Engineering hierarchical interfaces in high-temperature polymer dielectrics for electrostatic supercapacitors.

Dielectric capacitors are pivotal elements in advanced pulsed power devices and high-voltage, high-capacity power electronic converters, crucial for efficient energy storage. However, a major challenge remains the significant reduction in energy density and charge-discharged efficiency of dielectric polymers under high temperatures, primarily due to heightened electrical conduction losses. This study introduces a universal approach of heterojunction interface engineering in polyethersulfone (PESU) composites, aimed at improving capacitive performance across a broad temperature range. The introduction of one-dimensional heterojunction BaTiO3@Al2O3 nanofibers with large aspect ratios could enhance both the dielectric constant (εr) and breakdown strength (Eb). Specifically, the creation of hierarchical interfaces increases the trap density and energy levels for mobile charges, effectively reducing conduction losses and improving Eb under high-temperature conditions. Consequently, the PESU-3 vol% BaTiO3@Al2O3 nanocomposite achieves an excellent energy density of 7.3 J cm-3 with over 90% retention at 150 °C and 550 MV m-1. Finite element simulations further confirm that the heterojunction structure of BaTiO3@Al2O3 nanofibers effectively inhibits the growth of breakdown paths. This work demonstrates that hierarchical interface engineering offers a powerful strategy to enhance capacitive performance in dielectric polymer composites under harsh conditions.

Hepatocellular carcinoma and AIM2: Therapeutic potential through regulation of autophagy and macrophage polarization.

OBJECTIVE: Hepatocellular carcinoma (HCC) poses a significant challenge to global health. Its pathophysiology involves interconnected processes, including cell proliferation, autophagy, and macrophage polarization. However, the role of Absent in Melanoma 2 (AIM2) in HCC remains elusive. METHODS: The expression of AIM2 in Huh-7 and Hep3B cell lines was manipulated and cell proliferation, autophagy, apoptosis, and migration/invasion, together with the polarization of M2 macrophages, were evaluated. The markers of autophagy pathway, LC3B, Beclin-1, and P62, underwent examination through Western blot analysis. An autophagy inhibitor, 3-MA, was used to measured the role of autophagy in HCC. Finally, the effect of AIM2 overexpression on HCC was further evaluated using a subcutaneous tumor model in nude mice. RESULTS: Our results established that AIM2 overexpression inhibits HCC cell proliferation, migration, and invasion while promoting apoptosis and autophagy. Conversely, knockdown of AIM2 engendered opposite effects. AIM2 overexpression was correlated with reduced M2 macrophage polarization. The autophagy inhibitor substantiated AIM2's role in autophagy and identified its downstream impact on cell proliferation, migration, invasion, and macrophage polarization. In the in vivo model, overexpression of AIM2 led to the inhibition of HCC tumor growth. CONCLUSION: The findings underscore AIM2's crucial function in modulating major biological processes in HCC, pointing to its potential as a therapeutic target. This study inaugurally demonstrated that AIM2 activates autophagy and influences macrophage polarization, playing a role in liver cancer progression.

Ultra-Low Loading Fillers Induced Excellent Capacitive Performance in Polymer-Based Multilayer Nanocomposites under Harsh Environments.

Multilayer-structured nanocomposites are recognized as a prominent strategy for overcoming the paradox between the breakdown strength (Eb) and polarization (P) to achieve superior energy storage performance. However, current multilayer-structured nanocomposites involving substantial quantities of nanofillers (>10 vol.%) for high dielectric constant as polarization layer will inevitably deteriorate mechanical properties and breakdown strength. Herein, an innovative approach is reported to breaking conventional rules by designing a multilayered polymer composite with ultralow loading of Al2O3 nanoparticles, i.e., 0.3 vol.% for polarization layers and 2 vol.% for insulation layers. By modulating the spatial distribution of Al2O3 nanoparticles in polymer, a significantly increased interfacial dipole response is induced, and deep interfacial traps are constructed to capture the mobile charges, thereby suppressing high-temperature conduction loss. The resulting multilayered polymer composite exhibits an unparalleled discharged energy density of 7.8 J cm-3 with a charging/discharging efficiency exceeding 90% at 150 °C. This work provides valuable insights into achieving superior capacitive performance in multilayer composite films operating under extreme conditions.

van der Waals-bonded graphene clusters enhance thermal conductivity of phase-change materials for advanced thermal energy management.

