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1.
Medicine (Baltimore) ; 101(2): e28544, 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35029212

RESUMO

RATIONALE: Postmortem imaging (PMI), including computed tomography (PMCT), postmortem computed tomography angiography (PMCTA), and postmortem magnetic resonance imaging (PMMRI), is rapidly becoming effective and a practical method in forensic medicine. This study aimed to present a specific forensic case in which the PMI approach and its applications were used. PATIENT CONCERNS: A 40-year-old male patient had moderate unilateral nose bleeding constantly 10 times after suffering from a head injury induced by a car accident. After a bilateral massive nose bleeding for the last time, he died from hemorrhagic shock. Traumatic internal carotid artery pseudoaneurysm (TICAP) was suspected in this patient. DIAGNOSIS, INTERVENTIONS, AND OUTCOMES: A whole-body scanning was performed using PMCT and PMMRI. Then, PMCTA using left ventricular cardiac puncture was also implemented. A water-soluble contrast agent was injected into the left ventricle and pumped toward the intracranial, followed by a repeated whole-body PMCT scan. The PMCT/PMMRI detected a high-density/signal mass inside the left sphenoid sinus. The PMCTA detected a distinct leakage of the contrast agent into the left sphenoid sinus from an adjacent aneurysm of the C3 section of the left internal carotid artery. Autopsy and histology confirmed a TICAP inside the sphenoid sinus. LESSONS: This case showed that the PMI was of great value for identifying the cause of death in special cases. When vascular lesions are suspected in the body, PMI and especially the PMCTA approach may be an effective detection method.

2.
Magn Reson Imaging ; 85: 80-86, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34666158

RESUMO

OBJECTIVES: To develop and validate a radiomics nomogram for differentiating between malignant pulmonary nodules and benign nodules. METHODS: 56 benign and 51 malignant nodules from 96 patients were analyzed using manual segmentation of the T2-fBLADE-TSE, while the nodules signal intensity (SIlesion), lesion muscle ratio (LMR) and nodule size were all measured and recorded. The maximum relevance and minimum redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) were used to select nonzero coefficients and develop the model in pulmonary nodules diagnosis. The radiomics nomogram was also developed. The clinical prediction value was determined by the decision curve analysis (DCA). RESULTS: The nodule size, SIlesion and LMR of the benign group were 1.78 ± 0.57 cm, 227.50 ± 81.39 and 2.40 ± 1.27 respectively, in contrast to the 2.00 ± 0.64 cm, 232.87 ± 82.21 and 2.17 ± 0.91, respectively, in the malignant group (P = 0.09, 0.60 and 0.579). A total of 13 radiomics features were retained. The Rad-score of the benign nodules group was lower than that of the malignant nodules group (P < 0.001 & 0.049, training & test set). The AUC of radiomics signature for nodules diagnosis was 0.82 (95% CI, 0.73-0.91) in the training set and 0.71 (95% CI, 0.51-0.90) in the test set. A nomogram, consisting of 13 radiomics features and nodule size, produced good prediction in the training set (AUC, 0.82; 95% CI, 0.73-0.91), which was significantly better than that of T2-based quantitative parameters (AUC, 0.62; 95% CI, 0.50-0.75, P = 0.003). In the test set, the performance of radiomics nomogram (AUC, 0.70; 95% CI, 0.51-0.90) was also better than that of T2-based quantitative parameters (AUC, 0.46; 95% CI, 0.25-0.67) (P = 0.145). The DCA showed that radiomics nomogram and T2-based quantitative parameter had overall net benefits, while the performance of nomogram was better. CONCLUSION: We constructed and validated a T2-fBLADE-TSE-based radiomics nomogram that can help to differentiate between malignant pulmonary nodules and benign nodules.

