Patients' perceptions of post-treatment factors that influenced skill use after cognitive-behavioral therapy for bulimia nervosa spectrum disorders.

OBJECTIVE: Deterioration rate among patients with bulimia-spectrum eating disorders (BN-EDs) after receiving enhanced cognitive-behavioral therapy (CBT-E) remains high. Previous studies identified body image concerns, environmental triggers, lack of social support, lack of resources, comorbidity, and discontinued skill use as predictors of deterioration. However, no studies have qualitatively explored patients' perceptions of how these factors influenced their skill use and led to deterioration after receiving outpatient CBT. METHODS: This study aimed to qualitatively explore (1) what post-treatment factors patients believe contributed to deterioration, and (2) whether patients continued to practice the CBT skills they learned from treatment and identify motivators and barriers to post-treatment skill use. Twelve participants who had previously completed 16 sessions of CBT for their BN-EDs and experienced at least modest treatment responses participated in the qualitative interviews. RESULTS: Four themes were identified from the qualitative interviews. Post-treatment deterioration was primarily driven by decreased skill use due to a perceived sudden loss of accountability and continued body dissatisfaction after treatment ended. Discontinued practice of binge analysis led to decreased awareness of the relationship between poor skill use and ED behaviors. Difficulty accessing resources impeded participants from receiving external help to address challenges in skill practice, thus also contributing to deterioration. DISCUSSION: Findings suggested that outpatient treatment for BN-EDs patients should emphasize more on body image concern, and deterioration prevention for outpatient CBT-E should focus on building self-accountability to keep practicing skills after treatment ends. PUBLIC SIGNIFICANCE: This study was the first to qualitatively explore post-treatment factors influencing skill use and deterioration in patients with bulimia-spectrum eating disorders after they completed outpatient CBT. Findings indicated that decreased skill use was a primary driver of post-treatment deterioration, and that relapse prevention for outpatient CBT for BN-EDs should focus on enhancing patients' self-accountability to continue practicing therapeutic skills independently after treatment ended.

Early reduction in anxiety sensitivity predicts greater reduction in disordered eating and trait anxiety during treatment for bulimia nervosa.

OBJECTIVE: Anxiety sensitivity (AS), the trait-like fear of symptoms of anxiety, has been associated with eating disorder (ED) pathology broadly, bulimia nervosa (BN) symptoms specifically, and the anxiety disorders that are commonly comorbid with BN. AS, especially for physical symptoms specifically, maybe a risk and maintenance factor for BN and comorbid anxiety. METHOD: Adult participants with BN (n = 44) in a clinical trial comparing CBT to mindfulness and acceptance-based treatment (MABT) reported ED symptoms, trait anxiety, and AS through treatment and follow-up. We predicted that greater early reduction (i.e., within the first month of treatment) in AS would predict greater reductions in ED symptoms and trait anxiety at post-treatment and follow-up. RESULTS: Early reductions in AS for physical concerns predicted lower ED symptoms and trait anxiety at post-treatment but not follow-up. Exploratory analyses indicated that treatment groups did not differ in either early or total change in AS, controlling for baseline AS. DISCUSSION: Early reductions in AS may be an important treatment target for BN, and may additionally support reductions in anxiety. Future research should identify which components of CBT and MABT best target AS, to deliver these components early in treatment, when they can have maximum effect. PUBLIC SIGNIFICANCE: Anxiety sensitivity, the fear of symptoms of anxiety, is associated with eating disorders (ED). In this study, participants in treatment for bulimia nervosa reported ED symptoms, trait anxiety, and anxiety sensitivity through treatment and follow-up. Greater early reductions in anxiety sensitivity predicted lower ED symptoms and trait anxiety at post-treatment. Future research should identify which elements of treatment best target anxiety sensitivity, to deliver them early in treatment.

Behavioral weight loss treatment for adults with binge-eating disorder: A qualitative analysis of patients' perspectives and experiences.

