Deep learning methods for diagnosis of graves' ophthalmopathy using magnetic resonance imaging.

Background: The effect of diagnosing Graves' ophthalmopathy (GO) through traditional measurement and observation in medical imaging is not ideal. This study aimed to develop and validate deep learning (DL) models that could be applied to the diagnosis of GO based on magnetic resonance imaging (MRI) and compare them to traditional measurement and judgment of radiologists. Methods: A total of 199 clinically verified consecutive GO patients and 145 normal controls undergoing MRI were retrospectively recruited, of whom 240 were randomly assigned to the training group and 104 to the validation group. Areas of superior, inferior, medial, and lateral rectus muscles and all rectus muscles on coronal planes were calculated respectively. Logistic regression models based on areas of extraocular muscles were built to diagnose GO. The DL models named ResNet101 and Swin Transformer with T1-weighted MRI without contrast as input were used to diagnose GO and the results were compared to the radiologist's diagnosis only relying on MRI T1-weighted scans. Results: Areas on the coronal plane of each muscle in the GO group were significantly greater than those in the normal group. In the validation group, the areas under the curve (AUCs) of logistic regression models by superior, inferior, medial, and lateral rectus muscles and all muscles were 0.897 [95% confidence interval (CI): 0.833-0.949], 0.705 (95% CI: 0.598-0.804), 0.799 (95% CI: 0.712-0.876), 0.681 (95% CI: 0.567-0.776), and 0.905 (95% CI: 0.843-0.955). ResNet101 and Swin Transformer achieved AUCs of 0.986 (95% CI: 0.977-0.994) and 0.936 (95% CI: 0.912-0.957), respectively. The accuracy, sensitivity, and specificity of ResNet101 were 0.933, 0.979, and 0.869, respectively. The accuracy, sensitivity, and specificity of Swin Transformer were 0.851, 0.817, and 0.898, respectively. The ResNet101 model yielded higher AUC than models of all muscles and radiologists (0.986 vs. 0.905, 0.818; P<0.001). Conclusions: The DL models based on MRI T1-weighted scans could accurately diagnose GO, and the application of DL systems in MRI may improve radiologists' performance in diagnosing GO and early detection.

Self-calibrated atom-interferometer gyroscope by modulating atomic velocities.

Atom-interferometer gyroscopes have attracted much attention for their long-term stability and extremely low drift. For such high-precision instruments, self-calibration to achieve an absolute rotation measurement is critical. In this work, we propose and demonstrate the self-calibration of an atom-interferometer gyroscope. This calibration is realized by using the detuning of the laser frequency to control the atomic velocity, thus modulating the scale factor of the gyroscope. The modulation determines the order and the initial phase of the interference stripe, thus eliminating the ambiguity caused by the periodicity of the interferometric signal. This self-calibration method is validated through a measurement of the Earth's rotation rate, and a relative uncertainty of 162 ppm is achieved. Long-term stable and self-calibrated atom-interferometer gyroscopes have important applications in the fields of fundamental physics, geophysics, and long-time navigation.

Compact multi-channel radio frequency pulse-sequence generator with fast-switching capability for cold-atom interferometers.

Cold-atom interferometers have matured into a powerful tool for fundamental physics research, and they are currently moving from realizations in the laboratory to applications in the field. A radio frequency (RF) generator is an indispensable component of these devices for controlling lasers and manipulating atoms. In this work, we developed a compact RF generator for fast switching and sweeping the frequencies and amplitudes of atomic-interference pulse sequences. In this generator, multi-channel RF signals are generated using a field-programmable gate array (FPGA) to control eight direct digital synthesizers (DDSs). We further propose and demonstrate a method for pre-loading the parameters of all the RF pulse sequences to the DDS registers before their execution, which eliminates the need for data transfer between the FPGA and DDSs to change RF signals. This sharply decreases the frequency-switching time when the pulse sequences are running. Performance characterization showed that the generated RF signals achieve a 100 ns frequency-switching time and a 40 dB harmonic-rejection ratio. The generated RF pulse sequences were applied to a cold-atom-interferometer gyroscope, and the contrast of atomic interference fringes was found to reach 38%. This compact multi-channel generator with fast frequency/amplitude switching and/or sweeping capability will be beneficial for applications in field-portable atom interferometers.

[Effect of administration of acupuncture stimulation combined with Gushen Zhuyu Decoction on lumbar function in patients with disc herniation].

