The novel imaging methods in diagnosis and assessment of cerebrovascular diseases: an overview.

Cerebrovascular diseases, including ischemic strokes, hemorrhagic strokes, and vascular malformations, are major causes of morbidity and mortality worldwide. The advancements in neuroimaging techniques have revolutionized the field of cerebrovascular disease diagnosis and assessment. This comprehensive review aims to provide a detailed analysis of the novel imaging methods used in the diagnosis and assessment of cerebrovascular diseases. We discuss the applications of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography, highlighting their strengths and limitations. Furthermore, we delve into the emerging imaging techniques, including perfusion imaging, diffusion tensor imaging (DTI), and molecular imaging, exploring their potential contributions to the field. Understanding these novel imaging methods is necessary for accurate diagnosis, effective treatment planning, and monitoring the progression of cerebrovascular diseases.

Assessment of the impact of Tianwan Nuclear Power Plant on the adjacent marine ecosystem.

Based on the monitoring data of 137Cs and 90Sr in Tian Bay in 2005-2023, the impacts of the operation of Tianwan Nuclear Power Plant on the marine ecosystem were assessed. The 137Cs and 90Sr activity concentrations in the seawater and sediment varied within the background ranges. The radiation dose rates derived from 137Cs and 90Sr for the marine organisms ranged from 2.4 × 10-5 to 2.2 × 10-4 nGy/h, it was far below the most conservative screening dose rate (10 µGy/h). The committed effective dose for humans was 0.070-0.094 µSv, 1/1500th of the world's mean annual effective dose (0.12 mSv) from ingesting food containing uranium and thorium series nuclides. Radiation risk assessment showed no radiation risk for the long-term discharge of nuclear wastes in the future. Overall, the long-term normal operation of TNPPs has almost no radiation impact on the adjacent marine ecosystem.

Assessment of radiation in fishes derived from radiocesium in the port of Fukushima Daiichi nuclear power plant.

This study established specialized radiation dose models to evaluate the internal radiation doses derived from 137Cs and 134Cs in fishes in the port of the Fukushima Daiichi Nuclear Power Plant from 2012 to 2023. By August 2018, the activities of 134Cs and 137Cs in fishes decreased at the T1/2 of 176 d and 191 d, respectively. The corresponding mass concentrations were far lower than 1 mg/kg and the chemical toxicity can be negligible. Regarding radiotoxicity, 18,000 Bq/kgfresh weight of 134Cs and 137Cs in grouper Sebastes schlegelii produced 276 µGy/h of radiation dose, which was below the no-effect-dose-rate benchmarks (400 µGy/h). 740,000 Bq/kgfresh weight of 134Cs and 137Cs in greenling Hexagrammos otakii produced 12,600 µGy/h of radiation dose, which was much higher than 400 µGy/h, indicating the possibility of radiation effects. If a person eats these two reported fishes, the resulting committed effective doses for humans are 7.7 µSv and 6.31 mSv, respectively.

Completely Non-Fused Low-Cost Acceptor Enables Organic Photovoltaic Cells with 17 % Efficiency.

To meet the industrial requirements of organic photovoltaic (OPV) cells, it is imperative to accelerate the development of cost-effective materials. Thiophene-benzene-thiophene central unit-based acceptors possess the advantage of low synthetic cost, while their power conversion efficiency (PCE) is relatively low. Here, by incorporating a para-substituted benzene unit and 1st-position branched alkoxy chains with large steric hindrance, a completely non-fused non-fullerene acceptor, TBT-26, was designed and synthesized. The narrow band gap of 1.38 eV ensures the effective utilization of sunlight. The favorable phase separation morphology of TBT-26-based blend film facilitates the efficient exciton dissociation and charge transport in corresponding OPV cell. Therefore, the TBT-26-based small-area cell achieves an impressive PCE of 17.0 %, which is the highest value of completely non-fused OPV cells. Additionally, we successfully demonstrated the scalability of this design by fabricating a 28.8 cm2 module with a high PCE of 14.3 %. Overall, our work provides a practical molecular design strategy for developing high-performance and low-cost acceptors, paving the way for industrial applications of OPV technology.

Cost-Effective Cathode Interlayer Material for Scalable Organic Photovoltaic Cells.

