bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Convolutional Neural Network in the Diagnosis of Cavernous Sinus Invasion in Pituitary Adenoma
Authors: Fang Yi , Wang He , Feng Ming , Chen Hongjie , Zhang Wentai , Wei Liangfeng , Pei Zhijie , Wang Renzhi , Wang Shousen 
Published: April 2022

ObjectivesConvolutional neural network (CNN) is a deep-learning method for image classification and recognition based on a multi-layer NN. In this study, CNN was used to accurately assess cavernous sinus invasion (CSI) in pituitary adenoma (PA).MethodsA total of 371 patients with PA were enrolled in the retrospective study. The cohort was divided into the invasive (n = 102) and non-invasive groups (n = 269) based on surgically confirmed CSI. Images were selected on the T1-enhanced imaging on MR scans. The cohort underwent a fivefold division of randomized datasets for cross-validation. Then, a tenfold augmented dataset (horizontal flip and rotation) of the training set was enrolled in the pre-trained Resnet50 model for transfer learning. The testing set was imported into the trained model for evaluation. Gradient-weighted class activation mapping (Grad-CAM) was used to obtain the occlusion map. The diagnostic values were compared with different dichotomizations of the Knosp grading system (grades 0-1/2-4, 0-2/3a-4, and 0-3a/3b-4).ResultsBased on Knosp grades, 20 cases of grade 0, 107 cases of grade 1, 82 cases of grade 2, 104 cases of grade 3a, 22 cases of grade 3b, and 36 cases of grade 4 were recorded. The CSI rates were 0%, 3.7%, 18.3%, 37.5%, 54.5%, and 88.9%. The predicted accuracies of the three dichotomies were 60%, 74%, and 81%. The area under the receiver operating characteristic (AUC-ROC) of Knosp grade for CSI prediction was 0.84; the cutoff was 2.5 with a Youden value of 0.62. The accuracies of the CNN model ranged from 0.80 to 0.96, with AUC-ROC values ranging from 0.89 to 0.98. The Grad-CAM saliency maps confirmed that the region of interest of the model was around the sellar region.ConclusionsWe constructed a CNN model with a high proficiency at CSI diagnosis. A more accurate CSI identification was achieved with the constructed CNN than the Knosp grading system.
Transfer Learning-Based Autosegmentation of Primary Tumor Volumes of Glioblastomas Using Preoperative MRI for Radiotherapy Treatment
Authors: Tian Suqing , Wang Cuiying , Zhang Ruiping , Dai Zhuojie , Jia Lecheng , Zhang Wei , Wang Junjie , Liu Yinglong 
Published: April 2022

ObjectivesGlioblastoma is the most common primary malignant brain tumor in adults and can be treated with radiation therapy. However, tumor target contouring for head radiation therapy is labor-intensive and highly dependent on the experience of the radiation oncologist. Recently, autosegmentation of the tumor target has been playing an increasingly important role in the development of radiotherapy plans. Therefore, we established a deep learning model and improved its performance in autosegmenting and contouring the primary gross tumor volume (GTV) of glioblastomas through transfer learning.MethodsThe preoperative MRI data of 20 patients with glioblastomas were collected from our department (ST) and split into a training set and testing set. We fine-tuned a deep learning model for autosegmentation of the hippocampus on separate MRI scans (RZ) through transfer learning and trained this deep learning model directly using the training set. Finally, we evaluated the performance of both trained models in autosegmenting glioblastomas using the testing set.ResultsThe fine-tuned model converged within 20 epochs, compared to over 50 epochs for the model trained directly by the same training set, and demonstrated better autosegmentation performance [Dice similarity coefficient (DSC) 0.9404 ± 0.0117, 95% Hausdorff distance (95HD) 1.8107 mm ±0.3964mm, average surface distance (ASD) 0.6003 mm ±0.1287mm] than the model trained directly (DSC 0.9158±0.0178, 95HD 2.5761 mm ± 0.5365mm, ASD 0.7579 mm ± 0.1468mm) with the same test set. The DSC, 95HD, and ASD values of the two models were significantly different (P&lt;0.05).ConclusionA model developed with semisupervised transfer learning and trained on independent data achieved good performance in autosegmenting glioblastoma. The autosegmented volume of glioblastomas is sufficiently accurate for radiotherapy treatment, which could have a positive impact on tumor control and patient survival.
Application Value of Radiomic Nomogram in the Differential Diagnosis of Prostate Cancer and Hyperplasia
Authors: Gui Shaogao , Lan Min , Wang Chaoxiong , Nie Si , Fan Bing 
Published: April 2022

