Automatic assessment of DWI-ASPECTS for acute ischemic stroke based on deep learning.

BACKGROUND: Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a standardized semi-quantitative method for early ischemic changes in acute ischemic stroke. PURPOSE: However, ASPECTS is still affected by expert experience and inconsistent results between readers in clinical. This study aims to propose an automatic ASPECTS scoring model based on diffusion-weighted imaging (DWI) mode to help clinicians make accurate treatment plans. METHODS: Eighty-two patients with stroke were included in the study. First, we designed a new deep learning network for segmenting ASPECTS scoring brain regions. The network is improved based on U-net, which integrates multiple modules. Second, we proposed using hybrid classifiers to classify brain regions. For brain regions with larger areas, we used brain grayscale comparison algorithm to train machine learning classifiers, while using hybrid feature training for brain regions with smaller areas. RESULTS: The average DICE coefficient of the segmented hindbrain area can reach 0.864. With the proposed hybrid classifier, our method performs significantly on both region-level ASPECTS and dichotomous ASPECTS. The sensitivity and accuracy on the test set are 95.51% and 93.43%, respectively. For dichotomous ASPECTS, the intraclass correlation coefficient (ICC) between our automated ASPECTS score and the expert reading was 0.87. CONCLUSIONS: This study proposed an automated model for ASPECTS scoring of patients with acute ischemic stroke based on DWI images. Experimental results show that the method of segmentation first and then classification is feasible. Our method has the potential to assist physicians in the Alberta Stroke Program with early CT scoring and clinical stroke diagnosis.

Occurrence and ecological risk assessment of 16 phthalates in surface water of the mainstream of the Yangtze River, China.

Phthalic acid esters (PAEs), a class of typical endocrine disruptors, have received considerable attention due to their widespread applications and adverse effects on biological health. In this study, 30 water samples, along the mainstream of the Yangtze River (YR), were collected from Chongqing (upper stream) to Shanghai (estuary) from May to June in 2019. The total concentrations of 16 targeted PAEs ranged from 0.437 to 20.5 µg/L, with an average of 1.93 µg/L, where dibutyl phthalate (DBP, 0.222-20.2 µg/L), bis (2-ethylhexyl) phthalate (DEHP, 0.254-7.03 µg/L), and diisobutyl phthalate (DIBP, 0.0645-0.621 µg/L) were the most abundant PAEs. According to the pollution level in the YR to assess the ecological risk posed by PAEs, the results showed medium risk level of PAEs in the YR, among which DBP and DEHP posed a high ecological risk to aquatic organisms. The optimal solution for DBP and DEHP is found in ten fitting curves. The PNECSSD of them is 2.50 µg/L and 0.34 µg/L, respectively.

Trace metals in sediment from Chaohu Lake in China: Bioavailability and probabilistic risk assessment.

Bioavailability-based probabilistic risk assessment is an effective approach for risk characterization of trace metals towards aquatic species. However, it has not been routinely applied in lake management due to limited research. In this study, Chaohu Lake (Anhui Province, China) was selected as a case study, and total and bioavailable concentrations of trace metals in surface sediment were investigated using chemical extraction and diffusive gradients in thin films (DGT). Probabilistic risk assessment (PRA) was performed using Monte Carlo simulation. In addition, the species sensitivity distribution (SSD) was constructed using acute toxicity data to model the sensitivity of aquatic species towards metals. Three evaluation methods, namely, toxic units based on total content, modified potential ecological risk index (RI) based on chemical fractionation and DGT-SSD coupled PRA, were implemented and compared. Results showed that trace metals, especially Cd, were significantly affected by anthropogenic activities. Chemical fractionation analysis revealed that the majority of Cd was readily available to aquatic organisms, while Cr was stable under normal conditions. Toxic units based on the total content demonstrated that metals in sediment were at 91.6 % low and 8.4 % medium toxicity levels, while the modified RI based on chemical fractionation found toxicity levels of 84.1 % low and 15.9 % medium. Furthermore, the combined toxicity calculated from DGT-SSD coupled PRA showed that trace metals in sediment had a 24.8 % probability of toxic effects towards aquatic organisms, with Cu, Zn, Cd, and Ni being the main contributors. Comparative analysis suggested that the DGT-SSD coupled PRA could provide a more objective and scientific evidence for lake management with regard to metal contamination.

