Multiparametric MRI-Based Interpretable Radiomics Machine Learning Model Differentiates Medulloblastoma and Ependymoma in Children: A Two-Center Study.

RATIONALE AND OBJECTIVES: Medulloblastoma (MB) and Ependymoma (EM) in children, share similarities in age group, tumor location, and clinical presentation. Distinguishing between them through clinical diagnosis is challenging. This study aims to explore the effectiveness of using radiomics and machine learning on multiparametric magnetic resonance imaging (MRI) to differentiate between MB and EM and validate its diagnostic ability with an external set. MATERIALS AND METHODS: Axial T2 weighted image (T2WI) and contrast-enhanced T1weighted image (CE-T1WI) MRI sequences of 135 patients from two centers were collected as train/test sets. Volume of interest (VOI) was manually delineated by an experienced neuroradiologist, supervised by a senior. Feature selection analysis and the least absolute shrinkage and selection operator (LASSO) algorithm identified valuable features, and Shapley additive explanations (SHAP) evaluated their significance. Five machine-learning classifiers-extreme gradient boosting (XGBoost), Bernoulli naive Bayes (Bernoulli NB), Logistic Regression (LR), support vector machine (SVM), linear support vector machine (Linear SVC) classifiers were built based on T2WI (T2 model), CE-T1WI (T1 model), and T1 + T2WI (T1 + T2 model). A human expert diagnosis was developed and corrected by senior radiologists. External validation was performed at Sun Yat-Sen University Cancer Center. RESULTS: 31 valuable features were extracted from T2WI and CE-T1WI. XGBoost demonstrated the highest performance with an area under the curve (AUC) of 0.92 on the test set and maintained an AUC of 0.80 during external validation. For the T1 model, XGBoost achieved the highest AUC of 0.85 on the test set and the highest accuracy of 0.71 on the external validation set. In the T2 model, XGBoost achieved the highest AUC of 0.86 on the test set and the highest accuracy of 0.82 on the external validation set. The human expert diagnosis had an AUC of 0.66 on the test set and 0.69 on the external validation set. The integrated T1 + T2 model achieved an AUC of 0.92 on the test set, 0.80 on the external validation set, achieved the best performance. Overall, XGBoost consistently outperformed in different classification models. CONCLUSION: The combination of radiomics and machine learning on multiparametric MRI effectively distinguishes between MB and EM in childhood, surpassing human expert diagnosis in training and testing sets.

Intratumoral and peritumoral radiomics predict pathological response after neoadjuvant chemotherapy against advanced gastric cancer.

BACKGROUND: To investigate whether intratumoral and peritumoral radiomics may predict pathological responses after neoadjuvant chemotherapy against advanced gastric cancer. METHODS: Clinical, pathological, and CT data from 231 patients with advanced gastric cancer who underwent neoadjuvant chemotherapy at our hospital between July 2014 and February 2022 were retrospectively collected. Patients were randomly divided into a training group (n = 161) and a validation group (n = 70). The support vector machine classifier was used to establish radiomics models. A clinical model was established based on the selected clinical indicators. Finally, the radiomics and clinical models were combined to generate a radiomics-clinical model. ROC analyses were used to evaluate the prediction efficiency for each model. Calibration curves and decision curves were used to evaluate the optimal model. RESULTS: A total of 91 cases were recorded with good response and 140 with poor response. The radiomics model demonstrated that the AUC was higher in the combined model than in the intratumoral and peritumoral models (training group: 0.949, 0.943, and 0.846, respectively; validation group: 0.815, 0.778, and 0.701, respectively). Age, Borrmann classification, and Lauren classification were used to construct the clinical model. Among the radiomics-clinical models, the combined-clinical model showed the highest AUC (training group: 0.960; validation group: 0.843), which significantly improved prediction efficiency. CONCLUSION: The peritumoral model provided additional value in the evaluation of pathological response after neoadjuvant chemotherapy against advanced gastric cancer, and the combined-clinical model showed the highest predictive efficiency. CRITICAL RELEVANCE STATEMENT: Intratumoral and peritumoral radiomics can noninvasively predict the pathological response against advanced gastric cancer after neoadjuvant chemotherapy to guide early treatment decision and provide individual treatment for patients. KEY POINTS: 1. Radiomics can predict pathological responses after neoadjuvant chemotherapy against advanced gastric cancer. 2. Peritumoral radiomics has additional predictive value. 3. Radiomics-clinical models can guide early treatment decisions and improve patient prognosis.

Rapid detection of per- and polyfluoroalkyl substances (PFAS) using paper spray-based mass spectrometry.

