Differentiation of testicular seminomas from nonseminomas based on multiphase CT radiomics combined with machine learning: A multicenter study.

BACKGROUND: Differentiating seminomas from nonseminomas is crucial for formulating optimal treatment strategies for testicular germ cell tumors (TGCTs). Therefore, our study aimed to develop and validate a clinical-radiomics model for this purpose. METHODS: In this study, 221 patients with TGCTs confirmed by pathology from four hospitals were enrolled and classified into training (n = 126), internal validation (n = 55) and external test (n = 40) cohorts. Radiomics features were extracted from the CT images. After feature selection, we constructed a clinical model, radiomics models and clinical-radiomics model with different machine learning algorithms. The top-performing model was chosen utilizing receiver operating characteristic (ROC) curve analysis. Decision curve analysis (DCA) was also conducted to assess its practical utility. RESULTS: Compared with those of the clinical and radiomics models, the clinical-radiomics model demonstrated the highest discriminatory ability, with AUCs of 0.918 (95 % CI: 0.870 - 0.966), 0.909 (95 % CI: 0.829 - 0.988) and 0.839 (95 % CI: 0.709 - 0.968) in the training, validation and test cohorts, respectively. Moreover, DCA confirmed that the combined model had a greater net benefit in predicting seminomas and nonseminomas. CONCLUSION: The clinical-radiomics model serves as a potential tool for noninvasive differentiation between testicular seminomas and nonseminomas, offering valuable guidance for clinical treatment.

The optimal intravesical maintenance chemotherapy scheme for the intermediate-risk group non-muscle-invasive bladder cancer.

OBJECTIVE: Although the current European Association of Urology(EAU) guideline recommends that patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) should accept intravesical chemotherapy or Calmette-Guerin (BCG) for no more than one year after transurethral resection of bladder tumor(TURBT), there is no consensus on the optimal duration of chemotherapy. Hence, we explored the optimal duration of maintenance intravesical chemotherapy in patients with intermediate-risk NMIBC. SUBJECTS AND METHODS: This was a real-world single-center retrospective cohort study. In total 158 patients with pathologically confirmed intermediate-risk NMIBC were included, who were divided into 4 subgroups based on the number of instillations given. We used Cox regression analysis and survival analysis chart to explore the 3-yr recurrence outcomes of tumor.The optimal duration was determined by receive operating characteristic curve (ROC). RESULTS: The median follow-up was 5.2 years. Compared with instillation for 1-2 months, the Hazard Ratios(HR) values of instillation for less than 1 month, maintenance instillation for 3-6 months and > 6 months were 3.57、1.57 and 0.22(95% CI 1.27-12.41;0.26-9.28;0.07-0.80, P = 0.03;0.62;0.02, respectively). We found a significant improvement in 3-yr relapse-free survival in intermediate-risk NMIBC patients who maintained intravesical instillation chemotherapy for longer than 6 months, and the best benefit was achieved with 10.5 months of maintenance chemotherapy by ROC. CONCLUSIONS: In our scheme, the optimal duration of intravesical instillation with pirrubicin is 10.5 months. This new understanding provides valuable experience for the precise medical treatment model of intermediate-risk NMIBC.

An Illustration of FY-3E GNOS-R for Global Soil Moisture Monitoring.

An effective soil moisture retrieval method for FY-3E (Fengyun-3E) GNOS-R (GNSS occultation sounder II-reflectometry) is developed in this paper. Here, the LAGRS model, which is totally oriented for GNOS-R, is employed to estimate vegetation and surface roughness effects on surface reflectivity. Since the LAGRS (land surface GNSS reflection simulator) model is a space-borne GNSS-R (GNSS reflectometry) simulator based on the microwave radiative transfer equation model, the method presented in this paper takes more consideration on the physical scattering properties for retrieval. Ancillary information from SMAP (soil moisture active passive) such as the vegetation water content and the roughness coefficient are investigated for the final algorithm's development. At first, the SR (surface reflectivity) data calculated from GNOS-R is calculated and then calibrated, and then the vegetation roughness factor is achieved and used to eliminate the effects on both factors. After receiving the Fresnel reflectivity, the corresponding soil moisture estimated from this method is retrieved. The results demonstrate good consistency between soil moisture derived from GNOS-R data and SMAP soil moisture, with a correlation coefficient of 0.9599 and a root mean square error of 0.0483 cm3/cm3. This method succeeds in providing soil moisture on a global scale and is based on the previously developed physical LAGRS model. In this way, the great potential of GNOS-R for soil moisture estimation is presented.