Organic phase-change materials possess immense application potential, but their low thermal conductivity (≤0.5 W m-1 K-1) severely limits the thermal energy charge/discharge rate, impeding their practical implementation in the field of advanced energy. While incorporating thermally conductive fillers into the phase-change matrix can address this issue, achieving a thermal conductivity exceeding 10 W m-1 K-1 at a filler content below 30 vol% remains challenging, attributed to the absence of a well-designed filler interface and structure. Herein, a strategy for developing planar graphene clusters and subsequently integrating them with phase-change microcapsules to fabricate composites using compression molding was demonstrated. The proposed graphene clusters are formed by closely aligned and overlapping graphene sheets that bond together through van der Waals forces, resulting in a significant decrease in junction thermal resistance within the composites. Combining this interface design with compression-induced construction of a highly oriented structure, the composites achieved a remarkable thermal conductivity of 103 W m-1 K-1 with ≈29 vol% filler addition, enhancing the thermal energy charge/discharge rate by over two orders of magnitude. Furthermore, we demonstrated that the composites possess the essential enthalpy values, competent strength, and ease of shaping, making them applicable across various domains of thermal energy management.

Compressive Properties of Basalt Fibers and Polypropylene Fiber-Reinforced Lightweight Concrete.

With the development of high-rise and large-scale modern structures, traditional concrete has become a design limitation due to its excessive dead weight. High-strength lightweight concrete is being emphasized. Lightweight concrete has low density and the characteristics of a brittle material. This is an important factor affecting the strength and ductility of the lightweight concrete. To improve these shortcomings and proffer solutions, a three-phase composite lightweight concrete was prepared using a combination of tumbling and molding methods. This paper investigates the various influencing factors such as the stacking volume fraction of GFR-EMS, the type of fiber, and the content and length of fiber in the matrix. Studies have shown that the addition of fibers significantly increases the compressive strength of the concrete. The compressive strength of concrete with a 12 mm basalt fiber (BF) (1.5%) admixture is 9.08 MPa, which is 62.43% higher than that of concrete without the fiber admixture. The compressive strength was increased by 27.53 and 21.88% compared to concrete containing 3 mm BF (1.5%) and 0.5% BF (12 mm), respectively. Fibers can fill the pore defects within the matrix. Mutually overlapping fibers easily form a network structure to improve the bond between the cement matrix and the aggregate particles. The compressive strength of lightweight concrete with the addition of BF was 16.71% higher than that with the addition of polypropylene fiber (PPF) with the same length and content of fibers. BF has been shown to be more effective in improving the mechanical properties of concrete. In this work, the compressive mechanism and optimum preparation parameters of a three-phase composite lightweight concrete were analyzed through compression tests. This provides some insights into the development of lightweight concrete.

Highly oriented BN-based TIMs with high through-plane thermal conductivity and low compression modulus.