Source tracing with cadmium isotope and risk assessment of heavy metals in sediment of an urban river, China.

The Nanfei River was one of dominant inflowing rivers of the fifth largest freshwater Chaohu Lake in China, which had been subjected to increasing nutrients and contaminants from population expansion, rapid industrialization and agricultural intensification in recent decades. In present study, surface sediment from the Nanfei River was collected to investigate the anthropogenic impact on distribution and bioavailability of heavy metals. Possible Cd sources along the river were constrained by using Cd isotope signatures and labile concentrations of heavy metals in sediment were determined through the DGT technique for risk assessment. Results showed that Cd in river sediment showed greatest enrichment (EF 0.8-9.4), indicating massive pollution from anthropogenic activities. Among the various possible Cd source materials, urban road dust, industrial soil and chicken manure, displayed higher Cd abundance and enrichment that might contribute to Cd accumulation in river sediment. Cadmium isotopic composition in river sediment was ranged from -0.21 ± 0.01‰ to 0.13 ± 0.03‰, whereas yielded relative variation from -0.31 ± 0.02‰ to 0.23 ± 0.01‰ in source materials. Accordingly, Cd sources along the river were constrained, i.e. traffic and industrial activities in the upper and middle reaches whereas agricultural activities in the lower reaches. Furthermore, the evaluation on ecological risk of heavy metals in sediment on basis of SQGs and DGT-labile concentrations demonstrated that Pb and Zn might pose higher risk on aquatic species. The present study confirmed that Cd isotopes were promising source tracer in environmental studies.

Event-triggered H∞/passive synchronization for Markov jumping reaction-diffusion neural networks under deception attacks.

The issue of H∞/passive master-slave synchronization for Markov jumping neural networks with reaction-diffusion terms is investigated in this paper via an event-triggered control scheme under deception attacks. To lighten the burden of limited communication bandwidth as well as ensure the control performance, an event-triggered transmission scheme is developed. Meanwhile, the randomly occurring deception attacks, which received from the event generator are assumed to modify the sign of the control signal, are taken into account. Furthermore, sufficient conditions ensuring the prescribed H∞/passive performance level of the neural networks, are deduced beyond Lyapunov stability theory, and the controller gains are derived dealing with the matrix convex optimization problem. At last, the availability of the approach proposed is demonstrated via a numerical example.

Reliability and validity of DSM-IV and DSM-5 methamphetamine use disorder diagnoses using the Chinese Version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA).

BACKGROUND: The Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA) was developed to assess substance-use disorders and other psychiatric traits. We translated the SSADDA into Chinese and evaluated its inter-rater reliability and concurrent validity in diagnosing DSM-IV methamphetamine (MA) dependence and DSM-5 MA-use disorder (MUD). METHODS: The sample comprised 231 participants who were interviewed using the Chinese SSADDA and the Mini-International Neuropsychiatric Interview (Chinese MINI) for concurrent validation. Of the 231 participants, 191 were interviewed by two different interviewers two weeks apart. We evaluated the inter-rater reliability and concurrent validity of the diagnoses using percent agreement and Cohen's kappa coefficient (κ). Cohen's linear weighted kappa was used to assess the reliability of DSM-5 MUD severity. RESULTS: It showed good inter-rater reliability and no significant differences among the DSM-5 MUD (κ = 0.71), DSM-IV MA abuse or dependence (κ = 0.72), and the DSM-IV diagnoses of MA dependence (κ = 0.66) and abuse (κ = 0.68) tested separately. The weighted kappa was 0.67 across the three DSM-5 MUD severity levels. The reliability of each individual diagnostic criterion for DSM-5 MUD ranged from fair to excellent (κ = 0.41-0.80), except for "repeated attempts to quit/control use" (κ = 0.38). The concurrent validity based on MINI-derived diagnoses ranged from good to excellent (κ = 0.65-0.78). CONCLUSIONS: This study shows that the Chinese version of SSADDA has good reliability and validity among Chinese MA users.

Protocol for the economic evaluation of COVID-19 pandemic response policies.

