A Metric of Societal Burden Based on Virus Succession to Determine Economic Losses and Health Benefits of China's Lockdown Policies: Model Development and Validation.

BACKGROUND: The COVID-19 pandemic had a profound impact on the global health system and economic structure. Although the implementation of lockdown measures achieved notable success in curbing the spread of the pandemic, it concurrently incurred substantial socioeconomic costs. OBJECTIVE: The objective of this study was to delineate an equilibrium between the economic losses and health benefits of lockdown measures, with the aim of identifying the optimal boundary conditions for implementing these measures at various pandemic phases. METHODS: This study used a model to estimate the half-lives of the observed case fatality rates of different strains. It was based on global infection and death data collected by the World Health Organization and strain sequence time series data provided by Nextstrain. The connection between the health benefits and economic losses brought by lockdown measures was established through the calculation of disability-adjusted life years. Taking China's city lockdowns as an example, this study determined the cost-benefit boundary of various lockdown measures during the evolution of COVID-19. RESULTS: The study reveals a direct proportionality between economic losses due to lockdowns and the observed case fatality rates of virus strains, a relationship that holds true irrespective of population size or per capita economic output. As SARS-CoV-2 strains evolve and population immunity shifts, there has been a notable decrease in the observed case fatality rate over time, exhibiting a half-life of roughly 8 months. This decline in fatality rates may offset the health benefits of maintaining unchanged lockdown measures, given that the resultant economic losses might exceed the health benefits. CONCLUSIONS: The initial enforcement of lockdown in Wuhan led to significant health benefits. However, with the decline in the observed case fatality rate of the virus strains, the economic losses increasingly outweighed the health benefits. Consequently, it is essential to consistently refine and enhance lockdown strategies in accordance with the evolving fatality and infection rates of different virus strains, thereby optimizing outcomes in anticipation of future pandemics.

An Assessment of Administration Route on MSC-sEV Therapeutic Efficacy.

Mesenchymal stem/stromal cell-derived small extracellular vesicles (MSC-sEVs) are promising therapeutic agents. In this study, we investigated how the administration route of MSC-sEVs affects their therapeutic efficacy in a mouse model of bleomycin (BLM)-induced skin scleroderma (SSc). We evaluated the impact of topical (TOP), subcutaneous (SC), and intraperitoneal (IP) administration of MSC-sEVs on dermal fibrosis, collagen density, and thickness. All three routes of administration significantly reduced BLM-induced fibrosis in the skin, as determined by Masson's Trichrome staining. However, only TOP administration reduced BLM-induced dermal collagen density, with no effect on dermal thickness observed for all administration routes. Moreover, SC, but not TOP or IP administration, increased anti-inflammatory profibrotic CD163+ M2 macrophages. These findings indicate that the administration route influences the therapeutic efficacy of MSC-sEVs in alleviating dermal fibrosis, with TOP administration being the most effective, and this efficacy is not mediated by M2 macrophages. Since both TOP and SC administration target the skin, the difference in their efficacy likely stems from variations in MSC-sEV delivery in the skin. Fluorescence-labelled TOP, but not SC MSC-sEVs when applied to skin explant cultures, localized in the stratum corneum. Hence, the superior efficacy of TOP over SC MSC-sEVs could be attributed to this localization. A comparison of the proteomes of stratum corneum and MSC-sEVs revealed the presence of >100 common proteins. Most of these proteins, such as filaggrin, were known to be crucial for maintaining skin barrier function against irritants and toxins, thereby mitigating inflammation-induced fibrosis. Therefore, the superior efficacy of TOP MSC-sEVs over SC and IP MSC-sEVs against SSc is mediated by the delivery of proteins to the stratum corneum to reinforce the skin barrier.

Assessment of the Diuretic Properties of Rice Bean Accessions Using a Mouse Model and Identification of Active Polyphenolic Compounds.

