extremely challenging and there is a need to develop automatic methods for segmenting gland instances. Recently, due to the powerful noise-to-image denoising pipeline, the diffusion model has become one of the hot spots in computer vision research and has been explored in the field of image segmentation. In this paper, we propose an instance segmentation method based on the diffusion model that can perform automatic gland instance segmentation. Firstly, we model the instance segmentation process for colon histology images as a denoising process based on a diffusion model. Secondly, to recover details lost during denoising, we use Instance Aware Filters and multi-scale Mask Branch to construct global mask instead of predicting only local masks. Thirdly, to improve the distinction between the object and the background, we apply Conditional Encoding to enhance the intermediate features with the original image encoding. To objectively validate the proposed method, we compared several state-of-the-art deep learning models on the 2015 MICCAI Gland Segmentation challenge (GlaS) dataset (165 images), the Colorectal Adenocarcinoma Glands (CRAG) dataset (213 images) and the RINGS dataset (1500 images). Our proposed method obtains significantly improved results for CRAG (Object F1 0.853 ± 0.054, Object Dice 0.906 ± 0.043), GlaS Test A (Object F1 0.941 ± 0.039, Object Dice 0.939 ± 0.060), GlaS Test B (Object F1 0.893 ± 0.073, Object Dice 0.889 ± 0.069), and RINGS dataset (Precision 0.893 ± 0.096, Dice 0.904 ± 0.091). The experimental results show that our method significantly improves the segmentation accuracy, and the experiment results demonstrate the efficacy of the method.

Temporal contexts for motion tracking in ultrasound sequences with information bottleneck.

BACKGROUND: Recently, deep convolutional neural networks (CNNs) have been widely adopted for ultrasound sequence tracking and shown to perform satisfactorily. However, existing trackers ignore the rich temporal contexts that exists between consecutive frames, making it difficult for these trackers to perceive information about the motion of the target. PURPOSE: In this paper, we propose a sophisticated method to fully utilize temporal contexts for ultrasound sequences tracking with information bottleneck. This method determines the temporal contexts between consecutive frames to perform both feature extraction and similarity graph refinement, and information bottleneck is integrated into the feature refinement process. METHODS: The proposed tracker combined three models. First, online temporal adaptive convolutional neural network (TAdaCNN) is proposed to focus on feature extraction and enhance spatial features using temporal information. Second, information bottleneck (IB) is incorporated to achieve more accurate target tracking by maximally limiting the amount of information in the network and discarding irrelevant information. Finally, we propose temporal adaptive transformer (TA-Trans) that efficiently encodes temporal knowledge by decoding it for similarity graph refinement. The tracker was trained on 2015 MICCAI Challenge on Liver Ultrasound Tracking (CLUST) dataset to evaluate the performance of the proposed method by calculating the tracking error (TE) between the predicted landmarks and the ground truth landmarks for each frame. The experimental results are compared with 13 state-of-the-art methods, and ablation studies are conducted. RESULTS: On CLUST 2015 dataset, our proposed model achieves a mean TE of 0.81 ± 0.74 mm and a maximum TE of 1.93 mm for 85 point-landmarks across 39 ultrasound sequences in the 2D sequences. Tracking speed ranged from 41 to 63 frames per second (fps). CONCLUSIONS: This study demonstrates a new integrated workflow for ultrasound sequences motion tracking. The results show that the model has excellent accuracy and robustness. Reliable and accurate motion estimation is provided for applications requiring real-time motion estimation in the context of ultrasound-guided radiation therapy.

Dilational Rheological Properties of Surfactants at the Crude Oil-Water Interface: The Effect of Branch-Preformed Particle Gels and Polymers.

The interfacial properties of a heterogeneous composite flooding system containing a surfactant fatty alcohol polyoxyethylene carboxylate (C12EO3C), branched-preformed particle gel (B-PPG), and polymer partly hydrolyzed polyacrylamide (HPAM) at the crude oil-water interface were investigated by a dilational rheology method. The results demonstrated that the C12EO3C molecules can form an elastic interfacial film with certain strength at the crude oil-water interface. The addition of HPAM to the C12EO3C solution has a detrimental effect on the interfacial film formed by C12EO3C molecules, leading to a decrease in the dilational modulus and an increase in the phase angle. Moreover, the addition of B-PPG to the C12EO3C solution also disrupts the stability and strength of the interfacial film of C12EO3C. In particular, linear HPAM with a lower steric hindrance is more likely to insert into the interfacial film of C12EO3C; thus, HPAM possesses a stronger destruction ability for the interfacial film of C12EO3C than B-PPG. When HPAM is compounded with B-PPG, a superimposed effect exists to cause more severe disruption for the interfacial film. The heterogeneous composite flooding system not only enhances oil recovery by increasing the viscosity of the bulk phase but also weakens the interfacial film to facilitate the post-treatment of the recovered crude oil. Thus, the heterogeneous composite flooding system exhibits promising prospects in practical application.

