Myocardial mechanical function measured by cardiac magnetic resonance in patients with heart failure.

AIM: Strain analysis offers a valuable tool to assess myocardial mechanics, allowing for the detection of impairments in heart function. This study aims to evaluate the pattern of myocardial strain in patients with heart failure (HF). METHODS: In the present study, myocardial strain was measured by cardiac magnetic resonance imaging feature tracking in 35 control subjects without HF and 195 HF patients. The HF patients were further categorized as HF with preserved ejection fraction (HFpEF, n=80), with mid-range ejection fraction (HFmrEF, n=34), and with reduced ejection fraction (HFrEF, n=81). Additionally, quantitative tissue evaluation parameters, including native T1 relaxation time and extracellular volume (ECV), were examined. RESULTS: Compared to controls, patients in all HF groups (HFpEF, HFmrEF, and HFrEF) demonstrated impaired left ventricular (LV) strains and systolic and diastolic strain rates in all three directions (radial, circumferential, and longitudinal) (p < 0.05 for all). LV strains also showed significant correlations with left ventricular ejection fraction and brain natriuretic peptide levels (p < 0.001 for all). Notably, septal contraction was significantly affected in HFpEF compared to controls. While LV torsion was slightly increased in HFpEF, it was decreased in HFrEF. Native T1 relaxation times and ECV fractions were significantly higher in HFrEF compared to HFpEF (p < 0.05). Overall, myocardial strain parameters demonstrated good performance in differentiating HF categories. CONCLUSIONS: The myocardial strain impairments exhibit a spectrum of severity in patients with HFpEF, HFmrEF, and HFrEF compared to controls. Assessment of myocardial mechanics using strain analysis may offer a clinically useful tool for monitoring the progression of systolic and diastolic dysfunction in HF patients.

Association between Coronary Artery Disease Reporting and Data System-recommended Post-Coronary CT Angiography Management and Clinical Outcomes in Patients with Stable Chest Pain from a Chinese Registry.

Background Coronary Artery Disease Reporting and Data System (CAD-RADS) was developed to standardize and optimize disease management in patients after coronary CT angiography (CCTA), but the impact of CAD-RADS management recommendations on clinical outcomes remains unclear. Purpose To retrospectively assess the association between the appropriateness of post-CCTA management according to CAD-RADS version 2.0 and clinical outcomes. Materials and Methods From January 2016 to January 2018, consecutive participants with stable chest pain referred for CCTA were prospectively included in a Chinese registry and followed for 4 years. Retrospectively, CAD-RADS 2.0 classification and the appropriateness of post-CCTA management were determined. Propensity score matching (PSM) was used to adjust for confounding variables. Hazard ratios (HRs) for a major adverse cardiovascular event (MACE), relative risks for invasive coronary angiography (ICA), and the corresponding number needed to treat were estimated. Results Of the 14 232 included participants (mean age, 61 years ± 13 [SD]; 8852 male), 2330, 2756, and 2614 were retrospectively categorized in CAD-RADS 1, 2, and 3, respectively. Only 26% of participants with CAD-RADS 1-2 disease and 20% with CAD-RADS 3 received appropriate post-CCTA management. After PSM, appropriate post-CCTA management was associated with lower risk of MACEs (HR, 0.34; 95% CI: 0.22, 0.51; P < .001), corresponding to a number needed to treat of 21 in CAD-RADS 1-2 but not CAD-RADS 3 (HR, 0.86; 95% CI: 0.49, 1.85; P = .42). Appropriate post-CCTA management was associated with decreased use of ICA in CAD-RADS 1-2 (relative risk, 0.40; 95% CI: 0.29, 0.55; P < .001) and 3 (relative risk, 0.33; 95% CI: 0.28, 0.39; P < .001), resulting in a number needed to treat of 14 and 2, respectively. Conclusion In this retrospective secondary analysis, appropriate disease management after CCTA according to CAD-RADS 2.0 was associated with lower risk of MACEs and more prudent use of ICA. ClinicalTrials.gov registration no. NCT04691037 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Leipsic and Tzimas in this issue.