Traditional PFAS analysis by mass spectrometry (MS) is time-consuming, as laborious sample preparation (e.g., extraction and desalting) is necessary. Herein, we report fast detection of PFAS by paper spray (PS)-based MS techniques, which employs a triangular-shaped filter paper for sample loading and ionization (≤ 3 min per sample). In this study, PS-MS was first used for direct PFAS analysis of drinking water, tap water, and wastewater. Interestingly, food package paper materials can be directly cut and examined with PS-MS for possible PFAS contamination. For samples containing salt matrices which would suppress PFAS ion signal, desalting paper spray mass spectrometry (DPS-MS), was shown to be capable of rapidly desalting, ionizing and detecting PFAS species such as per-fluorooctanoic acid (PFOA) and per-fluorosulphonic acid (PFOS). The retention of PFAS on paper substrate while salts being washed away by water is likely due to hydrophilic interaction between the PFAS polar head (e.g., carboxylic acid, sulfonic acid) with the polar filter paper cellulose surface. The DPS-MS method is highly sensitive (limits of detection:1.2-4.5 ppt) and can be applicable for directly analyzing soil extract and soil samples. These results suggest the high potential of PS-MS and the related DPS-MS technique in real-world environmental analysis of PFAS.

Distinguishing Intracranial Diabetes-Related Atherosclerotic Plaques: A High-Resolution Magnetic Resonance Imaging-Based Radiomics Study.

INTRODUCTION: Diabetes markedly affects the formation and development of intracranial atherosclerosis. The study was aimed at evaluating whether radiomics features can help distinguish plaques primarily associated with diabetes. MATERIALS AND METHODS: We retrospectively analyzed patients who were admitted to our center because of acute ischemic stroke due to intracranial atherosclerosis between 2016 and 2022. Clinical data, blood biomarkers, conventional plaque features, and plaque radiomics features were collected for all patients. Odds ratios (ORs) with 95% confidence intervals (CIs) were determined from logistic regression models. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to describe diagnostic performance. The DeLong test was used to compare differences between models. RESULTS: Overall, 157 patients (115 men; mean age, 58.7 ± 10.7 years) were enrolled. Multivariate logistic regression analysis showed that plaque length (OR: 1.17; 95% CI: 1.07-1.28) and area (OR: 1.13; 95% CI: 1.02-1.24) were independently associated with diabetes. On combining plaque length and area as a conventional model, the AUCs of the training and validation cohorts for identifying diabetes patients were 0.789 and 0.720, respectively. On combining radiomics features on T1WI and contrast-enhanced T1WI sequences, a better diagnostic value was obtained in the training and validation cohorts (AUC: 0.889 and 0.861). The DeLong test showed the model combining radiomics and conventional plaque features performed better than the conventional model in both cohorts (p < 0.05). CONCLUSIONS: The use of radiomics features of intracranial plaques on high-resolution magnetic resonance imaging can effectively distinguish culprit plaques with diabetes as the primary pathological cause, which will provide new avenues of research into plaque formation and precise treatment.

Virtual biopsy using CT radiomics for evaluation of disagreement in pathology between endoscopic biopsy and postoperative specimens in patients with gastric cancer: a dual-energy CT generalizability study.

PURPOSE: To develop a noninvasive radiomics-based nomogram for identification of disagreement in pathology between endoscopic biopsy and postoperative specimens in gastric cancer (GC). MATERIALS AND METHODS: This observational study recruited 181 GC patients who underwent pre-treatment computed tomography (CT) and divided them into a training set (n = 112, single-energy CT, SECT), a test set (n = 29, single-energy CT, SECT) and a validation cohort (n = 40, dual-energy CT, DECT). Radiomics signatures (RS) based on five machine learning algorithms were constructed from the venous-phase CT images. AUC and DeLong test were used to evaluate and compare the performance of the RS. We assessed the dual-energy generalization ability of the best RS. An individualized nomogram combined the best RS and clinical variables was developed, and its discrimination, calibration, and clinical usefulness were determined. RESULTS: RS obtained with support vector machine (SVM) showed promising predictive capability with AUC of 0.91 and 0.83 in the training and test sets, respectively. The AUC of the best RS in the DECT validation cohort (AUC, 0.71) was significantly lower than that of the training set (Delong test, p = 0.035). The clinical-radiomic nomogram accurately predicted pathologic disagreement in the training and test sets, fitting well in the calibration curves. Decision curve analysis confirmed the clinical usefulness of the nomogram. CONCLUSION: CT-based radiomics nomogram showed potential as a clinical aid for predicting pathologic disagreement status between biopsy samples and resected specimens in GC. When practicability and stability are considered, the SECT-based radiomics model is not recommended for DECT generalization. CRITICAL RELEVANCE STATEMENT: Radiomics can identify disagreement in pathology between endoscopic biopsy and postoperative specimen.

Are radiomic spleen features useful for assessing the differentiation status of advanced gastric cancer?

