Quality assessment of radiomics models in carotid plaque: a systematic review.

Background: Although imaging techniques provide information about the morphology and stability of carotid plaque, they are operator dependent and may miss certain subtleties. A variety of radiomics models for carotid plaque have recently been proposed for identifying vulnerable plaques and predicting cardiovascular and cerebrovascular diseases. The purpose of this review was to assess the risk of bias, reporting, and methodological quality of radiomics models for carotid atherosclerosis plaques. Methods: A systematic search was carried out to identify available literature published in PubMed, Web of Science, and the Cochrane Library up to March 2023. Studies that developed and/or validated machine learning models based on radiomics data to identify and/or predict unfavorable cerebral and cardiovascular events in carotid plaque were included. The basic information of each piece of included literature was identified, and the reporting quality, risk of bias, and radiomics methodology quality were assessed according the TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) checklist, the Prediction Model Risk of Bias Assessment Tool (PROBAST), and the radiomics quality score (RQS), respectively. Results: A total of 2,738 patients from 19 studies were included. The mean overall TRIPOD adherence rate was 66.1% (standard deviation 12.8%), with a range of 45-87%. All studies had a high overall risk of bias, with the analysis domain being the most common source of bias. The mean RQS was 9.89 (standard deviation 5.70), accounting for 27.4% of the possible maximum value of 36. The mean area under the curve for diagnostic or predictive properties of these included radiomics models was 0.876±0.09, with a range of 0.741-0.989. Conclusions: Radiomics models may have value in the assessment of carotid plaque, the overall scientific validity and reporting quality of current carotid plaque radiomics reports are still lacking, and many barriers must be overcome before these models can be applied in clinical practice.

Radiomics in Carotid Plaque: A Systematic Review and Radiomics Quality Score Assessment.

Imaging modalities provide information on plaque morphology and vulnerability; however, they are operator dependent and miss a great deal of microscopic information. Recently, many radiomics models for carotid plaque that identify unstable plaques and predict cardiovascular outcomes have been proposed. This systematic review was aimed at assessing whether radiomics is a reliable and reproducible method for the clinical prediction of carotid plaque. A systematic search was conducted to identify studies published in PubMed and Cochrane library from January 1, 2001, to September 30, 2022. Both retrospective and prospective studies that developed and/or validated machine learning models based on radiomics data to classify or predict carotid plaques were included. The general characteristics of each included study were selected, and the methodological quality of radiomics reports and risk of bias were evaluated using the radiomics quality score (RQS) tool and Quality Assessment of Diagnostic Accuracy Studies-2, respectively. Two investigators independently reviewed each study, and the consensus data were used for analysis. A total of 2429 patients from 16 studies were included. The mean area under the curve of radiomics models for diagnostic or predictive performance of the included studies was 0.88 ± 0.02, with a range of 0.741-0.989. The mean RQS was 9.25 (standard deviation: 6.04), representing 25.7% of the possible maximum value of 36, whereas the lowest point was -2, and the highest score was 22. Radiomics models have revealed additional information on patients with carotid plaque, but with respect to methodological quality, radiomics reports are still in their infancy, and many hurdles need to be overcome.

Cost-effectiveness of cytomegalovirus vaccination for females in China: A decision-analytical Markov study.

BACKGROUND: The global burden of disease caused by congenital cytomegalovirus (CMV) infection is high. Previous modeling studies have suggested that CMV vaccination may be cost-effective in developed countries. Congenital CMV infection is more likely driven by maternal non-primary infection in China. We aimed to measure the effectiveness and cost-effectiveness of population-level CMV vaccination in Chinese females. METHODS: A decision tree Markov model was developed to simulate potential CMV vaccination strategies in a multi-cohort setting, with a population size of 1,000,000 each for the infant, adolescent (10-year-old) and young adult (20-year-old) cohorts. The hypothetical vaccines were assumed to have 50% efficacy, 20 years of protection, 70% coverage, at a price of US$120/dose for base-case analysis. Costs and disability-adjusted life years (DALYs) were discounted by 3% per year and the vaccination would be considered cost-effective if an incremental cost-effectiveness ratio (ICER) was lower than 2021 Chinese per capita GDP (US$12,500). FINDINGS: For the pre-infection (PRI) vaccine efficacy type, the adolescent strategy was the most cost-effective, with an ICER of US$12,213 (12,134 to 12,291) pre DALY averted, compared with the next best strategy (young adult strategy). For pre- and post-infection (P&PI) efficacy type, the young adult strategy was the most cost-effective as it was cost-saving. In one-way analysis varying the PRI vaccine price, the infant strategy, adolescent strategy and the young adult strategy would be a dominant strategy over others if the vaccine cost ≤US$60, US$61-121 and US$122-251 per dose respectively. In contrast, the young adult strategy continued to be the preferred strategy until the P&PI vaccine price exceeded US$226/dose. Our main results were robust under a wide variety of sensitivity analyses and scenario analyses. INTERPRETATION: CMV vaccination for females would be cost-effective and even cost-saving in China. Our findings had public health implications for control of CMV diseases.