In the pursuit of effective thermal management for electronic devices, it is crucial to develop insulation thermal interface materials (TIMs) that exhibit exceptional through-plane thermal conductivity, low thermal resistance, and minimal compression modulus. Boron nitride (BN), given its outstanding thermal conduction and insulation properties, has garnered significant attention as a potential material for this purpose. However, previously reported BN-based composites have consistently demonstrated through-plane thermal conductivity below 10 W m-1 K-1 and high compression modulus, whilst also presenting challenges in terms of mass production. In this study, low molecular weight polydimethylsiloxane (PDMS) and large-size BN were utilized as the foundational materials. Utilizing a rolling-curing integrated apparatus, we successfully accomplished the continuous preparation of large-sized, high-adhesion BN films. Subsequent implementation of stacking, cold pressing, and vertical cutting techniques enabled the attainment of a remarkable BN-based TIM, characterized by an unprecedented through-plane thermal conductivity of up to 12.11 W m-1 K-1, remarkably low compression modulus (55 kPa), and total effective thermal resistance (0.16 °C in2 W-1, 50 Psi). During the TIMs performance evaluation, our TIMs demonstrated superior heat dissipation capabilities compared with commercial TIMs. At a heating power density of 40 W cm-2, the steady-state temperature of the ceramic heating element was found to be 7 °C lower than that of the commercial TIMs. This pioneering feat not only contributes valuable technical insights for the development of high-performance insulating TIMs but also establishes a solid foundation for widespread implementation in thermal management applications across a range of electronic devices.

Ultrasound-Responsive Nanodelivery System of GPC3-Targeting and Sonosensitizer for Visualized Hepatocellular Carcinoma Therapy.

Purpose: The incidence of hepatocellular carcinoma (HCC) is continuously increasing, and the mortality rate remains high. Thus, more effective strategies are needed to improve the treatment of HCC. Methods: In this study, we report the use of a visualized glypican-3 (GPC3)-targeting nanodelivery system (named GC-NBs) in combination with sonodynamic therapy (SDT) to enhance the therapeutic efficacy for treating HCC. The obtained nanodelivery system could actively target hepatocellular carcinoma cells and achieve ultrasound imaging through phase changes into nanobubbles under low-intensity ultrasound irradiation. Meanwhile, the released chlorine e6 (Ce6) after the nanobubbles collapse could lead to the generation of reactive oxygen species (ROS) under ultrasound irradiation to induce SDT. Results: Both in vitro and in vivo experiments have shown that GC-NBs can accumulate in tumour areas and achieve sonodynamic antitumour therapy under the navigation action of glypican-3-antibody (GPC3-Ab). Furthermore, in vitro and in vivo experiments did not show significant biological toxicity of the nanodelivery system. Moreover, GC-NBs can be imaged with ultrasound, providing personalized treatment monitoring. Conclusion: GC-NBs enable a visualized antitumour strategy from a targeted sonodynamic perspective by combining tumour-specific targeting and stimuli-responsive controlled release into a single system.

A Super-Adhesive 2D Diamond Smart Nanofluid with Self-Healing Properties and Multifunctional Applications.

Smart responsive materials are capable of responding to external stimuli and, compared to traditional materials, can be effectively reused and reduce usage costs in applications. However, smart responsive materials often face challenges such as the inability to repair extensive damage, instability in long-term performance, and inapplicability in extreme environments. This study combines 2D diamond nanosheets with organic fluorinated molecules to prepare a smart nanofluid (fluorinated diamond nanosheets, F-DN) with self-healing and self-adhesion properties. This smart nanofluid can be used to design various coatings for different applications. For example, coatings prepared on textured steel plates using the drop-casting method have excellent superhydrophobic and high oleophobic properties; coatings on titanium alloy plates achieve low friction and wear in the presence of lubricating additives of F-DN in perfluoropolyether (PFPE). Most impressively, coatings on steel plates not only provide effective corrosion resistance but also have the ability to self-heal significant damage (approximately 2 mm in width), withstand extremely low temperatures (-64 °C), and resist long-term corrosion factors (immersion in 3.5 wt % NaCl solution for 35 days). Additionally, it can act as a "coating glue" to repair extensive damage to other corrosion-resistant organic coatings and recover their original protective properties. Therefore, the smart nanofluid developed in this study offers diverse applications and presents new materials system for the future development of smart responsive materials.

2D Materials-Based Thermal Interface Materials: Structure, Properties, and Applications.