The mutation screening in candidate genes related to thyroid dysgenesis by targeted next-generation sequencing panel in the Chinese congenital hypothyroidism.

OBJECTIVE: Congenital hypothyroidism (CH) is known to be due to thyroid dyshormonogenesis (DH), which is mostly inherited in an autosomal recessive inheritance pattern or thyroid dysgenesis (TD), whose inheritance pattern is controversial and whose molecular etiology remains poorly understood. DESIGN AND METHODS: The variants in 37 candidate genes of CH, including 25 genes related to TD, were screened by targeted exon sequencing in 205 Chinese patients whose CH cannot be explained by biallelic variants in genes related to DH. The inheritance pattern of the genes was analyzed in family trios or quartets. RESULTS: Of the 205 patients, 83 patients carried at least one variant in 19 genes related to TD, and 59 of those 83 patients harbored more than two variants in distinct candidate genes for CH. Biallelic or de novo variants in the genes related to TD in Chinese patients are rare. We also found nine probands carried only one heterozygous variant in the genes related to TD that were inherited from a euthyroid either paternal or maternal parent. These findings did not support the monogenic inheritance pattern of the genes related to TD in CH patients. Notably, in family trio or quartet analysis, of 36 patients carrying more than two variants in distinct genes, 24 patients carried these variants inherited from both their parents, which indicated that the oligogenic inheritance pattern of the genes related to TD should be considered in CH. CONCLUSIONS: Our study expanded the variant spectrum of the genes related to TD in Chinese CH patients. It is rare that CH in Chinese patients could be explained by monogenic germline variants in genes related to TD. The hypothesis of an oligogenic origin of the CH should be considered.

Multifunctional CuBiS2 Nanoparticles for Computed Tomography Guided Photothermal Therapy in Preventing Arterial Restenosis After Endovascular Treatment.

Chronic inflammation mediated by artery infiltrated macrophages plays critical role in artery restenosis after endovascular therapy. Evidence has demonstrated the potential ability of photothermal therapy (PTT) in eliminating chronic inflammation by targeting inflammatory cells including macrophages. Recently, increasing attention has been payed to copper chalcogenide nanocrystals doped of radiocontrast agent, e.g., bismuth (Bi) for computed tomography (CT) guided PTT. However, the application of imaging guided PTT in preventing artery restenosis is lacking and limited. Herein, a novel multifunctional CuBiS2 nanoparticles (CuBiS2 NPs) were synthesized for CT imaging guided PTT in artery re-stenosis prevention. The optimum amount and other conditions of CuBiS2 NPs were optimized to exert the maximum ablation effect on macrophages with good biocompatibility. In vivo carotid injury model revealed that CuBiS2 NPs exhibited promising therapeutic effect on inhibition of artery stenosis by eliminating macrophages with excellent CT imaging ability. The recent study highlights a new cost-effective metal nanostructures-based nanotechnology in prevention of artery restenosis after endovascular therapy.

Endovascular repair of aortic arch intramural hematoma and penetrating ulcers with 810 nm in situ laser-assisted fenestration: Preliminary results of a single-center.

PURPOSE: The aim of the present study was to report the clinical outcomes of the use of 810 nm in situ laser-generated fenestration (ISLF) for the treatment of aortic aneurysms (AAs) and intramural hematomas (IMHs) located in the aortic arch. STUDY DESIGN AND METHODS: Between April 2014 and September 2017, 23 patients (15 men, mean age 66.0 years) with AAs (n = 12) or IMHs (n = 11) underwent thoracic endovascular aortic repair (TEVAR) with 810 nm ISLF of the arch. The primary outcomes of the safety assessment were the presence of endoleaks, mortality and morbidity, including adverse in situ fenestration-related, cardiovascular, and cerebral events. RESULTS: Technical success was achieved in all cases. Urgent intervention was performed in 15 (65.2%) cases. Left subclavian artery (LSA) ISLF was applied in six patients, LSA and left common carotid artery (LCCA) ISLF in three patients, and total aortic arch vessel ISLF in two patients. One patient suffered minimal stroke after the procedure and recovered without permanent disability to the extremities in 2 weeks. There were no fenestration-related complications except in one patient with brachial artery access who suffered a hematoma and underwent incision repair at the puncture site. All fenestrations remained patent, and there were no endoleaks during a mean follow-up of 10.5 ± 5.7 (range: 2-21) months. CONCLUSIONS: Complete or incomplete endovascular arch reconstruction by ISLF in arch diseases (AAs and IMHs) is feasible and reproducible with safe, effective, and favorable primary results and no need for customized endografts. Lasers Surg. Med. 50:837-843, 2018. © 2018 Wiley Periodicals, Inc.

