Molecular characteristics of patients with colorectal signet-ring cell carcinoma with different ABO blood groups.

Background: Colorectal signet-ring cell carcinoma (SRCC) is a rare subtype of malignant adenocarcinoma, accounting for approximately 1 % of colorectal cancer (CRC) cases. Its biomarkers and molecular characteristics remain controversial, and there are no specific therapeutic targets or strategies for its clinical treatment. Methods: A retrospective study was conducted between January 2010 and December 2021. 1058 colorectal cancer cases from the Sun Yat-sen University Cancer Center and 489 cases from the Tumor Genome Atlas Project were included in the analysis, of which 64 were SRCC. Data extraction included patient demographics, blood types and risk factors, including clinical variables and genomics (either a 19-gene panel NGS or 1021-gene panel NGS). Univariate analyses were performed to identify factors significantly associated with overall survival. Results: The blood groups of 27 (42.2 %), 18 (28.1 %), 12 (18.8 %), and seven (10.9 %) patients were classified as O, A, B, and AB, respectively. We found that O was a unique blood group characterized by a low frequency of KRAS mutations, a high frequency of heterozygosity at each HLA class I locus, and a high tumor mutational burden (TMB). Patients in blood group A with high-frequency KRAS mutations and those in blood group B with anemia and metabolic abnormalities required targeted treatment. Furthermore, genetic alterations in SRCC differed from those in adenocarcinoma and mucinous adenocarcinoma. Conclusions: Our study revealed genomic changes in SRCC patients across different blood groups, which could advance the understanding and precise treatment of colorectal SRCC.

Deciphering the structure-function-quality improvement role of starch gels by wheat bran insoluble dietary fibers obtained from different fermentation patterns and its potential mechanisms.

Insoluble dietary fiber (IDF) isolated through co-fermented bran from probiotics may improve starch gel-based foods. This work aimed to elucidate the comprehensive impact of different IDF samples (CK, unfermented; NF, natively fermented; YF, yeast fermented; LF, Lactobacillus plantarum fermented; and MF, mix-fermented) and their addition ratios (0.3-0.9%) on gel structure-property function. Results indicated that IDF introduction altered the starch pasting behavior (decreased the viscosity and advanced the pasting time). Also, YF, LF, and MF showed less effect on gel multiscale morphology (SEM and CLSM); however, their excessively high ratio resulted in network structure deterioration. Moreover, FT-IR, XRD, and Raman characterization identified the composite gels interaction mechanisms mainly by hydrogen bonding forces, van der Waals forces, water competition, and physical entanglement. This modulation improved the composite gel water distribution, rheological/stress-strain behavior, textural properties, color, stability, and digestive characteristics. The obtained findings may shed light on the construction and development of whole-grain gel-based food products with new perspectives.

Chronic abdominal distention caused by diffuse nodular ileal and mesenteric lipomatosis: A case report.

RATIONALE: Diffuse intestinal and mesenteric lipomatosis is a rare condition characterized by the overgrowth of adipose tissue in the intestines and mesentery. This case report aims to highlight the rare occurrence of chronic abdominal distention caused by this disease and its unique invasion into the muscle layer, which has not been previously reported. PATIENT CONCERNS: A 36-year-old woman with a 7-year history of abdominal distension was admitted to our hospital's Department of Gastrointestinal Surgery. DIAGNOSE: Abdominal and pelvic computed tomography revealed diffuse small intestinal lipomatosis. INTERVENTIONS: The patient underwent surgery. We performed an open-field ilectomy involving removal of all lipomatous intestines (250 cm). OUTCOMES: During the surgery, diffuse nodular ileal and mesenteric lipomatosis was confirmed, characterized by the presence of multiple nodular lipomas within the submucosal and muscular layers. The surgical intervention involved the resection of 250 cm of the affected ileum, followed by jejunoileal anastomosis. Postoperative pathology confirmed the diagnosis, with lesions observed in both the submucosa and muscle layers. The patient showed significant improvement in symptoms, with normal intestinal function and weight gain observed over a 10-month follow-up period, and no signs of recurrence. LESSONS: Diffuse intestinal and mesenteric lipomatosis can lead to long-term abdominal distension. Additionally, it may be involved in the muscle layer of the intestinal wall. Surgery is the primary treatment option for symptomatic intestinal lipomatosis.

