A data augmentation method for fully automatic brain tumor segmentation.

Automatic segmentation of glioma and its subregions is of great significance for diagnosis, treatment and monitoring of disease. In this paper, an augmentation method, called TensorMixup, was proposed and applied to the three dimensional U-Net architecture for brain tumor segmentation. The main ideas included that first, two image patches with size of 128 × 128 × 128 voxels were selected according to glioma information of ground truth labels from the magnetic resonance imaging data of any two patients with the same modality. Next, a tensor in which all elements were independently sampled from Beta distribution was used to mix the image patches. Then the tensor was mapped to a matrix which was used to mix the one-hot encoded labels of the above image patches. Therefore, a new image and its one-hot encoded label were synthesized. Finally, the new data was used to train the model which could be used to segment glioma. The experimental results show that the mean accuracy of Dice scores are 92.15%, 86.71% and 83.49% respectively on the whole tumor, tumor core, and enhancing tumor segmentation, which proves that the proposed TensorMixup is feasible and effective for brain tumor segmentation.

Using Regularized Multi-Task Learning for Schizophrenia MRI Data Classification.

BACKGROUND: Machine learning techniques and magnetic resonance imaging methods have been widely used in computer-aided diagnosis and prognosis of severe brain diseases such as schizophrenia, Alzheimer, etc. Methods: In this paper, a regularized multi-task learning method for schizophrenia classification is proposed, and three MRI datasets of schizophrenia, collected from different data centers, are investigated. Firstly, slice extraction is used in image preprocessing. Then texture features of gray-level co-occurrence matrices are extracted from the above processed images. Finally, a p-norm regularized multi-task learning method is proposed to simultaneously learn the site-specific and site-shared features of the multi-site data, which can effectively discriminate schizophrenia patients from normal controls. RESULTS: The classification error rate on 10 datasets can be reduced from 10% to 30%. CONCLUSIONS: The proposed method obtains excellent results and provides objective evidence for clinical diagnosis and treatment of schizophrenia.

Alzheimer's Disease Classification Based on Image Transformation and Features Fusion.

It has become an inevitable trend for medical personnel to analyze and diagnose Alzheimer's disease (AD) in different stages by combining functional magnetic resonance imaging (fMRI) and artificial intelligence technologies such as deep learning in the future. In this paper, a classification method was proposed for AD based on two different transformation images of fMRI and improved the 3DPCANet model and canonical correlation analysis (CCA). The main ideas include that, firstly, fMRI images were preprocessed, and subsequently, mean regional homogeneity (mReHo) and mean amplitude of low-frequency amplitude (mALFF) transformation were performed for the preprocessed images. Then, mReHo and mALFF images were extracted features using the improved 3DPCANet, and these two kinds of the extracted features were fused by CCA. Finally, the support vector machine (SVM) was used to classify AD patients with different stages. Experimental results showed that the proposed approach was robust and effective. Classification accuracy for significant memory concern (SMC) vs. mild cognitive impairment (MCI), normal control (NC) vs. AD, and NC vs. SMC, respectively, reached 95.00%, 92.00%, and 91.30%, which adequately proved the feasibility and effectiveness of the proposed method.

Electrospun P(LLA-CL) Nanoscale Fibrinogen Patch vs Porcine Small Intestine Submucosa Graft Repair of Inguinal Hernia in Adults: A Randomized, Single-Blind, Controlled, Multicenter, Noninferiority Trial.

BACKGROUND: The aim of this study was to compare primary efficacy indicators of a low-cost, electrospun, nanoscale P(LLA-CL)/fibrinogen patch with a porcine small intestine submucosa patch for hernia repair. STUDY DESIGN: A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible patients (20 to 75 years old) with primary unilateral, reducible groin hernias were randomly assigned (1:1) to electrospun nanoscale P(LLA-CL)/fibrinogen patch (experimental group) or porcine small intestine submucosa (control group) patch groups. Patients were treated with the Lichtenstein technique, and the primary endpoint was hernia recurrence at 33 months after surgery. The secondary endpoints were postoperative complications including groin pain and operative site infections. RESULTS: Between July 2014 and February 2016, 172 patients were assigned to experimental (n = 86) and control (n = 86) groups. At 6-month follow-up, postoperative complications occurred in 5 patients (5 of 86, 5.81%) and 2 (2 of 86, 2.35%) patients in the control and experimental groups, respectively (p < 0.05). At 33-month follow-up, recurrence was observed in 2 patients (2 of 79, 2.53%) in the control group vs none in the experimental group (0 of 78) (the 95% CI difference between the experimental and control groups was -0.93% to 6.00% and within the preset noninferior margin of Δ10%). No significant differences were found in the degree of chronic pain and complications 33 months after surgery between the 2 groups. CONCLUSIONS: Because the recurrence rates and postoperative complications after 33 months were not inferior in the experimental group, we believe that the P(LLA-CL)/fibrinogen patch, as a low cost alternative, has prospects for widespread clinical use.