3.
Abdom Radiol (NY) ; 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34825269

RESUMO

PURPOSE: Studies have found that both FibroScan (FS) and Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging (Gd-MRI) could assess liver fibrosis (LF) with high effectiveness. The aim of this study is to compare their accuracy in the quantitative evaluation of LF in patients with chronic hepatitis B (CHB), and to explore the diagnostic accuracy of their combination. METHODS: 160 patients with CHB were included in this study. FS and Gd-MRI were performed within 3 months before the pathological LF staging, which was classified according to the Scheuer-Ludwig scale. The liver stiffness measurement (LSM) was obtained by FS. T1 mapping images of the liver before and 20 min after enhancement were obtained by Look-Locker Gd-MRI. RESULTS: There were 45, 35, 31 and 49 patients with stage S1, S2, S3 and S4 LF, respectively. LSM increased and the reduction rate of T1 relaxation time of 20 min (rrT120min%) decreased with the severity of LF. The area under curve (AUC) of LSM, rrT120min% and LSM + rrT120min% for the diagnosis of ≥ S2 LF were 0.892, 0.811 and 0.900, respectively. The AUC for ≥ S3 LF was 0.883, 0.838 and 0.899, respectively. The AUC for S4 LF was 0.882, 0.894 and 0.928, respectively. CONCLUSION: The diagnostic accuracy of FS is better than that of Gd-MRI in the evaluation of ≥ S2 stage LF. The combination of these two methods significantly improved the diagnostic efficiency in the evaluation of S4 stage LF.

4.
J Am Chem Soc ; 143(45): 18941-18951, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34747168

RESUMO

Carbon quantum dots (CQDs) have developed into prospective nanomaterials for next-generation lighting and displays due to their intrinsic advantages of high stability, low cost, and environmental friendliness. However, confined by the spin-forbidden nature of triplet state transitions, the highest theoretical value of external quantum efficiency (EQE) of fluorescent CQDs is merely 5%, which fundamentally limits their further application in electroluminescent light-emitting diodes (LEDs). Soluble phosphorescent CQDs offer a means of breaking the shackle to achieve efficient monochromatic electroluminescence, especially red emission, which is a pivotal constituent in full-color displays. Here, the synthesis of red (625 nm) phosphorescent carbon quantum dot organic frameworks (CDOFs) with a quantum yield of up to 42.3% and realization of high-efficiency red phosphorescent electroluminescent LEDs are reported. The LEDs based on the CDOFs exhibited a red emission with a maximum luminance of 1818 cd m-2 and an EQE of 5.6%. This work explores the possibility of a new perspective for developing high-performance CQD-based electroluminescent LEDs.

5.
Cancer Cell Int ; 21(1): 539, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663307

RESUMO

BACKGROUND: Cumulative CT radiation damage was positively correlated with increased tumor risks. Although it has recently been known that non-radiation MRI is alternative for pulmonary imaging. There is little known about the value of MRI T1-mapping in the diagnosis of pulmonary nodules. This article aimed to investigate the value of native T1-mapping-based radiomics features in differential diagnosis of pulmonary lesions. METHODS: 73 patients underwent 3 T-MRI examination in this prospective study. The 99 pulmonary lesions on native T1-mapping images were segmented twice by one radiologist at indicated time points utilizing the in-house semi-automated software, followed by extraction of radiomics features. The inter-class correlation coefficient (ICC) was used for analyzing intra-observer's agreement. Dimensionality reduction and feature selection were performed via univariate analysis, and least absolute shrinkage and selection operator (LASSO) analysis. Then, the binary logical regression (LR), support vector machine (SVM) and decision tree classifiers with the input of optimal features were selected for differentiating malignant from benign lesions. The receiver operative characteristics (ROC) curve, area under the curve (AUC), sensitivity, specificity and accuracy were calculated. Z-test was used to compare differences among AUCs. RESULTS: 107 features were obtained, of them, 19.5% (n = 21) had relatively good reliability (ICC ≥ 0.6). The remained 5 features (3 GLCM, 1 GLSZM and 1 shape features) by dimensionality reduction were useful. The AUC of LR was 0.82(95%CI: 0.67-0.98), with sensitivity, specificity and accuracy of 70%, 85% and 80%. The AUC of SVM was 0.82(95%CI: 0.67-0.98), with sensitivity, specificity and accuracy of 70, 85 and 80%. The AUC of decision tree was 0.69(95%CI: 0.49-0.87), with sensitivity, specificity and accuracy of 50, 85 and 73.3%. CONCLUSIONS: The LR and SVM models using native T1-mapping-based radiomics features can differentiate pulmonary malignant from benign lesions, especially for uncertain nodules requiring long-term follow-ups.