[Application and Development of Rehabilitation System of Intelligent Lower Limb Rehabilitation Based on Intelligent Medical Treatment].

To develop an intelligent lower limb rehabilitation instrument which could realize the quantification and visualization of lower limbs' raising angle and frequency, using the smart client to realize the remote control, autonomous data acquisition and the establishment of database. Doctors had the access to the database in order to adjust the rehabilitation program in time to meet the individual requirement. We realized the design of intelligent lower limb instrument based on the Andriod smartphone, which is suitable for clinical and family use.

Association of serum 25-hydroxyvitamins D2 and D3 with hearing loss in US adults: analysis from National Health and Nutrition Examination Survey, 2015-2016.

Background: Hearing loss (HL) is increasingly recognized as a significant global public health issue, and research on its relationship with vitamin D levels has gained wider attention. However, the association between serum biomarkers 25-hydroxyvitamin D2 (25(OH)D2) and D3 (25(OH)D3) with different types of HL remains unclear. This study aimed to investigate the potential association of serum 25(OH)D2 and 25(OH)D3 with HL in US adults. Methods: A sample of 3,684 individuals aged 20-69 years from the 2015-2016 National Health and Nutrition Examination (NHANES) was analyzed in this study. HL was defined as a pure tone average > 25 dB in either ear at low frequencies (500, 1,000, 2000 Hz), speech frequencies (500, 1,000, 2000, 4,000 Hz), and high frequencies (3,000, 4,000, 6,000, 8,000 Hz). Logistic regression was employed to examine the association between serum 25(OH)D2 and 25(OH)D3 and HL. The study population was then stratified by age, gender, race, and education level to analyze potential differences between adults in different subgroups. Results: In the multivariate analysis, it was found that serum 25(OH)D2 was independently associated with low-frequency hearing loss (LFHL) (OR: 1.012 [95% CI, 1.005-1.020]) and speech-frequency hearing loss (SFHL) (OR: 1.011 [95% CI, 1.003-1.018]). Restrictive cubic spline analysis demonstrated a linear dose-response relationship between serum 25(OH)D2 levels and LFHL (p for linearity <0.001), as well as SFHL (p for linearity = 0.001). Conversely, an L-shaped association was observed between serum 25(OH)D3 levels and both LFHL (p for nonlinearity = 0.014) and SFHL (p for nonlinearity = 0.025), with threshold values identified at 35.3 and 36.5 nmol/L, respectively. Higher levels of serum 25(OH)D3 were associated with a lower probability of high-frequency hearing loss (HFHL) (OR: 0.994 [95% CI, 0.989-0.999]), with a threshold value identified at 53.9 nmol/L. Furthermore, a significant interaction between diabetes and serum 25(OH)D2 in LFHL was revealed through subgroup analysis (p = 0.041). In the non-diabetic population, serum 25(OH)D2 maintained its association with LFHL. Conclusion: Our findings suggested a positive association between serum 25(OH)D2 concentrations and both LFHL and SFHL in the studied cohort. Additionally, an L-shaped relationship was found between serum 25(OH)D3 and LFHL and SFHL, and higher levels of serum 25(OH)D3 were identified to be associated with a lower risk of HFHL.

A Role for Systemic Inflammation in Stroke-Associated Infection and the Long-Term Prognosis of Acute Ischemic Stroke: A Mediation Analysis.

Background and Purpose: The dynamic systemic inflammation level and stroke-associated infection (SAI) are related to the prognosis of acute ischemic stroke (AIS). We aimed to explore whether the systemic inflammatory response index (SIRI), systemic immune inflammation index (SII), and their dynamic changes possess predictability for SAI and long-term prognosis. Methods: A total of 1804 AIS patients without intravenous thrombolysis in two hospitals were included. We explored the relationship between SIRI, SII, and their dynamic changes and outcomes by constructing clusters. The mediating effects of SAI between prognosis and systemic inflammation were further evaluated. Results: Each SD increase in the concentration of SIRI exhibited a significant correlation with the risk of poor functional outcome, mortality, and functional dependency. Through K-means clustering analysis, patients with dramatically elevated or decreased systemic inflammation levels of SIRI (OR: 2.293, 95% CI: 1.279-4.109) and SII (OR: 3.165, 95% CI: 1.627-6.156) within 7 days had a higher risk of functional outcome. Through mediation analysis, SAI mediated the association between systemic inflammation and poor prognosis (SIRI: 33.73%, SII: 16.01%). Conclusion: Dramatically changing dynamics of SIRI and SII were significantly associated with a higher risk of poor prognosis in AIS patients. SAI mediated the association between systemic inflammation and prognosis at 1 year.

Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage.

OBJECTIVE: This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. MATERIALS AND METHODS: This retrospective study included 190 set images of 38 participants, including axial T1- and T2-weighted FSE images using DLR (T1WIDL and T2WIDL, belong to FSEDL) and without using DLR (T1WIO and T2WIO, belong to FSEO) and 3D FSPGR images. Subjective evaluation (overall image quality, noise, contrast, artifacts, and identification of anatomical structures) was independently conducted by two radiologists. Objective evaluation including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was conducted using manual region-of-interest (ROI)-based analysis. Coefficient of variation (CV) and Bland-Altman plots were used to demonstrate the intra-rater repeatability of measurements for cartilage thickness on five different images. RESULTS: Both qualitative and quantitative results confirmed superior FSEDL to 3D FSPGR images (both p < 0.05), improving the diagnosis confidence of the observers. Lower lateral cartilage (LLC), upper lateral cartilage (ULC), and septal cartilage (SP) were relatively well delineated on the T2WIDL, while 3D FSPGR showed poorly on the septal cartilage. For the repeatability of cartilage thickness measurements, T2WIDL showed the highest intra-observer (%CV = 8.7% for SP, 9.5% for ULC, and 9.7% for LLC) agreements. In addition, the acquisition time for T1WIDL and T2WIDL was respectively reduced by 14.2% to 29% compared to 3D FSPGR (both p < 0.05). CONCLUSIONS: Two-dimensional equivalent-thin-slice T1- and T2-weighted images using DLR showed better image quality and shorter scan time than 3D FSPGR and conventional construction images in nasal cartilages. The anatomical details were preserved without losing clinical performance on diagnosis and prognosis, especially for pre-rhinoplasty planning.

Pretreatment of 3-hydroxyacetophenone in pharmaceutical wastewater using combined salting-out crystallization+ Fenton system and subsequent impact analysis of effluent water.

Selecting a suitable pretreatment process for pharmaceutical wastewater that is difficult to treat biochemically so that it can enter the subsequent biochemical treatment. In this study, pharmaceutical wastewater consisting of 45 g/L sodium bisulfate, 9 g/L 3-hydroxyacetophenone (3-HAP), and 36.75 g/L sulfuric acids,which is a kind of typical pharmaceutical wastewater, was used for the pretreatment case study, and the process was screened by technology. A salting-out crystallization+Fenton system(SC-F) was developed for the treatment of this wastewater. The salting-out agent is formed by the pH adjustment process without additional additions and the salting-out crystallization effect is significant for the precipitation of 3-HAP from the wastewater. Subsequently, the optimal operating conditions for SC-F were derived from experiments as H2O2 of 0.4692 mol/L, n(H2O2):n(Fe2+)=30:1, pH=3. Under optimal conditions, the reaction time of 2 h achieved a COD removal rate of 90% and a BOD/COD value of 0.56, confirming the effectiveness of the technology in treating this wastewater. Additionally, it was discovered that the Fenton treatment was not significantly impacted by the inorganic components of the effluent. Analysis of effluent properties and possible effects on subsequent treatment by LC-MS and toxicity analysis. The results show that the biodegradability are enhanced by the pretreatment technology. However, the effluent still suffers from high acidity and high salt content, and this study proposes a solution to this problem. Furthermore, research on the treatment of 3-HAP wastewater has not been reported and this study provides a new case study in the field of wastewater treatment.