INTRODUCTION: Several treatment options are available for COVID-19 to date. However, the use of a combination of non-pharmaceutical interventions (NPIs) is necessary for jurisdictions to contain its spread. Although the implementation cost of NPIs may be low from the healthcare system perspective, it can be costly when considering the indirect costs from the societal perspective. COVID-19 vaccination campaigns have begun in several countries worldwide. Nonetheless, the quantity of vaccines available remain limited over the next 1 to 2 years. A tool for informing vaccine prioritisation that considers both cost and effectiveness will be highly useful. This study aims to identify the most cost-effective combination of COVID-19 response policies, using Singapore as an example. METHODS AND ANALYSIS: An age-stratified Susceptible-Exposed-Infectious-Recovered model will be used to generate the number of infections stratified by disease severity under different intervention scenarios. Polices of interest include test-trace-isolate, travel restriction, compulsory face mask and hygiene practices, social distancing, dexamethasone/remdesivir therapy and vaccination. The latest phase 3 trial results and the WHO Target Product Profiles for COVID-19 vaccines will be used to model vaccine characteristics. A cost (expected resource utilisation and productivity losses) and quality-adjusted life years (QALYs) will be attached to these outputs for a cost-utility analysis. The primary outcome measure will be the incremental cost-effectiveness ratio generated from the incremental cost of policy alternatives expressed as a ratio of the incremental benefits (QALYs gained). Efficacy of policy options will be gathered from literature review and from its observed impacts in Singapore. Cost data will be gathered from healthcare institutions, Ministry of Health and published data. Sensitivity analysis such as threshold analysis and scenario analysis will be conducted. ETHICS AND DISSEMINATION: Ethics approval was not required for this study. The study findings will be disseminated through peer-reviewed journals.

Avoiding Trouble Ahead: Lessons Learned and Suggestions for Economic Evaluations of COVID-19 Vaccines.

With vaccines for coronavirus disease 2019 (COVID-19) being introduced in countries across the world, policy makers are facing many practical considerations about how best to implement a vaccination programme. The supply of vaccines is insufficient for the global population, so decisions must be made as to which groups are prioritised for any vaccination and when. Furthermore, the aims of vaccination programmes will differ between countries, with some prioritising economic benefits that could stem from the relaxation of non-pharmaceutical interventions and others seeking simply to reduce the number of COVID-19 cases or deaths. This paper aims to share the experiences and lessons learned from conducting economic evaluations in Singapore and Thailand on hypothetical COVID-19 vaccines to provide a basis for other countries to develop their own contextualised economic evaluations, with particular focus on the key uncertainties, technical challenges, and characteristics that modellers should consider in partnership with key stakeholders. Which vaccines, vaccination strategies, and policy responses are most economically beneficial remains uncertain. It is therefore important for all governments to conduct their own analyses to inform local policy responses to COVID-19, including the implementation of COVID-19 vaccines in both the short and the long run. It is essential that such studies are designed, and ideally conducted, before vaccines are introduced so that policy decisions and implementation procedures are not delayed.

[Bioavailability and Ecological Risk Assessment of Cadmium in the Sea-Land Interaction Sediments of the Pearl River Delta].

Cadmium (Cd) pollution poses a threat to human health, and research on Cd bioavailability as well as its ecological risk assessment can help prevent and mitigate Cd hazards. The enrichment characteristics and variability of Cd were investigated in sea-land interaction soil fractions and the associated environmental and ecological risks were evaluated using the accumulation index (Igeo), potential ecological hazard index (Er), and risk assessment coding (RAC). The results showed that:① The Cd content of miscellaneous fill material was typically lower than 0.3 mg·kg-1 and that of plain full was higher than 0.3 mg·kg-1. The Cd content of marine sediment was significantly higher than that of continental sediments, averaging 0.36 and 0.10 mg·kg-1, respectively. The concentration of Cd in marine sediments buried at shallow depths (<5 m) was generally higher than at greater depths (>5 m). ② There was a moderate correlation between Cd and CEC in artificial fill (Q4ml; correlation coefficient=0.52, P<0.05). There was a weak correlation between Cd and organic matter in the marine sediments (correlation coefficient=0.49, P<0.05). Total cadmium and the physical and chemical properties of soil had a significant influence on the fraction of soil cadmium. ③ The Igeo of artificially fill and marine sediment was dominated by the relationship 1 < Igeo < 2, which indicated a moderate level of pollution. The Er of artificial fill and marine sediment was mainly 80 < Er < 160, indicating a high potential ecological hazard. Soil acid-extractable Cd accounted for more than 50% of the total Cd in each drill hole, which generally indicated a very high potential ecological risk. These results provide a basis for environmental and agricultural decision-making and provide theoretical guidance for soil pollution investigations and remediation.