Nitrogen and Phosphorus Codoped Vertical Graphene/Carbon Cloth as a Binder-Free Anode for Flexible Advanced Potassium Ion Full Batteries.

With the fast development in flexible electronic technology, power supply devices with high performance, low-cost, and flexibility are becoming more and more important. Potassium ion batteries (KIBs) have a brilliant prospect for applications benefiting from high voltage, lost cost, as well as similar electrochemistry to lithium ion batteries (LIBs). Although carbon materials have been studied as KIBs anodes, their rate capability and cycling stability are still unsatisfactory due to the large-size potassium ions. Herein, a nitrogen (N) and phosphorus (P) dual-doped vertical graphene (N, P-VG) uniformly grown on carbon cloth (N, P-VG@CC) is reported as a binder-free anode for flexible KIBs. With the combined advantages of rich active sites, highly accessible surface, highly conductive network, larger interlayer spacing as well as robust structural stability, this binder-free N, P-VG@CC anode exhibits high capacity (344.3 mAh g-1 ), excellent rate capability (2000 mA g-1 ; 46.5% capacity retention), and prominent long-term cycling stability (1000 cycles; 82% capacity retention), outperforming most of the recently reported carbonaceous anodes. Moreover, a potassium ion full cell is successfully assembled on the basis of potassium Prussian blue (KPB)//N, P-VG@CC, exhibiting a large energy density of 232.5 Wh kg-1 and outstanding cycle stability.

Surface phosphation of 3D mesoporous NiCo2O4 nanowire arrays as bifunctional anodes for lithium and sodium ion batteries.

A novel surface phosphate strategy was adopted to dramatically improve the charge transport, ion diffusion, electroactive sites, and cycle stability of mesoporous NiCo2O4 nanowire arrays (NWAs), drastically boosting their electrochemical properties. Consequently, the as-prepared phosphated NiCo2O4 NWA (P-NiCo2O4 NWA) electrode achieved excellent energy storage performance as a bifunctional anode material for both lithium ion batteries (LIBs) and sodium ion batteries (SIBs). When evaluated as an anode for LIBs, this P-NiCo2O4 NWA electrode showed a high reversible capacity up to 1156 mA h g-1 for 1500 cycles at 200 mA g-1 without appreciable capacity attenuation, while in SIBs, the electrode could also deliver an admirable initial capacity as high as 687 mA h g-1 and maintained 83.5% of this after 500 cycles at the same current density. Most important, when the current density increased from 100 to 1000 mA g-1, the capacity retention was about 63% in LIBs and 54% in SIBs. This work may shed light on the engineering of efficient electrodes for multifunctional flexible energy storage device applications.

Deceleration and acceleration capacities of heart rate associated with heart failure with high discriminating performance.

Accurate measurements of autonomic nerve regulation in heart failure (HF) were unresolved. The discriminating performance of deceleration and acceleration capacities of heart rate in HF was evaluated in 130 HF patients and 212 controls. Acceleration capacity and deceleration capacity were independent risk factors for HF in males, evaluated by multiple logistic regression analysis, with odds ratios (ORs) of 5.94 and 0.13, respectively. Acceleration capacity was also an independent risk factor for HF in females, with an OR of 8.58. Deceleration capacity was the best cardiac electrophysiological index to classify HF in males, with an area under the receiver operating characteristic curve (AUC) of 0.88. Deceleration capacity was the best classification factor of HF in females with an AUC of 0.97, significantly higher than even left ventricular ejection fraction (LVEF). Acceleration capacity also showed high performance in classifying HF in males (0.84) and females (0.92). The cut-off values of deceleration capacity for HF classification in males and females were 4.55 ms and 4.85 ms, respectively. The cut-off values of acceleration capacity for HF classification in males and females were -6.15 ms and -5.75 ms, respectively. Our study illustrates the role of acceleration and deceleration capacity measurements in the neuro-pathophysiology of HF.

Risk factor panels associated with hypertension in obstructive sleep apnea patients with different body mass indexes.