Organic photovoltaic (OPV) cells have demonstrated remarkable success on the laboratory scale. However, the lack of cathode interlayer materials for large-scale production still limits their practical application. Here, we rationally designed and synthesized a cathode interlayer, named NDI-Ph. Benefiting from their well-modulated work function and self-doping effect, NDI-Ph-based binary OPV cells achieve an excellent power conversion efficiency (PCE) of 19.1%. NDI-Ph can be easily synthesized on a 100 g scale with a low cost of 1.96 $ g-1 using low-cost raw materials and a simple postprocessing method. In addition, the insensitivity to the film thickness of NDI-Ph enables it to maintain a high PCE at various coating speeds and solution concentrations, demonstrating excellent adaptability for high-throughput OPV cell manufacturing. As a result, a module with 21.9 cm2 active area achieves a remarkable PCEactive of 15.8%, underscoring the prospects of NDI-Ph in the large-scale production of OPV cells.

Bacterial transformation of lignin: key enzymes and high-value products.

Lignin, a natural organic polymer that is recyclable and inexpensive, serves as one of the most abundant green resources in nature. With the increasing consumption of fossil fuels and the deterioration of the environment, the development and utilization of renewable resources have attracted considerable attention. Therefore, the effective and comprehensive utilization of lignin has become an important global research topic, with the goal of environmental protection and economic development. This review focused on the bacteria and enzymes that can bio-transform lignin, focusing on the main ways that lignin can be utilized to produce high-value chemical products. Bacillus has demonstrated the most prominent effect on lignin degradation, with 89% lignin degradation by Bacillus cereus. Furthermore, several bacterial enzymes were discussed that can act on lignin, with the main enzymes consisting of dye-decolorizing peroxidases and laccase. Finally, low-molecular-weight lignin compounds were converted into value-added products through specific reaction pathways. These bacteria and enzymes may become potential candidates for efficient lignin degradation in the future, providing a method for lignin high-value conversion. In addition, the bacterial metabolic pathways convert lignin-derived aromatics into intermediates through the "biological funnel", achieving the biosynthesis of value-added products. The utilization of this "biological funnel" of aromatic compounds may address the heterogeneous issue of the aromatic products obtained via lignin depolymerization. This may also simplify the separation of downstream target products and provide avenues for the commercial application of lignin conversion into high-value products.

Low-cost BPO4 In Situ Synthetic Li3PO4 Coating and B/P-Doping to Boost 4.8 V Cyclability for Sulfide-Based All-Solid-State Lithium Batteries.

Structural damage of Ni-rich layered oxide cathodes such as LiNi0.8Co0.1Mn0.1O2 (NCM811) and serious interfacial side reactions and physical contact failures with sulfide electrolytes (SEs) are the main obstacles restricting ≥4.6 V high-voltage cyclability of all-solid-state lithium batteries (ASSLBs). To tackle this constraint, here, a modified NCM811 with Li3PO4 coating and B/P co-doping using inexpensive BPO4 as raw materials via the one-step in situ synthesis process is presented. Phosphates have good electrochemical stability and contain the same anion (O2-) and cation (P5+) as in cathode and SEs, respectively, thus Li3PO4 coating precludes interfacial anion exchange, lessening side reactivity. Based on the high bond energy of B─O and P─O, the lattice O and crystal texture of NCM811 can be stabilized by B3+/P5+ co-doping, thereby suppressing microcracks during high-voltage cycling. Therefore, when tested in combination with Li─In anode and Li6PS5Cl solid electrolytes (LPSCl), the modified NCM811 exhibits extraordinary performance, with 200.36 mAh g-1 initial discharge capacity (4.6 V), cycling 2300 cycles with decay rate as low as 0.01% per cycle (1C), and 208.26 mAh g-1 initial discharge capacity (4.8 V), cycling 1986 cycles with 0.02% per cycle decay rate. Simultaneously, it also has remarkable electrochemical abilities at both -20 °C and 60 °C.

Assessment of Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction and communication and the presence of restricted interests and repetitive behaviors. The importance of early detection of ASD and subsequent early intervention is well documented. Efforts have been made over the years to clarify ASD diagnostic criteria and develop predictive, accurate screening tools and evidence-based, standardized diagnostic instruments to aid in the identification of ASD. In this article, we review the most recent changes in ASD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, summarize evidence-based instruments for ASD screening and diagnostic evaluations as well as the assessment of co-occurring conditions in ASD, the impact of COVID-19 on ASD assessment, and directions for future research in the field of ASD assessment.

Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol.

As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine (TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials. Please cite this article as: Wang XC, Liu XY, Shi KL, Meng QG, Yu YF, Wang SY, Wang J, Qu C, Lei C, Yu XP. Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol. J Integr Med. 2023; 21(6): 528-536.

Trade-offs and synergies relationships of ecosystem services and their socio-ecological driving factors under different spatial scales in Shaoguan City, Guangdong, China.

Ecosystem services refer to the benefits that human obtain from natural ecosystems. Different ecosystem services are generated by the combination of social-ecological driving factors, and exhibit different spatial patterns across scales. The complex relationships and driving mechanisms among ecosystem services under different spatial scales remain unclear. With Shaoguan City from Guangdong Province as the study area, we analyzed the spatial patterns and relationships of four ecosystem services and their trade-offs/synergies (TOSs), quantified their responses to seven social-ecological drivers at the kilometer grid scale and sub-watershed scale, and proposed regional ecologi-cal management and planning strategies for cross-scale sustainable development. The results showed that the spatial distribution of ecosystem services in Shaoguan City exhibited spatial clustering and cross-scale variations. Habitat quality, water yield, and carbon storage exhibited similar spatial distribution pattern. High supply was mainly distributed in mountainous areas in the east, north, west, and south, while weak supply was distributed in plain areas in the central, northwest, south and northeast. In addition, the spatial clustering of these services intensified with increasing spatial scale. Ecosystem services displayed synergistic relationships at both spatial scales, and the intensity of the synergy changed with scale. At both the kilometer grid and sub-watershed scale, the primary drivers for ecosystem services were the normalized vegetation index and digital elevation model. The main driver for TOSs was the mean annual temperature at the kilometer grid scale, while it was the mean annual evapotranspiration at the sub-watershed scale. Based on the supply levels of ecosystem services, the study area could be divided into five distinct ecosystem service bundles, i.e., mountain ecological balance zone, forest ecological conservation zone, urban forest maintenance zone, ecologically sensitive zone, and ecological risk zone. All bundles exhibited both spatial heterogeneity and cross-scale variations. We integrated the cross-scale variations of four representative ecosystem services and their complex interactions and driving mechanisms in Shaoguan City into spatial planning to facilitate the sustainable ecosystem management across multiple scales, which could offer valuable references for the construction of ecological civilization in other regions.

Low-Cost Fully Non-fused Ring Acceptor Enables Efficient Organic Photovoltaic Modules for Multi-Scene Applications.

Organic photovoltaic (OPV) cells, with highly tunable light-response ranges, offer significant potential for use in driving low-power consumption off-grid electronics in multi-scenarios. However, development of photoactive layer materials that can meet simultaneously the requirements of diverse irradiation conditions is a still challenging task. Herein, a low-cost fully non-fused acceptor (denoted as GS60) featuring well-matched absorption spectra with solar, scattered light and artificial light radiation was designed and synthesized. Systematic characterizations revealed that GS60 possessed outstanding photoelectron properties and ideal morphology, which resulted in reduced voltage loss and suppressed charge recombination. By blending with a non-fused ring polymer PTVT-T, the as-obtained GS60 based OPV cells achieved a good power conversion efficiency (PCE) of 14.1 %, a high value for the cells based on non-fused ring bulk heterojunction. Besides, manufactured large-area OPV modules based on PTVT-T:GS60 yielded PCEs of 11.2 %, 11.8 %, 12.1 %, 23.1 %, and 20.3 % under irradiation of AM 1.5G, natural light of cloudy weather, natural light in shadow, laser and indoor, respectively. The PTVT-T:GS60 devices exhibited considerable potential in terms of improving photostability and reducing material cost. Overall, this work provides novel insight into the molecular design of low-cost non-fused ring acceptors, and extended potential of medium band gap acceptors based OPV cells used in various application scenarios.

Environmental management through examining the technical factors of carbon emissions in South Asian economies.