7.
Am J Trop Med Hyg ; 105(3): 718-726, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34242179

RESUMO

Most critically ill patients experience malnutrition, resulting in a poor prognosis. This study aimed to evaluate the association of prealbumin (PAB) with the prognosis for severely and critically ill coronavirus disease 2019 (COVID-19) patients and explore factors related to this association. Patients with laboratory-confirmed COVID-19 from West Campus of Union Hospital in Wuhan from January 29, 2020 to March 31, 2020 were enrolled in this study. Patients were classified into the PAB1 (150-400 mg/L; N = 183) and PAB2 (< 150 mg/L; N = 225) groups. Data collection was performed using the hospital's electronic medical records system. The predictive value of PAB was evaluated by measuring the area under the receiver-operating characteristic (AUROC) curve. Patients were defined as severely or critically ill based on the Guidance for COVID-19 (7th edition) by the National Health Commission of China. During this analysis, 316 patients had severe cases and 65 had critical cases. A reduced PAB level was associated with a higher risk of mortality and a longer hospital stay. The AUROC curve for the prognosis based on the PAB level was 0.93, with sensitivity of 97.2% and specificity of 77.6%. For severe cases, a lower level of PAB was associated with a higher risk of malnutrition, higher NK cell counts, and lower B lymphocyte counts; these factors were not significant in critical cases. C-reactive protein and nutritional status mediated the association between PAB and prognosis. This retrospective analysis suggests that the PAB level on admission is an indicator of the prognosis for COVID-19.


Assuntos
COVID-19/mortalidade , Pré-Albumina/análise , SARS-CoV-2 , Adulto , Idoso , Proteína C-Reativa/análise , COVID-19/sangue , Estado Terminal , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença
8.
BMC Pulm Med ; 21(1): 233, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256743

RESUMO

BACKGROUND: To explore the long-term trajectories considering pneumonia volumes and lymphocyte counts with individual data in COVID-19. METHODS: A cohort of 257 convalescent COVID-19 patients (131 male and 126 females) were included. Group-based multi-trajectory modelling was applied to identify different trajectories in terms of pneumonia lesion percentage and lymphocyte counts covering the time from onset to post-discharge follow-ups. We studied the basic characteristics and disease severity associated with the trajectories. RESULTS: We characterised four distinct trajectory subgroups. (1) Group 1 (13.9%), pneumonia increased until a peak lesion percentage of 1.9% (IQR 0.7-4.4) before absorption. The slightly decreased lymphocyte rapidly recovered to the top half of the normal range. (2) Group 2 (44.7%), the peak lesion percentage was 7.2% (IQR 3.2-12.7). The abnormal lymphocyte count restored to normal soon. (3) Group 3 (26.0%), the peak lesion percentage reached 14.2% (IQR 8.5-19.8). The lymphocytes continuously dropped to 0.75 × 109/L after one day post-onset before slowly recovering. (4) Group 4 (15.4%), the peak lesion percentage reached 41.4% (IQR 34.8-47.9), much higher than other groups. Lymphopenia was aggravated until the lymphocytes declined to 0.80 × 109/L on the fourth day and slowly recovered later. Patients in the higher order groups were older and more likely to have hypertension and diabetes (all P values < 0.05), and have more severe disease. CONCLUSIONS: Our findings provide new insights to understand the heterogeneous natural courses of COVID-19 patients and the associations of distinct trajectories with disease severity, which is essential to improve the early risk assessment, patient monitoring, and follow-up schedule.