Diagnostic Performance of Machine Learning-Derived Radiomics Signature of Pericoronary Adipose Tissue in Coronary Computed Tomography Angiography for Coronary Artery In-Stent Restenosis.

RATIONALE AND OBJECTIVES: Coronary inflammation can alter the perivascular fat phenotype. Hence, we aimed to assess the diagnostic performance of radiomics features of pericoronary adipose tissue (PCAT) in coronary computed tomography angiography (CCTA) for in-stent restenosis (ISR) after percutaneous coronary intervention. MATERIALS AND METHODS: In this study, 165 patients with 214 eligible vessels were included, and ISR was found in 79 vessels. After evaluating clinical and stent characteristics, peri-stent fat attenuation index, and PCAT volume, 1688 radiomics features were extracted from each peri-stent PCAT segmentation. The eligible vessels were randomly categorized into training and validation groups in a ratio of 7:3. After performing feature selection using Pearson's correlation, F test, and least absolute shrinkage and selection operator analysis, radiomics models and integrated models that combined selected clinical features and Radscore were established using five different machine learning algorithms (logistic regression, support vector machine, random forest, stochastic gradient descent, and XGBoost). Subgroup analysis was performed using the same method for patients with stent diameters of ≤ 3 mm. RESULTS: Nine significant radiomics features were selected, and the areas under the curves (AUCs) for the radiomics model and the integrated model were 0.69 and 0.79, respectively, for the validation group. The AUCs of the subgroup radiomics model based on 15 selected radiomics features and the subgroup integrated model were 0.82 and 0.85, respectively, for the validation group, which showed better diagnostic performance. CONCLUSION: CCTA-based radiomics signature of PCAT has the potential to identify coronary artery ISR without additional costs or radiation exposure.

Identification of vulnerable non-culprit lesions by coronary computed tomography angiography in patients with chronic coronary syndrome and diabetes mellitus.

Background: Among patients with diabetes mellitus (DM) and chronic coronary syndrome (CCS), non-culprit lesions (NCLs) are responsible for a substantial number of future major adverse cardiovascular events (MACEs). Thus, we aimed to establish the natural history relationship between adverse plaque characteristics (APCs) of NCLs non-invasively identified by coronary computed tomography angiography (CCTA) and subsequent MACEs in these patients. Methods: Between January 2016 and January 2019, 523 patients with DM and CCS were included in the present study after CCTA and successful percutaneous coronary intervention (PCI). All patients were followed up for MACEs (the composite of cardiac death, myocardial infarction, and unplanned coronary revascularization) until January 2022, and the independent clinical event committee classified MACEs as indeterminate, culprit lesion (CL), and NCL-related. The primary outcome was MACEs arising from untreated NCLs during the follow-up. The association between plaque characteristics detected by CCTA and primary outcomes was determined by Marginal Cox proportional hazard regression. Results: Overall, 1,248 NCLs of the 523 patients were analyzed and followed up for a median of 47 months. The cumulative rates of indeterminate, CL, and NCL-related MACEs were 2.3%, 14.5%, and 20.5%, respectively. On multivariate analysis, NCLs associated with recurrent MACEs were more likely to be characterized by a plaque burden >70% [hazard ratio (HR), 4.35, 95% confidence interval (CI): 2.92-6.44], a low-density non-calcified plaque (LDNCP) volume >30 mm3 (HR: 3.40, 95% CI: 2.07-5.56), a minimal luminal area (MLA) <4 mm2 (HR: 2.30, 95% CI: 1.57-3.36), or a combination of three APCs (HR: 13.69, 95% CI: 9.34-20.12, p < 0.0001) than those not associated with recurrent MACEs. Sensitivity analysis regarding all indeterminate MACEs as NCL-related ones demonstrated similar results. Conclusions: In DM patients who presented with CCS and underwent PCI, half of the MACEs occurring during the follow-up were attributable to recurrence at the site of NCLs. NCLs responsible for unanticipated MACEs were frequently characterized by a large plaque burden and LDNCP volume, a small MLA, or a combination of these APCs, as determined by CCTA.

Vibrational courtship disruption of Nilaparvata lugens using artificial disruptive signals.