Background: The differentiation status of gastric cancer is related to clinical stage, treatment and prognosis. It is expected to establish a radiomic model based on the combination of gastric cancer and spleen to predict the differentiation degree of gastric cancer. Thus, we aim to determine whether radiomic spleen features can be used to distinguish advanced gastric cancer with varying states of differentiation. Materials and methods: January 2019 to January 2021, we retrospectively analyzed 147 patients with advanced gastric cancer confirmed by pathology. The clinical data were reviewed and analyzed. Three radiomics predictive models were built from radiomics features based on gastric cancer (GC), spleen (SP) and combination of two organ position (GC+SP) images. Then, three Radscores (GC, SP and GC+SP) were obtained. A nomogram was developed to predict differentiation statue by incorporating GC+SP Radscore and clinical risk factors. The area under the curve (AUC) of operating characteristics (ROC) and calibration curves were assessed to evaluate the differential performance of radiomic models based on gastric cancer and spleen for advanced gastric cancer with different states of differentiation (poorly differentiated group and non- poorly differentiated group). Results: There were 147 patients evaluated (mean age, 60 years ± 11SD, 111 men). Univariate and multivariate logistic analysis identified three clinical features (age, cTNM stage and CT attenuation of spleen arterial phase) were independent risk factors for the degree of differentiation of GC (p =0.004,0.000,0.020, respectively). The clinical radiomics (namely, GC+SP+Clin) model showed powerful prognostic ability in the training and test cohorts with AUCs of 0.97 and 0.91, respectively. The established model has the best clinical benefit in diagnosing GC differentiation. Conclusion: By combining radiomic features (GC and spleen) with clinical risk factors, we develop a radiomic nomogram to predict differentiation status in patients with AGC, which can be used to guide treatment decisions.

Development and validation of a nonenhanced CT based radiomics model to detect brown adipose tissue.

Purpose: It has been reported that brown adipose tissue (BAT) has a protective effect regarding cardiovascular disease. Positron emission tomography-computed tomography (PET-CT) is the reference method for detecting active BAT; however, it is not feasible to screen for BAT due to the required radionuclides and high-cost. The purpose of this study is to develop and validate a nonenhanced CT based radiomics model to detect BAT and to explore the relationship between CT radiomics derived BAT and cardiovascular calcification. Patients and methods: 146 patients undergoing 18F-FDG PET-CT were retrospectively included from two centers for model development (n = 86) and external validation (n = 60). The data for the model development were randomly divided into a training cohort and an internal validation cohort with a 7:3 ratio, while the external validation data were divided 1:1 into a propensity score matching (PSM) cohort and a randomly sex matched cohort. Radiomics features of BAT and non-BAT depots were extracted from regions of interest (ROI) on nonenhanced CT corresponding to PET studies. Inter-class correlation coefficient (ICC) and Pearson's correlation analysis were performed to select radiomics features with high consistency. Next, least absolute shrinkage and selection operator (LASSO) with linear regression model was used to select radiomics features for model construction. Support vector machine (SVM) was used to develop the model and a radiomics score (RS) was calculated for each depot. The diagnostic performance of the radiomics model was evaluated both on a per-depot and per-patient basis by calculating the area under the receiver operating characteristic curve (AUROC). We further divided patients into BAT-RS group and non-BAT-RS group based on radiomics score and compared their cardiovascular calcification by calculating calcium volume and score. Results: A total of 22 radiomics features were selected for model construction. On a per-depot basis, the AUROCs were 0.87 (95% CI: 0.83-0.9), 0.85 (95% CI: 0.79-0.90), 0.72 (95% CI: 0.67-0.77) and 0.74 (95% CI: 0.69-0.79) for detecting BAT in the training, internal validation, external validation 1 and external validation 2 cohorts, respectively. On a per-patient basis, the radiomics model had high AUROCs of 0.91 (95% CI: 0.84-0.98), 0.77 (95% CI: 0.61-0.92) and 0.85 (95% CI: 0.72-0.98) in the training, external validation 1 and external validation 2 cohorts, respectively. When grouping based on the radiomics model, the BAT-RS group had lower odds of coronary artery calcium (CAC) and thoracic aorta calcium (TAC) compared with the non-BAT-RS group (CAC: 2.8% vs. 20.3%, p = 0.001; TAC: 19.4% vs. 39.2%, p = 0.009). The BAT-RS group had less CAC volume (4.1 ± 4.0 mm3 vs. 147.4 ± 274.3 mm3; p = 0.001), CAC score (2.8 ± 3.0 vs. 169.1 ± 311.5; p = 0.001), TAC volume (301.4 ± 450.2 mm3 vs. 635.3 ± 1100.7 mm3; p = 0.007) and TAC score (496.2 ± 132.6 vs. 749.2 ± 1297.3; p = 0.007) than the non-BAT-RS group. Conclusion: We developed and validated a nonenhanced CT based reliable radiomics model for detecting BAT with PET-CT findings as reference standard. Radiomics signatures from nonenhanced CT can reliably detect BAT and have promising potential to be used in routine clinical settings. Importantly, our study showed that patients with BAT had less cardiovascular calcification.

Distinguishing multiple primary lung cancers from intrapulmonary metastasis using CT-based radiomics.

