ChatCAD+: Towards a Universal and Reliable Interactive CAD using LLMs.

The integration of Computer-Aided Diagnosis (CAD) with Large Language Models (LLMs) presents a promising frontier in clinical applications, notably in automating diagnostic processes akin to those performed by radiologists and providing consultations similar to a virtual family doctor. Despite the promising potential of this integration, current works face at least two limitations: (1) From the perspective of a radiologist, existing studies typically have a restricted scope of applicable imaging domains, failing to meet the diagnostic needs of different patients. Also, the insufficient diagnostic capability of LLMs further undermine the quality and reliability of the generated medical reports. (2) Current LLMs lack the requisite depth in medical expertise, rendering them less effective as virtual family doctors due to the potential unreliability of the advice provided during patient consultations. To address these limitations, we introduce ChatCAD+, to be universal and reliable. Specifically, it is featured by two main modules: (1) Reliable Report Generation and (2) Reliable Interaction. The Reliable Report Generation module is capable of interpreting medical images from diverse domains and generate high-quality medical reports via our proposed hierarchical in-context learning. Concurrently, the interaction module leverages up-to-date information from reputable medical websites to provide reliable medical advice. Together, these designed modules synergize to closely align with the expertise of human medical professionals, offering enhanced consistency and reliability for interpretation and advice. The source code is available at GitHub.

Analysis and Recognition of Voluntary Facial Expression Mimicry Based on Depressed Patients.

Many clinical studies have shown that facial expression recognition and cognitive function are impaired in depressed patients. Different from spontaneous facial expression mimicry (SFEM), 164 subjects (82 in a case group and 82 in a control group) participated in our voluntary facial expression mimicry (VFEM) experiment using expressions of neutrality, anger, disgust, fear, happiness, sadness and surprise. Our research is as follows. First, we collected a large amount of subject data for VFEM. Second, we extracted the geometric features of subject facial expression images for VFEM and used Spearman correlation analysis, a random forest, and logistic regression-based recursive feature elimination (LR-RFE) to perform feature selection. The features selected revealed the difference between the case group and the control group. Third, we combined geometric features with the original images and improved the advanced deep learning facial expression recognition (FER) algorithms in different systems. We propose the E-ViT and E-ResNet based on VFEM. The accuracies and F1 scores were higher than those of the baseline models, respectively. Our research proved that it is effective to use feature selection to screen geometric features and combine them with a deep learning model for depression facial expression recognition.

Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus.

AIMS: Chronic kidney disease (CKD) and diabetes mellitus increase atherosclerotic cardiovascular diseases (ASCVD) risk. However, the association between renal outcome of diabetic kidney disease (DKD) and ASCVD risk is unclear. METHODS: This retrospective study enrolled 218 type 2 diabetic patients with biopsy-proven DKD, and without known cardiovascular diseases. Baseline characteristics were obtained and the 10-year ASCVD risk score was calculated using the Pooled Cohort Equation (PCE). Renal outcome was defined as progression to end-stage renal disease (ESRD). The association between ASCVD risk and renal function and outcome was analyzed with logistic regression and Cox analysis. RESULTS: Among all patients, the median 10-year ASCVD risk score was 14.1%. The median of ASCVD risk score in CKD stage 1, 2, 3, and 4 was 10.9%, 12.3%, 16.5%, and 14.8%, respectively (p = 0.268). Compared with patients with lower ASCVD risk (＜14.1%), those with higher ASCVD risk had lower eGFR, higher systolic blood pressure, and more severe renal interstitial inflammation. High ASCVD risk (>14.1%) was an independent indicator of renal dysfunction in multivariable-adjusted logistic analysis (OR, 3.997; 95%CI, 1.385-11.530; p = 0.010), though failed to be an independent risk factor for ESRD in patients with DKD in univariate and multivariate Cox analysis. CONCLUSIONS: DKD patients even in CKD stage 1 had comparable ASCVD risk score to patients in CKD stage 2, 3, and 4. Higher ASCVD risk indicated severe renal insufficiency, while no prognostic value of ASVCD risk for renal outcome was observed, which implied macroangiopathy and microangiopathy in patients with DKD were related, but relatively independent.