Rice bean [Vigna umbellata (Thunb.) Ohwi and Ohashi], an annual legume in the genus Vigna, is a promising crop suitable for cultivation in a changing climate to ensure food security. It is also a medicinal plant widely used in traditional Chinese medicine; however, little is known about the medicinal compounds in rice bean. In this study, we assessed the diuretic effect of rice bean extracts on mice as well as its relationship with the contents of eight secondary metabolites in seeds. Mice gavaged with rice bean extracts from yellow and black seeds had higher urinary output (5.44-5.47 g) and water intake (5.8-6.3 g) values than mice gavaged with rice bean extracts from red seeds. Correlation analyses revealed significant negative correlations between urine output and gallic acid (R = -0.70) and genistein (R = -0.75) concentrations, suggesting that these two polyphenols negatively regulate diuresis. There were no obvious relationships between mice diuresis-related indices (urine output, water intake, and weight loss) and rutin or catechin contents, although the concentrations of both of these polyphenols in rice bean seeds were higher than the concentrations of the other six secondary metabolites. Our study findings may be useful for future research on the diuretic effects of rice bean, but they should be confirmed on the basis of systematic medical trials.

Wealthy individual investors and stock markets' tail risk.

This paper employs a unique data set to analyze the trading behavior of wealthy individual investors across Mainland China and their impact on Chinese stock markets' tail risk. Results show that the wealthy individual investors' trading behavior can explain Chinese stock markets' tail risk, and the daily investment portfolios based on the network density of wealthy individual investors have significant excess returns. This paper also investigates the determinants of wealthy individual investors' trading behavior with the social network method and the spatial econometric model, and reveals that wealthy individuals benefit from the spillover effect of their trading behavior through the investor networks. The results of this paper not only reveal micro evidence for the formation mechanism of asset prices, but also provide insight into the behavior of wealthy individual investors.

Is cognitive behavioral therapy for insomnia more cost-effective? New-perspective on economic evaluations: a systematic review and meta-analysis.

STUDY OBJECTIVES: To investigate the cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI), with an additional focus on digital CBTI (dCBTI) in adults with insomnia. METHODS: We searched eight electronic databases for economic evaluations of CBTI: PubMed, Scopus, Web of Science, psycINFO, Cochrane, Library, CINAHL, ProQuest, and National Health Service Economic Evaluation Database. Meta-analyses were performed to investigate the effects and costs between CBTI and control groups (no treatment, other treatments included hygiene education and treatment as usual). Subgroup analyses for dCBTI were conducted. RESULTS: Twelve randomized controlled trial studies between 2004 and 2023 were included in our systematic review and meta-analyses. The incremental cost-utility ratios and incremental cost-effectiveness ratios showed that the CBTI and dCBTI groups were more cost-effective than controls, from healthcare perspective and societal perspective, respectively. Compared to controls, CBTI demonstrated significantly better efficacy within 12 months. Healthcare costs were significantly higher in the CBTI groups compared to the controls within 6 months but there was no difference at 12 months. Additionally, dCBTI was associated with significantly lower presenteeism costs compared to controls at 6 months. CONCLUSIONS: Our findings suggest that CBTI is more cost-effective than other treatments or no treatment for adults with insomnia. It may bring more economic benefits in the long term, especially in long-lasting efficacy and cost reduction. In addition, dCBTI is one of the cost-effective options for insomnia. PROSPERO REGISTRATION NUMBER: CRD42 022 383 440. URL: www.crd.york.ac.uk/PROSPERO. NAME FOR PROSPERO REGISTRATION: Cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI): a systematic review with meta-analysis.

Immune Assessment Today: Optimizing and Standardizing Efforts to Monitor Immune Responses in Cancer and Beyond.

As part of a symposium, current and former directors of Immune Monitoring cores and investigative oncologists presented insights into the past, present and future of immune assessment. Dr. Gnjatic presented a classification of immune monitoring technologies ranging from universally applicable to experimental protocols, while emphasizing the need for assay harmonization. Dr. Obeng discussed physiologic differences among CD8 T cells that align with anti-tumor responses. Dr. Lyerly presented the Soldano Ferrone lecture, commemorating the passionate tumor immunologist who inspired many, and covered a timeline of monitoring technology development and its importance to immuno-oncology. Dr. Sonabend presented recent achievements in glioblastoma treatment, accentuating the range of monitoring techniques that allowed him to refine patient selection for clinical trials. Dr. Guevara-Patiño focused on hypoxia within the tumor environment and stressed that T cell viability is not to be confused with functionality. Dr. Butterfield accentuated monitoring of dendritic cell metabolic (dys)function as a determinant for tumor vaccine success. Lectures were interspersed with select abstract presentations. To summarize the concepts, Dr. Maecker from Stanford led an informative forum discussion, pointing towards the future of immune monitoring. Immune monitoring continues to be a guiding light towards effective immunotherapeutic strategies.

Coordinated development of green finance and green technology innovation in China: from the perspective of network characteristics and prediction.