Assuntos
COVID-19 , Convalescença , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Adulto , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença
9.
Front Med (Lausanne) ; 8: 651556, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34211983

RESUMO

Objectives: Both coronavirus disease 2019 (COVID-19) pneumonia and influenza A (H1N1) pneumonia are highly contagious diseases. We aimed to characterize initial computed tomography (CT) and clinical features and to develop a model for differentiating COVID-19 pneumonia from H1N1 pneumonia. Methods: In total, we enrolled 291 patients with COVID-19 pneumonia from January 20 to February 13, 2020, and 97 patients with H1N1 pneumonia from May 24, 2009, to January 29, 2010 from two hospitals. Patients were randomly grouped into a primary cohort and a validation cohort using a seven-to-three ratio, and their clinicoradiologic data on admission were compared. The clinicoradiologic features were optimized by the least absolute shrinkage and selection operator (LASSO) logistic regression analysis to generate a model for differential diagnosis. Receiver operating characteristic (ROC) curves were plotted for assessing the performance of the model in the primary and validation cohorts. Results: The COVID-19 pneumonia mainly presented a peripheral distribution pattern (262/291, 90.0%); in contrast, H1N1 pneumonia most commonly presented a peribronchovascular distribution pattern (52/97, 53.6%). In LASSO logistic regression, peripheral distribution patterns, older age, low-grade fever, and slightly elevated aspartate aminotransferase (AST) were associated with COVID-19 pneumonia, whereas, a peribronchovascular distribution pattern, centrilobular nodule or tree-in-bud sign, consolidation, bronchial wall thickening or bronchiectasis, younger age, hyperpyrexia, and a higher level of AST were associated with H1N1 pneumonia. For the primary and validation cohorts, the LASSO model containing above eight clinicoradiologic features yielded an area under curve (AUC) of 0.963 and 0.943, with sensitivity of 89.7 and 86.2%, specificity of 89.7 and 89.7%, and accuracy of 89.7 and 87.1%, respectively. Conclusions: Combination of distribution pattern and category of pulmonary opacity on chest CT with clinical features facilitates the differentiation of COVID-19 pneumonia from H1N1 pneumonia.

10.
Z Gesundh Wiss ; : 1-9, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34104627

RESUMO

Aim: This study aimed to explore the current status of e-health literacy among Chinese older adults, and to summarize and analyze the related influencing factors. Subject and methods: Following the PRISMA Checklist, we searched MEDLINE, CINAHL Complete (EBSCO), PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Science and Technology Journal Database to identify the relevant literature published between January 2000 and December 2020. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of the studies. Results: Five articles were included for the systematic review. The results showed that the e-health literacy of Chinese older adults was low. Based on the social-ecological model, the influencing factors at the individual level included age, gender, educational attainment, socioeconomic status, physical and psychological conditions, frequency of internet use, and credibility perception of online health resources; at the interpersonal level, the influencing factors included marital status, being the family carer and being taught how to use internet to find health resources; at the social/community level, influencing factors included language barriers and cultural barriers. Conclusion: Current e-health literacy among Chinese older adults is low, which is affected by a number of factors. Medical staff should provide detailed health information with guaranteed accuracy and reliability for elderly people. It is necessary to develop intervention programs tailored to varied educational needs of the elderly with different backgrounds (i.e., age, gender, educational attainment, and socioeconomic status) need to be developed in the near future. Family members are encouraged to teach older adults how to use e-health resource in appropriate ways.