COP27 has provided a new direction in overcoming the issue of climate change. In the world of growing environmental degradation and climate change issues, the South Asian economies are playing a vital role in tackling these issues. Still, the literature focuses on industrialized economies while ignoring the newly emerging economies. This study evaluates the technological factors' influence on carbon emission in the four small South Asian economies (Sri Lanka, Bangladesh, Pakistan, and India) from 1989 to 2021. This study found the long-run equilibrium relationship between the variables using second-generation estimating tools. Employing the non-parametric and robust parametric approach, this study found that economic performance and development are substantial emissions drivers. In contrast, energy technology and tech innovation are the region's key environmental sustainability factors. Further, the study found that trade positively yet insignificantly impacts pollution. This study suggests further investment in energy technology and technological innovation to improve the production of energy-efficient products and services in these emerging economies.

The Roles of Carbon Trading System and Sustainable Energy Strategies in Reducing Carbon Emissions-An Empirical Study in China with Panel Data.

Carbon emission reduction is now a vital element in urban development. This study explores the effectiveness of the two emerging methods to reduce carbon emission, which are carbon emissions trading system (ETS) and sustainable energy strategy, in the process of urbanization. We review the policy in the past decades to demonstrate the development of these two streams of carbon emission reduction methods and empirically test the effectiveness of the two methods with panel data across 30 provinces in China from 2009 to 2019. The sustainable energy strategy is confirmed to be effective in reducing carbon emissions in the region, while the effectiveness of carbon emissions trading system varies. We find that (1) substituting fossil fuel with other sustainable energy resources can effectively reduce the carbon emission; (2) the rewards from carbon emissions trading is a good incentive for the enterprises to reduce the carbon emissions; however, it is more tempting in the provinces that have the carbon emissions trading system, although the trading can be conducted across the province boarder. Our findings indicate that the sustainable energy strategy is a good practice and worth expanding to the whole country. It can be difficult for some provinces to transform and adopt the sustainable energy strategy if the fossil fuel is the major source for economic production. It is important to avoid setting fossil fuel as the main source for economic production or household consumption in the urbanization process. Meanwhile the carbon emissions trading system is found to contribute to CO2 emissions reduction only within the province. Therefore, having more provinces piloting the ETS will help the CO2 emission reduction further.

Assessment of oligometastasis status of prostate cancer following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone using PSA percentage decline rate.

Objective: To compare the tumor control in prostate cancer patients with oligo-metastasis following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone based on total prostate-specific antigen (tPSA) assessment. Methods: Medical data of a total of 18 prostate cancer patients with oligometastasis administered in The First Affiliated Hospital of Nanchang University from March 2017 to March 2018 were prospectively collected. 10 patients received a combined therapy of robot-assisted radical prostatectomy and pharmaceutical androgen deprivation (RARP+ADT group), while 8 patients received pharmaceutical androgen deprivation therapy alone (ADT group). Then demographic characteristics, prostate volume, tumor characteristics and tPSA data were analysised and compared. Statistical analysis was performed using t-test for continuous variables and Pearson chi-square test or Fisher's exact test for categorical variables. Results: No significant difference was found in patients' age (p = 0.075), prostate volume (p = 0.134) and number of bone metastasis (p = 0.342). Pre-treatment Gleason score was significantly lower in RA group (p = 0.003). Patients in RARP+ADT group had significantly lower pre-treatment tPSA (p = 0.014), while no statistical difference was noted in reexamined tPSA (p = 0.140) on follow-up. No statistical difference was noted in tPSA decline rates (declined tPSA value per day) in RARP+ADT and ADT group (8.1 ± 4.7 verse 7.5 ± 8.0 ng/ml/d, p = 0.853). However, tPSA percentage decline rate (declined tPSA percentage per day) was significantly higher in RARP+ADT group (11.6 ± 1.5%/d verses 2.9 ± 2.2%/d, p< 0.001). Immediate urinary continence was achieved in 9 patients (90%) upon removal of urethral catheter on post-operative day 7 in RARP+ADT group. Conclusion: ADT alone and in combination with RARP both provide effective tumor control in patients suffering from prostate cancer with oligometastasis. ADT combined with RARP exhibited significant advantage in PSA percentage decline rate without compromising patients' urinary continence. Long-term tumor control requires further follow-up.

DOSE CALCULATION OF PROTON THERAPY BASED ON MONTE CARLO AND EMPIRICAL FORMULA.