Under the path of sustainable development, the key to achieving green and low-carbon transformation lies in green technology innovation (GTI), and how to effectively coordinate the relationship between green finance (GF) and GTI is an issue worth studying. This paper constructed an evaluation system of GF and GTI and combined them with the coupled coordination degree model to explore their coordination of Chinese provinces from 2012 to 2019. Then, the core network evolution and spatial structure characteristics of GTI and GF were studied using the modified gravity model. Finally, based on the link prediction, the general future network prediction is made to provide guidance and direction for the future GTI and GF development and construction. The results found that the coordination level between GF and GTI has been continuously improved from 0.356 to 0.436. The core network structure is keeping changing with their connection becoming more complex, and there is still room for optimization. Network centrality characteristics show that the spatial spillover effects are stronger in the more economically developed regions. The overall network possibility prediction shows the potential network connections in different urban agglomerations. This paper provides a certain reference role for China and developing countries to predict the GF and GTI cooperation network development in the future.

An IMU-Based Ground Reaction Force Estimation Method and Its Application in Walking Balance Assessment.

Walking is one of the most common daily movements of the human body. Therefore, quantitative evaluation of human walking has been commonly used to assist doctors in grasping the disease degree and rehabilitation process of patients in the clinic. Compared with the kinematic characteristics, the ground reaction force (GRF) during walking can directly reflect the dynamic characteristics of human walking. It can further help doctors understand the degree of muscle recovery and joint coordination of patients. This paper proposes a GRF estimation method based on the elastic elements and Newton-Euler equation hybrid driving GRF estimation method. Compared with the existing research, the innovations are as follows. 1) The hardware system consists of only two inertial measurement units (IMUs) placed on shanks. The acquisition of the overall motion characteristics of human walking is realized through the simplified four-link walking model and the thigh prediction method. 2) The method was validated not only on 10 healthy subjects but also on 11 Parkinson's patients and 10 stroke patients with normalized mean absolute errors (NMAEs) of 5.95%±1.32%, 6.09%±2.00%, 5.87%±1.59%. 3) This paper proposes a dynamic balance assessment method based on the acquired motion data and the estimated GRF. It evaluates the overall balance ability and fall risk at four key time points for all subjects recruited. Because of the low-cost system, ease of use, low motion interference and environmental constraints, and high estimation accuracy, the proposed GRF estimation method and walking balance automatic assessment have broad clinical value.

Study on the coupling coordination development of China's multidimensional digital economy and industrial carbon emission efficiency.

Exploring the coupling coordination between China's digital economy (DE) and industrial carbon emission efficiency (ICEE) is of great significance for achieving sustainable development goals. In the study, a multidimensional indicator system was established to evaluate DE, and spatiotemporal analysis and network analysis methods were used to reveal the dynamic evolution characteristics of DE and ICEE. The coupling coordination model and convergence model were adopted to explore the development trend of coupling coordination between DE and ICEE. The results show that the ICEE and DE in various provinces of China exhibit obvious spatial heterogeneity and spillover effects. Currently, the coupling coordination degree between the development of China's DE and ICEE has reached the level of primary coordination or above. The coupling coordination degree between DE and ICEE in the eastern, central, and northeastern regions has reached an intermediate level or above, with the highest degree in the eastern region. The fluctuation of China's ICEE has consistent σ-convergence and ß-convergence, and the convergence effect is higher with the introduction of the DE than without it. The condition ß-convergence result indicates that underdeveloped regions can narrow the gap between their ICEE and that of developed regions by utilizing their resource endowments, industrial structure, human capital, and other conditions, improving emission reduction measures and policies. This study provides a certain reference for the green and low-carbon development of industry in China and other developing countries in the digital economy era.

A dual-core system dynamics approach for carbon emission spillover effects analysis and cross-regional policy simulation.