11.
Pattern Recognit ; 119: 108071, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34092815

RESUMO

This paper aims to develop an automatic method to segment pulmonary parenchyma in chest CT images and analyze texture features from the segmented pulmonary parenchyma regions to assist radiologists in COVID-19 diagnosis. A new segmentation method, which integrates a three-dimensional (3D) V-Net with a shape deformation module implemented using a spatial transform network (STN), was proposed to segment pulmonary parenchyma in chest CT images. The 3D V-Net was adopted to perform an end-to-end lung extraction while the deformation module was utilized to refine the V-Net output according to the prior shape knowledge. The proposed segmentation method was validated against the manual annotation generated by experienced operators. The radiomic features measured from our segmentation results were further analyzed by sophisticated statistical models with high interpretability to discover significant independent features and detect COVID-19 infection. Experimental results demonstrated that compared with the manual annotation, the proposed segmentation method achieved a Dice similarity coefficient of 0.9796, a sensitivity of 0.9840, a specificity of 0.9954, and a mean surface distance error of 0.0318 mm. Furthermore, our COVID-19 classification model achieved an area under curve (AUC) of 0.9470, a sensitivity of 0.9670, and a specificity of 0.9270 when discriminating lung infection with COVID-19 from community-acquired pneumonia and healthy controls using statistically significant radiomic features. The significant features measured from our segmentation results agreed well with those from the manual annotation. Our approach has great promise for clinical use in facilitating automatic diagnosis of COVID-19 infection on chest CT images.

12.
J Affect Disord ; 293: 141-147, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34186232

RESUMO

BACKGROUND: With the global attack of Coronavirus Disease 2019 (COVID-19), cases with Post-traumatic Stress Disorder (PTSD) have been increasing steadily, which seriously affects the quality of life of patients and as such, seeking effective treatments is an urgent matter. Narrative Exposure Therapy (NET) is a typical cognitive behavioral therapy targeting trauma-related psychological disorders and may be an effective intervention. METHODS: A total of 111 COVID-19 patients near the discharge stage with positive screening results for posttraumatic stress symptoms (PTSS) were randomly assigned (1:1) to either the study group or the control group. The study group received NET and personalized psychological intervention, while the control group only received personalized psychological intervention. PTSS, depression, anxiety and sleep quality were measured pre- and post-intervention to evaluate the effect of NET. This trial was registered with the International Standard Randomized Clinical Trial Registry (No. ChiCTR2000039369). RESULTS: NET participants showed a significantly greater PTSS reduction in comparison with the control group after the intervention. Improvement in sleep quality, anxiety and depression after the intervention were pronounced but not significantly different between the two treatment groups. LIMITATIONS: The assessors weren't blinded for the convenience of measurement and protection of participants' psychological security. CONCLUSIONS: NET likely had a positive impact on PTSS of COVID-19 patients. Clinical staff should consider applying NET to improve the psychological well-being of patients who have experienced an epidemic such as COVID-19.


Assuntos
COVID-19 , Terapia Implosiva , Terapia Narrativa , Transtornos de Estresse Pós-Traumáticos , Humanos , Qualidade de Vida , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/terapia
13.
ACS Nano ; 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34181408

RESUMO

The development of effective antifungal agents remains a big challenge in view of the close evolutionary relationship between mammalian cells and fungi. Moreover, rapid mutations of fungal receptors at the molecular level result in the emergence of drug resistance. Here, with low tendency to develop drug-resistance, the subcellular organelle mitochondrion is exploited as an alternative target for efficient fungal killing by photodynamic therapy (PDT) of mitochondrial-targeting luminogens with aggregation-induced emission characteristics (AIEgens). With cationic isoquinolinium (IQ) moiety and proper hydrophobicity, three AIEgens, namely, IQ-TPE-2O, IQ-Cm, and IQ-TPA, can preferentially accumulate at the mitochondria of fungi over the mammalian cells. Upon white light irradiation, these AIEgens efficiently generate reactive 1O2, which causes irreversible damage to fungal mitochondria and further triggers the fungal death. Among them, IQ-TPA shows the highest PDT efficiency against fungi and negligible toxicity to mammalian cells, achieving the selective and highly efficient killing of fungi. Furthermore, we tested the clinical utility of this PDT strategy by treating fungal keratitis on a fungus-infected rabbit model. It was demonstrated that IQ-TPA presents obviously better therapeutic effects as compared with the clinically used rose bengal, suggesting the success of this PDT strategy and its great potential for clinical treatment of fungal infections.