Variations in the alveolar bone morphology in maxillary molar area: a retrospective CBCT study.

BACKGROUND: This study quantitatively analyzed the anatomic structure of the alveolar bone in the maxillary molar region at three potential locations for Temporary Anchorage Device (TAD) placement. Additionally, the study compared the variability in this region across different age groups, sagittal skeletal patterns, vertical facial types, and sexes. METHODS: In this retrospective cone-beam computed tomography study, the buccal alveolar bone was analyzed in the posterior molar area of 200 patients, the measurement items include buccal alveolar bone height, alveolar bone thickness, interradicular distance, and maxillary retromolar space. RESULTS: Buccal alveolar height was greatest in the U56 region. The interradicular space was largest in the U56 region and increased from the alveolar crest to the sinus floor. Buccal alveolar bone thickness was highest in the U67 region and generally increased from the alveolar crest to the sinus floor. The maxillary retromolar space gradually increased from the alveolar crest to the root apex. CONCLUSIONS: TADs are safest when placed in the buccal area between the maxillary second premolar and the first molar, particularly at the 9 mm plane. The U67 region is the optimal safe zone for TAD placement for maxillary dentition distalization. TADs placement in adolescents can be challenging. Maxillary third molar extraction can be considered for maxillary dentition distalization.

A Neutral Polysaccharide from Medicago sativa L.: Structural Properties and Hypoglycemic Activity in vitro and in vivo.

Medicago sativa polysaccharides (MSPs) are beneficial compounds extracted from Medicago sativa L. that exhibit multiple medicinal activities. However, little is known about their hypoglycemic effects. In this study, MSP-II-a, a neutral polysaccharide with an Mw of 4.3 × 104 Da, was isolated and purified from M. sativa L. Monosaccharide composition analysis determined that MSP-II-a was composed of arabinose, glucose, galactose, mannose, rhamnose, and xylose in a molar ratio of 2.1:4.0:1.1:0.4:1.4:1.1. Structural characterization of MSP-II was performed using a combination of methylation analysis, Fourier transform infrared spectroscopy, and scanning electron microscopy. The results showed that MSP-II-a was mainly comprised of 1,4-p-Glc, 1,3,4-Rha, and 1,3-p-Gal glycosidic linkages, revealing a mesh-like texture with irregular blade shapes. In vitro assays demonstrated that MSP-II-a, at concentrations of 200 and 400 µg/mL, promoted glucose uptake in insulin-resistant 3T3-L1 adipocytes. In vivo studies have shown that MSP-II-a significantly alleviates insulin resistance by reducing fasting blood glucose levels and increasing hepatic glycogen synthesis in HFD/STZ-induced diabetic mice. These findings revealed that MSP-II-a is a promising source of bioactive polysaccharides with potential hypoglycemic activity.

Long non-coding RNA TMEM147 antisense RNA 1/microRNA-124/signal transducer and activator of transcription 3 axis in estrogen receptor-positive breast cancer.

OBJECTIVE: This research aimed to probe the expression of long noncoding RNA TMEM147 antisense RNA 1 (TMEM147-AS1)/micro-RNA (miR)-124/signal transducer and activator of transcription 3 (STAT3) axis in estrogen receptor (ER)-positive breast cancer (BC). METHODS: Sixty ER-positive BC patients undergoing surgical treatment were gathered. TMEM147-AS1, miR-124, and STAT3 expression levels in BC cells and tissues were measured. The binding sites of TMEM147-AS1 and miR-124, miR-124, and STAT3 were analyzed and validated. The miR-124, STAT3 overexpression (oe) sequences, TMEM147-AS1 oe, and interference sequences and their control sequences were planned and cells were transfected to assess their functions in BC cells biological functions. RESULTS: TMEM147-AS1, as well as STAT3 was extremely expressed and miR-124 was lowly expressed in BC cells and tissues. Interference with TMEM147-AS1 restrained ER-positive BC cell malignant activities. Mechanistically, TMEM147-AS1 could competitively bind miR-124 in refraining miR-124 expression, and STAT3 was a target gene of miR-124. Oe of miR-124 effectively reversed the enhancement of BC cell proliferation and invasion induced by TMEM147-AS1 upregulation. Oe of STAT3 could reverse the inhibitory effect of miR-124 on BC cell malignant behaviors. CONCLUSION: TMEM147-AS1 has oncogenic activity in ER-positive BC, which may be a result of the altered miR-124/STAT3 axis. Therefore, targeting the TMEM147-AS1/miR-124/STAT3 axis may be a target for ER-positive BC therapy.