The brown planthopper (BPH), Nilaparvata lugens (Stål; Hemiptera: Delphacidae) is a piercing-sucking pest that causes serious damage to rice plants by sucking the phloem sap from the plants and transmitting viruses. During courtship, the BPH vibrates its abdomen to produce signals that are transmitted to rice plants through its legs. Male BPHs search, locate, and mate with female BPHs after they exchange courtship signals with each other. Currently, spraying chemical pesticides is still the primary method for controlling BPH populations in paddy fields, although this approach has led to severe environmental pollution. A physical control method based on BPH courtship disruption to reduce the mating rate is a promising strategy for cutting environmental pollution. To acquire effective courtship disruptive signals, we developed a vibration signal recording, monitoring, and playback system for BPHs. Using this system, BPH courtship signals and male competition signals were collected and analyzed to obtain their frequency spectra. Results show that the mean main vibration frequency of female courtship signals is 234 Hz and the mean pulse rate is 23 Hz. The mean main vibration and pulse frequencies of the male courtship signals are 255 Hz and 82 Hz, respectively. Besides, the mean main vibration frequency of the male competition signal is 281 Hz. Seven different forms and frequencies of artificial signals were played back to male BPHs, then the courtship and behavioral responses of male BPHs were analyzed. Results indicate that a pure tone of 225 Hz prevents the males from recognizing female courtship signals. The male reply rate fell from 95.6 to 33.3% and the mean reply delay time increased from 5.3 s to 9.1 s. The reply rates of the other six artificial signals ranged from 42.9 to 83.7%, and the mean reply delays were between 5.0 s and 9.3 s. Therefore, the courtship behavior of BPHs can be disrupted by using specific artificial disruptive signals.

An intelligent monitoring system of diseases and pests on rice canopy.

Accurate and timely surveys of rice diseases and pests are important to control them and prevent the reduction of rice yields. The current manual survey method of rice diseases and pests is time-consuming, laborious, highly subjective and difficult to trace historical data. To address these issues, we developed an intelligent monitoring system for detecting and identifying the disease and pest lesions on the rice canopy. The system mainly includes a network camera, an intelligent detection model of diseases and pests on rice canopy, a web client and a server. Each camera of the system can collect rice images in about 310 m2 of paddy fields. An improved model YOLO-Diseases and Pests Detection (YOLO-DPD) was proposed to detect three lesions of Cnaphalocrocis medinalis, Chilo suppressalis, and Ustilaginoidea virens on rice canopy. The residual feature augmentation method was used to narrow the semantic gap between different scale features of rice disease and pest images. The convolution block attention module was added into the backbone network to enhance the regional disease and pest features for suppressing the background noises. Our experiments demonstrated that the improved model YOLO-DPD could detect three species of disease and pest lesions on rice canopy at different image scales with an average precision of 92.24, 87.35 and 90.74%, respectively, and a mean average precision of 90.11%. Compared to RetinaNet, Faster R-CNN and Yolov4 models, the mean average precision of YOLO-DPD increased by 18.20, 6.98, 6.10%, respectively. The average detection time of each image is 47 ms. Our system has the advantages of unattended operation, high detection precision, objective results, and data traceability.

Reproducibility of radiomic features of pulmonary nodules between low-dose CT and conventional-dose CT.