The challenges associated with heat dissipation in high-power electronic devices used in communication, new energy, and aerospace equipment have spurred an urgent need for high-performance thermal interface materials (TIMs) to establish efficient heat transfer pathways from the heater (chip) to heat sinks. Recently, emerging 2D materials, such as graphene and boron nitride, renowned for their ultrahigh basal-plane thermal conductivity and the capacity to facilitate cross-scale, multi-morphic structural design, have found widespread use as thermal fillers in the production of high-performance TIMs. To deepen the understanding of 2D material-based TIMs, this review focuses primarily on graphene and boron nitride-based TIMs, exploring their structures, properties, and applications. Building on this foundation, the developmental history of these TIMs is emphasized and a detailed analysis of critical challenges and potential solutions is provided. Additionally, the preparation and application of some other novel 2D materials-based TIMs are briefly introduced, aiming to offer constructive guidance for the future development of high-performance TIMs.

Phage therapy combats pan drug-resistant Acinetobacter baumannii infection safely and efficiently.

Phage therapy offers a promising approach to combat the growing threat of antimicrobial resistance. Yet, key questions remain regarding dosage, administration routes, combination therapy, and the causes of therapeutic failure. In this study, we focused on a novel lytic phage, ФAb4B, which specifically targeted the Acinetobacter baumannii strains with KL160 capsular polysaccharide, including the pan-drug resistant A. baumannii YQ4. ФAb4B exhibited the ability to effectively inhibit biofilm formation and eradicate mature biofilms independently of dosage. Additionally, it demonstrated a wide spectrum of antibiotic-phage synergy and did not show any cytotoxic or haemolytic effects. Continuous phage injections, both intraperitoneally and intravenously over 7 d, showed no acute toxicity in vivo. Importantly, phage therapy significantly improved neutrophil counts, outperforming ciprofloxacin. However, excessive phage injections suppressed neutrophil levels. The combinatorial treatment of phage-ciprofloxacin rescued 91% of the mice, a superior outcome compared to phage alone (67%). The efficacy of the combinatorial treatment was independent of phage dosage. Notably, prophylactic administration of the combinatorial regimen provided no protection, but even when combined with a delayed therapeutic regimen, it saved all the mice. Bacterial resistance to the phage was not a contributing factor to treatment failure. Our preclinical study systematically describes the lytic phage's effectiveness in both in vitro and in vivo settings, filling in crucial details about phage treatment against bacteriemia caused by A. baumannii, which will provide a robust foundation for the future of phage therapy.

Prognostic value of angiogenic T cells in hepatitis B-induced liver cirrhosis.

This study was performed to investigate the frequency of angiogenic T cells (CD4+ Tang cells) among CD4+ T cells in patients with hepatitis B-induced liver cirrhosis (HBV-LC) and to evaluate the predictive role of these cells in the clinical outcome. In total, 185 patients with HBV-LC were recruited to measure the frequency of CD4+ Tang cells and chemokine levels using flow cytometry. RESULTS: There was 11.4% of death after 3-momth follow-up. The AUC for the ability of the frequency of CD4+ Tang cell to predict death was 0.724 (higher than those for the MELD score, FIB-4 score, and Child-Pugh classification). Cox regression analysis revealed an association between the frequency of CD4+ Tang cells and a 3-month survival chance. CONCLUSIONS: The lower frequency of CD4+ T ang cells was correlated with the severity of HBV-LC and may serve as a prognostic predictor.

High Thermal Conductivity and Radiative Cooling Designed Boron Nitride Nanosheets/Silk Fibroin Films for Personal Thermal Management.