PURPOSE: To develop CT-based radiomics models that can efficiently distinguish between multiple primary lung cancers (MPLCs) and intrapulmonary metastasis (IPMs). METHOD: This retrospective study included 127 patients with 254 lung tumors pathologically proved as MPLCs or IPMs between May 2009 and January 2020. Radiomics features of lung tumors were extracted from baseline CT scans. Particularly, we incorporated tumor-focused, refined radiomics by calculating relative radiomics differences from paired tumors of individual patients. We applied the L1-norm regularization and analysis of variance to select informative radiomics features for constructing radiomics model (RM) and refined radiomics model (RRM). The performance was assessed by the area under the receiver operating characteristic curve (AUC-ROC). The two radiomics models were compared with the clinical-CT model (CCM, including clinical and CT semantic features). We incorporated both radiomics features to construct fusion model1 (FM1). We also, build fusion model2 (FM2) by combing both radiomics, clinical and CT semantic features. The performance of the FM1 and FM2 were further compared with that of the RRM. RESULTS: On the validation set, the RM achieved an AUC of 0.857. The RRM demonstrated improved performance (validation set AUC, 0.870) than the RM, and showed significant differences compared with the CCM (validation set AUC, 0.782). Fusion models further led prediction performance (validation set AUC, FM1:0.885; FM2:0.889). There were no significant differences among the performance of the FM1, the FM2 and the RRM. CONCLUSIONS: The CT-based radiomics models presented good performance on the discrimination between MPLCs and IPMs, demonstrating the potential for early diagnosis and treatment guidance for MPLCs and IPMs.

Identification of high-risk intracranial plaques with 3D high-resolution magnetic resonance imaging-based radiomics and machine learning.

BACKGROUND: Identifying high-risk intracranial plaques is significant for the treatment and prevention of stroke. OBJECTIVE: To develop a high-risk plaque model using three-dimensional (3D) high-resolution magnetic resonance imaging (HRMRI) based radiomics features and machine learning. METHODS: 136 patients with documented symptomatic intracranial artery stenosis and available HRMRI data were included. Among these patients, 136 and 92 plaques were identified as symptomatic and asymptomatic plaques, respectively. A conventional model was developed by recording and quantifying the radiological plaque characteristics. Radiomics features from T1-weighted images (T1WI) and contrast-enhanced T1WI (CE-T1WI) were used to construct a high-risk plaque model with linear support vector classification (linear SVC). The radiological and radiomics features were combined to build a combined model. Receiver operating characteristic (ROC) curves were used to evaluate these models. RESULTS: Plaque length, burden, and enhancement were independently associated with clinical symptoms and were included in the conventional model, which had an AUC of 0.853 vs. 0.837 in the training and test sets. While the radiomics and the combined model showed an improved AUC: 0.923 vs. 0.925 for the training sets and 0.906 vs. 0.903 in the test sets. Both the radiomics model (p = 0.024, p = 0.018) and combined model (p = 0.042, p = 0.049) outperformed the conventional model in the two sets, whereas the performance of the combined model was not significantly different from that of the radiomics model in the two sets (p = 0.583 and p = 0.606). CONCLUSION: The radiomics model based on 3D HRMRI can accurately differentiate symptomatic from asymptomatic intracranial arterial plaques and significantly outperforms the conventional model.

Schistosoma japonicum Cystatin Alleviates Sepsis Through Activating Regulatory Macrophages.

Multi-organ failure caused by the inflammatory cytokine storm induced by severe infection is the major cause of death for sepsis. Sj-Cys is a cysteine protease inhibitor secreted by Schistosoma japonicum with strong immunomodulatory functions on host immune system. Our previous studies have shown that treatment with Sj-Cys recombinant protein (rSj-Cys) attenuated inflammation caused by sepsis. However, the immunological mechanism underlying the immunomodulation of Sj-Cys for regulating inflammatory diseases is not yet known. In this study, we investigated the effect of Sj-Cys on the macrophage M2 polarization and subsequent therapeutic effect on sepsis. The rSj-Cys was expressed in yeast Pichia pastoris. Incubation of mouse bone marrow-derived macrophages (BMDMs) with yeast-expressed rSj-Cys significantly activated the polarization of macrophages to M2 subtype characterized by the expression of F4/80+ CD206+ with the elated secretion of IL-10 and TGF-ß. Adoptive transfer of rSj-Cys treated BMDMs to mice with sepsis induced by cecal ligation and puncture (CLP) significantly improved their survival rates and the systemic clinical manifestations of sepsis compared with mice receiving non-treated normal BMDMs. The therapeutic effect of Sj-Cys-induced M2 macrophages on sepsis was also reflected by the reduced pathological damages in organs of heart, lung, liver and kidney and reduced serological levels of tissue damage-related ALT, AST, BUN and Cr, associated with downregulated pro-inflammatory cytokines (IFN-gamma and IL-6) and upregulated regulatory anti-inflammatory cytokines (IL-10 and TGF-ß). Our results demonstrated that Sj-Cys is a strong immunomodulatory protein with anti-inflammatory features through activating M2 macrophage polarization. The findings of this study suggested that Sj-Cys itself or Sj-Cys-induced M2 macrophages could be used as therapeutic agents in the treatment of sepsis or other inflammatory diseases.

ISSD: Improved SSD for Insulator and Spacer Online Detection Based on UAV System.

