A Dynamic Context Encoder Network for Liver Tumor Segmentation.

BACKGROUND: Accurate segmentation of liver tumor regions in medical images is of great significance for clinical diagnosis and the planning of surgical treatments. Recent advancements in machine learning have shown that convolutional neural networks are powerful in such image processing while largely reducing human labor. However, the variable shape, fuzzy boundary, and discontinuous tumor region of liver tumors in medical images bring great challenges to accurate segmentation. The feature extraction capability of a neural network can be improved by expanding its architecture, but it inevitably demands more computing resources in training and hyperparameter tuning. METHODS: This study presents a Dynamic Context Encoder Network (DCE-Net), which incorporates multiple new modules, such as the Involution Layer, Dynamic Residual Module, Context Extraction Module, and Channel Attention Gates, for feature extraction and enhancement. RESULTS: In the experiment, we used a liver tumor CT dataset of LiTS2017 to train and test the DCE-Net for liver tumor segmentation. The experimental results showed that the four evaluation indexes of the method, precision, recall, dice, and AUC, were 0.8961, 0.9711, 0.9270, and 0.9875, respectively. Furthermore, our ablation study reported that the accuracy and training efficiency of our network were markedly superior to the networks without involution or dynamic residual modules. CONCLUSION: Therefore, the DCE-Net proposed in this study has great potential for automatic segmentation of liver lesion tumors in the clinical diagnostic environment.

A study on short-term efficacy and safety of Iodine-125 brachytherapy coupled with preoperative arterial chemoembolization for hypervascular spinal metastasis.

PURPOSE: Hypervascular spinal metastatic malignancies can cause severe pain and intraoperative bleeding and selection of appropriate treatment can be challenging. This study aimed to observe the short-term efficacy and safety of Iodine-125 brachytherapy (125I BT) combined with preoperative transcatheter arterial chemoembolization (TACE) for hypervascular spinal metastasis. METHODS: This study included a total of 33 patients (39 lesions) with hypervascular spinal metastasis. All of them carried out a regimen of TACE followed by 125I BT under CT guidance. A brachytherapy planning system has been utilized for the purpose of designing treatment plans and optimizing dose distribution. Pain relief was evaluated using a numeric rating scale (NRS) and intraoperative bleeding was recorded. Follow-up was conducted for 6 months to observe the local control rate and clinical complications. RESULTS: All patients tolerated combined treatment well and intraoperative blood loss of every patient was not more than 10 ml. The 2- and 6- month local disease control rates were 92.3% and 83.8%. The NRS scores for thirty-three tumor patients before surgery and after one week, two, and six months of surgery were recorded as 7.33 ± 1.80, 7.39 ± 1.89, 3.15 ± 2.35, and 4.16 ± 2.15, respectively. The NRS score 2 months after treatment was found considerably lower in comparison to the NRS score before operation (p < 0.05). CONCLUSIONS: According to our findings, 125I BT as well as preoperative TACE leads to perioperative hemostasis, pain alleviation, and reduced tumor burden, indicating that this combined treatment could be effective and promising for hypervascular spinal metastases.

Exciton-to-Dopant Energy Transfer Dynamics in Mn2+ Doped CsPbBr3 Nanowires Synthesized by Diffusion Doping.

Mn2+ doped perovskite nanocrystals have garnered significant attention in optoelectronic applications. However, the synthesis of Mn2+ doped perovskite nanowires (NWs) poses challenges, and the dynamics of energy transfer from the exciton to Mn2+ remains unexplored, which is crucial for optimizing Mn2+ luminescence efficiency. Herein, we present a method to synthesize Mn2+ doped CsPbBr3 NWs with a photoluminescence quantum yield of 52% by diffusing Mn2+ into seed CsPbBr3 NWs grown via a hot injection method. We control the solution and lattice chemical potentials of Pb2+ and Mn2+ to enable Mn2+ to diffuse into the CsPbBr3 NWs while minimizing Ostwald ripening. Variable temperature photoluminescence spectroscopy reveals that the energy transfer from the exciton to Mn2+ in Mn2+ doped CsPbBr3 NWs is temperature dependent. A dynamic competition is observed between energy transfer and backward energy transfer, resulting in stronger Mn2+ photoluminescence at 80 K. This work provides a specific synthesis pathway for Mn2+ doped CsPbBr3 NWs and sheds light on their exciton-to-Mn2+ energy transfer dynamics.

mfeeU-Net: A multi-scale feature extraction and enhancement U-Net for automatic liver segmentation from CT Images.

Medical image segmentation of the liver is an important prerequisite for clinical diagnosis and evaluation of liver cancer. For automatic liver segmentation from Computed Tomography (CT) images, we proposed a Multi-scale Feature Extraction and Enhancement U-Net (mfeeU-Net), incorporating Res2Net blocks, Squeeze-and-Excitation (SE) blocks, and Edge Attention (EA) blocks. The Res2Net blocks which are conducive to extracting multi-scale features of the liver were used as the backbone of the encoder, while the SE blocks were also added to the encoder to enhance channel information. The EA blocks were introduced to skip connections between the encoder and the decoder, to facilitate the detection of blurred liver edges where the intensities of nearby organs are close to the liver. The proposed mfeeU-Net was trained and evaluated using a publicly available CT dataset of LiTS2017. The average dice similarity coefficient, intersection-over-union ratio, and sensitivity of the mfeeU-Net for liver segmentation were 95.32%, 91.67%, and 95.53%, respectively, and all these metrics were better than those of U-Net, Res-U-Net, and Attention U-Net. The experimental results demonstrate that the mfeeU-Net can compete with and even outperform recently proposed convolutional neural networks and effectively overcome challenges, such as discontinuous liver regions and fuzzy liver boundaries.