As carbon emission continue to rise and climate issues grow increasingly severe, countries worldwide have taken measures to reduce carbon emission. However, carbon dioxide is continuously flowing in the atmosphere and is easily influenced by neighboring cities' policies. Therefore, how to solve the problem of carbon emission spillover effect has become the key to improve policy efficiency. Cross-regional carbon governance provides a perspective on solving the carbon emission problem by regulating and guiding the cooperative behavior of cross-regional governance actors. Taking Chengdu-Chongqing area as an example, this study used the SDM to analyze the influencing factors and spatial spillover effects of emission. Then we used the system dynamics method to construct a dual-core carbon emission system, and simulated the spillover effect and emission reduction potential of Chengdu and Chongqing emission reduction policies under different policy schemes. The results reveal that the mobility of population and enterprises have a significant impact on carbon emission prediction. Carbon reduction policies exhibit the phenomena of "carbon transfer" and "free-riding." When Chengdu lowers its economic growth rate, it leads to the transfer of high energy-consuming enterprises to Chongqing, increasing carbon emission in Chongqing. The implementation of comprehensive carbon reduction policies in Chongqing has a positive effect on Chengdu. Emission reduction policies exhibit issues related to their temporal efficacy, as the effects of industrial structural policies in Chengdu yield opposite outcomes in the short and long term. Each city's unique circumstances necessitate tailored carbon reduction policies. In order to reduce carbon emissions, Chengdu and Chongqing require opposite population policies.

Dynamic simulation of carbon emission under different policy scenarios in Pearl River Delta urban agglomeration, China.

Global climate continues to warm; by reducing carbon emission (CE) to cope with climate warming has become a global consensus. The influencing factors of CE exhibit diversification and spatial characteristics, and the complexity of the CE system poses challenges to green and low-carbon development and the realization of China's dual-carbon goals. Taking the Pearl River Delta urban agglomeration as an example, this study explored the influencing factors of CE and designed emission reduction schemes with the help of multi-scale geographically weighted regression (MGWR). Based on this, the system dynamics model was used to construct a CE system framework considering multi-dimensional driving factors, so as to combine the complex CE system with the emission reduction countermeasures considering spatial heterogeneity, and realize the dynamic simulation of CE reduction policies. The results showed that the urban agglomeration as a whole will reach carbon peak by 2025. Shenzhen, Zhuhai, and Dongguan have achieved carbon peak before 2020, while other cities will reach carbon peak by 2025-2030. The government policy constraints can effectively curb CE, but if government constraints were relaxed, CE will rise and individual cities will not reach carbon peak. Comprehensive CE reduction policies are better than a single CE reduction policy. The study found that this model framework provides a systematic analysis of carbon reduction strategies for urban agglomerations, offering decision-makers various combinations of economic development and green low-carbon objectives. This will further contribute to a multi-faceted mitigation of high emission in urban agglomeration and promote regional sustainable development.

An economic evaluation of pit and fissure sealants and fluoride varnishes in preventing dental caries: a systematic review.

The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries prevention. We searched four electronic databases including the Cochrane Oral Health Group's Trials Register (till 03 June 2022), Web of Science (from 1945 to 03 June 2022), PubMed (from 1996 to 03 June 2022), and EMBASE via Ovid (from 1980 to 03 June 2022) to identify the cost and effectiveness of PFSs and FVs in decreasing dental caries incidence. Two researchers independently screened search results, extracted data from the included studies, and conducted the risk of bias assessments. The main characteristics of the included studies were extracted and analyzed. The initial search produced 874 articles. After removing duplicates and full-text review, 19 studies were included. In this study: nine studies were on PFSs comparison with control; five on PFSs comparison with FVs; and five on FVs comparison with control. Regarding the type of economic evaluation (EE), 13 studies conducted cost-effectiveness analysis, five conducted cost-utility analyses, and one conducted both cost-effectiveness analysis and cost-utility analyses. The cost-effectiveness evaluation of PFSs and FVs in the available studies was limited. The prevalence of dental caries, payers' willingness to pay, length of follow-ups, delivery settings, retention rate of PFS, and application intervals of FV can affect the economic evaluation of these two methods for dental caries prevention. Therefore, more studies in the future are need to draw clear conclusions about which method is more cost-effective for the two preventive interventions in future.

Health benefits from risk information of air pollution in China.