The implementation of passive cooling strategies is crucial for transitioning from the current high-power- and energy-intensive thermal management practices to more environmentally friendly and carbon-neutral alternatives. Among the various approaches, developing thermal management materials with high thermal conductivity and emissivity for effective cooling of personal and wearable devices in both indoor and outdoor settings poses significant challenges. In this study, we successfully fabricated a cooling patch by combining biodegradable silk fibroin with boron nitride nanosheets. This patch exhibits consistent heat dissipation capabilities under different ambient conditions. Leveraging its excellent radiative cooling efficiency (Rsolar = 0.89 and εLWIR = 0.84) and high thermal conductivity (in-plane 27.58 W m-1 K-1 and out-plane 1.77 W m-1 K-1), the cooling patch achieves significant simulated skin temperature reductions of approximately 2.5 and 8.2 °C in outdoor and indoor conditions, respectively. Furthermore, the film demonstrates excellent biosafety and can be recycled and reused for at least three months. This innovative BNNS/SF film holds great potential for advancing the field of personal thermal management materials.

Visualization of therapeutic intervention for acute liver injury using low-intensity pulsed ultrasound-responsive phase variant nanoparticles.

Acute liver injury (ALI) is a highly fatal condition characterized by sudden massive necrosis of liver cells, inflammation, and impaired coagulation function. Currently, the primary clinical approach for managing ALI involves symptom management based on the underlying causes. The association between excessive reactive oxygen species originating from macrophages and acute liver injury is noteworthy. Therefore, we designed a novel nanoscale phase variant contrast agent, denoted as PFP@CeO2@Lips, which effectively scavenges reactive oxygen species, and enables visualization through low intensity pulsed ultrasound activation. The efficacy of the nanoparticles in scavenging excess reactive oxygen species from RAW264.7 and protective AML12 cells has been demonstrated through in vitro and in vivo experiments. Additionally, these nanoparticles have shown a protective effect against LPS/D-GalN attack in C57BL/6J mice. Furthermore, when exposed to LIPUS irritation, the nanoparticles undergo liquid-gas phase transition and enable ultrasound imaging.

A low red/far-red ratio restricts nitrogen assimilation by inhibiting nitrate reductase associated with downregulated TaNR1.2 and upregulated TaPIL5 in wheat (Triticum aestivum L.).

Understanding the physiological mechanism underlying nitrogen levels response to a low red/far-red ratio (R/FR) can provide new insights for optimizing wheat yield potential but has been not well documented. This study focused on the changes in nitrogen levels, nitrogen assimilation and nitrate uptake in wheat plants grown with and without additional far-red light. A low R/FR reduced wheat nitrogen accumulation and grain yield compared with the control. The levels of total nitrogen, free amino acid and ammonium were decreased in leaves but nitrate content was temporarily increased under a low R/FR. The nitrate reductase (NR) activity in leaves was more sensitive to a low R/FR than glutamine synthetase, glutamate synthase, glutamic oxalacetic transaminase and glutamic-pyruvic transaminase. Further analysis showed that a low R/FR had little effect on the NR activation state but reduced the level of NR protein and the expression of encoding gene TaNR1.2. Interestingly, a low R/FR rapidly induced TaPIL5 expression rather than TaHY5 and other members of TaPILs in wheat, suggesting that TaPIL5 was the key transcription factor response to a low R/FR in wheat and might be involved in the downregulation of TaNR1.2 expression. Besides, a low R/FR downregulated the expression of TaNR1.2 in leaves earlier than that of TaNRT1.1/1.2/1.5/1.8 in roots, which highlights the importance of NR and nitrogen assimilation in response to a low R/FR. Our results provide revelatory evidence that restricted nitrate reductase associated with downregulated TaNR1.2 and upregulated TaPIL5 mediate the suppression of nitrogen assimilation under a low R/FR in wheat.

In Situ Construction of High-Thermal-Conductivity and Negative-Permittivity Epoxy/Carbon Fiber@Carbon Composites with a 3D Network by High-Temperature Chemical Vapor Deposition.