ObjectiveProstate cancer and hyperplasia require different treatment strategies and have completely different outcomes; thus, preoperative identification of prostate cancer and hyperplasia is very important. The purpose of this study was to evaluate the application value of magnetic resonance imaging (MRI)-derived radiomic nomogram based on T2-weighted images (T2WI) in differentiating prostate cancer and hyperplasia.Materials and MethodsOne hundred forty-six patients (66 cases of prostate cancer and 80 cases of prostate hyperplasia) who were confirmed by surgical pathology between September 2019 and September 2019 were selected. We manually delineated T2WI of all patients using ITK-SNAP software and radiomic analysis using Analysis Kit (AK) software. A total of 396 tumor texture features were extracted. Subsequently, the effective features were selected using the LASSO algorithm, and the radiomic feature model was constructed. Next, combined with independent clinical risk factors, a multivariate Logistic regression model was used to establish a radiomic nomogram. The receiver operator characteristic (ROC) curve was used to evaluate the prediction performance of the radiomic nomogram. Finally, the clinical application value of the nomogram was evaluated by decision curve analysis.ResultsThe PSA and the selected imaging features were significantly correlated with the differential diagnosis of prostate cancer and hyperplasia. The radiomic model had good discrimination efficiency for prostate cancer and hyperplasia. The training set (AUC = 0.85; 95% CI: 0.77–0.92) and testing set (AUC = 0.84; 95% CI: 0.72–0.96) were effective. The radiomic nomogram, combined with the radiomic characteristics of MRI and independent clinical risk factors, showed better differentiation efficiency in the training set (AUC = 0.91; 95% CI: 0.85–0.97) and testing set (AUC = 0.90; 95% CI: 0.81–0.99). The decision curve showed the clinical application value of the radiomic nomogram.ConclusionThe radiomic nomogram of T2-MRI combined with clinical risk factors can easily identify prostate cancer and hyperplasia. It also provides suggestions for further clinical events.
Evaluation of Amide Proton Transfer-Weighted Imaging for Risk Factors in Stage I Endometrial Cancer: A Comparison With Diffusion-Weighted Imaging and Diffusion Kurtosis Imaging
Authors: Jin Xingxing , Yan Ruifang , Li Zhong , Zhang Gaiyun , Liu Wenling , Wang Hongxia , Zhang Meng , Guo Jinxia , Wang Kaiyu , Han Dongming 
Published: April 2022

BackgroundEndometrial cancer (EC) is one of the most common gynecologic malignancies in clinical practice. This study aimed to compare the value of diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and amide proton transfer-weighted imaging (APTWI) in the assessment of risk stratification factors for stage I EC including histological subtype, grade, stage, and lymphovascular space invasion (LVSI).MethodsA total of 72 patients with stage I EC underwent pelvic MRI. The apparent diffusion coefficient (ADC), mean diffusivity (MD), mean kurtosis (MK), and magnetization transfer ratio asymmetry (MTRasym at 3.5 ppm) were calculated and compared in risk groups with the Mann–Whitney U test or independent samples t-test. Spearman’s rank correlation was applied to depict the correlation of each parameter with risk stratification. The diagnostic efficacy was evaluated with receiver operating characteristic (ROC) curve analysis and compared using the DeLong test. A multivariate logistic regression was conducted to explore the optimal model for risk prediction.ResultsThere were significantly greater MTRasym (3.5 ppm) and MK and significantly lower ADC and MD in the non-adenocarcinoma, stage IB, LVSI-positive, high-grade, and non-low-risk groups (all p &lt; 0.05). The MK and MTRasym (3.5 ppm) were moderately positively correlated with risk stratification as assessed by the European Society for Medical Oncology (EMSO) clinical practice guidelines (r = 0.640 and 0.502, respectively), while ADC and MD were mildly negatively correlated with risk stratification (r = −0.358 and −0.438, respectively). MTRasym (3.5 ppm), MD, and MK were identified as independent risk predictors in stage I EC, and optimal predictive performance was obtained with their combinations (AUC = 0.906, sensitivity = 70.97%, specificity = 92.68%). The results of the validation model were consistent with the above results, and the calibration curve showed good accuracy and consistency.ConclusionsAlthough similar performance was obtained with each individual parameter of APTWI, DWI, and DKI for the noninvasive assessment of aggressive behavior in stage I EC, the combination of MD, MK, and MTRasym (3.5 ppm) provided improved predictive power for non-low-risk stage I EC and may serve as a superior imaging marker.
Reproducibility for Hepatocellular Carcinoma CT Radiomic Features: Influence of Delineation Variability Based on 3D-CT, 4D-CT and Multiple-Parameter MR Images
Authors: Duan Jinghao , Qiu Qingtao , Zhu Jian , Shang Dongping , Dou Xue , Sun Tao , Yin Yong , Meng Xiangjuan 
Published: April 2022