OBJECTIVE: Understanding the perspectives of behavioral weight loss (BWL) participants could inform whether, how, and for whom BWL should be offered. METHOD: All 126 participants in a clinical trial of BWL for adults with binge-eating disorder (BED) and overweight/obesity were contacted about a qualitative study. 45 participants, 11 of whom had dropped out of the parent study, completed qualitative interviews. The interview guide was developed using data from a survey of providers who offer Health at Every Size and other weight-neutral lifestyle interventions. Questions were phrased to invite even the most negative responses. Questions focused on participants' experiences of weight stigma during treatment, perceptions of BWL's calorie and WL goals, and opinions of BWL and weight-neutral interventions. RESULTS: We identified four themes using thematic analysis: (1) BWL did not perpetuate weight stigma. (2) Calorie and WL goals did not exacerbate participants' binge eating. (3) Patients should have the right to pursue any treatment that aligns with their personal goals. (4) BWL can improve participants' overall health. DISCUSSION: BWL participants with BED and overweight/obesity want others to have access to a program that can reduce both weight and binge eating. Participants emphasized that no treatment works for everyone, and they all agreed that BWL had not perpetuated weight stigma. Fewer than 20% of participants considered the program's calorie and WL goals to be harmful; most participants viewed those goals as achievable and helpful, and many asserted that their participation in BWL had improved their overall health. PUBLIC SIGNIFICANCE: We interviewed adults with binge-eating disorder and overweight/obesity who had participated in a behavioral weight loss (BWL) program. Our participants wanted others in their position to have access to BWL because it aims to reduce both weight and binge-eating frequency. Efforts should be made to provide patients, clinicians, and policymakers with the knowledge that supervised, evidence-based BWL is an effective and desired treatment choice for this population.

Subchronic toxicity evaluation of Huobahuagen extract and plasma metabolic profiling analysis combined with conventional pathology methods.

Huobahua, namely, Tripterygium hypoglaucum (Levl.) Hutch, known as a traditional Chinese herbal medicine, especially its underground parts, has been widely developed into several Tripterygium agents for the treatment of rheumatoid arthritis and other autoimmune diseases. It has sparked wide public concern about its safety, such as multi-organ toxicity. However, the toxic characteristics and damage mechanism of Huobahuagen extract (HBHGE) remain unclear. In the present study, subchronic oral toxicity study of HBHGE (10.0 g crude drug/kg/day for 12 weeks) was performed in male rats. Hematological, serum biochemical, and histopathological parameters, urinalysis, and plasma metabolic profiling were assessed. The single-dose subchronic toxicity results related to HBHGE exhibited obvious toxicity to the testis and epididymis of male rats. Furthermore, plasma metabolomics analysis suggested that a series of metabolic disorders were induced by oral administration of HBHGE, mainly focusing on amino acid (glutamate, phenylalanine, and tryptophan) metabolisms, pyrimidine metabolism, glutathione metabolism, and steroid hormone biosynthesis. Moreover, it appeared that serum testosterone in male rats treated with HBHGE for 12 weeks, decreased significantly, and was susceptible to the toxic effects of HBHGE. Taken together, conventional pathology and plasma metabolomics for preliminarily exploring subchronic toxicity and underlying mechanism can provide useful information about the reduction of toxic risks from HBHGE and new insights into the development of detoxification preparations.

In-Vitro Diagnostic Reagent Evaluation of Commercially Available Cardiac Troponin I Assay Kits Using H/D Exchange Mass Spectrometry for Antibody-Epitope Mapping.