Relationship between multi-slice computed tomography features and pathological risk stratification assessment in gastric gastrointestinal stromal tumors.

BACKGROUND: Computed tomography (CT) imaging features are associated with risk stratification of gastric gastrointestinal stromal tumors (GISTs). AIM: To determine the multi-slice CT imaging features for predicting risk stratification in patients with primary gastric GISTs. METHODS: The clinicopathological and CT imaging data for 147 patients with histologically confirmed primary gastric GISTs were retrospectively analyzed. All patients had received dynamic contrast-enhanced CT (CECT) followed by surgical resection. According to the modified National Institutes of Health criteria, 147 lesions were classified into the low malignant potential group (very low and low risk; 101 lesions) and high malignant potential group (medium and high-risk; 46 lesions). The association between malignant potential and CT characteristic features (including tumor location, size, growth pattern, contour, ulceration, cystic degeneration or necrosis, calcification within the tumor, lymphadenopathy, enhancement patterns, unenhanced CT and CECT attenuation value, and enhancement degree) was analyzed using univariate analysis. Multivariate logistic regression analysis was performed to identify significant predictors of high malignant potential. The receiver operating curve (ROC) was used to evaluate the predictive value of tumor size and the multinomial logistic regression model for risk classification. RESULTS: There were 46 patients with high malignant potential and 101 with low-malignant potential gastric GISTs. Univariate analysis showed no significant differences in age, gender, tumor location, calcification, unenhanced CT and CECT attenuation values, and enhancement degree between the two groups (P > 0.05). However, a significant difference was observed in tumor size (3.14 ± 0.94 vs 6.63 ± 3.26 cm, P < 0.001) between the low-grade and high-grade groups. The univariate analysis further revealed that CT imaging features, including tumor contours, lesion growth patterns, ulceration, cystic degeneration or necrosis, lymphadenopathy, and contrast enhancement patterns, were associated with risk stratification (P < 0.05). According to binary logistic regression analysis, tumor size [P < 0.001; odds ratio (OR) = 26.448; 95% confidence interval (CI): 4.854-144.099)], contours (P = 0.028; OR = 7.750; 95%CI: 1.253-47.955), and mixed growth pattern (P = 0.046; OR = 4.740; 95%CI: 1.029-21.828) were independent predictors for risk stratification of gastric GISTs. ROC curve analysis for the multinomial logistic regression model and tumor size to differentiate high-malignant potential from low-malignant potential GISTs achieved a maximum area under the curve of 0.919 (95%CI: 0.863-0.975) and 0.940 (95%CI: 0.893-0.986), respectively. The tumor size cutoff value between the low and high malignant potential groups was 4.05 cm, and the sensitivity and specificity were 93.5% and 84.2%, respectively. CONCLUSION: CT features, including tumor size, growth patterns, and lesion contours, were predictors of malignant potential for primary gastric GISTs.

Health insurance fraud detection by using an attributed heterogeneous information network with a hierarchical attention mechanism.