Risk-related information regarding air pollution can help people understand the risk involved and take preventive measures to reduce health loss. However, the health benefits through these protective behaviors and the health threat of information inequality have not been systematically measured. This article reports the health gains and losses caused by the interaction of "air pollution-air pollution information-human", and studies the heterogeneity and impact of this interaction. Based on field investigations and transfer learning algorism, this study compiled the first nationwide city-level risk-related information (ERI) response parameter set in China. Then, we developed a Information-Behavioral Equivalent PM2.5 Exposure Model (I-BEPEM) model to project the health benefits caused by the impact of environmental risk-related information on residents' protective behaviors under different scenarios. The protective behavior led by air pollution risk information reduces 5.7% PM2.5-related premature deaths per year. With a 1% increase in regional ERI reception, PM2.5-related premature mortality decreases by 0.1% on average; If the level of information perception and behavioral protection in all cities is the same as that in Beijing, PM2.5-related premature deaths will decrease by 6.9% annually in China. Further, changing the air quality standard issued by China to the American standard can reduce the overall PM2.5-related premature deaths by 9.9%. Meanwhile, compared with men, other age groups and rural residents, women, older persons, and urban residents are more likely to conceive risk information and adopt protective behaviors to reduce the risk of premature death from air pollution. Air pollution risk information can significantly reduce people's health loss. Changing the real-time air quality monitoring information indicator standard to a more stringent level can quickly and effectively enhance this effect. However, the uneven distribution of this information in regions and populations has resulted in the inequality of health gains and losses.

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.

Cost and Effectiveness of Percutaneous Endoscopic Interlaminar Discectomy versus Microscope-Assisted Tubular Discectomy for L5-S1 Lumbar Disc Herniation.

OBJECTIVE: To assess the cost and effectiveness of percutaneous endoscopic interlaminar discectomy (PEID) and microscope-assisted tubular discectomy (MATD) for patients with L5/S1 lumbar disc herniation (LDH). METHODS: The medical and financial records of patients diagnosed with L5/S1 LDH and who underwent either PEID or MATD from April 2021 to April 2022 were retrospectively collected. Demographic and baseline information, perioperative observational index, clinical outcomes, and inpatient costs were analyzed. RESULTS: Sixty patients were included, with 30 patients in the PEID group and 30 patients in the MATD group. No significant difference was found in demographic and baseline information between the 2 groups (P > 0.05). The PEID group showed significantly shorter incision length, less intraoperative blood loss, shorter hospital stays, and higher intraoperative fluoroscopy frequency compared with the MATD group (P < 0.05). There were no significant differences in visual analog scale back/leg score, Oswestry Disability Index, and 36-Item Short-Form Survey score between PEID and MATD groups before the surgery and at any follow-up time points (P > 0.05). The total cost, surgery cost, and surgical instruments/materials cost were significantly higher in the PEID group compared with the MATD group (P < 0.05). In contrast, the drug and nursing costs were significantly higher in the MATD group than in the PEID group (P < 0.05). CONCLUSIONS: PEID and MATD provide equivalent clinical efficacy and safety in treating LDH at L5/S1 segment within a 1-year follow-up. However, PEID is less invasive and MATD is less costly. No one surgical technique is superior in all aspects and patients should make decisions according to their top concern.

Role of comprehensive geriatric assessment in screening for mild cognitive disorders.

BACKGROUND: The role of comprehensive geriatric assessment (CGA) in screening for mild cognitive disorders was not known. AIM: To evaluate the role of CGA in screening for mild cognitive disorders. METHODS: A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis. Using Petersen as the diagnostic gold standard, healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group. The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed. Patients' Montreal Cognitive Assessment (MoCA) and CGA screening results were compared, and the sensitivity and specificity were calculated to assess the screening role of CGA. RESULTS: CGA assessment yielded higher diagnostic accuracy than MoCA. The results of the multivariate regression analysis showed no correlation of gender, age, body mass index and literacy with cognitive function. Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals (P < 0.05). In the CGA scale, patients with mild cognitive impairment showed significantly lower Mini-mental State Examination, Miniature Nutritional Assessment and Berg Balance Scale scores, and higher Activity of Daily Living, Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals (P < 0.05), whereas the other assessment scales showed no significant differences (P > 0.05). The CGA provides higher diagnostic sensitivity and specificity than the MoCA (P < 0.05). CONCLUSION: CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity, facilitating timely and effective intervention, and is thus recommended for clinical use.

Assessment of cardio-renal-hepatic function in patients with valvular heart disease: a multi-biomarker approach-the cardio-renal-hepatic score.