Modern highly integrated microelectronic devices are unable to dissipate heat over time, which greatly affects the operating efficiency and service life of electronic equipment. Constructing high-thermal-conductivity composites with 3D network structures is a hot research topic. In this article, carbon fiber felt (CFF) was prepared by airflow netting forming technology and needle punching combined with stepped heat treatment. Then, carbon-coated carbon fiber felt (C@CFF) with a three-dimensional network structure was constructed in situ by high-temperature chemical vapor deposition (CVD). Finally, high-temperature treatment was used to improve the degree of crystallinity of C@CFF and further enhance its graphitization. The epoxy (EP) composites were prepared by simple vacuum infiltration-molding curing. The test results showed that the in-plane thermal conductivity (K∥) and through-plane thermal conductivity (K⊥) of EP/C@CFF-2300 °C could reach up to 13.08 and 2.78 W/mK, respectively, where the deposited carbon content was 11.76 vol %. The in-plane thermal conductivity enhancement (TCE) of EP/C@CFF-2300 °C was improved by 6440 and 808% compared to those of pure EP and EP/CFF, respectively. The high-temperature treatment greatly provides an improvement in thermal conductivity for the in-plane and the through-plane. Infrared imaging showed excellent thermal management properties of the prepared epoxy composites. EP/C@CFF-2300 °C owned an in-plane AC conductivity of up to 0.035 S/cm at 10 kHz, and Lorentz-Drude-type negative permittivity behaviors were observed at the tested frequency region. The CFF thermally conductive composites prepared by the above method have a broad application prospect in the field of advanced thermal management and electromagnetics.

Anisotropic Black Phosphorene Structural Modulation for Thermal Storage and Solar-Thermal Conversion.

Exploiting novel strategies for simultaneously harvesting ubiquitous, renewable, and easily accessible solar energy based on the photothermal effect, and efficiently storing the acquired thermal energy plays a vital role in revolutionizing the current fossil fuel-dominating energy structure. Developing black phosphorene-based phase-change composites with optimized photothermal conversion efficiencyand high latent heat is the most promising way to achieve efficient solar energy harvesting and rapid thermal energy storage. However, exfoliating high-quality black phosphorene nanosheets  remains challenging, Furthermore, an efficient strategy that can construct the aligned black phosphorene frameworks to maximize thermal conductivity enhancement is still lacking. Herein, high-quality black phosphorene nanosheets are prepared by an optimized exfoliating strategy. Meanwhile, by regulating the temperature gradient during freeze-casting, the framework consisting of shipshape aligned black phosphorene at long-range is successfully fabricated, improving the thermal conductivity of the poly(ethylene glycol) matrix up to 1.81 W m-1  K-1 at 20 vol% black phosphorene loading. The framework also endows the composite with excellent phase-change material encapsulation capacity and  high latent heat of 103.91 J g-1 . It is envisioned that the work advances the paradigm of contrasting frameworks with nanosheets toward controllable structure thermal enhancement of the composites.

Prevalence of antibody to hepatitis B surface antigen among qualified blood donors in Nanjing, China.

Universal infant hepatitis B vaccination has been implemented more than three decades. This study aimed to determine the prevalence of antibodies to hepatitis B surface antigen (anti-HBs) and to hepatitis B core antigen (anti-HBc) in qualified blood donors in Nanjing, China. Plasmas of 815 qualified blood donors, collected from February through May 2019, were measured for anti-HBs and anti-HBc by enzyme-linked immunosorbent assay. There were 449 (55.1%) male and 366 (44.9%) female blood donors, with a median age of 28.9 years (18-60). The seroprevalence of anti-HBs was 58.8%, with no significant difference in different genders and different age groups. The overall prevalence of anti-HBc was 7.0%, with an increasing trend with age, from 0% in 18-20 years old group to 17.9% in 51-60 years old group (χ2 = 46.7965, p < .0001). The prevalence of anti-HBc in donors born after the implementation of universal hepatitis B vaccination was significantly lower than that in donors born before (1.0% vs 15.5%; χ2 = 63.6033, p < .0001). Our data suggest that more than half of the blood donors in Nanjing are anti-HBs positive. Since a blood recipient usually receives more than one unit of red blood cells or plasma, passively acquired anti-HBs in blood recipients may neutralize hepatitis B virus potentially presented in blood donors with occult hepatitis B infection. In addition, the presence of anti-HBs and/or anti-HBc in blood donors may cause unique hepatitis B serological profile in blood recipients.