In power inspection tasks, the insulator and spacer are important inspection objects. UAV (unmanned aerial vehicle) power inspection is becoming more and more popular. However, due to the limited computing resources carried by a UAV, a lighter model with small model size, high detection accuracy, and fast detection speed is needed to achieve online detection. In order to realize the online detection of power inspection objects, we propose an improved SSD (single shot multibox detector) insulator and spacer detection algorithm using the power inspection images collected by a UAV. In the proposed algorithm, the lightweight network MnasNet is used as the feature extraction network to generate feature maps. Then, two multiscale feature fusion methods are used to fuse multiple feature maps. Lastly, a power inspection object dataset containing insulators and spacers based on aerial images is built, and the performance of the proposed algorithm is tested on real aerial images and videos. Experimental results show that the proposed algorithm can efficiently detect insulators and spacers. Compared with existing algorithms, the proposed algorithm has the advantages of small model size and fast detection speed. The detection accuracy can achieve 93.8%. The detection time of a single image on TX2 (NVIDIA Jetson TX2) is 154 ms and the capture rate on TX2 is 8.27 fps, which allows realizing online detection.

Evaluating the Quality of Health-Related WeChat Public Accounts: Cross-Sectional Study.

BACKGROUND: As representatives of health information communication platforms accessed through mobile phones and mobile terminals, health-related WeChat public accounts (HWPAs) have a large consumer base in the Chinese-speaking world. However, there is still a lack of general understanding of the status quo of HWPAs and the quality of the articles they release. OBJECTIVE: The aims of this study were to assess the conformity of HWPAs to the Health on the Net Foundation Code of Conduct (HONcode) and to evaluate the suitability of articles disseminated by HWPAs. METHODS: The survey was conducted from April 23 to May 5, 2019. Based on the monthly (March 1-31, 2019) WeChat Index provided by Qingbo Big Data, the top 100 HWPAs were examined to evaluate their HONcode compliance. The first four articles published by each HWPA on the survey dates were selected as samples to evaluate their suitability. All materials were assessed by three raters. The materials were assessed using the HONcode checklist and the Suitability Assessment of Materials (SAM) score sheet. Data analysis was performed with SPSS version 17.0 (SPSS Inc, Chicago, IL, USA) and Excel version 2013 (Microsoft Inc, Washington DC, USA). RESULTS: A total of 93 HWPAs and 210 of their released articles were included in this study. For six of the eight principles, the 93 HWPAs nearly consistently did not meet the requirements of the HONcode. The HWPAs certified by Tencent Corporation (66/93, 71%) were generally slightly superior to those without such certification (27/93, 29%) in terms of compliance with HONcode principles. The mean SAM score for the 210 articles was 67.72 (SD 10.930), which indicated "adequate" suitability. There was no significant difference between the SAM scores of the articles published by certified and uncertified HWPAs (P=.07), except in the literacy requirements dimension (tdf=97=-2.418, P=.02). CONCLUSIONS: The HWPAs had low HONcode conformity. Although the suitability of health information released by HWPAs was at a moderate level, there were still problems identified, such as difficulty in tracing information sources, excessive implicit advertisements, and irregular usage of charts. In addition, the low approval requirements of HWPAs were not conducive to improvement of their service quality.

Enhanced Charge Transfer between Fullerene and Non-Fullerene Acceptors Enables Highly Efficient Ternary Organic Solar Cells.

Insufficient driving forces defined as the energetic offsets of the frontier molecular orbitals between a donor and an acceptor influence the charge separation in organic solar cells (OSCs), thus restricting the improvement of quantum efficiencies. Herein, we demonstrate that enhancing charge transfer between fullerene and non-fullerene acceptors via ternary strategy is an effective method to address this problem. By introducing an electron acceptor [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) as the third component to the binary blends based on the polymer donor of poly[(2,6-(4,8-bis(5-(2-ethylhexyl)-4-fluorothiophen-2-yl)-benzo[1,2- b:4,5- b']dithiophene))- alt-(5,5-(1',3'-di-2-thienyl-5',7'-bis(2-ethylhexyl)benzo[1',2'- c:4',5'- c']dithiophene-4,8-dione)] (PBDB-TF) and the small-molecule acceptor of 2,2'-((2 Z,2' Z)-(((2,5-difluoro-1,4-phenylene)bis(4,4-bis(2-ethylhexyl)-4 H-cyclopenta[2,1- b:3,4- b']dithiophene-6,2-diyl))bis(methanylylidene))bis(5,6-difluoro-3-oxo-2,3-dihydro-1 H-indene-2,1-diylidene))dimalononitrile (HF-PCIC) or 2,2'-((2 Z,2' Z)-(((2,5-difluoro-1,4-phenylene)bis(4,4-bis(2-ethylhexyl)-4 H-cyclopenta[2,1- b:3,4- b']dithiophene-6,2-diyl))bis(methanylylidene))bis(5,6-dichloro-3-oxo-2,3-dihydro-1 H-indene-2,1-diylidene))dimalononitrile (HC-PCIC) with unfused cores, the quantum efficiencies can be boosted from ∼70% for binary blends to over 80% for ternary blends in the longer wavelength ranges. PC71BM shows lower energy levels and higher electron mobility, benefiting the charge transfer and transport in ternary OSCs and resulting in an enhanced quantum efficiency. As a result, ternary OSCs based on PBDB-TF/HF-PCIC/PC71BM and PBDB-TF/HC-PCIC/PC71BM exhibit high power conversion efficiencies (PCEs) of 11.55 and 12.36%, respectively. In addition, excellent thermal stabilities are realized for both ternary OSCs, which retained ∼80% initial PCEs after thermal treatment at 130 °C for 12 h, indicating that the active layer morphology containing fullerene/non-fullerene acceptors is stabilized. This work demonstrates efficient and thermally stable ternary OSCs with enhanced charge transfer between fullerene and non-fullerene acceptors via the modulation of energy levels, which helps to better understand the working mechanism of ternary OSCs.