OBJECTIVE: To investigate the therapeutic effect of acupuncture stimulation combined with administration of"Gushen Zhuyu Tang"(decoction for consolidating kidney to eliminate blood stasis, DCKEBS) in the treatment of lumbar disc herniation (LDH) patients. METHODS: A total of 147 patients with LDH were randomly divided into DCKEBS, acupuncture and DCKEBS+acupuncture groups (n= 49 cases in each group). The patients of the acupuncture group received a) acupuncture stimulation of Dazhui (GV14), Ganshu (BL18), Shenshu (BL23), Tianshu (ST25), Yanglingquan (GB34), etc., b) fire needle pricking of the topical tendons, cord-like points, tender-points, c) row-needles stimulation of the attachment sites of muscles of the sacroiliac joint or crista iliaca, and d) acupotomy-debonding of the topical high-tension muscles, twice a week for 4 weeks. Those patients of the DCKEBS group were ordered to take DCKEBS [containing fried Yiyiren (Semen Coicis), Shanzhuyu (Fructus Corni), fried Baizhu (Rhizoma Astractylodis), Sangjisheng (Ramulus Loranthi), Duzhong (Cortex Eucommiae), Buguzhi (Fructus Psoraieae), etc.] 150 mL, twice daily, continuously for 4 weeks, and those of the DCKEBS+acupuncture group received the combined treatment mentioned above in the acupuncture and DCKEBS groups. The pain severity was assessed by using visual ana-logue scale (VAS, 0-10 points) and the modified Japan Orthopaedic Association questionnaire (M-JOA) score (0-30 points), separately, and the lumbar range of motion (ROM) and lumbar muscle strength were tested to evaluate the lumbar motor function. The levels of serum tumor necrosis factor α(TNF-α), matrix metalloproteinase-2 (MMP-2), and apoptosis related factors Caspase-3 and Caspase-9 were assayed using ELISA. The total effective rates of the three groups were compared. RESULTS: After the treatment, the VAS and M-JOA scores, contents of serum TNF-α, MMP-2, Caspase-3 and Caspase-9 were significantly decreased (P<0.01), and the myodynamia of lumbar muscular flexor and extensor was considerably increased (P<0.01) in the three groups, and the ROM angles of lumbar extending and buckling were increased (P<0.01) in the DCKEBS+acupuncture group compared with pretreatment. Comparison among the 3 groups showed that the VAS and M-JOA scores, and serum TNF-α, MMP-2, Caspase-3 and Caspase-9 contents of the DCKEBS+acupuncture group were significantly lower than those of both DCKEBS and acupuncture groups (P<0.01), while the ROM angles of lumbar extending and buckling, and the myodynamia of lumbar muscular flexor and extensor were obviously higher in the DCKEBS+acupuncture group than those of the DCKEBS and acupuncture groups (P<0.01). The total effective rate was 93.88%(46/49) in the DCKEBS+acupuncture group, higher than 75.51%(37/49) in the DCKEBS group and 71.43%(35/49) in the acupuncture group (P<0.05). CONCLUSION: Acupuncture combined with DCKEBS can relieve pain, improve lumbar muscle strength and lumbar movement function, and reduce serum TNF-α, MMP-2, Caspase-3 and Caspase-9 levels in LDH patients.

[Core stability training combined with acupuncture in treatment of chronic nonspecific low back pain: a prospective randomized controlled trial].

OBJECTIVE: To investigate the clinical effect of core stability training combined with acupuncture in the treatment of chronic nonspecific low back pain (CLBP). METHODS: Seventy-five CLBP patients were randomly divided into experimental group (n=38) and control group (n=37) according to a random number table. Patients in the control group were required to perform core stability training, whereas those in the experimental group received core stability training combined with fire needle acupuncture, once every two days, three times per week, for four successive weeks. The Oswestry disability index (ODI), visual analogue scale (VAS), lumbar muscular endurance index, clinical efficacy, as well as average electromyographic (AEMG), root mean square (RMS), median frequency (MF), and average median frequency (AMF) values during multifidus muscle contraction in the two groups before and after the treatment were compared. RESULTS: After treatment, ODI, VAS, MF, and AMF of the two groups were lower than those before the treatment (P<0.01), while the lumbar static and dynamic muscular endurance, AEMG, and RMS values were higher (P<0.01). The ODI, VAS, MF, and AMF of the experimental group significantly declined as compared with those of the control group (P<0.01), whereas the lumbar static and dynamic muscular endurance, AEMG, and RMS values were elevated (P<0.01). The total effective rate of the experimental group was 97.14%(34/35), higher than 85.71%(30/35) of the control group(P<0.01). CONCLUSION: Core stability training combined with acupuncture effectively enhances lumbar muscular endurance, improves electromyographic signals of multifidus muscle and lumbar function, and relieves pain, implying the good efficacy of such combined therapy in treating CLBP.

[Effects of Carriers on ANAMMOX Sludge Activity Recovery and Microbial Flora Characteristics].