BACKGROUND: With the rapid growth of healthcare services, health insurance fraud detection has become an important measure to ensure efficient use of public funds. Traditional fraud detection methods have tended to focus on the attributes of a single visit and have ignored the behavioural relationships of multiple visits by patients. METHODS: We propose a health insurance fraud detection model based on a multilevel attention mechanism that we call MHAMFD. Specifically, we use an attributed heterogeneous information network (AHIN) to model different types of objects and their rich attributes and interactions in a healthcare scenario. MHAMFD selects appropriate neighbour nodes based on the behavioural relationships at different levels of a patient's visit. We also designed a hierarchical attention mechanism to aggregate complex semantic information from the interweaving of different levels of behavioural relationships of patients. This increases the feature representation of objects and makes the model interpretable by identifying the main factors of fraud. RESULTS: Experimental results using real datasets showed that MHAMFD detected health insurance fraud with better accuracy than existing methods. CONCLUSIONS: Experiment suggests that the behavioral relationships between patients' multiple visits can also be of great help to detect health care fraud. Subsequent research fraud detection methods can also take into account the different behavioral relationships between patients.

CNN-assisted SERS enables ultra-sensitive and simultaneous detection of Scr and BUN for rapid kidney function assessment.

Kidney disease is highly prevalent and may result in severe clinical outcomes. Serum creatinine (Scr) and blood urea nitrogen (BUN) are the most widely used biomarkers for kidney function assessment, yet when measured alone, the result can be affected by a variety of parameters such as age, gender, protein consumption, etc. Measuring Scr and BUN simultaneously can eliminate most of the external influences and greatly improve the assessment of kidney function. In this study, a real-time kidney function assessment system based on dual biomarker detection was proposed. Scr and BUN were determined using surface-enhanced Raman scattering (SERS) within the concentration range of 10-1 to 10-6 M and 0.28 to 100 mg dl-1, respectively. A one-dimensional convolutional neural network (1D-CNN) model was employed to quantitatively analyze the concentration of biomarkers from the SERS spectral measurements. Moreover, we simulated a variety of kidney health conditions with 16 groups of mixed Scr and BUN in serum. The proposed CNN-assisted SERS method was used to quantify both biomarkers and provide diagnostic results. The Au core-Ag shell nanoprobes provided ultra-sensitive SERS detection and the CNN model achieved excellent regression results with an R2 of 0.9871 in the testing dataset. The system demonstrated a rapid and robust evaluation for the assessment of kidney function, providing a promising idea for medical diagnosis with the help of spectroscopy and deep learning methods.

Multiresidue analysis and dietary risk assessment of pesticides in eight minor vegetables from Guizhou, China.

Several minor vegetables are widely employed as hot pot dishes and condiments in Southwest China. To gain insight into pesticide exposure risk via the intake of minor vegetables, vegetable samples (400) obtained from different farms in Guizhou were subjected to multiresidue analyses. Gas chromatography-tandem mass spectrometry and high performance liquid chromatography-tandem mass spectrometry were developed to detect and quantify 97 pesticide residues simultaneously in samples using modified QuEChERS methods. The results showed that no pesticides were detected in 248 samples. Pesticides of different levels were detected in 152 samples, of which 69 samples exhibited residue concentrations exceeding maximum residue limit of European Union. The acute and chronic dietary exposure risk of 15 pesticides in eight minor vegetables were accepted. The risk ranking result showed the most samples contained low-risk pesticides. The results will provide a reference for designing future pesticide supervision programs and risk management programs.

Assessment to the Antifungal Effects in vitro and the Ocular Pharmacokinetics of Solid-Lipid Nanoparticle in Rabbits.

INTRODUCTION: Fungal keratitis (FK) remains a severe sight-threatening disease, and case management is difficult due to ocular intrinsic barriers and drug shortages. Econazole (ECZ), a broad-spectrum antifungal agent, is limited in ocular applications due to the poor water solubility and strong irritant property. METHODS: We successfully prepared solid-lipid nanoparticle-based ECZ eye drops (E-SLNs) by microemulsion method, and the physicochemical properties of E-SLNs were investigated. Corneal permeability, antifungal ability against Fusarium spp., irritation and bioavailability compared to ECZ Suspension (E-Susp) were evaluated in vitro and in vivo. RESULTS: E-SLNs were a uniform and stable system which had an average particle size of 19 nm and a spherical morphology. E-SLNs also exhibited controlled release, enhanced antifungal activity without irritation. The pharmacokinetic analysis in vivo confirmed that E-SLNs showed an improved ocular bioavailability and the drug concentration in the cornea were above minimum inhibitory concentration (MIC) for 3 h after single administration. CONCLUSION: The E-SLNs colloid system is a promising therapeutic approach for fungal keratitis and could serve as a candidate strategy for other ocular diseases.

