High-throughput metagenomics analysis in early and precise diagnosis of eosinophilic meningoencephalitis complicated with respiratory failure: A case report.

RATIONALE: Human infection with Angiostrongylus cantonensis is uncommon and has only been sporadically reported in the literature. Patients infected with A cantonensis usually have a delayed diagnosis and sometimes a poor prognosis. PATIENT CONCERNS: A 70-year-old woman presented to the respiratory department with complaints of headache, chest pain, myalgia, fatigue, and anorexia for 7 days. DIAGNOSES: Complete blood count showed eosinophilia. The serum was tested showing a positive finding of A cantonensis antibody. Cerebrospinal fluid was tested using high-throughput metagenomics analysis and 16 reads for A cantonensis were mapped. The patient was diagnosed with A cantonensis infection. INTERVENTIONS: The patient received a 7-day course of albendazole and 4-day course of prednisone. OUTCOMES: When discharged from the hospital, the patient still suffered from fatigue and poor memory. Aminotransferase levels were high due to albendazole's liver toxicity. In a post-discharge follow-up about 1 month later she had recovered completely both physically and mentally, and peripheral eosinophil count and aminotransferase levels were both normal. LESSONS: Because the direct identification of parasites is difficult, high-throughput metagenomics analysis may provide a reliable alternative tool for the diagnoses of infection with A cantonensis. When albendazole is prescribed, caution must be taken with respect to its liver toxicity.

Thyroid hormones as biomarkers of lung cancer: a retrospective study.

BACKGROUND: Thyroid hormones are key regulators of several physiological processes, including differentiation, embryonic development, proliferation, and metabolism. Several prospective studies have shown a relationship between hyperthyroidism and cancer incidence; however, since the association between thyroid hormone levels and lung cancer remains controversial, this study aimed to determine the correlation between the same. METHODS: We retrospectively analyzed 289 patients, who were diagnosed with lung cancer at the Huzhou Central Hospital between January 2016 and January 2021, and 238 healthy subjects. The baseline clinical data of two groups were collected. The concentrations of thyroid hormones, tumor CEA, CYF, SCC, and NSE in both the lung cancer patient and healthy volunteer groups were analyzed. Student's t-test or Mann-Whitney test was used to compare continuous variables. A chi-square test was adopted to estimate the relationship between serum thyroid hormones level and clinical characteristics of lung cancer cases. ROC curve analyses were used to determine the characteristics of thyroid hormones for recognizing lung cancer. RESULTS: The results showed that serum thyroid stimulating hormone (TSH), total thyroxine, total triiodothyronine, and free triiodothyronine (FT3) levels were significantly decreased, while free thyroxine (FT4) levels were increased in patients with lung cancer. In addition, FT3 was identified as a potential diagnostic biomarker of stage I-IV lung cancer with the area under the curve values of 0.807. What's more, FT3 and FT4 were used in combination with CEA and were identified as potential diagnostic biomarkers of stage 0 lung cancer (Tis) with the area under the curve values of 0.774. CONCLUSIONS: Our study highlights the possibility of using thyroid hormones as innovative diagnostic markers for lung cancer.

Serum TSH, TT4, TT3, and FT3 levels were significantly decreased in patients with lung cancer.low TT3 concentration was positively associated with age (p < 0.05), sex (p < 0.05), tumor size (p < 0.05) and lymph node metastasis (p < 0.05). Moreover, the concentration of FT3 was dependent on age (p < 0.05) and tumor size (p < 0.05). The serum FT4 concentration was discernible with obviously higher concentration in stage IV patients compared with stage I­III patients (p < 0.05).When FT3 was used in combination with CEA and CYF, the sensitivity and specificity in the screening for stage I­IV lung cancer were markedly increased to 85.9% and 97.5%, respectively. When we included FT3, FT4, and CEA in the diagnosis, the AUC was 0.774. The sensitivity and specificity of screening for stage 0 lung cancer were increased to 70.2% and 75.2%, respectively.

Investigation into Rheological Behavior of Warm-Mix Recycled Asphalt Binders with High Percentages of RAP Binder.