Cardiac troponin I (cTnI) is the biomarker of choice and considered a gold standard for the diagnosis of acute myocardial infarction. However, the quantitative results of cTnI assay kits from different manufacturers are not comparable. Based on the H/D exchange mass spectrometry (HDX-MS) workflow, we developed an in-vitro diagnostic reagent antibody evaluation strategy to analyze the interactions of epitopes and antibody cocktails─(R195, F12, S13) and (D1, D2, pAb2). The HDX results indicate that the quantitative result bias of the different reagents originates from the ability of antibodies to recognize various cTnI complex forms, such as free cTnI, hydrolyzed cTnI, and cTnI combined with cTnT or TnC as binary or ternary complexes (cTnIC, cTnTIC), in blood based on different epitopes. The data obtained from the peptide HDX of interest after treatment with various antibody cocktails clearly indicated epitope specificity. The consistency of quantitative results can be improved by a thorough investigation into the epitopes recognized by the antibodies of various diagnostic kits, which will lead to the standardization of cTnI diagnosis.

ConLBS: An Attack Investigation Approach Using Contrastive Learning with Behavior Sequence.

Attack investigation is an important research field in forensics analysis. Many existing supervised attack investigation methods rely on well-labeled data for effective training. While the unsupervised approach based on BERT can mitigate the issues, the high degree of similarity between certain real-world attacks and normal behaviors makes it challenging to accurately identify disguised attacks. This paper proposes ConLBS, an attack investigation approach that combines the contrastive learning framework and multi-layer transformer network to realize the classification of behavior sequences. Specifically, ConLBS constructs behavior sequences describing behavior patterns from audit logs, and a novel lemmatization strategy is proposed to map the semantics to the attack pattern layer. Four different augmentation strategies are explored to enhance the differentiation between attack and normal behavior sequences. Moreover, ConLBS can perform unsupervised representation learning on unlabeled sequences, and can be trained either supervised or unsupervised depending on the availability of labeled data. The performance of ConLBS is evaluated in two public datasets. The results show that ConLBS can effectively identify attack behavior sequences in the cases of unlabeled data or less labeled data to realize attack investigation, and can achieve superior effectiveness compared to existing methods and models.

MCW: A Generalizable Deepfake Detection Method for Few-Shot Learning.

With the development of deepfake technology, deepfake detection has received widespread attention. Although some deepfake forensics techniques have been proposed, they are still very difficult to implement in real-world scenarios. This is due to the differences in different deepfake technologies and the compression or editing of videos during the propagation process. Considering the issue of sample imbalance with few-shot scenarios in deepfake detection, we propose a multi-feature channel domain-weighted framework based on meta-learning (MCW). In order to obtain outstanding detection performance of a cross-database, the proposed framework improves a meta-learning network in two ways: it enhances the model's feature extraction ability for detecting targets by combining the RGB domain and frequency domain information of the image and enhances the model's generalization ability for detecting targets by assigning meta weights to channels on the feature map. The proposed MCW framework solves the problems of poor detection performance and insufficient data compression resistance of the algorithm for samples generated by unknown algorithms. The experiment was set in a zero-shot scenario and few-shot scenario, simulating the deepfake detection environment in real situations. We selected nine detection algorithms as comparative algorithms. The experimental results show that the MCW framework outperforms other algorithms in cross-algorithm detection and cross-dataset detection. The MCW framework demonstrates its ability to generalize and resist compression with low-quality training images and across different generation algorithm scenarios, and it has better fine-tuning potential in few-shot learning scenarios.

Comparative Genomic Analysis of a Methylorubrum rhodesianum MB200 Isolated from Biogas Digesters Provided New Insights into the Carbon Metabolism of Methylotrophic Bacteria.