Assessment of fibula flap with flexor hallucis longus's effect on head & neck tumor patients' quality of life and function of donor site.

OBJECTIVE: Free fibular flaps (FFFs) have been widely used in mandibular reconstruction. It is still unclear whether retaining flexor hallucis longus (FHL) is needed for flaps. This study introduces a comparison in quality of life and donor-site function between those who have and haven't harvested FHL with FFF. METHODS: Patients with FFFs were single-blind-randomly assigned into the FHL group or nFHL group. Patients were followed up preoperatively and 1, 3 and 6 months postoperatively via subjective evaluations (SF-36/AOFAS) and objective evaluation s(muscle strength and range of motion). Patients' hospitalization and intraoperative information, donor site morbidity were recorded. RESULTS: Each group had 15 patients. The flap harvesting time in FHL group was shorter significantly than nFHL group (125.9 ± 24.8 min vs 146.7 ± 29.9 min, P = 0.048). There were no significant differences in hospitalization information such as operation time, hospitalization days and cost. Donor site morbidities at 1, 3 and 6 months postoperatively showed no significant differences except for the presence of claw toes (nFHL group > FHL group, 40% vs 0, P = 0.017; 53.3% vs 6.7%, P = 0.014; 60.0% vs 13.3%, P = 0.021). There were no significant differences in SF-36 and AOFAS scores. There were no significant differences in muscle strength and range of motion. CONCLUSION: Excision of the FHL lowered the flap harvesting time. It did not increase donor site morbidity. The impacts on patients' quality of life and foot function were the same. The surgeons can use the FHL without considering the influence on patients if not retaining the FHL.

Corrosion Sensors for Structural Health Monitoring of Oil and Natural Gas Infrastructure: A Review.

Corrosion has been a great concern in the oil and natural gas industry costing billions of dollars annually in the U.S. The ability to monitor corrosion online before structural integrity is compromised can have a significant impact on preventing catastrophic events resulting from corrosion. This article critically reviews conventional corrosion sensors and emerging sensor technologies in terms of sensing principles, sensor designs, advantages, and limitations. Conventional corrosion sensors encompass corrosion coupons, electrical resistance probes, electrochemical sensors, ultrasonic testing sensors, magnetic flux leakage sensors, electromagnetic sensors, and in-line inspection tools. Emerging sensor technologies highlight optical fiber sensors (point, quasi-distributed, distributed) and passive wireless sensors such as passive radio-frequency identification sensors and surface acoustic wave sensors. Emerging sensors show great potential in continuous real-time in-situ monitoring of oil and natural gas infrastructure. Distributed chemical sensing is emphasized based on recent studies as a promising method to detect early corrosion onset and monitor corrosive environments for corrosion mitigation management. Additionally, challenges are discussed including durability and stability in extreme and harsh conditions such as high temperature high pressure in subsurface wellbores.

Dissipation, residues and risk assessment of oxine-copper and pyraclostrobin in citrus.

An efficient, sensitive, simple and fast method for the simultaneous determination of oxine-copper and pyraclostrobin in citrus fruit was developed and validated. The method uses ethylene diamine tetra-acetic acid as a competitive ligand to convert oxine-copper to soluble 8-hydroxyquinoline for analysis by QuEChERS and LC-MS/MS. Linear relationships were determined with correlation coefficients ranging from 0.9904 to 0.9998. The limits of detection for the analytes were 0.012-0.8 µg kg-1, and the limits of quantitation were 0.04-2.6 µg kg-1 in citrus. The average recoveries were 79.1-114.9% with relative standard deviations of less than 7.4%. The analyses of dissipation indicated that the half-lives of oxine-copper and pyraclostrobin were 1.94-3.67 and 1.79-2.48 days and the terminal residues were <0.08-8.99 and <0.02-1.90 mg kg-1, respectively. The risk quotients of oxine-copper and pyraclostrobin were 0.026-0.199 and 0.003-0.022, respectively. This risk assessment provides a reference for the safe and reasonable use of oxine-copper and pyraclostrobin and may help to establish maximum residue limits for these pesticides in China.