Measurements on ATP induced cellular fluctuations using real-time dual view transport of intensity phase microscopy.

Dual view transport of intensity phase microscopy is adopted to quantitatively study the regulation of adenosine triphosphate (ATP) on cellular mechanics. It extracts cell phases in real time from simultaneously captured under- and over-focus images. By computing the root-mean-square phase and correlation time, it is found that the cellular fluctuation amplitude and speed increased with ATP compared to those with ATP depletion. Besides, when adenylyl-imidodiphosphate (AMP-PNP) was introduced, it competed with ATP to bind to the ATP binding site, and the cellular fluctuation amplitude and speed decreased. The results prove that ATP is a factor in the regulation of cellular mechanics. To our best knowledge, it is the first time that the dual view transport of intensity phase microscopy was used for live cell phase imaging and analysis. Our work not only provides direct measurements on cellular fluctuations to study ATP regulation on cellular mechanics, but it also proves that our proposed dual view transport of intensity phase microscopy can be well used, especially in quantitative phase imaging of live cells in biological and medical applications.

Interfacial dilational properties of tri-substituted alkyl benzene sulfonates at air/water and decane/water interfaces.

The dilational rheological properties of absorbed film of three pairs of structural isomers, tri-substituted alkyl benzene sulfonates, at the air-water and decane-water interfaces have been investigated by drop shape analysis method. The influences of bulk concentration on dilational elasticity and viscosity were expounded. Interfacial tension relaxation method was employed to obtain dilational parameters in a reasonably broad frequency range. The experimental results showed that the meta-alkyl to sulfonate group plays a crucial role in the interfacial dilational properties: the longer meta-alkyl will lead to higher dilational parameters for air-water interface and lower ones for decane-water interface when the total alkyl carbon numbers are equal. For alkyl benzene sulfonates with shorter meta-alkyl, the surface dilational properties are similar to interfacial dilational properties, whereas the surface dilational parameters are obviously higher than the interfacial dilational parameters for alkyl benzene sulfonates with longer meta-alkyl in general. The possible mechanism has been proposed and ensured by Cole-Cole plots.

The interfacial dilational properties of hydrophobically modified associating polyacrylamide studied by the interfacial tension relaxation method at an oil-water interface.

The interfacial dilational viscoelastic properties of hydrophobically associating block copolymer composed of acrylamide (AM) and a low amount of 2-phenoxylethyl acrylate (POEA) (<1.0 mol%) at the octane-water interfaces were studied by means of the interfacial tension relaxation method. The dependencies of interfacial dilational elasticity and viscous component on the dilational frequency were investigated. The interaction of hydrophobically associating block copolymer [P(AM/POEA)] with sodium dodecyl sulfate (SDS) has been explored. The results show that at lower frequency, the dilational elasticity for different concentration copolymer is close to zero; at higher frequency, the dilational elasticity shows no change with increased frequency; At moderate frequency (10(-3)-1 Hz), the dilational elasticity decreased with a decrease in the dilational frequency. The results show that the hydrophobic groups of [P(AM/POEA)] chains can be associated by inter- or intrachain liaisons in water solution. The dilational viscous component for P(AM/POEA) comes forth a different maximum value at different frequencies when the polymer concentration is different. It is generally believed that the dilational viscous component reflects the summation of the various microscopic relaxation processes at and near the interface and different relaxation processes have different characteristic frequencies. The spectrum of dilational viscous component may appear more than once maximum values at different frequencies. The influence of SDS on the limiting dilational elasticity and viscous component for polymer solution was elucidated. For 5000 ppm polymer solution, the limiting dilational elasticity decreased with an increase in SDS concentration. The dilational viscous component passed through a maximum value with a rise in the dilational frequency, which appeared at different frequency when SDS concentration is different; and the higher is the concentration, the lower is the dilational frequency. It can be explained that macromolecules may be substituted by SDS molecules in the interface and the interaction of molecules decrease, which makes the limiting dilational elasticity decrease. For 200 ppm polymer solution, the limiting dilational elasticity increased firstly and then decreased with SDS concentration increasing. This may be explained that the interfacial polymer concentration is so low that SDS molecules absorbed in the interface dominate dilational properties of the interfacial film even at very low SDS concentration. However, SDS molecules can gradually substitute the polymer molecules in the interface with a rise in SDS concentration, which results in the decrease in the limiting dilational elasticity.