Therapeutic effect of Schistosoma japonicum cystatin on bacterial sepsis in mice.

BACKGROUND: Sepsis is a life-threatening complication of an infection and remains one of the leading causes of mortality in surgical patients. Bacteremia induces excessive inflammatory responses that result in multiple organ damage. Chronic helminth infection and helminth-derived materials have been found to immunomodulate host immune system to reduce inflammation against some allergic or inflammatory diseases. Schistosoma japonicum cystatin (Sj-Cys) is a cysteine protease inhibitor that induces regulatory T-cells and a potential immunomodulatory. The effect of Sj-Cys on reducing sepsis inflammation and mortality was investigated. METHODS: Sepsis was induced in BALB/c mice using cecal ligation and puncture (CLP), followed by intraperitoneal injection of different doses (10, 25 or 50 µg) of recombinant Sj-Cys (rSj-Cys). The therapeutic effect of rSj-Cys on sepsis was evaluated by observing the survival rates of mice for 96 h after CLP and the pathological injury of liver, kidney and lung by measuring the levels of alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN) and creatinine (Cr) in sera and the tissue sections pathology, and the expression of MyD88 in liver, kidney and lung tissues. The immunological mechanism was investigated by examining pro-inflammatory cytokines (TNF-α, IL-6, IL-1ß) and IL-10 and TGF-ß1 in mice sera and in culture of macrophages stimulated by lipopolysaccharides (LPS). RESULTS: rSj-Cys treatment provided significant therapeutic effects on CLP-induced sepsis in mice demonstrated with increased survival rates, alleviated overall disease severity and tissue injury of liver, kidney and lung. The rSj-Cys conferred therapeutic efficacy was associated with upregualted IL-10 and TGF-ß1 cytokines and reduced pro-inflammatory cytokines TNF-α, IL-6, IL-1ß. MyD88 expression in liver, kidney and lung tissues of rSj-Cys-treated mice was reduced. In vitro assay with macrophages also showed that rSj-Cys inhibited the release of pro-inflammatory cytokines and mediator nitric oxide (NO) after being stimulated by lipopolysaccharide (LPS). CONCLUSIONS: The results suggest the anti-inflammatory potential of rSj-Cys as a promising therapeutic agent on sepsis. The immunological mechanism underlying its therapeutic effect may involve the downregulation of pro-inflammatory cytokines and upregulation of IL-10 and TGF-ß1 cytokines possibly via downregulation of the TLR adaptor-transducer MyD88 pathway. The findings suggest rSj-Cys is a potential therapeutic agent for sepsis and other inflammatory diseases.

The Efficacy of Couple-Based Interventions on Health-Related Quality of Life in Cancer Patients and Their Spouses: A Meta-analysis of 12 Randomized Controlled Trials.

BACKGROUND: Couple-based interventions on health-related quality of life (HRQoL) of cancer patients and their spouses have received increasing attention in recent years, but the findings of previous studies are inconsistent. OBJECTIVE: The aim of this study was to investigate the effects of couple-based interventions on the HRQoL of cancer patients and their spouses using a meta-analysis approach. METHOD: English- and Chinese-language publications were collected from PubMed, EBSCO, EMBASE, CMB, and CNKI. The outcome measures included physical health, depression, anxiety, hopelessness, and marital satisfaction (MS). Pooled, weighted mean differences and 95% confidence intervals were estimated using fixed- and random-effects models. Publication bias and sensitivity analyses were performed. RESULTS: Twelve randomized controlled trials were included in this study. Compared with the control groups, the weighted mean differences of depression, anxiety, and MS were significantly improved in the intervention groups. However, improvements in the measures of physical health and hopelessness were nonsignificant. Psychoeducational interventions yielded a larger effect size than did skill training and blending interventions. Publication bias was not significant, and a sensitivity analysis indicated that the results were robust. CONCLUSIONS: Couple-based interventions can improve anxiety, depression, and MS among cancer patients and their spouses, and psychoeducational interventions may be an effective approach. Given the small number of studies utilized in this analysis, the results should be considered preliminary and interpreted with caution. IMPLICATIONS FOR PRACTICE: Couple-based interventions may be an adjunctive method for cancer patients and their spouses to improve HRQoL. Further study concerning couple-based skill training and blending intervention are needed to better understand intervention effects.