The rheological properties of warm-mix recycled asphalt binders are critical to enhancing design quality and interpreting the performance mechanisms of the corresponding mixtures. This study investigated the rheological behavior of warm-mix recycled asphalt binders with high percentages of RAP binder. The effects of two warm-mix additives [wax-based Sasobit (S) and surfactant-based Evotherm-M1 (E)], a rejuvenating aging [ZGSB (Z)], four RAP binder contents (0%, 30%, 50% and 70%), and three aging states (unaged, short-term aged and long-term aged) were evaluated in detail using the dynamic shear rheometer (DSR), bending beam rheometer (BBR) and Brookfield rotational viscometer tests as well as conventional performance tests over the whole range of temperatures. The results showed that the rejuvenating agent Z effectively alleviated the aging effect of the RAP binder; however, it could hardly eliminate entirely this negative impact, especially at higher RAP binder contents. The addition of S remarkably lowered the apparent viscosity of the warm-mix recycled binders by up to 35.0%, whereas E had little influence on the binder viscosity due to its surfactant nature. Besides, S performed much better in improving rutting resistance (with the increase of up to 411.3% in |G*|/sinδ) than E, while E exhibited superior fatigue performance (with the reduction of up to 42.3% in |G*|·sinδ) to that of S. In terms of the thermal cracking resistance, E had very slight influence and S even yielded an adverse impact (with the increase of up to 70.2% in Sa and the decrease of up to 34.1% in m-value). Further, S broadened the ranges of pavement service temperatures by about 12 °C, whereas E almost did not change the PG grades of the binders. Finally, regarding the characteristics of viscoelastic master curves, S considerably improved the dynamic modulus and lowered the phase angle of the binders over a wide range of frequencies and temperatures but led to the failure of the time-temperature superposition principle due to its thermorheologically complex nature. Nevertheless, in this regard, the effect of E was found very mild.

A combined predictive model based on radiomics features and clinical factors for disease progression in early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy.

Purpose: To accurately assess disease progression after Stereotactic Ablative Radiotherapy (SABR) of early-stage Non-Small Cell Lung Cancer (NSCLC), a combined predictive model based on pre-treatment CT radiomics features and clinical factors was established. Methods: This study retrospectively analyzed the data of 96 patients with early-stage NSCLC treated with SABR. Clinical factors included general information (e.g. gender, age, KPS, Charlson score, lung function, smoking status), pre-treatment lesion status (e.g. diameter, location, pathological type, T stage), radiation parameters (biological effective dose, BED), the type of peritumoral radiation-induced lung injury (RILI). Independent risk factors were screened by logistic regression analysis. Radiomics features were extracted from pre-treatment CT. The minimum Redundancy Maximum Relevance (mRMR) and the Least Absolute Shrinkage and Selection Operator (LASSO) were adopted for the dimensionality reduction and feature selection. According to the weight coefficient of the features, the Radscore was calculated, and the radiomics model was constructed. Multiple logistic regression analysis was applied to establish the combined model based on radiomics features and clinical factors. Receiver Operating Characteristic (ROC) curve, DeLong test, Hosmer-Lemeshow test, and Decision Curve Analysis (DCA) were used to evaluate the model's diagnostic efficiency and clinical practicability. Results: With the median follow-up of 59.1 months, 29 patients developed progression and 67 remained good controlled within two years. Among the clinical factors, the type of peritumoral RILI was the only independent risk factor for progression (P< 0.05). Eleven features were selected from 1781 features to construct a radiomics model. For predicting disease progression after SABR, the Area Under the Curve (AUC) of training and validation cohorts in the radiomics model was 0.88 (95%CI 0.80-0.96) and 0.80 (95%CI 0.62-0.98), and AUC of training and validation cohorts in the combined model were 0.88 (95%CI 0.81-0.96) and 0.81 (95%CI 0.62-0.99). Both the radiomics and the combined models have good prediction efficiency in the training and validation cohorts. Still, DeLong test shows that there is no difference between them. Conclusions: Compared with the clinical model, the radiomics model and the combined model can better predict the disease progression of early-stage NSCLC after SABR, which might contribute to individualized follow-up plans and treatment strategies.

Influence of Size on Optical and Electrical Properties of GaN-Based Membrane µ-LED.

The electrical and optical properties of micro-light emitting diodes (µ-LEDs), including current-voltage (I-V), capacitance-voltage (C-V) curves, photoluminescence (PL) as well as electroluminescence (EL) spectra have been measured and analyzed. It is found that the unit area emitting intensity of small size µ-LED is stronger that of big size µ-LED at the same conditions, due to the enhancement of both the internal quantum efficiency ηint and extraction efficiency Cex. The present method of utilizing the µ-LED for improving the unit area brightness of LEDs is applicable to high efficiency surface emitting device on GaN-on-silicon platform.