Zirconia and Crofer Joint Made by Reactive Air Brazing Using the Silver Base Paste and Cu-Ti Coating Layer.

This study proposes a method to enhance the airtightness of the joint between the ZrO2 and Crofer alloy using coating technology. With the aid of vacuum sputtering technology, a titanium-copper alloy layer with a thickness between 1.5 µm and 6 µm was first deposited on the surface of ZrO2 and Crofer, respectively. The chemical composition of the deposited reaction layer was 70.2 Cu and 29.8 Ti in at%. Then, using silver as the base material in the reactive air brazing (RAB) process, we explore the use of this material design to improve the microstructure and reaction mechanism of the joint surface between ceramics and metal, compare the effects of different pretreatment thicknesses on the microstructure, and evaluate its effectiveness through air tightness tests. The results show that a coating of Cu-Ti alloy on the ZrO2 substrate can significantly improve bonding between the Ag filler and ZrO2. The Cu-Ti metallization layer on the ZrO2 substrate is beneficial to the RAB. After the brazing process, the coated Cu-Ti layers form suitable reaction interfaces between the filler, the metal, the filler, and the ceramic. In terms of coating layer thickness, the optimized 3 µm coated Cu-Ti alloy layer is achieved from the experiment. Melting and dissolving the Cu-Ti coated layer into the ZrO2 substrate results in a defect-free interface between the Ag-rich braze and the ZrO2. The air tightness test result shows no leakage under 2 psig at room temperature for 28 h. The pressure condition can still be maintained even under high-temperature conditions of 600 °C for 24 h.

The Influencing Factors of Implementation in Emergency Medical Service Systems - A Scoping Review.

OBJECTIVES: Emergency medical services (EMS) provide health care in situations with limited time and resources. Challenges arise when introducing novel medications, treatments, or technologies or modifying existing practices in these settings. Effective implementation strategies are pivotal for their success. This study aims to identify and categorize potential facilitators and barriers in the implementation of prehospital EMS through a review of relevant research articles. METHODS: We searched PubMed and EMbase to identify studies published before December 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for our search strategy and scoping review. We included original articles written in English that report on the factors that influence the implementation in prehospital settings. We extracted and categorized the factors into different themes. RESULTS: Out of the 371 retrieved papers, we selected 19 (5%) for inclusion in this review. We extracted 46 influencing factors from the selected articles and categorized them into ten themes: (1) Outer system, (2) Inner system, (3) Practitioner characteristics, (4) Resources, (5) Communication and collaboration, (6) Patient factors, (7) Intervention characteristics, (8) De-implementation of prior practices, (9) Logistical issues, and (10) Quality improvement. CONCLUSIONS: This study examined the literature on EMS implementation factors and proposed a 10-theme EMS model framework. Key factors include training/education, equipment/tools, communication with hospitals, and practitioners' attitudes.

Leveraging Transfer Superposition Theory for StableState Visual Evoked Potential Cross-Subject Frequency Recognition.