Although hypertension (HTN), obstructive sleep apnea (OSA), and obesity frequently co-occur, the precise role of obesity in this interrelationship is not completely understood. A total of 727 OSA patients were assigned to body mass index (BMI) <25 (27.6%; n = 201), 25≤ BMI <29.99 (53.4%; n = 388), and BMI ≥30 (19%; n = 138). HTN risk factors in each group were evaluated. A total of 244 (33.6%) patients exhibited co-morbid HTN, of whom 20.5% (50/244), 52.9% (129/244), and 26.6% (65/244) were distributed between the BMI <25, 25≤ BMI <29.99, and BMI ≥30 groups, respectively. Multiple logistic regression indicated that age, male gender, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and apnea-hypopnea index (AHI) scores were HTN risk factors for the BMI<25 group. In the 25≤ BMI <29.99 group, risk factors were age, BMI, diabetes, and AHI. Finally, in the BMI ≥30 group, risk factors were age, diabetes, TG, LDL-C and AHI. These results demonstrate that different risk factor panels were associated with HTN in OSA patients with different BMIs.

Endothelial nitric oxide synthase dimerization is regulated by heat shock protein 90 rather than by phosphorylation.

Endothelial nitric oxide synthase (eNOS) is a multifunctional enzyme with roles in diverse cellular processes including angiogenesis, tissue remodeling, and the maintenance of vascular tone. Monomeric and dimeric forms of eNOS exist in various tissues. The dimeric form of eNOS is considered the active form and the monomeric form is considered inactive. The activity of eNOS is also regulated by many other mechanisms, including amino acid phosphorylation and interactions with other proteins. However, the precise mechanisms regulating eNOS dimerization, phosphorylation, and activity remain incompletely characterized. We utilized purified eNOS and bovine aorta endothelial cells (BAECs) to investigate the mechanisms regulating eNOS degradation. Both eNOS monomer and dimer existed in purified bovine eNOS. Incubation of purified bovine eNOS with protein phosphatase 2A (PP2A) resulted in dephosphorylation at Serine 1179 (Ser1179) in both dimer and monomer and decrease in eNOS activity. However, the eNOS dimer∶monomer ratio was unchanged. Similarly, protein phosphatase 1 (PP1) induced dephosphorylation of eNOS at Threonine 497 (Thr497), without altering the eNOS dimer∶monomer ratio. Different from purified eNOS, in cultured BAECs eNOS existed predominantly as dimers. However, eNOS monomers accumulated following treatment with the proteasome inhibitor lactacystin. Additionally, treatment of BAECs with vascular endothelial growth factor (VEGF) resulted in phosphorylation of Ser1179 in eNOS dimers without altering the phosphorylation status of Thr497 in either form. Inhibition of heat shock protein 90 (Hsp90) or Hsp90 silencing destabilized eNOS dimers and was accompanied by dephosphorylation both of Ser1179 and Thr497. In conclusion, our study demonstrates that eNOS monomers, but not eNOS dimers, are degraded by ubiquitination. Additionally, the dimeric eNOS structure is the predominant condition for eNOS amino acid modification and activity regulation. Finally, destabilization of eNOS dimers not only results in eNOS degradation, but also causes changes in eNOS amino acid modifications that further affect eNOS activity.

Inhibition of Rho and Rac geranylgeranylation by atorvastatin is critical for preservation of endothelial junction integrity.

BACKGROUND: Small GTPases (guanosine triphosphate, GTP) are involved in many critical cellular processes, including inflammation, proliferation, and migration. GTP loading and isoprenylation are two important post-translational modifications of small GTPases, and are critical for their normal function. In this study, we investigated the role of post-translational modifications of small GTPases in regulating endothelial cell inflammatory responses and junctional integrity. METHODS AND RESULTS: Confluent human umbilical vein endothelial cell (HUVECs ) treated with atorvastatin demonstrated significantly decreased lipopolysaccharide (LPS)-mediated IL-6 and IL-8 generation. The inhibitory effect of atorvastatin (Atorva) was attenuated by co-treatment with 100 µM mevalonate (MVA) or 10 µM geranylgeranyl pyrophosphate (GGPP), but not by 10 µM farnesyl pyrophosphate (FPP). Atorvastatin treatment of HUVECs produced a time-dependent increase in GTP loading of all Rho GTPases, and induced the translocation of small Rho GTPases from the cellular membrane to the cytosol, which was reversed by 100 µM MVA and 10 µM GGPP, but not by 10 µM FPP. Atorvastatin significantly attenuated thrombin-induced HUVECs permeability, increased VE-cadherin targeting to cell junctions, and preserved junction integrity. These effects were partially reversed by GGPP but not by FPP, indicating that geranylgeranylation of small GTPases plays a major role in regulating endothelial junction integrity. Silencing of small GTPases showed that Rho and Rac, but not Cdc42, play central role in HUVECs junction integrity. CONCLUSIONS: In conclusion, our studies show that post-translational modification of small GTPases plays a vital role in regulating endothelial inflammatory response and endothelial junction integrity. Atorvastatin increased GTP loading and inhibited isoprenylation of small GTPases, accompanied by reduced inflammatory response and preserved cellular junction integrity.