Heavy Metal Pollution in Settled Dust Associated with Different Urban Functional Areas in a Heavily Air-Polluted City in North China.

Understanding variations of heavy metals in atmospheric particles between different functional areas is significant for pollution control and urban planning in cities. To reveal pollution and spatial distribution of heavy metals in atmospheric particles from different urban functional areas in Shijiazhuang in North China, 43 settled dust samples were collected over the main urban area and heavy metal concentrations were determined in their <63 µm fractions using an ICP-OES. The results suggest that Cr, Mn, Fe, Co, Ni, and V in the dust are not or slightly enriched and their concentrations vary slightly between different sites, implying their natural origins; whereas Cu, Zn, Cd, and Pb are often notably enriched and their concentrations vary significantly between different functional areas, indicating their anthropogenic sources. Integrated pollution indexes (IPIs) of the ten heavy metals are 2.7-13.6 (5.7 ± 2.2), suggesting high or very high pollution levels of most dust. Relatively lower IPIs occur mainly in the administration-education area, the commercial area, and other unclassified sites; while peaks occur mainly in the North Railway Station, the northeastern industrial area, and some sites near heavily trafficked areas, implying the significant influence of intensive industrial (including coal combustion) and traffic activities on atmospheric heavy metal accumulation. These results suggest a clear need of mitigating atmospheric heavy metal pollution via controlling emissions of toxic metals (especially Cd and Pb) from industrial and traffic sources in the city.

Preliminary Assessment of Health Risks of Potentially Toxic Elements in Settled Dust over Beijing Urban Area.

To examine levels, health risks, sources, and spatial distributions of potentially toxic elements in settled dust over Beijing urban area, 62 samples were collected mostly from residential building outdoor surfaces, and their <63 µm fractions were measured for 12 potentially toxic elements. The results show that V, Cr, Mn, Co, Ni, and Ba in dust are from predominantly natural sources, whereas Cu, Zn, As, Cd, Sb, and Pb mostly originate from anthropogenic sources. Exposure to these elements in dust has significant non-cancer risks to children but insignificant to adults. Cancer risks of Cr, Co, Ni, As, and Cd via inhalation and dermal contact are below the threshold of 10(-6)-10(-4) but As via dust ingestion shows a tolerable risk. The non-cancer risks to children are contributed mainly (75%) by As, Pb, and Sb, and dominantly (92%) via dust ingestion, with relatively higher risks mainly occurring in the eastern and northeastern Beijing urban areas. Although Cd, Zn, and Cu in dust are heavily affected by anthropogenic sources, their health risks are insignificant. Source appointments suggest that coal burning emissions, the dominant source of As, are likely the largest contributors to the health risk, and traffic-related and industrial emissions are also important because they contribute most of the Pb and Sb in dust.

Ara-C increases gastric cancer cell invasion by upregulating CD-147-MMP-2/MMP­9 via the ERK signaling pathway.