Methylotrophic bacteria are widely distributed in nature and can be applied in bioconversion because of their ability to use one-carbon source. The aim of this study was to investigate the mechanism underlying utilization of high methanol content and other carbon sources by Methylorubrum rhodesianum strain MB200 via comparative genomics and analysis of carbon metabolism pathway. The genomic analysis revealed that the strain MB200 had a genome size of 5.7 Mb and two plasmids. Its genome was presented and compared with that of the 25 fully sequenced strains of Methylobacterium genus. Comparative genomics revealed that the Methylorubrum strains had closer collinearity, more shared orthogroups, and more conservative MDH cluster. The transcriptome analysis of the strain MB200 in the presence of various carbon sources revealed that a battery of genes was involved in the methanol metabolism. These genes are involved in the following functions: carbon fixation, electron transfer chain, ATP energy release, and resistance to oxidation. Particularly, the central carbon metabolism pathway of the strain MB200 was reconstructed to reflect the possible reality of the carbon metabolism, including ethanol metabolism. Partial propionate metabolism involved in ethyl malonyl-CoA (EMC) pathway might help to relieve the restriction of the serine cycle. In addition, the glycine cleavage system (GCS) was observed to participate in the central carbon metabolism pathway. The study revealed the coordination of several metabolic pathways, where various carbon sources could induce associated metabolic pathways. To the best of our knowledge, this is the first study providing a more comprehensive understanding of the central carbon metabolism in Methylorubrum. This study provided a reference for potential synthetic and industrial applications of this genus and its use as chassis cells.

Hydrogen-Bond Network Promotes Water Splitting on the TiO2 Surface.

Breaking the strong covalent O-H bond of an isolated H2O molecule is difficult, but it can be largely facilitated when the H2O molecule is connected with others through hydrogen-bonding. How a hydrogen-bond network forms and performs becomes crucial for water splitting in natural photosynthesis and artificial photocatalysis and is awaiting a microscopic and spectroscopic understanding at the molecular level. At the prototypical photocatalytic H2O/anatase-TiO2(001)-(1×4) interface, we report the hydrogen-bond network can promote the coupled proton and hole transfer for water splitting. The formation of a hydrogen-bond network is controlled by precisely tuning the coverage of water to above one monolayer. Under ultraviolet (UV) light irradiation, the hydrogen-bond network opens a cascaded channel for the transfer of a photoexcited hole, concomitant with the release of the proton to form surface hydroxyl groups. The yielded hydroxyl groups provide excess electrons to the TiO2 surface, causing the reduction of Ti4+ to Ti3+ and leading to the emergence of gap states, as monitored by in situ UV/X-ray photoelectron spectroscopy. The density functional theory calculation reveals that the water splitting becomes an exothermic process through hole oxidation with the assistance of the hydrogen-bond network. In addition to the widely concerned exotic activity from photocatalysts, our study demonstrates the internal hydrogen-bond network, which is ubiquitous at practical aqueous/catalyst interfaces, is also indispensable for water splitting.

Commutability assessment of reference materials for homocysteine.

OBJECTIVES: Commutability of reference materials is essential for ensuring the traceability of patient measurement results and the technical basis for the use of reference materials. Commutability is only relevant for matrixed reference material; it is a prerequisite for the accuracy and authenticity of calibration methods. In this study, we evaluated the commutability of reference materials for homocysteine. METHODS: Five conventional measurement methods were applied to simultaneously measure 30 serum samples and seven homocysteine reference materials from the National Institute of Standards and Technology and the National Institute of Metrology. Liquid chromatography tandem-mass spectrometry was used as a reference method. Two methods were used to evaluate the commutability of the seven reference materials according to the Clinical and Laboratory Standards Institute EP30-A and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) commutability assessment document. RESULTS: Among 35 combinations of the five conventional methods and seven reference materials, after evaluation in accordance with the EP30-A, the seven reference materials passed the commutability assessment, and 34 combinations were commutable. According to the IFCC, the commutability evaluation of 28 combinations was conclusive (commutable or non-commutable), while results for the remaining seven combinations could not be determined. CONCLUSIONS: The homocysteine reference materials showed good commutability. The sensitivity of the measurement procedure, measurement deviation and uncertainty, and differences in the "measurand" selected by different methods may affect the evaluation results. Additionally, different judgment standards for different methods may explain the observed variations in evaluation results.

Epitope mapping of antibodies in C-reactive protein assay kits by hydrogen-deuterium exchange mass spectrometry explains differential results across kits.