[Component analysis of excretory/secretory protein from Trichinella spiralis adult worm].

Objective: To analyze the component of adult worm excretory/secretory protein(AWESP) from Trichinella spiralis using the shotgun method, and find out the active component underlying its regulatory effect on colitis in humans. Methods: The T. spiralis AWESP was prepared, separated by SDS-PAGE, lysed with trypsin, and analyzed by shotgun LC-MS/MS. The protein components were determined with the Masco software and classified using the Gene Ontology(GO) method in cellular components, molecular functions, and biological processes. Results: The AWESPs isolated by SDS-PAGE had a Mr of 15 000-116 000. A total of 280 proteins were revealed by LC-MS/MS, of which 96 were identified by Masco software, 98 were putative, and the remaining 86 were unclear. Preliminary results showed that 4 proteins had regulatory potential for colitis, including cysteine protease inhibitor, serine protease, 53 000 excretory/secretory antigen, and glutathione-S-transferase. GO enrichment analysis showed that the identified proteins had 104 different molecular functions, involved in 363 biological processes. Conclusion: As revealed by the Masco software, T. spiralis AWESP has complex components and 96 have been identified in this study. Four of them are preliminarily shown to be associated with the anti-colitis effect of T. spiralis.

Maternal pre-pregnancy risk factors for miscarriage from a prevention perspective: a cohort study in China.

OBJECTIVE: To assess the relationship of the pre-pregnancy modifiable risks with miscarriage. STUDY DESIGN: We randomly selected 51 communities or villages from January 2013 to December 2014 in Anhui, China. We calculated incidence rate ratios (RR) and 95% confidence intervals (CIs) for each risk factor for miscarriage. RESULTS: The incidence rate of miscarriage was 7.45%, and pre-embryonic loss account for 12.66%, embryonic loss account for 38%, and fetal losses account for 49.34% of all loss. In multivariate analysis, women with hypertension (RR=2.272, 95% CI=1.27-4.04), women had a family history of abortion in their mother (RR=1.96, 95% CI=1.22-3.14) prior to pregnancy had significantly higher adjusted risk ratio for miscarriage. Obese, overweight, and underweight prior to pregnancy were about 2.01 (95% CI=1.1-3.68), 1.71 (95% CI=1.04-2.81), and 2.05 (95% CI=1.3-3.23) times more likely to end in miscarriage compared with normal weight. Some physical examination indicators, for example pH value of leucorrhea ≥4.5 (RR=2.13, 95% CI=1.48-3.07), red blood cell count <5 10(12)/L (RR=1.52, 95% CI=1.02-2.26), and positive LgG antibodies to human cytomegalovirus (RR=1.45, 95% CI=1.02-3.14) prior to pregnancy had good prediction effect on miscarriage. We also found remarkable differences on risk factors between non-fetal losses and fetal losses. CONCLUSIONS: Our results suggest that these modifiable risks should be included into pre-conception counseling as important risk factors for screening high-risk population and reducing the rate of spontaneous abortion.

Antiretroviral therapy among pregnant and postpartum women in China: A systematic review and meta-analysis.

BACKGROUND: The objectives of this study were to estimate the antiretroviral therapy (ART) rate and the proportion of women with adequate ART adherence (100%), and to identify the reasons for not initiating ART in HIV-infected pregnant women in China. METHODS: We searched MEDLINE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang (Chinese) to identify research studies published from 1990-2015. Only descriptive epidemiologic studies were eligible for this study. RESULTS: A total of 58 eligible studies were included in this meta-analysis. The eligible articles were published from 2006-2015 and covered all Chinese provinces. The estimated ART rate in HIV-positive pregnant women was continually increased, and the mean estimated ART rate increased from 47.1% (95% confidence interval [CI], 22.4-71.8) in 2006 to 95.0% (95% CI, 93.2-96.0) in 2013. In the meta-regression model, study year, study region, and income level were statistically significantly associated with ART rate estimates. During the last 10 years, the pooled ART adherence proportions for all studies yielded an estimate of 76.7% (95% CI, 61.0-92.5) of patients with adequate ART adherence (100%). Emergency cesarean delivery (57.9%; 95% CI, 9.9-100) and not knowing their HIV-infection status before starting (45.7%; 95% CI, 24.4-67.0) account for the dominant reasons for not initiating ART. CONCLUSIONS: The geographic variation in ART rate of HIV-infected pregnant women was significant in China, and >25% of pregnant women did not achieved optimal ART adherence. It is crucial to investigate specific barriers for lower ART rates in the high-income regions and to develop interventions to maintain the adequate ART adherence.

[In vitro Effect of Hypericin against Toxoplasma gondii Tachyzoites].