PurposeAccurate lesion segmentation is a prerequisite for radiomic feature extraction. It helps to reduce the features variability so as to improve the reporting quality of radiomics study. In this research, we aimed to conduct a radiomic feature reproducibility test of inter-/intra-observer delineation variability in hepatocellular carcinoma using 3D-CT images, 4D-CT images and multiple-parameter MR images.Materials and MethodsFor this retrospective study, 19 HCC patients undergoing 3D-CT, 4D-CT and multiple-parameter MR scans were included in this study. The gross tumor volume (GTV) was independently delineated twice by two observers based on contrast-enhanced computed tomography (CECT), maximum intensity projection (MIP), LAVA-Flex, T2W FRFSE and DWI-EPI images. We also delineated the peritumoral region, which was defined as 0 to 5 mm radius surrounding the GTV. 107 radiomic features were automatically extracted from CECT images using 3D-Slicer software. Quartile coefficient of dispersion (QCD) and intraclass correlation coefficient (ICC) were applied to assess the variability of each radiomic feature. QCD&lt;10% and ICC≥0.75 were considered small variations and excellent reliability. Finally, the principal component analysis (PCA) was used to test the feasibility of dimensionality reduction.ResultsFor tumor tissues, the numbers of radiomic features with QCD&lt;10% indicated no obvious inter-/intra-observer differences or discrepancies in 3D-CT, 4D-CT and multiple-parameter MR delineation. However, the number of radiomic features (mean 89) with ICC≥0.75 was the highest in the multiple-parameter MR group, followed by the 3DCT group (mean 77) and the MIP group (mean 73). The peritumor tissues also showed similar results. A total of 15 and 7 radiomic features presented excellent reproducibility and small variation in tumor and peritumoral tissues, respectively. Two robust features showed excellent reproducibility and small variation in tumor and peritumoral tissues. In addition, the values of the two features both represented statistically significant differences among tumor and peritumoral tissues (P&lt;0.05). The PCA results indicated that the first seven principal components could preserve at least 90% of the variance of the original set of features.ConclusionDelineation on multiple-parameter MR images could help to improve the reproducibility of the HCC CT radiomic features and weaken the inter-/intra-observer influence.
Hidden Infection in Asymptomatic Congenital Lung Malformations—A Decade Retrospective Study
Authors: Liu Chenyu , Yu Xuejiao , Cheng Kaisheng , Luo Dengke , Yuan Miao , He Taozhen , Xu Chang 
Published: April 2022

BackgroundWhether to operate on asymptomatic patients with congenital lung malformations (CLMs) remains controversial. Our study intended to find out the proportion of hidden infection in CLMs and its effect on surgery, to provide help for the management of asymptomatic CLMs patients.MethodsA retrospective review of the medical records of patients with asymptomatic CLMs from January 2011 to December 2020 was performed in our center. Selected asymptomatic patients were divided into a non-hidden infection group (NHI) and a hidden infection group (HI).ResultsA total of 581 asymptomatic CLMs patients were included in this study. Thirty-two percent of asymptomatic CLMs patients had hidden infection in the lesion. Among various CLMs diseases, intralobular pulmonary sequestration had the highest percentage of hidden infection (48.8%). With age, the proportion of HI gradually increased. Patients in the HI and NHI groups were 223 and 121. The incidence of pleural adhesion and focal abscess in the HI group were 14.9 and 7.4%. Statistical significances were shown between the two groups in intraoperative blood loss (p = 0.002), operation time (p = 0.045), chest tube drainage time (p &lt; 0.001), postoperative hospital stay (p &lt; 0.001), and air leak (p = 0.012).ConclusionThe proportion of HI detected by postoperative pathological results was high and they could increase the difficulty and risk of surgery. Therefore, early surgery may be a more appropriate choice for the management of asymptomatic CLMs patients.
The Efficacy and Safety of Bivalirudin Versus Heparin in the Anticoagulation Therapy of Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis
Authors: Ma Min , Liang Shichu , Zhu Jingbo , Dai Manyu , Jia Zhuoran , Huang He , He Yong 
Published: April 2022