The human cost of global warming: Deadly landslides and their triggers (1995-2014).

Worldwide, landslides incur catastrophic and significant economic and human losses. Previous studies have characterized the patterns in landslides' fatalities, from all kinds of triggering causes, at a continental or global scale, but they were based on data from periods of <10 years. The research herein presented hypothesizes that climate change associated with extreme rainfall and population distribution is contributing to a higher number of deadly landslides worldwide. This study maps and identified deadly landslides in 128 countries and it encompasses their role, for a 20 years' period from January/1995 to December/2014, considered representative for establishing a relationship between landslides and their meteorological triggers. A database of georeferenced landslides, their date, and casualties' information, duly validated, was implemented. A hot spot analysis for the daily record of landslide locations was performed, as well as a percentile-based approach to evaluate the trend of extreme rainfall events for each occurrence. The relationship between casualty, population distribution, and rainfall was also evaluated. For 20 years, 3876 landslides caused a total of 163,658 deaths and 11,689 injuries globally. They occurred most frequently between June and December in the Northern Hemisphere, and between December and February in the Southern Hemisphere. A significant global rise in the number of deadly landslides and hotspots across the studied period was observed. Analysis of daily rainfall confirmed that more than half of the events were in areas exposed to the risk of extreme rainfall. The relationships established between extreme rainfall, population distribution, seasonality, and landslides provide a useful basis for efforts to model the adverse impacts of extreme rainfall due to climate change and human activities and thus contribute towards a more resilient society.

Dissipation, residues, and risk assessment of imidacloprid in Zizania latifolia and purple sweet potato under field conditions using LC-MS/MS.

A shortened version of Quick, Easy, Cheap, Effective, Rugged, and Safe method (QuEChERS) for determining the dissipation and residue of imidacloprid present in Zizania latifolia and purple sweet potato was established by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The average recoveries of imidacloprid in the two crops ranged from 82.12 to 113.79%, with relative standard deviation (RSD) of <7.32%. The dissipation dynamics of imidacloprid in Z. latifolia plants and purple sweet potato plants followed first-order kinetics, with half-lives of 3.2-5.5 days in each of sampling locations. The terminal imidacloprid residues in Z. latifolia and purple sweet potato at each of location were <0.005-0.120 mg kg-1. According to the risk assessment results, both the acute dietary risk quotient and chronic dietary risk quotient values were <1, indicating that imidacloprid is unlikely to pose health risks to humans with normal recommended use. The present study may serve as a valuable reference for the safe and reasonable use of imidacloprid in Z. latifolia and purple sweet potato fields.

Residues, dissipation kinetics, and dietary intake risk assessment of two fungicides in grape and soil.

The residue behavior and dietary intake risk of two fungicides (dimethomorph and pyraclostrobin) in grape (Vitis vinifera L.) were investigated from field trials. A modified quick, easy, cheap, effective, rugged, and safe method for simultaneously determining dimethomorph and pyraclostrobin residues in grape and soil was established using high performance liquid chromatography-tandem mass spectrometry. The average recoveries of dimethomorph and pyraclostrobin in the grape and soil matrices varied from 76.88% to 97.05%, with relative standard deviations of 1.73%-10.38%. The degradation half-lives of dimethomorph and pyraclostrobin were 7.3-12.0 days and 3.6-7.0 days in grape and soil, respectively. The terminal residues of dimethomorph and pyraclostrobin in the two matrices were 0.05-0.87 mg/kg. For dietary exposure risk assessments, all of the hazard quotient and hazard quotient index values were below 100%, which indicated that the suspending agents of dimethomorph and pyraclostrobin were sprayed on grape at the recommended dosages with no significant potential risks for Chinese consumers. This study provides a reference for analytically evaluating residual degradation behavior and dietary intake risk of two fungicides under field conditions.

Novel multimodal analgesia regimen improves post-TACE pain in patients with hepatocellular carcinoma.