In steady-state visual evoked potential (SSVEP)based brain-computer interfaces (BCIs), various spatial filtering methods based on individual calibration data have been proposed to alleviate the interference of spontaneous activities in SSVEP signals for enhancing the SSVEP detection performance. However, the necessary calibration procedures take time, cause visual fatigue and reduce usability. For the calibration-free scenario, we propose a cross-subject frequency identification method based on transfer superimposed theory for SSVEP frequency decoding. First, a multi-channel signal decomposition model was constructed. Next, we used the cross least squares iterative method to create individual specific transfer spatial filters as well as source subject transfer superposition templates in the source subject. Then, we identified common knowledge among source subjects using a prototype spatial filter to make common transfer spatial filters and common impulse responses. Following, we reconstructed a global transfer superimposition template with SSVEP frequency characteristics. Finally, an ensemble cross-subject transfer learning method was proposed for SSVEP frequency recognition by combining the sourcesubject transfer mode, the global transfer mode, and the sinecosine reference template. Offline tests on two public datasets show that the proposed method significantly outperforms the FBCCA, TTCCA, and CSSFT methods. More importantly, the proposed method can be directly used in online SSVEP recognition without calibration. The proposed algorithm was robust, which is important for a practical BCI.

Continuous Positive Airway Pressure Treatment and Hypertensive Adverse Outcomes in Pregnancy: A Systematic Review and Meta-Analysis.

Importance: Pregnancy may contribute to the development or exacerbation of obstructive sleep apnea (OSA) and increase the risk of gestational complications. Continuous positive airway pressure (CPAP) is the first-line and criterion standard treatment for OSA and is regarded as the most feasible choice during pregnancy. However, the association between CPAP therapy in pregnant women with OSA and reduced gestational complications remains inconclusive. Objective: To investigate the association between CPAP therapy in pregnant women with OSA and the reduction of adverse hypertensive outcomes during gestation. Data Sources: Keyword searches of PubMed, Embase, and the Cochrane Database of Systematic Reviews and Clinical Trials were conducted from inception to November 5, 2023. Study Selection: Original studies reporting the treatment effect of CPAP use on lowering hypertension and preeclampsia risks in pregnant women with OSA were selected. Data Extraction and Synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed in the reporting of reviews. Data were independently extracted by 2 authors. Random-effects model meta-analyses were performed and risk ratios (RRs) reported. Subgroup analysis, meta-regression based on age and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and publication bias assessment were also conducted. Main Outcome and Measures: The primary outcome was the RR of gestational hypertension and preeclampsia between pregnant women with OSA receiving CPAP treatment and those who did not receive CPAP treatment. Results: Six original studies in 809 participants (mean age, 31.4 years; mean BMI, 34.0) were identified and systematically reviewed for meta-analysis. The pooled results showed significant differences between the intervention (CPAP use) and the control (non-CPAP use) groups in reducing the risk of gestational hypertension (RR, 0.65; 95% CI, 0.47-0.89; P = .008) and preeclampsia (RR, 0.70; 95% CI, 0.50-0.98; P = .04). Meta-regression revealed that patients' age (coefficient, -0.0190; P = .83) and BMI (coefficient, -0.0042; P = .87) were not correlated with reduction of risk of hypertension and preeclampsia. Conclusions and Relevance: These findings suggest that implementing CPAP treatment in pregnant women with OSA may reduce the risk of gestational hypertension and preeclampsia.

Evaluating the impact of ecological factors on the quality and habitat distribution of Lonicera japonica Flos using HPLC and the MaxEnt model.