Background: The reproducibility of radiomic features is essential to lung cancer detection. This study aimed to investigate the reproducibility of radiomic features of pulmonary nodules between low-dose computed tomography (LDCT) and conventional-dose computed tomography (CDCT). Methods: A total of 105 patients with 119 pulmonary nodules [39 ground-glass nodules (GGNs) and 80 solid nodules] who underwent LDCT and CDCT were retrospectively studied between September 2019 and November 2020. Pulmonary nodules were manually segmented and 1,125 radiomic features (shape, first-order intensity, texture, wavelet, and Laplacian of the Gaussian features) were extracted from both LDCT and CDCT images. The concordance correlation coefficient (CCC) was used to evaluate the reproducibility of these radiomic features. Results: Of the 1,125 radiomic features considered, 35.5% (399 of 1,125) and 41.5% (467 of 1,125) were reproducible (CCC ≥0.85) for GGNs and solid nodules, respectively. The intensity, texture, and wavelet features of solid nodules were more reproducible than those of GGNs. The mean CCC values for intensity and texture features of solid nodules were of 0.85 and above, whereas the mean values for those of GGNs were of less than 0.85. After Gaussian kernel (σ =2) preprocessing, the CCC of intensity and texture features of GGNs improved from 0.77 to 0.90, and 84.9% (79 of 93) of the radiomic features were reproducible (mean CCC increase from 0.84±0.13 to 0.92±0.08 for intensity features, and from 0.75±0.15 to 0.89±0.11 for texture features). Wavelet features had the lowest CCCs for both GGNs and solid nodules. Conclusions: The majority of the radiomic feature classes of solid pulmonary nodules have a high level of reproducibility between LDCT and CDCT. However, LDCT should not be used as an alternative to CDCT in the radiomic study of GGNs.

The white blood cell count to mean platelet volume ratio for ischemic stroke patients after intravenous thrombolysis.

Background and Purpose: White blood cell count to mean platelet volume ratio (WMR) is increasingly recognized as a promising biomarker. However, its predictive capability for acute ischemic stroke (AIS) patients is relatively less researched. The primary aim of this study is to explore its prognostic value in AIS patients after reperfusion regarding 3-month poor functional outcome. Methods: A total of 549 AIS patients who had undergone vascular reperfusion procedure with complete 3-month follow-up were retrospectively recruited in this study. White blood cell count, mean platelet volume at 24 h of admission were recorded. Stroke severity had been estimated using the National Institutes of Health Stroke Scale (NIHSS) and poor outcome was defined as modified Rankin Scale (mRS) 3-6 at 3 months. Results: AIS patients with poor functional outcome at 3 months displayed higher WMR. A positive correlation between WMR and NIHSS score was found (r = 0.334, p < 0.001). After adjusting potential confounders, WMR was still an independent risk factor for poor prognosis at 3 months (OR = 2.257, 95% CI [1.117-4.564], p = 0.023) in multivariate logistic regression model. Subgroup analyses further suggested a significant association between WMR and poor outcome in high baseline NIHSS (per 0.1-point increase: OR = 1.153, 95% CI [1.014-1.312], p = 0.030) group. Receiver operating characteristic (ROC) curves analysis was utilized to assess the predictive ability of WMR, indicating a cut-off value of 0.86. A nomogram that includes age, sex, NIHSS on admission, high WMR for predicting 1-year all-cause survival was also developed (C-index = 0.628). Conclusions: WMR is significantly correlated with stroke severity on admission and is proved to be an important prognostic indicator for AIS outcomes, especially in high NIHSS on admission group. Additionally, the developed nomogram that includes high WMR for predicting 1-year survival provides us with an effective visualization tool.

Case Report: A Giant Left-Ventricular Intramural Pseudoaneurysm Arise From Ruptured Left Sinus of Valsalva Aneurysm.

In this report, we present a case study of an extremely rare left sinus Valsalva aneurysm (SVA) rupture into the left-ventricular myocardium. Acute ozone inhalation and long-term hypertension are possible contributors to the condition. Utilizing multimodal cardiovascular imaging techniques [echocardiogram, computed tomography (CT), and cardiac magnetic resonance (CMR)], a large, left-ventricular, intramural pseudoaneurysm (IPA) arising from the ruptured left SVA, was clearly observed anatomically and functionally. Subsequently, our patient underwent patch repair and valvoplasty which offered an excellent prognosis. This report describes the manifestation of the ruptured left SVA and its possible etiology. This case also emphasizes the need for multimodal imaging for subsequent surgical repair.

Heat/pH-boosted release of 5-fluorouracil and albumin-bound paclitaxel from Cu-doped layered double hydroxide nanomedicine for synergistical chemo-photo-therapy of breast cancer.