Assessment of antioxidant and antidiabetic properties of Agaricus blazei Murill extracts.

Agaricus blazei Murill (ABM), a medicinal mushroom, has beneficial effects on various human metabolic diseases. The objective of this research was to evaluate the antioxidant and antidiabetic properties of ABM extracts (ethanol extract and ethyl acetate extract). The antioxidant activities of ABM ethanol extract (EE) and ethyl acetate extract (EA) were analyzed using 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and hydroxyl radical scavenging assays and the reducing power using K3Fe(CN)6 in vitro. Moreover, the effects of EE and EA on α-glucosidase inhibitory activity and improving glucose uptake by HepG2 cells were investigated in vitro. The EA showed stronger antioxidant activity, as well as inhibition of α-glucosidase, compared to EE. The analysis of glucose uptake by HepG2 cells showed that EA had significant glucose-lowering activity and exhibited no difference compared to metformin. The results suggest that ABM extracts could improve the glucose uptake by HepG2 cells and thereby alleviate postprandial hyperglycemia. This investigation provides a strong rationale for further studies on the application of ABM to control type 2 diabetes.

Levels and risk assessment of metals in sediment and fish from Chaohu Lake, Anhui Province, China.

Chaohu Lake is the fifth largest freshwater lake in China, which tolerates substantial amount of anthropogenic discharge from surrounding cities that resulting in the degradation of water and damage of aquatic ecosystem. Metal analysis of sediment and aquatic organisms can provide important information on the environmental contamination and potential impact of aquatic food consumption. Thus, the concentrations of Cu, Pb, Zn, Cr, Cd, As, and Hg in sediment and fish from Chaohu Lake were analyzed with inductively coupled plasma mass spectrometry and atomic fluorescence spectrometry. The mean content of Cu, Pb, Zn, Cr, Cd, As, and Hg in the sediment samples were 27.4 ± 6.3, 40.5 ± 12.3, 136.8 ± 65.5, 68.5 ± 9.1, 0.357 ± 0.141, 10.8 ± 1.7, and 0.117 ± 0.049 mg/kg, respectively. The results were compared with background values and evaluation methods, to characterize the potential ecological risk. The concentrations of Cu, Pb, Zn, Cr, Cd, As, and Hg in the fish muscle samples were 1.68-5.31, 0.078-0.31, 15.55-372.98, 0.31-0.93, 0.001-0.033, 0.29-1.03, and 0.04-0.197 mg kg-1 of dry mass, respectively. Most of the concentrations of the studied metals in muscles were found to be below the safe limits; however, the concentration of inorganic As (10% of total As) in two specimens exceeded the maximum allowance in fish. The ecological risk evaluation showed that the metals in sediment posed low to medium risk. The health risk assessment suggested that the consumption of fish from Chaohu Lake is currently safe with respect to the metals.

Assessment of calcium and zinc accumulation in cultivated and wild apples.

BACKGROUND: Apple is one of the staple fruits worldwide which are a good source of mineral nutrients. However, little is known about genetic variation for mineral nutrition in apple germplasm. In this study, the calcium and zinc contents in mature fruits of 378 apple cultivars and 39 wild relatives were assessed. Mineral concentrations were quantified using flame atomic absorption spectroscopy (FAAS). RESULTS: Both calcium and zinc accumulation showed great variation among accessions tested. Overall, wild fruits were significantly richer in zinc than cultivated fruits, while the average concentration of calcium was similar between cultivated and wild fruits. The difference in zinc concentration between wild and cultivated fruits may be an indirect result of artificial selection on fruit characteristics during apple domestication. Moreover, calcium concentration in fruit showed a decreasing trend throughout fruit development of apple, while zinc concentration in fruit displayed a complex variation pattern in the late stages of fruit development. CONCLUSION: The finding of a wild genetic variation for fruit calcium and zinc accumulation in apple germplasm could be helpful for future research on genetic dissection and improvement of calcium and zinc accumulation in apple fruit. © 2017 Society of Chemical Industry.