Introduction: The quality of traditional Chinese medicine is based on the content of their secondary metabolites, which vary with habitat adaptation and ecological factors. This study focuses on Lonicera japonica Flos (LJF), a key traditional herbal medicine, and aims to evaluate how ecological factors impact its quality. Methods: We developed a new evaluation method combining high-performance liquid chromatography (HPLC) fingerprinting technology and MaxEnt models to assess the effects of ecological factors on LJF quality. The MaxEnt model was used to predict suitable habitats for current and future scenarios, while HPLC was employed to analyze the contents of key compounds. We also used ArcGIS for spatial analysis to create a quality zoning map. Results: The analysis identified 21 common chromatographic peaks, with significant variations in the contents of Hyperoside, Rutin, Chlorogenic acid, Cynaroside, and Isochlorogenic acid A across different habitats. Key environmental variables influencing LJF distribution were identified, including temperature, precipitation, and elevation. The current suitable habitats primarily include regions south of the Yangtze River. Under future climate scenarios, suitable areas are expected to shift, with notable expansions in southern Gansu, southeastern Tibet, and southern Liaoning. The spatial distribution maps revealed that high-quality LJF is predominantly found in central and southern Hebei, northern Henan, central Shandong, central Sichuan, southern Guangdong, and Taiwan. Discussion: The study indicates that suitable growth areas can promote the accumulation of certain secondary metabolites in plants, as the accumulation of these metabolites varies. The results underscore the necessity of optimizing quality based on cultivation practices. The integration of HPLC fingerprinting technology and the MaxEnt model provides valuable insights for the conservation and cultivation of herbal resources, offering a new perspective on evaluating the impact of ecological factors on the quality of traditional Chinese medicines.

The SGLT2 inhibitor dapagliflozin ameliorates renal fibrosis in hyperuricemic nephropathy.

Hyperuricemic nephropathy (HN) is a global metabolic disorder characterized by uric acid (UA) metabolism dysfunction, resulting in hyperuricemia (HUA) and tubulointerstitial fibrosis (TIF). Sodium-dependent glucose transporter 2 inhibitor, dapagliflozin, has shown potential in reducing serum UA levels in patients with chronic kidney disease (CKD), though its protective effects against HN remain uncertain. This study investigates the functional, pathological, and molecular changes in HN through histological, biochemical, and transcriptomic analyses in patients, HN mice, and UA-stimulated HK-2 cells. Findings indicate UA-induced tubular dysfunction and fibrotic activation, which dapagliflozin significantly mitigates. Transcriptomic analysis identifies estrogen-related receptor α (ERRα), a downregulated transcription factor in HN. ERRα knockin mice and ERRα-overexpressed HK-2 cells demonstrate UA resistance, while ERRα inhibition exacerbates UA effects. Dapagliflozin targets ERRα, activating the ERRα-organic anion transporter 1 (OAT1) axis to enhance UA excretion and reduce TIF. Furthermore, dapagliflozin ameliorates renal fibrosis in non-HN CKD models, underscoring the therapeutic significance of the ERRα-OAT1 axis in HN and CKD.

Exosomes derived from bone marrow mesenchymal stem cells induce the proliferation and osteogenic differentiation and regulate the inflammatory state in osteomyelitis in vitro model.

Chronic osteomyelitis is a chronic bone infection characterized by progressive osteonecrosis and dead bone formation, which is closely related to persistent infection and chronic inflammation. Exosomes derived from bone marrow-derived mesenchymal stem cells (BMSC) play an important role in bone tissue regeneration and the modulation of inflammatory processes. However, their role and mechanism of action in osteomyelitis have not been reported so far. This paper explores the potential effect of BMSC-derived exosomes on osteomyelitis in vitro model with the aim of providing a theoretical basis for the treatment of osteomyelitis in the future. In this study, exosomes were isolated and extracted from BMSCs and identified. MC3T3-E1 cells were treated with Staphylococcal protein A (SPA) to establish an in vitro model of osteomyelitis. Next, the effects of BMSC-derived exosomes on cell proliferation, apoptosis, angiogenesis, and autophagy in MC3T3-E1 cells treated with SPA were evaluated. Results showed that the proliferation ability of MC3T3-E1 cells increased after co-culture with BMSC-derived exosomes. Moreover, exosomes induced autophagy and osteogenic differentiation in MC3T3-E1 cells. The mRNA and protein levels of factors related to proliferation, differentiation, apoptosis, autophagy, and angiogenesis including ß-Catenin, Runx2, Bcl-2, VEGFA, and Beclin-1 upregulated in SPA-treated MC3T3-E1 cells, whereas the levels of inflammatory cytokines including TNF-α, IL-1ß, and IL-6 decreased in the supernatant. The results showed that exosomes derived from BMSCs may participate in the attenuation of osteomyelitis by inducing proliferation and osteogenic differentiation and regulating the inflammatory state in bone cells.