A phase II study of S-1 with concurrent radiotherapy in elderly patients with esophageal cancer.

BACKGROUND: Concurrent chemoradiotherapy (CCRT) using conventional platinum-based doublets are often associated with significant incidence of toxic effects in elderly patients with esophageal cancer. We previously reported a phase I trial of CCRT using S-1, an oral 5-fluorouracil derivative, which yielded well safe and active outcomes. METHODS: Patients with histologically confirmed esophageal cancer, who were age of 70 years or older with performance status (PS) score of 0-2 or age of 66 to 69 with PS score of 2, were eligible for this Phase II trial. Radiotherapy was delivered in 1.8 Gy per fraction to a total dose of 54 Gy. Concurrently, S-1 was administered at 70 mg/m2 on days 1-14 and 29-42. The primary end point was 2-year overall survival rate. RESULTS: Thirty patients were enrolled, and 28 patients completed the full course of radiotherapy. No grade 4 toxicity or treatment-related death occurred. The grade 3 toxicities included esophagitis (16.7%), leucopoenia (13.3%), neutropenia (10%), anaemia (3.3%), pneumonitis (3.3%) and fatigue (3.3%). The median progression-free survival time and median survival time was 19 and 24 months, respectively. The 2-year overall survival rate was 45.1%, which exceeded the predefined threshold of 2-year OS 35% and met the primary end point of the study. CONCLUSIONS: The results suggest that CCRT using S-1 is effective with mild toxicity in elderly patients with esophageal cancer. A phase III trial is needed to further evaluate this regimen.

Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in ischemia-causing coronary stenosis: a meta-analysis.

PURPOSE: Fractional flow reserve based on coronary computed tomographic angiography (CCTA; FFRCT) can evaluate functional severity in coronary artery disease (CAD). This study investigated the diagnostic value of FFRCT for determining CAD severity. MATERIALS AND METHODS: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until June 16, 2016 using the following search terms: fractional flow reserve, coronary computed tomography angiography, myocardial ischemia. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in the analysis. RESULTS: Twenty-one studies were included with a total of 2216 subjects and 2798 vessels. FFRCT, sensitivity per-vessel and per-patient were ≥82% and specificity was ≥73% for diagnosis of ischemia. FFRCT had better diagnostic accuracy and discrimination than CCTA. CONCLUSION: This study indicates that FFRCT may be a good tool for screening and diagnosing of myocardial ischemia in patients with CAD.

A phase I dose escalation study of S-1 with concurrent radiotherapy in elderly patients with esophageal cancer.

BACKGROUND: Concurrent chemoradiotherapy (CRT) with 5-fluorouracil (5-FU) and cisplatin (CDDP) are often associated with significant incidence of toxic effects in elderly patients with esophageal cancer. This phase I trial was designed to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of S-1, an oral 5-FU derivative, when given with radiotherapy in elderly patients. METHODS: Patients who were age of 70 years or older with histologically confirmed esophageal cancer, and had an Eastern Cooperative Oncology Group (ECOG) score of 0-2 were eligible for this study. Radiotherapy was administered in 1.8 Gy fractions 5 times weekly to a total dose of 54 Gy. S-1 was administered on days 1-14 and 29-42 at the following dosages: 60, 70, and 80 mg/m(2)/day. TRIAL REGISTRATION: NCT01175447 (ClinicalTrials.gov). RESULTS: Twelve previously untreated patients were enrolled in this study. No grade 3 or 4 toxicity was observed in six patients treated at the 60 and 70 mg/m(2) dose levels. DLT was observed in four of six patients treated at the 80 mg/m(2) dose level. Two patients developed grade 3 esophagitis, one patient developed grade 3 esophagitis and pneumonitis, and one patient developed grade 3 thrombocytopaenia. Endoscopic complete response (CR) was observed in eight patients (66.7%). The median progression free survival (PFS) was 20 months and median overall survival was 29 months. CONCLUSIONS: The MTD of S-1 was 80 mg/m(2), and the recommended dose (RD) for phase II studies was 70 mg/m(2). This regimen was well tolerated and active in elderly patients with esophageal cancer, meriting further investigation in phase II studies.