C-Reactive protein (CRP) is an important marker for in vitro diagnosis (IVD) of inflammation. However, CRP immunoturbidimetric kits from different manufacturers exhibit inconsistency in evaluation, making clinical diagnosis challenging. The use of immunological methods in diagnosis means that the differences in epitopes across kits may directly lead to inconsistent results. Therefore, to provide consistent results, it is essential to perform epitope mapping of different kits. The composition of antibodies in a single kit is typically complex, with a combination of polyclonal antibodies or monoclonal antibodies. Here, we show an epitope screening strategy for complex antibodies in a kit based on hydrogen-deuterium exchange mass spectrometry (HDX-MS). We applied this workflow to successfully map the epitopes for three kits from three different manufacturers and compared their quantitative results. We obtained different quantitative results using kits from different manufacturers upon epitope mapping, confirming the correlation between the quantitative results and the epitopes. Thus, we have established a workflow based on HDX-MS to screen epitopes in IVD kits. This work helps determine the quantitative accuracy of a kit based on structural information, can guide the design and production of IVD reagents, and further improves the accuracy of IVD.

Understanding self-monitoring to inform a mobile intervention for binge eating and weight management: A proof-of-concept randomized trial.

OBJECTIVE: This study explored consumers' perspectives on self-monitoring, a common feature in behavioral interventions that helps inform consumers' progress and answer their questions, to learn what outcome metrics matter to consumers and whether self-selection of these metrics leads to greater engagement (i.e., compliance, satisfaction) in self-monitoring than monitoring only default options. METHODS: In a proof-of-concept randomized trial, 48 adult participants were randomly assigned to "clinician-determined monitoring" or "clinician + self-determined monitoring" conditions. Before starting monitoring, all participants shared outcomes that would matter to them in a mobile intervention for binge eating and weight management. Then, for 3 weeks, participants in the "clinician-determined" condition monitored their weight and binge-eating episodes, and participants in the "clinician + self-determined" condition monitored these and another metric of their choosing. After, satisfaction and compliance were assessed. RESULTS: Participants identified 116 metrics, grouped into 12 themes, that mattered to them. During monitoring, participants in the "clinician + self-determined" condition monitored 41 metrics. Surprisingly, participants in the "clinician-determined" condition also monitored metrics besides weight and binge eating. This resulted in a failure of our experimental manipulation, which represents a significant limitation of this research. No significant differences emerged in satisfaction or compliance between conditions. DISCUSSION: Although our proof-of-concept trial yielded null quantitative results, findings also suggested binge eating and weight management interventions may benefit from including an individually customizable monitoring option in addition to default metrics, warranting testing in future research. PUBLIC SIGNIFICANCE: Examining consumers' self-monitoring preferences for a mobile intervention for binge eating and weight management revealed a variety of metrics that matter to consumers, although binge eating and weight were still most valued. Findings from our proof-of-concept trial suggest design implications of encouraging an individually customizable monitoring option, in addition to default metrics, which needs to be tested in future research over a longer period and during actual mobile intervention delivery.

Family functioning and eating disorders treatment in a partial hospitalization program in adolescent females with eating disorders.

OBJECTIVE: Previous research examining family functioning in eating disorder (ED) treatment has focused primarily on outpatient settings. However, few studies have examined this aspect in partial hospitalization programs. To address this gap, this study examined family functioning over the course of an ED partial hospitalization program (PHP) in adolescent females (M(SD) age = 15.66 (1.50)). METHOD: Participants (n = 105) completed the Family Assessment Device and Eating Disorder Examination Questionnaire at treatment admission, 1-month post-admission, and discharge. RESULTS: Results from repeated measures analysis of variance indicated adolescents perceived an improvement in family functioning regarding Communication, Affective Responsiveness, and Behavioral Control through 1-year follow-up (p values < .05). Neither family functioning at admission nor change in family functioning in the first month correlated with any outcomes (weight, ED symptoms, and remission). DISCUSSION: Results support that family functioning does not contribute to ED severity, and that treatment can improve adolescent perception of family functioning. Given the importance of involving the family in ED treatment, identifying mediators of treatment outcomes is critical to improve treatment efficacy. PUBLIC SIGNIFICANCE: Adolescents in a partial hospital program (PHP) for eating disorders (EDs) perceived improvements in their family communication, behavior, and ability to process appropriate emotions from admission to 1-year post-treatment, although these aspects did not significantly predict treatment outcomes. The findings provide helpful information for future research on adolescents with EDs in higher levels of care and underscore the importance of exploring mechanisms of family-based treatment in PHP.