Transposition with Tn3-family elements occurs through interaction with the host ß-sliding clamp processivity factor.

Tn3 family transposons are a widespread group of replicative transposons, notorious for contributing to the dissemination of antibiotic resistance, particularly the global prevalence of carbapenem resistance. The transposase (TnpA) of these elements catalyzes DNA breakage and rejoining reactions required for transposition. However, the molecular mechanism for target site selection with these elements remains unclear. Here, we identify a QLxxLR motif in N-terminal of Tn3 TnpAs and demonstrate that this motif allows interaction between TnpA of Tn3 family transposon Tn1721 and the host ß-sliding clamp (DnaN), the major processivity factor of the DNA replication machinery. The TnpA-DnaN interaction is essential for Tn1721 transposition. Our work unveils a mechanism whereby Tn3 family transposons can bias transposition into certain replisomes through an interaction with the host replication machinery. This study further expands the diversity of mobile elements that use interaction with the host replication machinery to bias integration.

TMJ-105, an extract of Carpesium cernuum, induced G2/M phase arrest and apoptosis via the JAK2/STAT3 axis and MAPKs signaling pathway in leukemia HEL cells.

Leukemia is a malignant tumor of the hematologic system. Studies have shown that cernuumolide J (TMJ-105), an extract of Carpesium cernuum, has anti-cancer effects, but the underlying mechanism is unclear. In this study, we investigated the effect of TMJ-105 on the proliferation of human leukemia HEL cells and its molecular mechanism. MTT analysis showed TMJ-105 had revealed that it shows significant IC50 in HEL cells at lower doses (1.79 ± 0.29 µmol/L) than in K562 cells (3.89 ± 0.80 µmol/L), and the suppression of HEL cell proliferation was time- and concentration-dependent. Meanwhile, TMJ-105 induced G2/M phase blockage, leading to DNA damage in HEL cells. TMJ-105 promoted HEL cells to release of reactive oxygen species (ROS) and changed mitochondrial membrane potential (MMP). Furthermore, TMJ-105 induced apoptosis by upregulating the cleaved-caspase9 and cleaved-caspase3 protein expression, while caspase pan inhibitor (Z-VAD-FMK) blocked the inhibition effect. Finally, TMJ-105 downregulated the phosphorylation of JAK2, STAT3 and Erk, and activated the phosphorylation of JNK and p38. Collectively, these results demonstrated that TMJ-105 inhibited proliferation of leukemia cells and the underlying mechanism via the JAK2/STAT3 axis and MAPKs signaling pathway. Based on these results, the present study suggested the sesquiterpene lactone TMJ-105 is a new chemotherapeutic agent for the treatment of leukemia.

Accuracy and influencing factors of Type B2 vessels in predicting the invasion depth of superficial esophageal squamous cell carcinoma under narrow-band imaging magnifying endoscopy.

OBJECTIVE: To evaluate the accuracy of Type B2 based on narrow-band imaging-magnifying endoscopy (NBI-ME) in judging invasion depth of superficial esophageal squamous cell carcinoma (SESCC) and analyze potential influencing factors. METHOD: Data from 113 patients where Type B2 was observed by magnifying endoscopy and confirmed by postoperative pathology as SESCC at the First Affiliated Hospital of Fujian Medical University and Fujian Provincial Hospital from January 2015 to April 2024 were retrospectively analyzed. Patients were divided into correct prediction and incorrect prediction groups according to the postoperative pathological results, and the prediction accuracy was calculated. The incorrect prediction group was further divided into overestimation and underestimation groups to identify the influential factors for overprediction and underprediction, respectively. The independent influential factors for the prediction were assessed using multivariate Cox logistic regression analysis. RESULTS: B2-narrow (Type B2 area ≤ 5 mm) (p < 0.001) and Type B2 around erosion (p = 0.040) were independent risk factors of overpredicting the invasion depth of SESCC based on Type B2. The presence of significant endoscopic features was an independent protective factor for overpredicting the invasion depth of SESCC (p = 0.014), whereas the presence of significant features under endoscopy was an independent risk factor for the underprediction (p = 0.005). CONCLUSION: B2-narrow (Type B2 area ≤ 5 mm), Type B2 vessels around erosion, and non- significant endoscopic features are closely related to overpredicting the invasion depth of SESCC based on Type B2, and the presence of significant endoscopic features is closely associated with underprediction.