Assessment of Sugar Components and Genes Involved in the Regulation of Sucrose Accumulation in Peach Fruit.

Soluble sugar contents in mature fruits of 45 peach accessions were quantified using gas chromatography analysis. Sucrose is the predominant sugar in mature fruit, followed by glucose and fructose, which have similar concentrations. Overall, sucrose metabolism and accumulation are crucial determinants of sugar content in peach fruit, and there is a wide range of sucrose concentrations among peach genotypes. To understand the mechanisms regulating sucrose accumulation in peach fruit, expression profiles of genes involved in sucrose metabolism and transport were compared among four genotypes. Two sucrose-cleaving enzyme genes (SUS4 and NINV8), one gene involved in sucrose resynthesis (SPS3), and three sugar transporter genes (SUT2, SUT4, and TMT2) were prevalently expressed in peach fruit, and their expression levels are significantly correlated with sucrose accumulation. In contrast, the VAINV genes responsible for sucrose cleavage in the vacuole were weakly expressed in mature fruit, suggesting that the sucrose-cleaving reaction is not active in the vacuole of sink cells of mature peach fruit. This study suggests that sucrose accumulation in peach fruit involves the coordinated interaction of genes related to sucrose cleavage, resynthesis, and transport, which could be helpful for future peach breeding.

Comparative assessment of sugar and malic acid composition in cultivated and wild apples.

Soluble sugar and malic acid contents in mature fruits of 364 apple accessions were quantified using high-performance liquid chromatography (HPLC). Fructose and sucrose represented the major components of soluble sugars in cultivated fruits, whilst fructose and glucose were the major items of sugars in wild fruits. Wild fruits were significantly more acidic than cultivated fruits, whilst the average concentration of total sugars and sweetness index were quite similar between cultivated and wild fruits. Thus, our study suggests that fruit acidity rather than sweetness is likely to have undergone selection during apple domestication. Additionally, malic acid content was positively correlated with glucose content and negatively correlated with sucrose content. This suggests that selection of fruit acidity must have an effect on the proportion of sugar components in apple fruits. Our study provides information that could be helpful for future apple breeding.

Distribution and assessment of Pb in the supergene environment of the Huainan Coal Mining Area, Anhui, China.

Coal mining area is highly subject to lead (Pb) pollution from coal mining activities. Several decades of coal mining and processing practices in dozens of coal mines in the Huainan Coal Mining Area (HCMA) have led to the accumulation of massive amounts of coal gangue, which piled in dumps. In order to investigate the impacts of coal gangue dumps on Pb level in the supergene media of the HCMA, a systematic sampling campaign comprising coal gangue, soil, wheat, and earthworm samples was conducted. The average Pb content in the coal mining area soil is 24 mg/kg, which is slightly higher than the associated coal gangues (23 mg/kg) and markedly higher than reference region soil (12.6 mg/kg). Soil in the HCMA present a slight to moderate Pb contamination, which might be related to the weathering and leaching of coal gangue dumps. Lateral distribution of Pb in HCMA soil differed among individual coal mines. The soil profile distribution of Pb depends on both natural and anthropogenic contributions. Average Pb content is higher in roots than in stems, leaves, and wheat husks, while the Pb level in seeds exceeded the maximum Pb allowance for foods (Maximum Levels of Contaminants in Foods of China, GB 2762-2012). Earthworms in the selected area are significantly enriched in Pb, suggesting higher bio-available Pb level in soil in the HCMA.

DNA microarray assessment of putative Borrelia burgdorferi lipoprotein genes.

A DNA microarray containing fragments of 137 Borrelia burgdorferi B31 putative lipoprotein genes was used to examine Lyme disease spirochetes. DNA from B. burgdorferi sensu stricto B31, 297, and N40; Borrelia garinii IP90; and Borrelia afzelii P/Gau was fluorescently labeled and hybridized to the microarray, demonstrating the degree to which the individual putative lipoprotein genes were conserved among the genospecies. These data show that a DNA microarray can globally examine the genes encoding B. burgdorferi lipoproteins.