15.
Nurse Educ Today ; 103: 104923, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33962185

RESUMO

BACKGROUND: With the development of information technology, game-based teaching has continuously attracted the attention of nursing educators. It has been proven that games, as an auxiliary tool of traditional teaching, can improve students' learning motivation and learning effects. However, compared with the traditional scenario simulation teaching, whether game-based teaching has obvious advantages is still unknown. OBJECTIVES: This study aimed to explore whether theme game-based teaching is more effective than scenario simulation in improving students' disaster nursing competency. DESIGN: A randomized controlled trial. SETTING: The study was conducted at a provincial vocational college in Xiaogan, Hubei, China. PARTICIPANTS: A total of 104 sophomore nursing students (intervention group = 51, control group = 53) participated. METHODS: After the participants were randomly assigned to the intervention group or control group, disaster-themed games were used in the intervention group, while multi-station disaster simulation was applied in the control group. Pre- and post-tests were conducted to assess the participants' disaster nursing competence using the Questionnaire of Disaster Rescue Ability. RESULTS: After the intervention, disaster nursing competence levels were significantly higher in the intervention group than in the control group (4.04 ± 0.43 vs. 3.77 ± 0.45, P = 0.002). Three domains of disaster nursing competence, cognition (4.05 ± 0.56 vs. 3.75 ± 0.48, P = 0.004), skill (3.88 ± 0.50 vs. 3.62 ± 0.53, p = 0.008) and affective response (4.25 ± 0.42 vs. 4.02 ± 0.48, P = 0.010), were also significantly higher in the intervention group. CONCLUSIONS: Compared with scenario simulation, theme game-based teaching is more effective in improving the disaster nursing competence of nursing students.


Assuntos
Desastres , Bacharelado em Enfermagem , Estudantes de Enfermagem , China , Competência Clínica , Humanos , Aprendizagem , Ensino
16.
Theor Appl Genet ; 134(8): 2613-2637, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34018019

RESUMO

KEY MESSAGE: Association analysis for ionomic concentrations of 20 elements identified independent genetic factors underlying the root and shoot ionomes of rice, providing a platform for selecting and dissecting causal genetic variants. Understanding the genetic basis of mineral nutrient acquisition is key to fully describing how terrestrial organisms interact with the non-living environment. Rice (Oryza sativa L.) serves both as a model organism for genetic studies and as an important component of the global food system. Studies in rice ionomics have primarily focused on above ground tissues evaluated from field-grown plants. Here, we describe a comprehensive study of the genetic basis of the rice ionome in both roots and shoots of 6-week-old rice plants for 20 elements using a controlled hydroponics growth system. Building on the wealth of publicly available rice genomic resources, including a panel of 373 diverse rice lines, 4.8 M genome-wide single-nucleotide polymorphisms, single- and multi-marker analysis pipelines, an extensive tome of 321 candidate genes and legacy QTLs from across 15 years of rice genetics literature, we used genome-wide association analysis and biparental QTL analysis to identify 114 genomic regions associated with ionomic variation. The genetic basis for root and shoot ionomes was highly distinct; 78 loci were associated with roots and 36 loci with shoots, with no overlapping genomic regions for the same element across tissues. We further describe the distribution of phenotypic variation across haplotypes and identify candidate genes within highly significant regions associated with sulfur, manganese, cadmium, and molybdenum. Our analysis provides critical insight into the genetic basis of natural phenotypic variation for both root and shoot ionomes in rice and provides a comprehensive resource for dissecting and testing causal genetic variants.