Multiple Responsive Hydrogel Films Based on Dynamic Phenylboronate Bond Linkages with Simple but Practical Linear Response Mode and Excellent Glucose/Fructose Response Speed.

Multiple responsive hydrogels are usually constructed by the addition of many different functional groups. Generally, these groups have different responsive behaviors which lead to interleaved and complex modes of the multi-response system. It is difficult to get a practical application. In this study, we show that multi-response hydrogels can also be constructed using dynamic bonds as crosslinks. The multiple responsive hydrogel films with thicknesses on the sub-micrometer or micrometer scale can be fabricated from P(DMAA-3-AAPBA), a copolymer of N,N-dimethylacrylamide, 3-(acrylamido)phenylboronic acid, and poly(vinylalcohol) (PVA) though a simple layer-by-layer (LbL) technique. The driving force for the film build up is the in situ-formed phenylboronate ester bonds between the two polymers. The films exhibit Fabry-Perot fringes on their reflection spectra which can be used to calculate the equilibrium swelling degree (SDe) of the film so as to characterize its responsive behaviors. The results show that the films are responsive to temperature, glucose, and fructose with simple and practical linear response modes. More importantly, the speed of which the films respond to glucose or fructose is quite fast, with characteristic response times of 45 s and 7 s, respectively. These quick response films may have potential for real-time, continuous glucose or fructose monitoring. With the ability to bind with these biologically important molecules, one can expect that hydrogels may find more applications in biomedical areas in the future.

Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001).

There is considerable potential for integrating transarterial chemoembolization (TACE), programmed death-(ligand)1 (PD-[L]1) inhibitors, and molecular targeted treatments (MTT) in hepatocellular carcinoma (HCC). It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations. In this nationwide, retrospective, cohort study, 826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT (combination group, n = 376) or TACE monotherapy (monotherapy group, n = 450) were included from January 2018 to May 2021. The primary endpoint was progression-free survival (PFS) according to modified RECIST. The secondary outcomes included overall survival (OS), objective response rate (ORR), and safety. We performed propensity score matching approaches to reduce bias between two groups. After matching, 228 pairs were included with a predominantly advanced disease population. Median PFS in combination group was 9.5 months (95% confidence interval [CI], 8.4-11.0) versus 8.0 months (95% CI, 6.6-9.5) (adjusted hazard ratio [HR], 0.70, P = 0.002). OS and ORR were also significantly higher in combination group (median OS, 19.2 [16.1-27.3] vs. 15.7 months [13.0-20.2]; adjusted HR, 0.63, P = 0.001; ORR, 60.1% vs. 32.0%; P < 0.001). Grade 3/4 adverse events were observed at a rate of 15.8% and 7.5% in combination and monotherapy groups, respectively. Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS, OS, and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice, with an acceptable safety profile.

Mn-Doped AgZnInS/ZnS Nanocrystals (NCs): Effects of Zn Etching on the NC Optical Properties.

Mn-doped I(II)-III-VI NCs (e.g., Mn-doped AgZnInS/ZnS NCs) possessing low-energy excitation, high brightness and long fluorescence lifetimes have been desired for time-gated fluorescence biosensing/imaging. In this type of NCs, their optical properties are significantly affected by the microscopic interactions between Mn and Mn and between Mn and host NC, the compositions of NCs, and the defects in NCs. On the other hand, it is known that Zn etching to core I(II)-III-VI NCs in NC synthesis can significantly enhance the NC brightness because Zn can exchange surface atoms (e.g., Ag and In) in NCs to minimize NC surface-defects. But for Mn-doped I(II)-III-VI NCs, Zn etching could etch out not only surface-atoms of host NCs (e.g., Ag and In) but also Mn in NCs. As a result, it could significantly affect the NC compositions and the microscopic interactions between Mn and Mn as well as between Mn and host NC, and thus the optical properties of NCs (like lifetime and absorption/emission spectra). Therefore, it is needed to investigate how Zn etching would affect the optical properties of such Mn-doped NCs. In this study, a series of Mn-doped AgZnInS NCs with different Mn doping levels were prepared through nucleation doping, and then Zn etching was applied to etch these core NCs. To identify the effects of Zn etching on NC optical properties, ZnS coating (a different ZnS shelling approach by injecting Zn precursor and S precursor alternately in synthesis) was performed on the same Mn:AgZnInS NCs, and the optical properties of NCs with these two different ZnS shelling approaches were compared. Experimental results showed that under appropriate Mn doping levels in synthesis, Zn etching instead of ZnS coating can produce low-energy excitable NCs with higher QYs and longer lifetimes, which would further facilitate the use of such NCs in time-gated fluorescence measurement. To understand the reasons for the different optical properties under different ZnS shelling approaches, the material characteristics of the prepared NCs were further measured/analyzed and the possible fluorescence mechanisms were discussed.

Extrachromosomal circular DNA in cancer drug resistance and its potential clinical implications.

Chemotherapy is widely used to treat patients with cancer. However, resistance to chemotherapeutic drugs remains a major clinical concern. The mechanisms of cancer drug resistance are extremely complex and involve such factors such as genomic instability, DNA repair, and chromothripsis. A recently emerging area of interest is extrachromosomal circular DNA (eccDNA), which forms owing to genomic instability and chromothripsis. eccDNA exists widely in physiologically healthy individuals but also arises during tumorigenesis and/or treatment as a drug resistance mechanism. In this review, we summarize the recent progress in research regarding the role of eccDNA in the development of cancer drug resistance as well as the mechanisms thereof. Furthermore, we discuss the clinical applications of eccDNA and propose some novel strategies for characterizing drug-resistant biomarkers and developing potential targeted cancer therapies.