Evaluation of the degenerative lumbar osseous morphology using zero echo time magnetic resonance imaging (ZTE-MRI).

PURPOSE: To determine and compare the performance of zero echo imaging (ZTE) with conventional MRI sequences on lumbar osseous morphology in patients suspected with lumbar degeneration with multi-slice computed tomography (MSCT) as standard reference. METHODS: 22 subjects with concerned lumbar degeneration were recruited. All subjects were scanned with ZTE sequence after routine conventional MR sequences on a 3.0 T system and also received MSCT examination. Image quality was assessed. The quantitative and qualitative parameters of lumbar osseous morphology on MSCT, ZTE and MRI images were evaluated by three musculoskeletal radiologists independently. Inter-reader and inter-modality reliability and the difference between the modalities were calculated. RESULTS: There was no difference for the osseous parameters between modalities, including axial orientation (p = 0.444), IAD (p = 0.381), lateral recess (p = 0.370), pedicle width (p = 0.067), pedicle height (p = 0.056), and osteophyte grade (p = 0.052). The measurement of the foramina diameter was statistically different between conventional MRI and MSCT (p < 0.05) but not between the MSCT and ZTE (p = 0.660). Conventional MRI was more likely to miss cortical bone abnormalities. ZTE appeared blurrier in cortical bone than MSCT, especially in cases with severe lumbar degeneration. The inter-reader agreement between MSCT and ZTE-MRI was higher than between MSCT and conventional MRI. CONCLUSIONS: ZTE-MRI could offer more cortical bone details than conventional MRI images and might be a valid alternative to CT for lumbar osseous morphology assessment to some extent.

Comprehensive Comparative Analysis and Development of Molecular Markers for Dianthus Species Based on Complete Chloroplast Genome Sequences.

Dianthus spp. is a genus with high economic and ornamental value in the Caryophyllaceae, which include the famous fresh-cut carnation and the traditional Chinese herbal medicine, D. superbus. Despite the Dianthus species being seen everywhere in our daily lives, its genome information and phylogenetic relationships remain elusive. Thus, we performed the assembly and annotation of chloroplast genomes for 12 individuals from seven Dianthus species. On this basis, we carried out the first comprehensive and systematic analysis of the chloroplast genome sequence characteristics and the phylogenetic evolution of Dianthus. The chloroplast genome of 12 Dianthus individuals ranged from 149,192 bp to 149,800 bp, containing 124 to 126 functional genes. Sequence repetition analysis showed the number of simple sequence repeats (SSRs) ranged from 75 to 80, tandem repeats ranged from 23 to 41, and pair-dispersed repeats ranged from 28 to 43. Next, we calculated the synonymous nucleotide substitution rates (Ks) of all 76 protein coding genes to obtain the evolution rate of these coding genes in Dianthus species; rpl22 showed the highest Ks (0.0471), which suggested that it evolved the swiftest. By reconstructing the phylogenetic relationships within Dianthus and other species of Caryophyllales, 16 Dianthus individuals (12 individuals reported in this study and four individuals downloaded from NCBI) were divided into two strongly supported sister clades (Clade A and Clade B). The Clade A contained five species, namely D. caryophyllus, D. barbatus, D. gratianopolitanus, and two cultivars ('HY' and 'WC'). The Clade B included four species, in which D. superbus was a sister branch with D. chinensis, D. longicalyx, and F1 '87M' (the hybrid offspring F1 from D. chinensis and 'HY'). Further, based on sequence divergence analysis and hypervariable region analysis, we selected several regions that had more divergent sequences, to develop DNA markers. Additionally, we found that one DNA marker can be used to differentiate Clade A and Clade B in Dianthus. Taken together, our results provide useful information for our understanding of Dianthus classification and chloroplast genome evolution.