Computed tomography manifestations of common inferior vena cava dysplasia and its clinical significance.

This study aimed to review and analyse the computed tomography (CT) imaging results of frequently encountered developmental anomalies of the inferior vena cava (IVC). The underlying clinical significance was evaluated with reference to the relevant literature. CT images of patients who received abdominal or thoracic scanning between July 2009 and September 2011 were reviewed. Developmental anomalies observed in the IVC were identified and categorised. Images of the cases with typical anomalies were presented and their developmental mechanism, as well as clinical significance, was discussed. The most frequently encountered IVC developmental anomalies include the left vena cava, double vena cava, azygos continuation of the IVC, left circumaortic renal vein, left retroaortic renal vein and retrocaval ureter. The embryogenesis of the IVC is a complex process that results in various congenital anomalies. The developmental anomalies of the IVC are distinguished using a CT scan and have significant implications on clinical perspective.

Prophylactic intra-aortic balloon pump reduces C-reactive protein levels and early mortality in high-risk patients undergoing percutaneous coronary intervention.

OBJECTIVE: Intra-aortic balloon pump (IABP) plays a pivotal role in the treatment of cardiogenic shock complicating acute myocardial infarction. However, the usefulness of prophylactic IABP support in high-risk patients during percutaneous coronary intervention (PCI) is still controversial, and its influence on the inflammatory response following PCI has not been well evaluated. In this study we sought to assess the impact of prophylactic IABP support upon C-reactive protein (CRP) level and clinical prognosis in high-risk patients undergoing PCI. METHODS AND RESULTS: A total of 106 high-risk patients diagnosed with acute ST-elevation or non-ST-elevation myocardial infarction (Cardiogenic shock was excluded) were enrolled and divided into two groups at random: 51 cases receiving PCI accompanied by prophylactic IABP support, and the remaining 55 cases undergoing PCI without IABP insertion served as the control group. CRP levels were determined on admission, day 3 and day 7, respectively. The troponin I (TNI) peak, left ventricular functions and major adverse cardiovascular events (MACE) were compared during follow-up. We found that the IABP group had a lower TNI peak as well as CRP level after PCI. Left ventricular function was improved at 2-week instead of 3-month followup. Although the mortality did not reach a significant decline after 6-month follow-up, it had improved in-hospital and at 30-day follow-up. CONCLUSION: The use of a prophylactic IABP in high-risk patients before PCI could reduce the CRP level and reduce mortality during the early phase following PCI.

Intra-aortic balloon pump improves clinical prognosis and attenuates C-reactive protein level in acute STEMI complicated by cardiogenic shock.

OBJECTIVES: Intra-aortic balloon pump (IABP) plays a pivotal role in the treatment of cardiogenic shock (CS) complicating acute ST-segment elevation myocardial infarction (STEMI). However, the influence of IABP on the inflammatory response has not been well evaluated. We sought to assess the effects of IABP support upon C-reactive protein (CRP) levels in patients with STEMI complicated by CS undergoing percutaneous coronary intervention (PCI). METHODS: This was a prospective study and a total of 91 patients with STEMI complicated by CS receiving emergency PCI were enrolled, 43 cases of which received IABP support, and the remaining cases without IABP therapy were the control group. CRP levels were determined at admission, and on days 3 and 7. Troponin I peak, left ventricular function and major adverse cardiovascular events were compared following PCI. RESULTS: The IABP group had lower CRP levels at days 3 and 7, greater improvement in left ventricular function and lower troponin peak following PCI. Significant differences were also observed in the incidence of mortality at 6-month follow-up, both in hospital and after 30 days. CONCLUSIONS: IABP support improves clinical prognosis and attenuates the CRP level in patients with CS complicating STEMI after PCI.