BACKGROUND: Valvular heart disease (VHD) can cause damage to extra-cardiac organs, and lead to multi-organ dysfunction. However, little is known about the cardio-renal-hepatic co-dysfunction, as well as its prognostic implications in patients with VHD. The study sought to develop a multi-biomarker index to assess heart, kidney, and liver function in an integrative fashion, and investigate the prognostic role of cardio-renal-hepatic function in VHD. METHODS: Using a large, contemporary, prospective cohort of 6004 patients with VHD, the study developed a multi-biomarker score for predicting all-cause mortality based on biomarkers reflecting heart, kidney, and liver function (N-terminal pro-B-type natriuretic peptide [NT-proBNP], creatinine, and albumin). The score was externally validated in another contemporary, prospective cohort of 3156 patients with VHD. RESULTS: During a median follow up of 731 (704-748) days, 594 (9.9%) deaths occurred. Increasing levels of NT-proBNP, creatinine, and albumin were independently and monotonically associated with mortality, and a weighted multi-biomarker index, named the cardio-renal-hepatic (CRH) score, was developed based on Cox regression coefficients of these biomarkers. The CRH score was a strong and independent predictor of mortality, with 1-point increase carrying over two times of mortality risk (overall adjusted hazard ratio [95% confidence interval]: 2.095 [1.891-2.320], P < 0.001). The score provided complementary prognostic information beyond conventional risk factors (C index: 0.78 vs 0.81; overall net reclassification improvement index [95% confidence interval]: 0.255 [0.204-0.299]; likelihood ratio test P < 0.001), and was identified as the most important predictor of mortality by the proportion of explainable log-likelihood ratio χ2 statistics, the best subset analysis, as well as the random survival forest analysis in most types of VHD. The predictive performance of the score was also demonstrated in patients under conservative treatment, with normal left ventricular systolic function, or with primary VHD. It achieved satisfactory discrimination (C index: 0.78 and 0.72) and calibration in both derivation and validation cohorts. CONCLUSIONS: A multi-biomarker index was developed to assess cardio-renal-hepatic function in patients with VHD. The cardio-renal-hepatic co-dysfunction is a powerful predictor of mortality and should be considered in clinical management decisions.

Assessment of androgen receptor expression in breast cancer patients using 18 F-FDG PET/CT radiomics and clinicopathological characteristics.

OBJECTIVE: In the present study, we mainly aimed to predict the expression of androgen receptor (AR) in breast cancer (BC) patients by combing radiomic features and clinicopathological factors in a non-invasive machine learning way. MATERIALS AND METHODS: A total of 48 BC patients, who were initially diagnosed by 18F-FDG PET/CT, were retrospectively enrolled in this study. LIFEx software was used to extract radiomic features based on PET and CT data. The most useful predictive features were selected by the LASSO (least absolute shrinkage and selection operator) regression and t-test. Radiomic signatures and clinicopathologic characteristics were incorporated to develop a prediction model using multivariable logistic regression analysis. The receiver operating characteristic (ROC) curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA) were conducted to assess the predictive efficiency of the model. RESULTS: In the univariate analysis, the metabolic tumor volume (MTV) was significantly correlated with the expression of AR in BC patients (p < 0.05). However, there only existed feeble correlations between estrogen receptor (ER), progesterone receptor (PR), and AR status (p = 0.127, p = 0.061, respectively). Based on the binary logistic regression method, MTV, SHAPE_SphericityCT (CT Sphericity from SHAPE), and GLCM_ContrastCT (CT Contrast from grey-level co-occurrence matrix) were included in the prediction model for AR expression. Among them, GLCM_ContrastCT was an independent predictor of AR status (OR = 9.00, p = 0.018). The area under the curve (AUC) of ROC in this model was 0.832. The p-value of the H-L test was beyond 0.05. CONCLUSIONS: A prediction model combining radiomic features and clinicopathological characteristics could be a promising approach to predict the expression of AR and noninvasively screen the BC patients who could benefit from anti-AR regimens.

An intelligent colony optimization imaging method for composites health monitoring using ultrasonic guided wave.

Damage imaging technology based on ultrasonic guided wave can characterize and visualize structural damage. However, current imaging methods require high accuracy in wave packets information extraction, resulting in artifacts, large spots and false imaging. Therefore, an intelligent colony optimization imaging method is proposed to transform the damage imaging problem into the scattering sources search problem. The number of imaging trajectories through potential scattering sources is employed as the fitness function to assess the damage possibility in this individual. The fitness function is further implemented to particle swarm optimization algorithm for iterative search of actual scattering sources to find out the damage area with highest damage possibility. After the scattering sources search, the location of the damage can be identified through observing the distribution of the population. The experimental results illustrate that the proposed intelligent imaging method can accurately locate the crack damage of different lengths and delamination damage in composites, and the damage imaging effect is better than that of elliptic imaging.