FA-Net: A hierarchical feature fusion and interactive attention-based network for dose prediction in liver cancer patients.

Dose prediction is a crucial step in automated radiotherapy planning for liver cancer. Several deep learning-based approaches for dose prediction have been proposed to enhance the design efficiency and quality of radiotherapy plan. However, these approaches usually take CT images and contours of organs at risk (OARs) and planning target volume (PTV) as a multi-channel input and is thus difficult to extract sufficient feature information from each input, which results in unsatisfactory dose distribution. In this paper, we propose a novel dose prediction network for liver cancer based on hierarchical feature fusion and interactive attention. A feature extraction module is first constructed to extract multi-scale features from different inputs, and a hierarchical feature fusion module is then built to fuse these multi-scale features hierarchically. A decoder based on attention mechanism is designed to gradually reconstruct the fused features into dose distribution. Additionally, we design an autoencoder network to generate a perceptual loss during training stage, which is used to improve the accuracy of dose prediction. The proposed method is tested on private clinical dataset and obtains HI and CI of 0.31 and 0.87, respectively. The experimental results are better than those by several existing methods, indicating that the dose distribution generated by the proposed method is close to that approved in clinics. The codes are available at https://github.com/hired-ld/FA-Net.

Accuracy of 18F-FDG PET Imaging in Differentiating Parkinson's Disease from Atypical Parkinsonian Syndromes: A Systematic Review and Meta-Analysis.

RATIONALE AND OBJECTIVE: To quantitatively assess the accuracy of 18F-FDG PET in differentiating Parkinson's Disease (PD) from Atypical Parkinsonian Syndromes (APSs). METHODS: PubMed, Embase, and Web of Science databases were searched to identify studies published from the inception of the databases up to June 2024 that used 18F-FDG PET imaging for the differential diagnosis of PD and APSs. The risk of bias in the included studies was assessed using the QUADAS-2 or QUADAS-AI tool. Bivariate random-effects models were used to calculate the pooled sensitivity, specificity, and the area under the curves (AUC) of summary receiver operating characteristic (SROC). RESULTS: 24 studies met the inclusion criteria, involving a total of 1508 PD patients and 1370 APSs patients. 12 studies relied on visual interpretation by radiologists, of which the pooled sensitivity, specificity, and SROC-AUC for direct visual interpretation in diagnosing PD were 96% (95%CI: 91%, 98%), 90% (95%CI: 83%, 95%), and 0.98 (95%CI: 0.96, 0.99), respectively; the pooled sensitivity, specificity, and SROC-AUC for visual interpretation supported by univariate algorithms in diagnosing PD were 93% (95%CI: 90%, 95%), 90% (95%CI: 85%, 94%), and 0.96 (95%CI: 0.94, 0.97), respectively. 12 studies relied on artificial intelligence (AI) to analyze 18F-FDG PET imaging data. The pooled sensitivity, specificity, and SROC-AUC of machine learning (ML) for diagnosing PD were 87% (95%CI: 82%, 91%), 91% (95%CI: 86%, 94%), and 0.95 (95%CI: 0.93, 0.96), respectively. The pooled sensitivity, specificity, and SROC-AUC of deep learning (DL) for diagnosing PD were 97% (95%CI: 95%, 98%), 95% (95%CI: 89%, 98%), and 0.98 (95%CI: 0.96, 0.99), respectively. CONCLUSION: 18F-FDG PET has a high accuracy in differentiating PD from APS, among which AI-assisted automatic classification performs well, with a diagnostic accuracy comparable to that of radiologists, and is expected to become an important auxiliary means of clinical diagnosis in the future.