Considerable attention has been devoted to nanomedicine development for breast cancer therapy, while the therapeutic efficiency is far from satisfactory owing to non-specific biodistribution-caused side effects and limitation of single modal treatment. In this study, we have developed a novel nanomedicine for efficient combination breast cancer therapy. This nanomedicine was based on copper-doped layered double hydroxide (Cu-LDH) nanoparticles loaded with two FDA-approved anticancer drugs, i.e. 5-fluorouracil (5-FU) and albumin-bound paclitaxel (nAb-PTX) with complementary chemotherapeutic actions. The 5-FU/Cu-LDH@nAb-PTX nanomedicine showed pH-sensitive heat-facilitated therapeutic on-demand release and demonstrated the moderate-to-strong synergy of photothermal therapy and chemotherapy in inducing apoptosis of breast cancer cells (4 T1). This nanomedicine had a high colloidal stability in saline and serum, and efficiently accumulated in the tumor tissue. Remarkably, this nanomedicine nearly eliminated 4 T1 tumors in vivo after a two-course treatment under mild 808 nm laser irradiation (0.75 W/cm2, 3 min) at very low doses of 5-FU and nAb-PTX (0.25 and 0.50 mg/kg, 8-50 times less than that used in other nanoformulations), without observable side effects. Therefore, this research provides a novel approach to designing multifunctional nanomedicines for on-demand release of chemotherapeutics to cost-effectively treat breast cancer with minimal side effects in future clinic applications.

Dynamic Neutrophil-Lymphocyte Ratios Predict Short-term Prognostic Outcome of Thrombolysis in Patients with Acute Ischemic Stroke.

AIM: The main purpose of this study was to investigate the dynamic changes of neutrophils-lymphocytes ratios (NLRs) in patients with acute ischemic stroke (AIS) and their relationships with 3-month prognostic outcomes. METHODS: Two hundred ninety-one patients with AIS were included in this study, followed up for 3 months. At admission, 1 and 7 days after recombinant tissue plasminogen activator (r-tPA) injection, blood samples were obtained. Outcome events included excellent outcome, good outcome, and death defined as modified Rankin Scale (mRS) scores of 0-1, 0-2, and 6 respectively. RESULTS: NLRs measured in admission and 7 days after r-tPA treatment were associated with prognosis outcome after 3 months. Twenty-four-hour NLR is an excellent indicator in forecasting (excellent outcome's the areas under the curve (AUC) = 0.725; good outcome AUC = 0.742; death AUC = 0.759). In addition, we were surprised to find that dynamic increase in NLR within 24 h is significantly related to excellent and good outcomes. CONCLUSIONS: Twenty-four-hour NLR is related to the severity of AIS and poor prognosis, which can help early risk stratification. SIGNIFICANCE: We can predict the prognosis of AIS more accurately. Compared with previous studies, our study has shown the dynamic changes of NLR and its relationship with NIHSS and multiple prognostic.

Neutrophil-Related Ratios Predict the 90-Day Outcome in Acute Ischemic Stroke Patients After Intravenous Thrombolysis.

BACKGROUND AND PURPOSE: Mounting researches have illuminated that the neutrophil-related ratios were related to the prognosis of acute ischemic stroke (AIS). However, few have compared their predictive value and accuracy. To make such comparison and identify the best indicator on the 90-day outcome, we investigated biomarkers including neutrophil ratio (Nr), neutrophil count (Nc), lymphocyte (L), neutrophil-to-lymphocyte ratio (NLR), platelet (P or PLT), platelet-to-neutrophil ratio (PNR), NLR-to-platelet ratio (NLR/PLT), eosinophil (E), neutrophil-to-eosinophil ratio (NER), monocyte (M), and monocyte-to-neutrophil ratio (MNR). METHODS: This retrospective study recruited 283 AIS and 872 healthy controls (HCs) receiving intravenous thrombolysis (IVT). Blood samples were collected after 24 h of admission before IVT. Propensity Score Matching (PSM) was used to explore whether these ratios differentiated AIS and HCs. We applied univariate and multivariate analyses to evaluate the prediction effect of these ratios separately or added in the model and figured out a clinical prediction model. To estimate the discrimination and calibration of the new models, the receiver operating characteristics (ROC) curve analysis, DeLong method, and likelihood ratio test (LR test) were utilized. RESULTS: PSM showed that Nr, Nc, NLR, P, PNR, NLR/PLT, NER, and MNR facilitates the differentiation of the HCs and AIS. Among the eight biomarkers, PNR and MNR could differentiate the 90-day outcome, and it was found out that PNR performed better. Univariate regression analysis demonstrated that PNR was the only independent predictor which needs no adjustment. Besides, the multivariate regression analysis, Delong method, and LR test indicated that among the neutrophil-related ratios, NLR, PNR, NLR/PLT, NER, and MNR exerted little influence on the discrimination but could enhance the calibration of the base model, and NER proved to work best. CONCLUSION: Low PNR was the best indicator among the neutrophil-related ratios tin predicting a poor 90-day outcome of AIS patients. Moreover, high NER performed best when predicting the 90-day outcome to improve the calibration of the base model.