In this work, we used the Monte Carlo-based TOPAS simulation software to calculate the ambient dose equivalents and annual effective dose due to the secondary neutron field produced in proton therapy, also we introduced a USTC phantom to access the organ equivalent dose. The ambient dose equivalent and annual effective dose were calculated in several positions of interest inside and outside the facility. The simulation results were compared qualitatively to the results of the Empirical Formula, showing that the Empirical Formula calculations overestimated the dose, 28.95 times higher than the MC simulations, on average, which would lead to over shielding. In addition, the highest equivalent dose rate of a single radiation-sensitive organ simulated by TOPAS was 1.50 × 10-9 mSv/a for the eye lens, 2.36 × 10-3 mSv/a for limbs and 1.01 × 10-3 mSv/a for skin, which also meets the limits. Therefore, MC simulation has great advantages in shielding design and safety evaluation. And this work presents a new method to calculate the dose, introducing a more anthropogenic phantom can get more realistic results.

Unique roles in health promotion of dietary flavonoids through gut microbiota regulation: Current understanding and future perspectives.

Advances in understanding the biological effects of dietary flavonoids and flavonoid-rich foods have been reported. Improving knowledge about their beneficial effects, and mechanisms of action, is crucial for better utilization. However, mechanisms responsible for their health benefits are still unclear. Previous research considered has suggested that gut microbiota might be linked to the metabolism of dietary flavonoids. To understand the bioactivities of dietary flavonoids/flavonoid-rich foods better, and the role of microbiota, we explored systematically 1) types of dietary flavonoids and associated health benefits, 2) low bioaccessibilities and metabolic characteristics, 3) gut microbiota role in regulation, and 4) crosstalk between regulation mechanisms. Current challenges and future perspectives were also considered, offering new research directions and identifying trends in the development of flavonoid-rich food products.

Global disease burden and trends of leukemia attributable to occupational risk from 1990 to 2019: An observational trend study.

Background: Leukemia caused by occupational risk is a problem that needs more attention and remains to be solved urgently, especially for acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphoid leukemia (CLL). However, there is a paucity of literature on this issue. We aimed to assess the global burden and trends of leukemia attributable to occupational risk from 1990 to 2019. Methods: This observational trend study was based on the Global Burden of Disease (GBD) 2019 database, the global deaths, and disability-adjusted life years (DALYs), which were calculated to quantify the changing trend of leukemia attributable to occupational risk, were analyzed by age, year, geographical location, and socio-demographic index (SDI), and the corresponding estimated annual percentage change (EAPC) values were calculated. Results: Global age-standardized DALYs and death rates of leukemia attributable to occupational risk presented significantly decline trends with EAPC [-0.38% (95% CI: -0.58 to -0.18%) for DALYs and -0.30% (95% CI: -0.45 to -0.146%) for death]. However, it was significantly increased in people aged 65-69 years [0.42% (95% CI: 0.30-0.55%) for DALYs and 0.38% (95% CI: 0.26-0.51%) for death]. At the same time, the age-standardized DALYs and death rates of ALL, AML, and CLL were presented a significantly increased trend with EAPCs [0.78% (95% CI: 0.65-0.91%), 0.87% (95% CI: 0.81-0.93%), and 0.66% (95% CI: 0.51-0.81%) for DALYs, respectively, and 0.75% (95% CI: 0.68-0.82%), 0.96% (95% CI: 0.91-1.01%), and 0.55% (95% CI: 0.43-0.68%) for death], respectively. The ALL, AML, and CLL were shown an upward trend in almost all age groups. Conclusion: We observed a substantial reduction in leukemia due to occupational risks between 1990 and 2019. However, the people aged 65-69 years and burdens of ALL, AML, and CLL had a significantly increased trend in almost all age groups. Thus, there remains an urgent need to accelerate efforts to reduce leukemia attributable to occupational risk-related death burden in this population and specific causes.

Integration of reginal shear measurements at the foot-ground interface during routine balance assessment of the elderly population.