Gastric cancer cell are not particularly sensitive to Ara-C, a deoxycytidine analog that affects DNA synthesis. In the present study, AGS and MKN-45 gastric cancer cell lines were treated with Ara-C to determine its role in cell prolife-ration and apoptosis. The antiproliferative effect of Ara-C was assessed using the Cell Counting kit-8. Gelatinase zymography was utilized to detect the activity of MMP-2 and MMP-9, and an in vitro invasion assay was performed. Using RT-PCR, CD-147, MMP-2 and MPP-9 mRNA levels were assessed in AGS cells with various doses of Ara-C treatment. CD-147, MMP-2 and MMP-9 protein levels were analysed in Ara-C­treated AGS and MKN-45 cells. AGS cells were treated with or without U-0126 or siRNA-CD147 and/or Ara-C for 24 h, and an in vitro invasion assay was performed. Although low-dose Ara-C had no obvious effect on cell proliferation, it upregulated the expression of MMP-2, MMP-9 and CD-147 and ERK activation. Low-dose Ara-C increased gastric cancer cell invasion. U-0126 and siRNA-CD-147 inhibited the induction of Ara-C in gastric cancer cell invasion. Therefore, Ara-C enhances the invasiveness of gastric cancer cells by expression of CD-147 /MMP-2 and MMP-9 via the ERK signaling pathway. The results are therefore useful in the prevention of Ara-C collateral damage associated with standard, conventional protocols of chemotherapy administration.

A hybrid method to recognize 3D object.

A hybrid method using the support vector machine (SVM) correlation filter and the phase-shift interferometry (PSI) holography is proposed to recognize 3D object, which can improve the correct decision rate and resist the distortion of object rotation and noise. The different images of two types of both in-plane and out-of-plane rotated object recorded by digital holography are reconstructed. The reconstructed images of two types are selected to synthesize the SVM correlation filter, respectively. To compare the correct decision rates of the SVM correlation filter with other three ones, it is found that the experimental result is better in rotation resistance and noise tolerance.

A blind robust watermarking scheme with non-cascade iterative encrypted kinoform.

A blind robust watermarking scheme is proposed. A watermark is firstly transformed into a non-cascade iterative encrypted kinoform with non-cascade phase retrieve algorithm and random fractional Fourier transform (RFrFT). An iterative algorithm and Human Visual System (HVS) are both presented to adaptively embed the kinoform watermark into corresponding 2-level DWT coefficients of the cover image. The kinoform accounts for much less data amount to be embedded than regular computer-generated hologram (CGH). And the kinoform can be extracted with the only right phase key and right fractional order, and reconstructed to represent original watermark without original cover image. The experiments have shown the scheme's high security, good imperceptibility, and robustness to resist attacks such as noise, compression, filtering, cropping.

A hybrid heuristic algorithm to improve known-plaintext attack on Fourier plane encryption.

A hybrid heuristic attack scheme that combines the hill climbing algorithm and the simulated annealing algorithm is proposed to speed up the search procedure and to obtain a more accurate solution to the original key in the Fourier plane encryption algorithm. And a unit cycle is adopted to analyze the value space of the random phase. The experimental result shows that our scheme can obtain more accurate solution to the key that can achieve better decryption result both for the selected encrypted image and another unseen ciphertext image. The searching time is significantly reduced while without any exceptional case in searching procedure. For an image of 64x64 pixels, our algorithm costs a comparatively short computing time, about 1 minute, can retrieve the approximated key with the normalized root mean squared error 0.1, therefore, our scheme makes the known-plaintext attack on the Fourier plane image encryption more practical, stable, and effective.

Prevalence of cerebral palsy in children aged 1 - 6 in Guangxi, China.

OBJECTIVE: To study the prevalence of cerebral palsy (here in after referred to CP) in children aged 1 - 6 in Guangxi, China, and its epidemiologic characteristics and relevant risk factors. METHODS: Investigations on the prevalence and etiology of CP in children at ages of 1 - 6 were conducted in Nanning, Hengxian and Qinzhou of Guangxi from June to December in 1998, with a cluster sampling. RESULTS: Totally, 150 806 children aged 1 - 6 were investigated in Nanning, Hengxian and Qinzhou of Guangxi, with 89 418 boys and 61 388 girls. Among them, 193 children were diagnosed as CP, with a prevalence rate of 1.28 per thousand, higher in boys (136 cases, 1.52 per thousand ) than in girls (57 cases, 0.93 per thousand ), with statistical significance (chi(2) = 9.536 7, P = 0.02). Logistic regression analysis showed that risk factors for CP were children who could not cry after birth (neonatal asphyxia), Apgar score less than eight, delivery at lower level of maternity hospital, number of mother's gravidity, no prenatal checks for mothers, and taking antipyretics and preserved food with salt during pregnancy. CONCLUSIONS: Prevalence of CP in children of Guangxi was at a lower level in comparison with that in other areas at home and abroad, which, maybe, was related with the lower neonatal survival and higher infant mortality.