BACKGROUD: Transarterial chemoembolization (TACE) is the primary palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). However, it is often accompanied by postoperative pain which hinder patient recovery. This study was to examine whether preemptive parecoxib and sufentanil-based patient controlled analgesia (PCA) could improve the pain management in patients receiving TACE for inoperable HCC. METHODS: From June to December 2016, 84 HCC patients undergoing TACE procedure were enrolled. Because of the willingness of the individuals, it is difficult to randomize the patients to different groups. We matched the patients' age, gender and pain scores, and divided the patients into the multimodal group (n = 42) and control group (n = 42). Patients in the multimodal group received 40 mg of parecoxib, 30 min before TACE, followed by 48 h of sufentanil-based PCA. Patients in the control group received a routine analgesic regimen, i.e., 5 mg of dezocine during operation, and 100 mg of tramadol or equivalent intravenous opioid according to patient's complaints and pain intensity. Postoperative pain intensity, percentage of patients as per the pain category, adverse reaction, duration of hospital stay, cost-effectiveness, and patient's satisfaction were all taken into consideration when evaluated. RESULTS: Compared to the control group, the visual analogue scale scores for pain intensity was significantly lower at 2, 4, 6, and 12 h (all P < 0.05) in the multimodal group and a noticeably lower prevalence of post-operative nausea and vomiting in the multimodal group (31.0% vs. 59.5%). Patient's satisfaction in the multimodal group was also significantly higher than that in the control group (95.2% vs. 69.0%). No significant difference was observed in the duration of hospital stay between the two groups. CONCLUSION: Preemptive parecoxib and sufentanil-based multimodal analgesia regime is a safe, efficient and cost-effective regimen for postoperative pain control in HCC patients undergoing TACE.

Benzophenone-UV filters in personal care products and urine of schoolchildren from Shenzhen, China: Exposure assessment and possible source.

The use of benzophenone (BP)-type UV filters in personal care products (PCPs) has rapidly increased in China over the past decade, leading to growing concerns on the potential adverse effects associated with the usage. Urine analysis is an ideal non-invasive approach for human biomonitoring of xenobiotics that are excreted mainly through urinary system. To investigate human exposure of PCPs to children from South China, we determined BP-type UV filters in a total of 156 commercial PCP goods covering 11 categories, as well as 280 urine samples collected from elementary school students in Shenzhen, China. Five BP analogues (i.e., BP1, BP2, BP3, BP8, and 4HB) were frequently detected in both PCPs and urine, among which BP3 was the dominant analogue, accounting for 96.3% of the total BPs in PCPs and 53.2% in urine, respectively. Sunscreens contained the highest BP concentrations (mean: 2.15 × 104 ng g-1) among all PCP goods. Girls exhibited higher urinary BP concentrations than boys, and body mass index positively influenced BP concentrations. However, no regional difference in urinary BP concentration was observed. The estimated dermal uptake of BPs from PCPs after considering the percutaneous absorption rates was much lower than the estimated dermal intake. The total daily excretion doses estimated from urinary BPs were 74.4 and 47.4 ng·kg-1bw day-1 for girls and boys, respectively. The higher usage of body lotions, hand lotions, and sunscreens by girls than boys (1.49 vs. 1.03 times week-1) might play an important role.

Effect of socioeconomic inequalities on cholecystectomy outcomes: a 10-year population-based analysis.

BACKGROUND: Although numerous epidemiological studies on cholecystectomy have been conducted worldwide, only a few have considered the effect of socioeconomic inequalities on cholecystectomy outcomes. Specifically, few studies have focused on the low-income population (LIP). METHODS: A nationwide prospective study based on the Taiwan National Health Insurance dataset was conducted during 2003-2012. The International Classification of ICD-9-CM procedure codes 51.2 and 51.21-51.24 were identified as the inclusion criteria for cholecystectomy. Temporal trends were analyzed using a joinpoint regression, and the hierarchical linear modeling (HLM) method was used as an analytical strategy to evaluate the group-level and individual-level factors. Interactions between age, gender and SES were also tested in HLM model. RESULTS: Analyses were conducted on 225,558 patients. The incidence rates were 167.81 (95% CI: 159.78-175.83) per 100,000 individuals per year for the LIP and 123.24 (95% CI: 116.37-130.12) per 100,000 individuals per year for the general population (GP). After cholecystectomy, LIP patients showed higher rates of 30-day mortality, in-hospital complications, and readmission for complications, but a lower rate of routine discharge than GP patients. The hospital costs and length of stay for LIP patients were higher than those for GP patients. The multilevel analysis using HLM revealed that adverse socioeconomic status significantly negatively affects the outcomes of patients undergoing cholecystectomy. Additionally, male sex, advanced age, and high Charlson Comorbidity Index (CCI) scores were associated with higher rates of in-hospital complications and 30-day mortality. We also observed that the 30-day mortality rates for patients who underwent cholecystectomy in regional hospitals and district hospitals were significantly higher than those of patients receiving care in a medical center. CONCLUSION: Patients with a disadvantaged finance status appeared to be more vulnerable to cholecystectomy surgery. This result suggested that further interventions in the health care system are necessary to reduce this disparity.

