BSMNet: Boundary-salience multi-branch network for intima-media identification in carotid ultrasound images.

Carotid artery intima-media thickness (CIMT) is an essential factor in signaling the risk of cardiovascular diseases, which is commonly evaluated using ultrasound imaging. However, automatic intima-media segmentation and thickness measurement are still challenging due to the boundary ambiguity of intima-media and inherent speckle noises in ultrasound images. In this work, we propose an end-to-end boundary-salience multi-branch network, BSMNet, to tackle the carotid intima-media identification from ultrasound images, where the prior shape knowledge and anatomical dependence are exploited using a parallel linear structure learning modules followed by a boundary refinement module. Moreover, we design a strip attention model to boost the thin strip region segmentation with shape priors, in which an anisotropic kernel shape captures long-range global relations and scrutinizes meaningful local salient contexts simultaneously. Extensive experimental results on an in-house carotid ultrasound (US) dataset demonstrate the promising performance of our method, which achieves about 0.02 improvement in Dice and HD95 than other state-of-the-art methods. Our method is promising in advancing the analysis of systemic arterial disease with ultrasound imaging.

Therapeutic Potential of Chinese Medicine for Endogenous Neurogenesis: A Promising Candidate for Stroke Treatment.

Strokes are a leading cause of morbidity and mortality in adults worldwide. Extensive preclinical studies have shown that neural-stem-cell-based treatments have great therapeutic potential for stroke. Several studies have confirmed that the effective components of traditional Chinese medicine can protect and maintain the survival, proliferation, and differentiation of endogenous neural stem cells through different targets and mechanisms. Therefore, the use of Chinese medicines to activate and promote endogenous nerve regeneration and repair is a potential treatment option for stroke patients. Here, we summarize the current knowledge regarding neural stem cell strategies for ischemic strokes and the potential effects of these Chinese medicines on neuronal regeneration.

Inhibition of mGluR5/PI3K-AKT Pathway Alleviates Alzheimer's Disease-Like Pathology Through the Activation of Autophagy in 5XFAD Mice.

BACKGROUND: The metabotropic glutamate receptor 5 (mGluR5) is widely expressed in postsynaptic neurons and plays a vital role in the synaptic plasticity of the central nervous system. mGluR5 is a coreceptor for amyloid-ß (Aß) oligomer, and downregulation or pharmacological blockade of mGluR5 presents the therapeutic potential of Alzheimer's disease (AD). However, the abnormality of mGluR5 in the pathogenesis of AD and its mechanism of pathology is not clear. OBJECTIVE: In this study, we would like to investigate the expression of mGluR5 in the process of AD and explore the effects and the underlying mechanisms of antagonizing mGluR5 on cognitive function, synaptic structure, and inflammation in 5xFAD mice. METHODS: mGluR5 expression and interactions with PrPc in 5XFAD mice were detected using western blot and co-immunoprecipitation. The selective mGluR5 antagonist MPEP was infused into 4-month-old 5XFAD mice for 60 consecutive days. Then, cognitive function, AD-like pathology and synaptic structure were measured. Further observations were made in mGluR5 knockdown 5XFAD mice. RESULTS: mGluR5 expression was increased with Aß levels at 6 months in 5XFAD mice. mGluR5 antagonist rescued cognitive disorders, promoted synaptic recovery, and alleviated both the Aß plaque load and abnormal hyperphosphorylation in 6-month-old 5XFAD mice. Meanwhile, the results were validated in mGluR5 knockdown mice. Blockade of mGluR5 efficiently alleviates AD-like pathologies by inhibiting the PI3K/AKT/mTOR pathway and activates autophagy in 5XFAD mice. Furthermore, antagonism of mGluR5 attenuated neuroinflammation by inactivating the IKK/NF-κB pathway. CONCLUSION: These findings suggest that mGluR5 may be an effective drug target for AD treatment, and inhibition of the mGluR5/PI3K-AKT pathway alleviates AD-like pathology by activating autophagy and anti-neuroinflammation in 5XFAD mice.

The correlations between kinematic profiles and cerebral hemodynamics suggest changes of motor coordination in single and bilateral finger movement.

Objective: The correlation between the performance of coordination movement and brain activity is still not fully understood. The current study aimed to identify activated brain regions and brain network connectivity changes for several coordinated finger movements with different difficulty levels and to correlate the brain hemodynamics and connectivity with kinematic performance. Methods: Twenty-one right-dominant-handed subjects were recruited and asked to complete circular motions of single and bilateral fingers in the same direction (in-phase, IP) and in opposite directions (anti-phase, AP) on a plane. Kinematic data including radius and angular velocity at each task and synchronized blood oxygen concentration data using functional near-infrared spectroscopy (fNIRS) were recorded covering six brain regions including the prefrontal cortex, motor cortex, and occipital lobes. A general linear model was used to locate activated brain regions, and changes compared with baseline in blood oxygen concentration were used to evaluate the degree of brain region activation. Small-world properties, clustering coefficients, and efficiency were used to measure information interaction in brain activity during the movement. Result: It was found that the radius error of the dominant hand was significantly lower than that of the non-dominant hand (p < 0.001) in both clockwise and counterclockwise movements. The fNIRS results confirmed that the contralateral brain region was activated during single finger movement and the dominant motor area was activated in IP movement, while both motor areas were activated simultaneously in AP movement. The Δhbo were weakly correlated with radius errors (p = 0.002). Brain information interaction in IP movement was significantly larger than that from AP movement in the brain network (p < 0.02) in the right prefrontal cortex. Brain activity in the right motor cortex reduces motor performance (p < 0.001), while the right prefrontal cortex region promotes it (p < 0.05). Conclusion: Our results suggest there was a significant correlation between motion performance and brain activation level, as well as between motion deviation and brain functional connectivity. The findings may provide a basis for further exploration of the operation of complex brain networks.

Prevention of venous thromboembolism in patients undergoing major orthopedic surgery in China: a qualitative study of patients' perceptions.

BACKGROUND: Venous thromboembolism (VTE) is the third leading cause of cardiovascular-associated death worldwide, and VTE prevention is one of the top patient safety strategies that hospitals can adopt. This study aimed to understand patients' perceptions of VTE prevention related to major orthopedic surgery in order to guide the clinical practice of medical staff and improve patient quality of life. Patients undergoing major orthopedic surgery should receive interventions to prevent VTE. To encourage patient participation, these interventions should be patient-centered. However, few studies have examined the perceptions of VTE prevention among patients undergoing major orthopedic surgery. METHODS: Participants were purposively selected from among patients undergoing major orthopedic surgery in the orthopedic department of a level-three, class-A hospital in Beijing, China. Data were collected through in-depth semi-structured interviews, and findings were based on a thematic content analysis. All interviews were held during each patient's hospital stay. RESULTS: From eight patients who participated, the following themes were identified: (1) unclear understanding of VTE, (2) poor understanding of the severity of postoperative VTE, and (3) poor understanding of VTE prevention. CONCLUSIONS: There are weak links in clinical care related to VTE prevention. We should aim to more completely understand patients' needs, strengthen the health education provided to patients, and improve patient adherence to preventative measures.