Assuntos
Mapeamento Cromossômico/métodos , Cromossomos de Plantas/genética , Regulação da Expressão Gênica de Plantas , Oryza/genética , Proteínas de Plantas/metabolismo , Raízes de Plantas/genética , Brotos de Planta/genética , Estudo de Associação Genômica Ampla , Oryza/crescimento & desenvolvimento , Fenótipo , Proteínas de Plantas/genética , Raízes de Plantas/crescimento & desenvolvimento , Brotos de Planta/crescimento & desenvolvimento , Locos de Características Quantitativas
17.
Biomolecules ; 11(2)2021 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-33670596

RESUMO

Accurate grading of liver fibrosis can effectively assess the severity of liver disease and help doctors make an appropriate diagnosis. This study aimed to perform the automatic staging of hepatic fibrosis on patients with hepatitis B, who underwent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging with dynamic radiomics analysis. The proposed dynamic radiomics model combined imaging features from multi-phase dynamic contrast-enhanced (DCE) images and time-domain information. Imaging features were extracted from the deep learning-based segmented liver volume, and time-domain features were further explored to analyze the variation in features during contrast enhancement. Model construction and evaluation were based on a 132-case data set. The proposed model achieved remarkable performance in significant fibrosis (fibrosis stage S1 vs. S2-S4; accuracy (ACC) = 0.875, area under the curve (AUC) = 0.867), advanced fibrosis (S1-S2 vs. S3-S4; ACC = 0.825, AUC = 0.874), and cirrhosis (S1-S3 vs. S4; ACC = 0.850, AUC = 0.900) classifications in the test set. It was more dominant compared with the conventional single-phase or multi-phase DCE-based radiomics models, normalized liver enhancement, and some serological indicators. Time-domain features were found to play an important role in the classification models. The dynamic radiomics model can be applied for highly accurate automatic hepatic fibrosis staging.


Assuntos
Hepatite B/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Feminino , Gadolínio DTPA/análise , Humanos , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Modelos Teóricos
18.
Ann Transl Med ; 9(3): 216, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33708843

RESUMO

Background: The assessment of the severity of coronavirus disease 2019 (COVID-19) by clinical presentation has not met the urgent clinical need so far. We aimed to establish a deep learning (DL) model based on quantitative computed tomography (CT) and initial clinical features to predict the severity of COVID-19. Methods: One hundred ninety-six hospitalized patients with confirmed COVID-19 were enrolled from January 20 to February 10, 2020 in our centre, and were divided into severe and non-severe groups. The clinico-radiological data on admission were retrospectively collected and compared between the two groups. The optimal clinico-radiological features were determined based on least absolute shrinkage and selection operator (LASSO) logistic regression analysis, and a predictive nomogram model was established by five-fold cross-validation. Receiver operating characteristic (ROC) analyses were conducted, and the areas under the receiver operating characteristic curve (AUCs) of the nomogram model, quantitative CT parameters that were significant in univariate analysis, and pneumonia severity index (PSI) were compared. Results: In comparison with the non-severe group (151 patients), the severe group (45 patients) had a higher PSI (P<0.001). DL-based quantitative CT indicated that the mass of infection (MOICT) and the percentage of infection (POICT) in the whole lung were higher in the severe group (both P<0.001). The nomogram model was based on MOICT and clinical features, including age, cluster of differentiation 4 (CD4)+ T cell count, serum lactate dehydrogenase (LDH), and C-reactive protein (CRP). The AUC values of the model, MOICT, POICT, and PSI scores were 0.900, 0.813, 0.805, and 0.751, respectively. The nomogram model performed significantly better than the other three parameters in predicting severity (P=0.003, P=0.001, and P<0.001, respectively). Conclusions: Although quantitative CT parameters and the PSI can well predict the severity of COVID-19, the DL-based quantitative CT model is more efficient.