Objective: To investigate the killing effect of hypericin on tachyzoites of Toxoplasma gondii RH strain in vitro. Methods: Normal saline （group A） and different concentrations of hypericin (5 µg/ml, group B; 50 µg/ml, group C; 500 µg/ml, group D） were added to T. gondii tachyzoites in 24-well plate（1×10(6)/well）. The tachyzoites were harvested after 2, 4 and 6 h, and underwent the following treatment: trypan blue staining to calculate the dyeing rate, Giemsa staining to observe the morphological and structural alterations of tachyzoites, and transmission electron microscopy to observe the ultrastructure of tachyzoites. In addition, flow cytometry was performed to calculate the survival rate of YFP-carrying Toxoplasma with the same treatment. Results: The trypan blue dyeing rate at 2 h after treatment in groups B, C and D was（11.0±3.6）%, （25.0±6.3）% and（40.0±2.7）% respectively, with a significant difference of group D versus B and C （P<0.01）, and groups C and D versus group A ［（6.0±3.0）%）］. The dyeing rate at 4 h and 6 h in group D was（97.0±2.0）% and （98.0±1.7）%, respectively, both significantly higher than that of groups C ［（30.0±7.2）%, （42.7±5.5）%ï¼½, B ［（20.0±3.0）%, （34.0±6.6）%ï¼½ and A ［（10.0±1.0）%, （19.3±4.9）%］（P<0.01）. Giemsa staining showed gradual end swelling and necrosis of tachyzoites with increased treatment duration and dosage. Transmission electron microscopy showed swelling of worm body, gap between cell membrane and matrix, increase and enlargement of vacuoles inside worm body, disruption of cell membrane, and dissolving of inner structures, with increased treatment duration. Flow cytometry showed significant difference of tachyzoite survival rate at 2, 4 and 6 h after hypericin treatment with that of the control group（P<0.01）. The survival rate of group C at 2 h after hypericin treatment was（7.9±1.9）%, significantly lower than that of groups B ［（38.1±5.5）%ï¼½ and A ［（81.8±6.0）%ï¼½ （P<0.01）. No tachyzoite was found to survive in group D at 2 h and in group C at 4 h. The survival rate of group B at 4 and 6 h after hypericin treatment was（14.3±7.9）% and （1.4±1.8）%, respectively, both significantly lower than that of group A［（73.8±11.3）% and（64.1±14.4）%, respectivelyï¼½ （P<0.01）. Conclusion: Hypericin has a remarkable killing effect on T. gondii tachyzoites, and the efficacy positively correlates with the dose and treatment duration.

[Role of CD8+ T cells in the tumor growth delay induced by Toxoplasma gondii excreted-secreted antigen in B16F10 mouse melanoma model].

OBJECTIVE: To observe the role of CD8+ T cells in the tumor growth delay induced by Toxoplasma gondii excreted-secreted antigens (TgESA) in B16FI0 mouse melanoma model in the early stage. METHODS: TgESA were prepared by incubating T. gondii tachyzoites for 12 h in vitro. 15 C57BL/6 mice were randomly assigned to group A, B, and C (5 mice per group). Each mouse in group B and C was subcutaneously injected in right flank with 2 x 10(5) B16F10 cells. Mice in group C were intraperitoneally injected with TgESA (100 microl per mouse) at 7d after B16F10 cells injection. Mice of group A were only injected with PBS. On the 13th day after melanoma cell injection, the mice were sacrificed and spleen was removed. The percentage of CD8+ T cells in the spleen was analyzed by flow cytometry. CD8+ T cells were isolated from spleen cells by using immunomagnetic beads. The activity of CD8+ T cells against B16F10 melanoma cells was determined by LDH release assay at different effect-to-target cell ratios (2.5:1, 5:1, and 10:1). Other 30 C57BL/6 mice were randomly divided into group E, F, and G. Each mice were injected with 2 x 10(5) B16F10 cells. At the same time, mice in group F and G were simultaneously injected via the tail vein with CD8+ T cells isolated from mice in group B and C. Tumor growth, mortality and survival time of mice were observed and recorded during 35-d observation period. RESULTS: The percentage of CD3+CD8+T cells in the spleen cells of group C [(15.74 +/- 0.28)%] was significantly higher than that of group B [(14.18 +/- 0.27)%] and A [(13.86 +/- 0.13)%] (P < 0.05). At different effect-to-target cell ratios, the activity of CD8+ T cells against B16F10 cells in group C was significantly higher than that of group B (P < 0.05). The average time of tumor formation in group G [(14.9 +/- 1.2) d] was longer than that in group F [(11.9 +/- 0.7) d] and E [(9.4 +/- 1.2) d] (P < 0.05). The tumor size in these groups increased, but there was no obvious difference in the tumor growth rate among the three groups. The tumor size of group G was significantly smaller than the other two groups (P < 0.05). In group E, F and G, mice began to die on the 26th day, the 29th day and the 30th day after tumor inoculation, and the number of survival mice was 3, 5 and 7, respectively, at the 35th day after injection. CONCLUSIONS: TgESA may up-regulate the quantity and function of CD8+ T cell in B16F10 melanoma mouse model, which plays a role of delaying tumor growth in early stage.