In order to realize the rapid recovery of ANAMMOX sludge bacterial activity after long-term room temperature storage, three groups of reactors were added to ANAMMOX sludge that had been stored without substrate at room temperature (15-30℃) for 9 months. Among the three groups of reactors, comet fiber carrier and K3 carrier were added to R2 and R3 reactors, respectively, as biological carriers. The effects of different carriers on the recovery rate of ANAMMOX sludge bacterial activity were investigated. The results showed that ANAMMOX reactions in the R2 and R3 reactors began taking place on the 8th and 10th day, respectively, with respective TIN removal rates of 82.25% and 80.92%, which were significantly improved compared with that in the R1 reactor, in which no carrier was added (ANAMMOX reaction started occurring on the 15th day with a TIN removal rate of 80.26%). After 42 days with influent, ρ(NH4+-N) and ρ(NO2--N) respectively increased to 300 mg·L-1 and 396 mg·L-1, and the TIN removal rates of the three groups of reactors were respectively 78.96%, 84.92%, and 84.66%. Microbial community structure analysis showed that the relative abundances of ANAMMOX bacteria in the R2 and R3 reactor were respectively 6.85% and 6.06%, two to four times that in the R1 reactor. The predominant ANAMMOX bacteria in the sludge was Candidatus Jettenia, whose relative abundances in the three groups of reactors were respectively 1.62%, 5.74%, and 5.21%. The results show that ANAMMOX biofilm-granular sludge complex systems constructed by adding carriers can considerably shorten the time for recovering ANAMMOX sludge bacterial activity after long-term room temperature storage without substrate. The carriers effectively promoted the relative abundances of ANAMMOX bacteria in the reactors, whereas the promoting effect of comet fiber carrier was slightly more significant than that of the K3 carrier.

Recognize and assessment of key host humic-reducing microorganisms of antibiotic resistance genes in different biowastes composts.

Humic-reducing microorganisms (HRMs) can utilize humic substance as terminal electron mediator promoting the bioremediation of contaminate, which is ubiquitous in composts. However, the impacts of HRMs on antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) in composts and different HRMs community composition following the types of biowastes effected the spread of ARGs have not been investigated. Herein, the dynamics and mobility of ARGs and HRMs during protein-, lignocellulose- and lignin-rich composting were investigated. Result show that ARGs change significantly at the thermophilic phase, and the relative abundance of most ARGs increase during composting. Seven groups of HRMs communities are classified as primary host HRMs of ARGs, and most host HRMs groups from protein-rich composts. Conclusively, regulating methods for inhibiting ARGs spread for different composts are proposed. HRMs show a higher ARGs dissemination capacity in protein-rich composts than lignocellulose- and lignin-rich composts, but the spread of ARGs can be inhibited by regulate physicochemical parameters in protein-rich composts. In contrary, most HRMs have inhibitory effects on ARGs spread in lignocellulose- and lignin-rich composts, and those HRMs can be used as a new agent that inhibits the spread of ARGs. Our results can help in understanding the potential risk spread of ARGs by inoculating functional bacteria derived from different biowastes composts for environmental remediation, given their expected importance to developing a classification-oriented approach for composting different biowastes.

[Effects of acupuncture on plasma endogenous opioid peptides in patients with stroke-associated headache in convalescence].

OBJECTIVE: To observe the clinical effect of acupuncture on patients with stroke-related headache during convalescent and analyze its related factors. METHODS: A total of 116 stroke-related headache patients admitted to the Acupuncture Department of Gongli Hospital of Pudong New Area, Shanghai, from October 2018 to December 2019 were divided into a treatment group and a control group according to a random number table, with 58 cases in each group. Patients in both groups were given conventional treatments for control of blood pressure, blood sugar, blood lipids and anticoagulation. At the same time, patients in the treatment group were treated with "nape seven needles" (acupuncture at Fengfuï¼»GV16ï¼½, bilateral Fengchiï¼»GB20ï¼½, bilateral Tianzhuï¼»BL10ï¼½ and bilateral Wanguï¼»GB12ï¼½)combined with penetration needling for 30 min; patients in the control group were treated with Flunarizine hydrochloride capsules (5 mg). Both interventions were conducted once daily for 4 weeks. The visual analogue scale(VAS) score and integrative sores of headache, and plasma serotonin (5-HT), dopamine (DA), substance P (SP), α-endorphin (α-EP), and ß-endorphin (ß-EP) levels before and after treatment were compared between the two groups. The total therapeutic effective rate of the two groups was calculated. RESULTS: There was no significant difference in VAS score, headache score, plasma 5-HT, DA, SP, α-EP, ß-EP levels between the two groups before treatment (P>0.05). After treatment, both groups have significant decrease in the VAS score, integrative sores of headache, the plasma 5-HT, DA, SP levels (P<0.05), and significant increase in the plasma α-EP and ß-EP levels (P<0.05). At the same time, the VAS score, integrative sores of headache, the plasma 5-HT, DA, SP levels of the treatment group were lower (P<0.05), and the plasma α-EP and ß-EP levels were higher (P<0.05) than those in the control group. The total effective rate of the treatment group(51/58, 87.9%) was higher than that of the control group (42/58, 72.4%, P<0.05). CONCLUSION: Acupuncture therapy can increase the release of endogenous opioid peptide, reduce the secretion of 5-HT, DA, SP, and have a significant effect in treating stroke related headache.