19.
Eur Heart J Cardiovasc Imaging ; 22(8): 844-851, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-33686389

RESUMO

AIMS: In order to determine acute cardiac involvement in patients with COVID-19, we quantitatively evaluated tissue characteristics and mechanics by non-invasive cardiac magnetic resonance (CMR) in a cohort of patients within the first 10 days of the onset of COVID symptoms. METHODS AND RESULTS: Twenty-five patients with reverse transcription polymerase chain reaction confirmed COVID-19 and at least one marker of cardiac involvement [cardiac symptoms, abnormal electrocardiograph (ECG), or abnormal cardiac biomarkers] and 25 healthy age- and gender-matched control subjects were recruited to the study. Patients were divided into those with elevated (n = 8) or normal TnI (n = 17). There were significant differences in global longitudinal strain among patients who were positive and negative for hs-TnI, and controls [-12.3 (-13.3, -11.5)%, -13.1 (-14.2, -9.8)%, and -15.7 (-18.3, -12.7)%, P = 0.004]. Native myocardial T1 relaxation times in patients with positive and negative hs-TnI manifestation (1169.8 ± 12.9 and 1113.2 ± 31.2 ms) were significantly higher than the normal (1065 ± 57 ms) subjects, respectively (P < 0.001). The extracellular volume (ECV) of patients who were positive and negative for hs-TnI was higher than that of the normal controls [32 (31, 33)%, 29 (27, 30)%, and 26 (24, 27.5)%, P < 0.001]. In our study, quantitative T2 mapping in patients who were positive and negative for hs-TnI [51 (47.9, 52.8) and 48 (47, 49.4) ms] was significantly higher than the normal [42 (41, 45.2) ms] subjects (P < 0.001). CONCLUSION: In patients with early-stage COVID-19, myocardial oedema, and functional abnormalities are a frequent finding, while irreversible regional injury such as necrosis may be infrequent.


Assuntos
COVID-19 , Estudos de Casos e Controles , Humanos , Imageamento por Ressonância Magnética , Imagem Cinética por Ressonância Magnética , Miocárdio , Valor Preditivo dos Testes , Estudos Prospectivos , SARS-CoV-2
20.
Quant Imaging Med Surg ; 11(2): 714-724, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33532271

RESUMO

Background: Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (AIDS-KS) was the first malignant neoplasm to be described as being related to AIDS. The lungs are the most common visceral site of AIDS-KS. This study aimed to analyze the computed tomography (CT) manifestations of pulmonary involvement in AIDS-KS. Methods: Twenty-nine male patients were enrolled in this retrospective study. Imaging evaluation parameters included lesion distribution, the flame sign, interlobular septal thickening, peribronchovascular interstitium thickening, ground-glass opacity (GGO), dilated blood vessels in lesions, and pleural effusion. Results: A peribronchovascular distribution was observed in all patients, predominantly in the lower lobes. Of the patients, 58.62% (17/29) exhibited the flame sign, 75.86% (22/29) had interlobular septal thickening, 72.41% (21/29) had peribronchovascular interstitium thickening, 82.76% (24/29) had GGO, and 34.48% (10/29) had pleural effusion. Enlarged lymph nodes with a short-axis diameter >1.0 cm were found in 41.38% (12/29) of the patients. Of the 12 patients who underwent contrast-enhanced CT (CECT), 90.91% (11/12) had dilated blood vessels, and nodules, consolidations, and lymph nodes were observed to be strongly enhanced. Intrapulmonary lesions decreased in size or number after appropriate treatment during follow-up. Conclusions: Common CT manifestations of pulmonary AIDS-KS include the flame sign, peribronchovascular distribution, peribronchovascular interstitium thickening, interlobular septa thickening, GGO, dilated blood vessel, and strong enhancement of nodules, consolidations, and lymph nodes. It is helpful to follow up the therapeutic effect of pulmonary AIDS-KS by chest CT.

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