Background:Bivalirudin is a direct thrombin inhibitor (DTI) that can be an alternative to unfractionated heparin (UFH). The efficacy and safety of bivalirudin in anticoagulation therapy in extracorporeal membrane oxygenation (ECMO) remain unknown.Methods:This study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A systematic literature search was performed in PubMed, EMBASE, and The Cochrane Library databases to identify all relevant original studies estimating bivalirudin’s efficacy and safety versus UFH as anticoagulation therapy in ECMO. The time limit for searching is from the search beginning to June 2021. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. The meta-analysis (CRD42020214713) was performedviathe RevMan version 5.3.5 Software and STATA version 15.1 Software.Results:Ten articles with 847 patients were included for the quantitative analysis. Bivalirudin can significantly reduce the incidence of major bleeding in children (I2= 48%,p= 0.01, odd ratio (OR) = 0.17, 95% confidence interval (CI): 0.04–0.66), patient thrombosis (I2= 0%,p= 0.02, OR = 0.58, 95% CI: 0.37–0.93), in-circuit thrombosis/interventions (I2= 0%,p= 0.0005, OR = 0.40, 95% CI: 0.24–0.68), and in-hospital mortality (I2= 0%,p= 0.007, OR = 0.64, 95% CI: 0.46–0.88). Also, comparable clinical outcomes were observed in the incidence of major bleeding in adults (I2= 48%,p= 0.65, OR = 0.87, 95% CI: 0.46–1.62), 30-day mortality (I2= 0%,p= 0.61, OR = 0.83, 95% CI: 0.41–1.68), and ECMO duration in adults (I2= 41%,p= 0.75, mean difference (MD) = −3.19, 95% CI: −23.01–16.63) and children (I2= 76%,p= 0.65, MD = 40.33, 95% CI:−135.45–216.12).Conclusions:Compared with UFH, bivalirudin can be a safe and feasible alternative anticoagulant option to UFH as anticoagulation therapy in ECMO, especially for heparin resistance (HR) and heparin-induced thrombocytopenia (HIT) cases.
Population Pharmacokinetics of Intravenous Acyclovir in Oncologic Pediatric Patients
Authors: Maximova Natalia , Nisticò Daniela , Luci Giacomo , Simeone Roberto , Piscianz Elisa , Segat Ludovica , Barbi Egidio , Di Paolo Antonello 
Published: April 2022

Background: Acyclovir represents the first-line prophylaxis and therapy for herpes virus infections. However, its pharmacokinetics in children exposes them to the risk of ineffective or toxic concentrations. The study was aimed at investigating the population pharmacokinetics (POP/PK) of intravenous (IV) acyclovir in oncologic children.Methods: Patients (age, 8.6 ± 5.0 years, 73 males and 47 females) received IV acyclovir for prophylaxis (n = 94) and therapy (n = 26) under a therapeutic drug monitoring (i.e., minimum and maximal plasma concentrations, &gt;0.5 and &lt;25 mg/L, respectively). Plasma concentrations were fitted by nonlinear mixed effect modeling and a simulation of dosing regimens was performed. Findings were stratified according to an estimated glomerular filtration rate (eGFR) threshold of 250 ml/min/1.73 m2.Results: The final 1-compartment POP/PK model showed that eGFR had a significant effect on drug clearance, while allometric body weight influenced both clearance and volume of distribution. The population clearance (14.0 ± 5.5 L/h) was consistent across occasions. Simulation of standard 1-h IV infusion showed that a 10-mg/kg dose every 6 h achieved target concentrations in children with normal eGFR (i.e., ≤250 ml/min/1.73 m2). Increased eGFR values required higher doses that led to an augmented risk of toxic peak concentrations. On the contrary, simulated prolonged (i.e., 2 and 3-h) or continuous IV infusions at lower doses increased the probability of target attainment while reducing the risk of toxicities.Conclusion: Due to the variable pharmacokinetics of acyclovir, standard dosing regimens may not be effective in some patients. Prospective trials should confirm the therapeutic advantage of prolonged and continuous IV infusions
Interactions, Diffusion, and Membrane Fluctuations in Concentrated Unilamellar Lipid Vesicle Solutions
Authors: Kelley Elizabeth G. , Blick Emily E. , Prabhu Vivek M. , Butler Paul D. , Nagao Michihiro 
Published: April 2022