Flame Retardancy of Epoxy Resins Modified with Few-Layer Black Phosphorus.

Few-layer black phosphorus (BP)- and red phosphorus (RP)-modified diglycidyl ether of bisphenol A-based epoxy resins (EP) was prepared with 4,4'-diaminodiphenylsulfone as a curing agent. The thermal stability and flame-retardant properties of the modified EPs were compared. Both BP and RP were able to improve the flame-retardant properties of EPs, while the BP showed higher flame-retardant efficiency than RP. As a two-dimensional nanomaterial, BP exhibited good compatibility, high flame-retardant efficiency, and negligible impact on the mechanical and thermal stability of EP. Pyrolysis-gas Fourier-transform infrared spectroscopic analysis of EP showed that the addition of BP significantly inhibited the release of pyrolysis products in the gas phase. The modes of action for flame-retardant BPs in gas phase and condensed phase were proposed.

A Hierarchically Structured Graphene/Ag Nanowires Paper as Thermal Interface Material.

With the increase in heat power density in modern integrating electronics, thermal interface materials (TIM) that can efficiently fill the gaps between the heat source and heat sinks and enhance heat dissipation are urgently needed owing to their high thermal conductivity and excellent mechanical durability. Among all the emerged TIMs, graphene-based TIMs have attracted increasing attention because of the ultrahigh intrinsic thermal conductivity of graphene nanosheets. Despite extensive efforts, developing high-performance graphene-based papers with high through-plane thermal conductivity remains challenging despite their high in-plane thermal conductivity. In this study, a novel strategy for enhancing the through-plane thermal conductivity of graphene papers by in situ depositing AgNWs on graphene sheets (IGAP) was proposed, which could boost the through-plane thermal conductivity of the graphene paper up to 7.48 W m-1 K-1 under packaging conditions. In the TIM performance test under actual and simulated operating conditions, our IGAP exhibits strongly enhanced heat dissipation performance compared to the commercial thermal pads. We envision that our IGAP as a TIM has great potential for boosting the development of next-generation integrating circuit electronics.

Development and evaluation clinical-radiomics analysis based on T1-weighted imaging for diagnosing neonatal acute bilirubin encephalopathy.

Purpose: To investigate the value of clinical-radiomics analysis based on T1-weighted imaging (T1WI) for predicting acute bilirubin encephalopathy (ABE) in neonates. Methods: In this retrospective study, sixty-one neonates with clinically confirmed ABE and 50 healthy control neonates were recruited between October 2014 and March 2019. Two radiologists' visual diagnoses for all subjects were independently based on T1WI. Eleven clinical and 216 radiomics features were obtained and analyzed. Seventy percent of samples were randomly selected as the training group and were used to establish a clinical-radiomics model to predict ABE; the remaining samples were used to validate the performance of the models. The discrimination performance was assessed by receiver operating characteristic (ROC) curve analysis. Results: Seventy-eight neonates were selected for training (median age, 9 days; interquartile range, 7-20 days; 49 males) and 33 neonates for validation (median age, 10 days; interquartile range, 6-13 days; 24 males). Two clinical features and ten radiomics features were finally selected to construct the clinical-radiomics model. In the training group, the area under the ROC curve (AUC) was 0.90 (sensitivity: 0.814; specificity: 0.914); in the validation group, the AUC was 0.93 (sensitivity: 0.944; specificity: 0.800). The AUCs of two radiologists' and the radiologists' final visual diagnosis results based on T1WI were 0.57, 0.63, and 0.66, respectively. The discriminative performance of the clinical-radiomics model in the training and validation groups was increased compared to the radiologists' visual diagnosis (P < 0.001). Conclusions: A combined clinical-radiomics model based on T1WI has the potential to predict ABE. The application of the nomogram could potentially provide a visualized and precise clinical support tool.