Time- and momentum-resolved image-potential states of 2H-MoS2 surface.

Rydberg-like image potential states (IPSs) form special series surface states on metal and semiconducting surfaces. Here, using time-resolved and momentum-resolved multi-photon photoemission (mPPE), we measured the energy positions, band dispersion, and carrier lifetimes of IPSs at the 2H-MoS2 surface. The energy minima of the IPSs (n = 1 and 2) were located at 0.77 and 0.21 eV below the vacuum level. In addition, the effective masses of these two IPSs are close to the rest mass of the free electron, clearly showing nearly-free-electron character. These properties suggest a good screening effect in the MoS2 parallel to the surface. The multi-photon resonances between the valence band and IPS (n = 1) are observed, showing a k‖-momentum-dependent behavior. Our time-resolved mPPE measurements show that the lifetime of photoexcited electrons in the IPS (n = 1) is about 33 fs.

Part-Aware Mask-Guided Attention for Thorax Disease Classification.

Thorax disease classification is a challenging task due to complex pathologies and subtle texture changes, etc. It has been extensively studied for years largely because of its wide application in computer-aided diagnosis. Most existing methods directly learn global feature representations from whole Chest X-ray (CXR) images, without considering in depth the richer visual cues lying around informative local regions. Thus, these methods often produce sub-optimal thorax disease classification performance because they ignore the very informative pathological changes around organs. In this paper, we propose a novel Part-Aware Mask-Guided Attention Network (PMGAN) that learns complementary global and local feature representations from all-organ region and multiple single-organ regions simultaneously for thorax disease classification. Specifically, multiple innovative soft attention modules are designed to progressively guide feature learning toward the global informative regions of whole CXR image. A mask-guided attention module is designed to further search for informative regions and visual cues within the all-organ or single-organ images, where attention is elegantly regularized by automatically generated organ masks and without introducing computation during the inference stage. In addition, a multi-task learning strategy is designed, which effectively maximizes the learning of complementary local and global representations. The proposed PMGAN has been evaluated on the ChestX-ray14 dataset and the experimental results demonstrate its superior thorax disease classification performance against the state-of-the-art methods.

Diffusion tensor imaging in the evaluation of the long-term efficacy of HBO2 therapy in rats after traumatic spinal cord injury.

Objective: This study explored the feasibility of diffusion tensor imaging (DTI) in the evaluation of the long-term efficacy of hyperbaric oxygen (HBO2) therapy in rats after traumatic spinal cord injury (TSCI) with different degrees of injury. Method: Adult Sprague-Dawley rats (total n = 60) were randomly separated into three groups of mild, moderate and severe TSCI (20 rats per group). Each group was then randomly divided into TSCI and TSCI+HBO2 subgroups (10 rats per subgroup). Basso Beattie and Bresnahan (BBB) scores and DTI parameters including fractional anisotropy (FA), mean apparent diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were collected at pre-TSCI and at 0, six and 24 hours, and three, seven, 14, 21, 28 and 56 days post-TSCI. Two-way repeated measures analysis of variance was used for comparison between the TSCI and TSCI+HBO2 subgroups over time in the mild, moderate and severe TSCI groups. Pearson correlation analysis was applied to analyze the correlations between BBB scores and DTI parameters. Results: BBB scores, FA, MD and RD values showed significant differences between the TSCI and TSCI+HBO2 subgroups over time in the mild, moderate and severe TSCI groups (all p<0.01). FA, MD and RD values were positively correlated with BBB scores in all TSCI and TSCI+HBO2 subgroups (all p<0.05). Conclusions: DTI parameters, especially MD, could quantifiably assess the long-term efficacy of HBO2 therapy and reflect the functional recovery in rats after TSCI with different degrees of injury.