Lipid vesicles are widely used as models for cell membranes, hosts for membrane protein studies, and containers for hydrophilic molecules. The vesicle solutions in these applications are usually prepared at a specific lipid concentration; however, because vesicles are solvent-filled structures, the corresponding volume fraction of vesicles is at least a factor of three times higher than the corresponding lipid volume fraction and critically depends on the vesicle radii. Here we show that these higher than may be expected vesicle volume fractions result in measurable interactions between the vesicles as well as affect the vesicle diffusion. We show that vesicle solutions prepared with lipid mass fractions, mL, as low as ≈ 0.004, which correspond to a lipid concentration of ≈ 4 mg/mL or 5 mmol/L (mM), not only have a measurable apparent structure factor (S′(q)) in small angle neutron scattering (SANS) experiments, but that this repulsive structure factor also affects the measured diffusion coefficient at small scattering vectors (q) such as those probed with dynamic light scattering (DLS). The measured diffusion coefficients are further affected by indirect solvent mediated interactions described by a hydrodynamic factor (H(q)). Accounting for the concentration-dependence of the vesicle diffusion shows that the lipid concentration dependence measured in neutron spin echo (NSE) spectroscopy is due to differences in the effective vesicle diffusion coefficients and not the membrane fluctuation dynamics. The results have practical implications for static and dynamic scattering experiments as well as provide interesting insights into the interactions between soft lipid vesicles.
Influence of Swimming Training Session on Selected Saliva Components in Youth Swimmers
Authors: Grzesiak-Gasek Iwona , Kaczmarek Urszula 
Published: April 2022

Exercise may induce many changes in biochemical parameters of the saliva. Thanks to non-invasive access, saliva can be used as a diagnostic material in physical activity monitoring. The aim of the study was comparison of selected salivary components in swimmers before and after training session. 40 male subjects aged 12–15, out of whom 30 were competitive swimmers and 10 control were involved in the study. Salivary samples were collected from all subjects in the morning, and in the afternoon; from the swimmers, they were also collected before and after the workout. Salivary flow rate-V, pH, total protein-P, alpha-amylase-Amy, salivary peroxidase-SPO, cortisol-C, total antioxidant status-TAS, sialic acid (free-FSA, bound-GSA, total-TSA), calcium-Ca, magnesium-Mg were measured. The swimmers assessed the workout intensity of training session using the RPE Foster’s scale. The circadian rhythm pattern of some salivary components and differences after training were found. In swimmers after the morning exercise significant increase of P (0.83 ± 0.27 vs. 1.10 ± 0.58 g/L), Amy (64.91 ± 70.86 vs. 87.07 ± 92.46IU/L), Ca (3.83 ± 1.33 vs. 4.99 ± 2.24 mg/L), Mg (0.52 ± 0.32 vs. 0.73 ± 0.34 mg/L), TAS (0.64 ± 0.27 vs. 0.72 ± 0.26 mmol/L) and decrease V (0.47 ± 0.37 vs. 0.36 ± 0.22 mg/min), C (5.86 ± 5.00 vs. 3.54 ± 5.07 μg/ml) were found. After the afternoon training significant increase of pH (7.13 ± 0.33 vs. 7.27 ± 0.24), Amy (111.53 ± 120.13 vs. 130.91 ± 161.14IU/L), Ca (3.72 ± 1.34 vs. 4.61 ± 1.58 mg/L), Mg (0.48 ± 0.28 vs. 0.60 ± 0.39 mg/L), TSA (5.64 ± 3.78 vs. 6.10 ± 3.08 mg/L), GSA (3.00 ± 3.06 vs. 3.38 ± 2.26 mg/L), and decrease of V (0.63 ± 0.63 vs. 0.49 ± 0.39 ml/min) were noticed. Before training in the morning in the swimmers significantly higher of V (0.47 ± 0.37 vs. 0.26 ± 0.15 mg/min), TAS (0.64 ± 0.27 vs. 0.40 ± 0.16 mmol/L), and lower pH (7.01 ± 0.46 vs. 7.53 ± 0.33), P (0.83 ± 0.27 vs. 1.86 ± 1.28 g/L), Amy (64.91 ± 70.86 vs. 146.56 ± 114.45IU/L) compared to the control were found. In the afternoon in swimmers before training session significantly lower pH (7.13 ± 0.33 vs. 7.53 ± 0.49) and Amy (111.53 ± 120.13 vs. 170.98 ± 107.72IU/L) in comparison to the control were noticed. The RPE scores were negatively correlated with V (rho = −0.500, p = 0.05 and pH (rho = −0.382, p = 0.03) measured after the morning session and after the afternoon training with V (rho = −0.570, p = 0.01) and Ca (rho = −0.401, p = 0.08). The levels of salivary flow rate, alpha amylase, cortisol, calcium, magnesium were associated with swimming training session, and showed circadian variation without a significant effect on their responses to exercise.