BACKGROUND: Force-plate posturography offers a convenient way for quantitative assessment of postural stability in the elderly. However, studies focusing on routine balance assessment have usually not taken reginal shear distributions (i.e., arising from horizontal forces) into consideration. RESEARCH QUESTION: (1) Does plantar shear distribution differ between young and elderly subjects during upright standing? (2) How do the maximum plantar shear forces vary at different regions of the foot? METHODS: The new reginal shear measurement (RSM) method can simultaneously capture the three-dimensional force distributions at regional plantar sites while subjects maintaining standing balance. The feasibility of the proposed method in characterizing the magnitude and distribution of plantar shear forces was tested in thirty-two normal young and nineteen elderly subjects. Statistical analysis was performed using the independent samples t-test for both the continuous and ordinal variables. RESULTS: For regional AP shear forces, statistically significant differences were found between the two groups for the toe region of the right foot and the midfoot of both feet. For ML shear distributions, statistically significant differences were found at nearly all plantar sites expect for the hallux and lateral metatarsal. The maximum increase in ML shear forces occurred in the toe region of the right foot, where the peak shear values were 113.16% higher than those of the young subjects. The peak ML shear occurred in the midfoot were averagely 83.19% and 70.57% higher in the elderly's left and right feet, respectively. SIGNIFICANCE: The RSM method may offer unique solutions to identify functional decline in postural control of the elderly. The plantar shear pattern has potential to become an important parameter in evaluating one's balance performance during upright standing.

Development of a Convolutional Neural Network-Based Colonoscopy Image Assessment Model for Differentiating Crohn's Disease and Ulcerative Colitis.

Objective: Evaluation of the endoscopic features of Crohn's disease (CD) and ulcerative colitis (UC) is the key diagnostic approach in distinguishing these two diseases. However, making diagnostic differentiation of endoscopic images requires precise interpretation by experienced clinicians, which remains a challenge to date. Therefore, this study aimed to establish a convolutional neural network (CNN)-based model to facilitate the diagnostic classification among CD, UC, and healthy controls based on colonoscopy images. Methods: A total of 15,330 eligible colonoscopy images from 217 CD patients, 279 UC patients, and 100 healthy subjects recorded in the endoscopic database of Tongji Hospital were retrospectively collected. After selecting the ResNeXt-101 network, it was trained to classify endoscopic images either as CD, UC, or normal. We assessed its performance by comparing the per-image and per-patient parameters of the classification task with that of the six clinicians of different seniority. Results: In per-image analysis, ResNeXt-101 achieved an overall accuracy of 92.04% for the three-category classification task, which was higher than that of the six clinicians (90.67, 78.33, 86.08, 73.66, 58.30, and 86.21%, respectively). ResNeXt-101 also showed higher differential diagnosis accuracy compared with the best performing clinician (CD 92.39 vs. 91.70%; UC 93.35 vs. 92.39%; normal 98.35 vs. 97.26%). In per-patient analysis, the overall accuracy of the CNN model was 90.91%, compared with 93.94, 78.79, 83.33, 59.09, 56.06, and 90.91% of the clinicians, respectively. Conclusion: The ResNeXt-101 model, established in our study, performed superior to most clinicians in classifying the colonoscopy images as CD, UC, or healthy subjects, suggesting its potential applications in clinical settings.

Treatment and economic burden of mucormycosis in China: Case report review and burden estimation.

WHAT IS KNOWN AND OBJECTIVE: Mucormycosis is an opportunistic fungal infection associated with low incidence but high mortality. Few studies have shown the treatment and disease burden of mucormycosis in China. This study aims at collecting all the reported cases to describe the characteristics and treatment patterns and to assess the economic burden of mucormycosis in China. METHODS: We conducted a literature review of mucormycosis case reports in Chinese patients to summarize the characteristics and treatment patterns of the disease in China. An economic model was built to evaluate the total cost of mucormycosis per person, including direct medical cost, direct non-medical cost and indirect cost. RESULTS AND DISCUSSION: A total of 676 case reports showed that the most common type of mucormycosis was pulmonary mucormycosis (299/676, 44.2%), and rhinocerebral mucormycosis had the highest case fatality rate (122/185, 68.5%). Among those who used empiric therapies, 48.8% (231/473) did not include anti-mucor drugs; 79.8% (336/421) of the therapies include amphotericin B (AMB) or AMB-lipo after detection of mucormycetes; 98.6% (69/70) of the reported adverse events were associated with AMB and AMB-lipo. The duration of treatment ranged from 90 to 180 days; the length of stay ranged from 22 to 95 days. The average total cost per patient was 166 thousand Chinese Yuan (CNY), of which 93.1% was the direct medical cost (155 thousand CNY). WHAT IS NEW AND CONCLUSION: There are a limited number of antifungal treatment options for mucormycosis in China. This study highlights the critical need to introduce innovative and broader spectrum antifungal drugs with improved safety, better clinical efficacy, easier administration and reduced economic burden to Chinese mucormycosis patients.