Systemic Immune-Inflammation Index Predicts 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis.

BACKGROUND AND PURPOSE: Systemic immune-inflammation index (SII), a novel inflammation index derived from counts of circulating platelets, neutrophils and lymphocytes, has been studied in developing incident cancer. However, the clinical value of SII in acute ischemic stroke (AIS) patients had not been further investigated. Therefore, we aimed to explore the association between SII and severity of stroke as well as 3-month outcome of AIS patients. METHODS: A total of 216 AIS patients receiving intravenous thrombolysis (IVT) and 875 healthy controls (HCs) were retrospectively recruited. Blood samples were collected within 24h after admission. Severity of stroke was assessed by the National Institute of Health stroke scale (NIHSS) scores on admission and poor 3-month functional outcome was defined as Modified Rankin Scale (mRS) > 2. RESULTS: SII levels in AIS patients were higher than in HCs. The cut-off value of SII is 545.14×109/L. Patients with SII > 545.14×109/L had higher NIHSS scores (median: 5 vs 9, p < 0.001), a positive correlation between SII and NIHSS was observed (rs = 0.305, p < 0.001). Multivariate logistic regression analyses showed that high SII was one of the independent risk factors for poor prognosis at 3 months of AIS patients (OR = 3.953, 95% CI = 1.702-9.179, p = 0.001). The addition of SII to the conventional prognostic model improved the reclassification (but not discrimination) of the functional outcome (net reclassification index 39.3%, p = 0.007). CONCLUSION: SII is correlated with stroke severity at admission and can be a novel prognostic biomarker for AIS patients treated with IVT.

Artificial Intelligence-Aided Diagnosis Software to Identify Highly Suspicious Pulmonary Nodules.

INTRODUCTION: To evaluate the value of artificial intelligence (AI)-assisted software in the diagnosis of lung nodules using a combination of low-dose computed tomography (LDCT) and high-resolution computed tomography (HRCT). METHOD: A total of 113 patients with pulmonary nodules were screened using LDCT. For nodules with the largest diameters, an HRCT local-target scanning program (combined scanning scheme) and a conventional-dose CT scanning scheme were also performed. Lung nodules were subjectively assessed for image signs and compared by size and malignancy rate measured by AI-assisted software. The nodules were divided into improved visibility and identical visibility groups based on differences in the number of signs identified through the two schemes. RESULTS: The nodule volume and malignancy probability for subsolid nodules significantly differed between the improved and identical visibility groups. For the combined scanning protocol, we observed significant between-group differences in subsolid nodule malignancy rates. CONCLUSION: Under the operation and decision of AI, the combined scanning scheme may be beneficial for screening high-risk populations.

Matrix-assisted catalytic printing for the fabrication of multiscale, flexible, foldable, and stretchable metal conductors.

Matrix-assisted catalytic printing (MACP) is developed as a low-cost and versatile printing method for the fabrication of multiscale metal conductors on a wide variety of plastic, elastomeric, and textile substrates. Highly conductive Cu interconnects (2.0 × 108 S/m) fabricated by MACP at room temperature display excellent flexibility, foldability, and stretchability.