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OBJECTIVES: To explore the relevant protective and risk factors that affect spontaneous supratentorial large volume intracerebral hemorrhage. METHODS: Clinical data of hospitalized patients with spontaneous supratentorial intracerebral hemorrhage in Xiangya Hospital of Central South University from January 2014 to December 2018 were retrospectively analyzed. According to the amount of intracerebral hemorrhage (≥30 mL), the patients were divided into a large volume intracerebral hemorrhage group (255 cases) and a non-large volume intracerebral hemorrhage group (397 cases). Univariate and multivariate logistic regression analysis for the clinical data from the two groups of patients were performed. RESULTS: Systolic blood pressure, diastolic blood pressure, white blood cell count, neutrophil count, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, calcium ion concentration, and international standard ratio between the large volume intracerebral hemorrhage group and the non-large volume intracerebral hemorrhage group were significantly different (all P<0.05). Multivariate logistic regression analysis showed the increased LDL cholesterol (OR=0.709, 95% CI 0.564 to 0.892, P=0.003) and the increased calcium concentration (OR=0.084, 95% CI 0.023 to 0.309, P<0.001) were the protective factors for large volume intracerebral hemorrhage on the screen; while the increased white blood cell count (OR=1.268, 95% CI 1.194 to 1.347, P<0.001), the increased high-density lipoprotein cholesterol (OR=1.884, 95% CI 1.199 to 2.961, P=0.006), the increased systolic blood pressure at admission (OR=1.022, 95% CI 1.014 to 1.030, P<0.001), and the increased international standard ratio (OR=26.209, 95% CI 4.712 to 145.764, P<0.001) were the risk factors. CONCLUSIONS: The occurrence of spontaneous supratentorial large volume intracerebral hemorrhage is the result of combination of multiple factors. The increased white blood cell count, the increased systolic blood pressure, the increased high-density lipoprotein cholesterol, and the increased international standard ratio may increase its risk, while the increased LDL cholesterol and calcium concentration may reduce its risk.

Evaluation of hyperbaric oxygen therapy for spinal cord injury in rats with different treatment course using diffusion tensor imaging.

STUDY DESIGN: Animal study. OBJECTIVES: To evaluate the efficacy of hyperbaric oxygen (HBO) therapy for spinal cord injury (SCI) in rats with different treatment course using diffusion tensor imaging (DTI). SETTING: Hospital in Fuzhou, China. METHODS: Fifty adult Sprague-Dawley rats were grouped as: (A) sham-operated group (n = 10); (B) SCI without HBO therapy group (n = 10); (C) SCI with HBO therapy for 2 weeks (SCI+HBO2W) group (n = 10); (D) SCI with HBO therapy for 4 weeks (SCI+HBO4W) group (n = 10); (E) SCI with HBO therapy for 6 weeks (SCI+HBO6W) group (n = 10). Basso Beattie Bresnahan (BBB) scores and diffusion tensor imaging parameters including fractional anisotropy (FA), mean diffusivity (MD), radial diffusion (RD), and axial diffusion (AD) values in the injury epicenter, as well as 2 mm rostral and caudal to the injury epicenter were collected and analyzed 6 weeks post-injury. RESULTS: Higher BBB score and FA values were found in the SCI+HBO4W group than in the SCI and SCI+HBO2W groups (all P < 0.05), whereas no significant differences of these metrics were observed between the SCI+HBO4W and SCI+HBO6W groups. MD and RD values of the SCI+HBO4W group were significantly lower than those of the SCI group (all P < 0.01). FA values were positively correlated with BBB scores. MD and RD values were negatively correlated with BBB scores. CONCLUSION: DTI parameters, especially FA, could non-invasively and quantifiably evaluate the efficacy of HBO treatment for rats with SCI and 4 weeks may be the more appropriate treatment course.