Dissipation, residues and risk assessment of spirotetramat and its four metabolites in citrus and soil under field conditions by LC-MS/MS.

A modified Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) method for the simultaneous determination of spirotetramat and its four metabolite residues in citrus, peel, pulp and soil was developed and validated by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The samples were extracted with acetonitrile (1%, glacial acetic acid, v/v) and purified using primary secondary amine and octadecylsilane. The limit of detection was 0.01-0.13 mg/kg, whereas that of quantification was 0.02-0.40 mg/kg for spirotetramat and its metabolites. The average recoveries of spirotetramat, spirotetramat-enol, spirotetramat-mono-hydroxy, spirotetramat-enol-glucoside and spirotetramat-ketohydroxy in all matrices were 73.33-107.91%, 75.93-114.85%, 76.44-100.78%, 71.46-103.19% and 73.08-105.27%, respectively, with relative standard deviations < 12.32%. The dissipation dynamics of spirotetramat in citrus and soil followed first-order kinetics, with half-lives of 2.3-8.5 days in the three sampling locations. The terminal residues of spirotetramat in four matrices at the three locations were measured below the 1.0 mg/kg maximum residue limit set by China, and residues were found to be concentrated on the peel. The risk assessment of citrus was evaluated using risk quotients. The risk quotient values were found to be significantly <1, suggesting that the risk to human health was negligible when using the recommended doses of spirotetramat in citrus. These results could provide guidance for the safe and proper application of spirotetramat in citrus in China.

Assessment of nonarteritic anterior ischemic optic neuropathy with intravoxel incoherent motion diffusion-weighted imaging using readout-segmented echo-planar imaging, parallel imaging, and 2D navigator-based reacquisition.

PURPOSE: To determine the feasibility of intravoxel incoherent motion (IVIM) for characterizing perfusion properties and its potential diagnostic utility for nonarteritic anterior ischemic optic neuropathy (NAION). IVIM diffusion-weighted imaging is a promising technique that can measure perfusion and diffusion characteristics simultaneously in a noninvasive manner. MATERIALS AND METHODS: Orbital IVIM in a 3.0T scanner was performed on 33 patients with NAION and 15 controls using readout-segmented echo-planar imaging, parallel imaging, and 2D navigator-based reacquisition (RESOLVE-IVIM). Both visual field (VF) and visual acuity (VA) examinations were performed in 19 of the patients. The vascular volume fraction (f), diffusion coefficient (D), and pseudodiffusion coefficient (D*) were calculated for quantitative analysis. Additionally, correlation analyses of IVIM parameters with visual function were also performed. RESULTS: Affected optic nerves showed significantly lower f values than both unaffected contralateral nerves of the patients and nerves of the controls (P < 0.0001), and no significant difference for f was found between unaffected contralateral nerves and nerves of the controls (P = 0.1602). In addition, D and D* values showed no significant differences among the three groups (P = 0.0979, 0.0600, 0.6136 for D and 0.1779, 0.6253, 0.4743 for D*). Correlation analysis only demonstrated significant correlations between f values and the mean deviation of the visual field (r = 0.576, P = 0.0051). CONCLUSION: RESOLVE-IVIM measurement may reflect the perfusion abnormality and visual function impairment in NAION patients, demonstrating its potential application for the diagnosis and clinical evaluation of NAION. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1760-1766.