Lung cancer is one of the leading causes of cancer-related death worldwide. Cytology plays an important role in the initial evaluation and diagnosis of patients with lung cancer. However, due to the ...subjectivity of cytopathologists and the region-dependent diagnostic levels, the low consistency of liquid-based cytological diagnosis results in certain proportions of misdiagnoses and missed diagnoses. In this study, we performed a weakly supervised deep learning method for the classification of benign and malignant cells in lung cytological images through a deep convolutional neural network (DCNN). A total of 404 cases of lung cancer cells in effusion cytology specimens from Shanghai Pulmonary Hospital were investigated, in which 266, 78, and 60 cases were used as the training, validation and test sets, respectively. The proposed method was evaluated on 60 whole-slide images (WSIs) of lung cancer pleural effusion specimens. This study showed that the method had an accuracy, sensitivity, and specificity respectively of 91.67%, 87.50% and 94.44% in classifying malignant and benign lesions (or normal). The area under the receiver operating characteristic (ROC) curve (AUC) was 0.9526 (95% confidence interval (CI): 0.9019-9.9909). In contrast, the average accuracies of senior and junior cytopathologists were 98.34% and 83.34%, respectively. The proposed deep learning method will be useful and may assist pathologists with different levels of experience in the diagnosis of cancer cells on cytological pleural effusion images in the future.
Rh-catalyzed three-component C(sp
3
)/C(sp
2
)-H activation has been achieved through a two-directing group strategy. This protocol provides a convenient and efficient pathway for the construction of ...diverse 8-alkyl quinoline derivatives in one-pot. Furthermore, mechanistic studies revealed that the first C-H amidation was significantly faster than the sequential C-H alkylation.
Rh-catalyzed three-component C(sp
3
)/C(sp
2
)-H activation has been achieved through a two-directing group strategy, providing a convenient and efficient pathway for the construction of diverse 8-alkyl quinoline derivatives in one-pot.
Objectives
To assess the efficacy and safety of bivalirudin during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in high‐bleeding‐risk elderly patients.
Background
...Bivalirudin reduces PCI‐related bleeding; however, its efficacy and safety in patients with CTO, especially elderly patients with a high bleeding risk, remain unclear.
Methods
This single‐center prospective randomized controlled trial assigned 123 high‐bleeding‐risk elderly patients with CTO to either the unfractionated heparin (UFH) group (n = 55) or the bivalirudin group (n = 68). The primary efficacy endpoint was the incidence of major adverse cardiac events (MACEs) during hospitalization and at the 6‐month follow‐up. The safety endpoint was bleeding or procedure (access)‐related complications after PCI.
Results
MACE incidence was 17.6% and 20.0% in the bivalirudin and UFH groups, respectively (P = 0.82). Bleeding Academic Research Consortium (BARC) type 1–2 bleeding events during hospitalization were comparable between the groups (UFH: 10.9% vs. bivalirudin: 8.8%, P = 0.77). No BARC type 3–5 bleeding events or severe procedure (access)‐related complications (subcutaneous hematoma >5 cm) occurred in either group. At the 6‐month follow‐up, MACE incidence was comparable between the groups (UFH: 3.6% vs. bivalirudin: 1.5%, P = 0.59). The Kaplan–Meier analysis revealed that MACE‐free survival rates were comparable between the groups (P = 0.43). One case of BARC type 3–5 bleeding (fatal intracranial hemorrhage) was observed in the UFH group at the 6‐month follow‐up.
Conclusions
Bivalirudin and UFH showed comparable efficacy and safety in elderly patients with a high bleeding risk, undergoing PCI for CTO lesions.
The LIM homeobox 2 transcription factor Lhx2 is known to control crucial aspects of neural development in various species. However, its function in human neural development is still elusive. Here, we ...demonstrate that LHX2 plays a critical role in human neural differentiation, using human embryonic stem cells (hESCs) as a model. In hESC-derived neural progenitors (hESC-NPs), LHX2 was found to be expressed before PAX6, and co-expressed with early neural markers. Conditional ectopic expression of LHX2 promoted neural differentiation, whereas disruption of LHX2 expression in hESCs significantly impaired neural differentiation. Furthermore, we have demonstrated that LHX2 regulates neural differentiation at two levels: first, it promotes expression of PAX6 by binding to its active enhancers, and second, it attenuates BMP and WNT signaling by promoting expression of the BMP and WNT antagonist Cerberus 1 gene (CER1), to inhibit non-neural differentiation. These findings indicate that LHX2 regulates the transcription of downstream intrinsic and extrinsic molecules that are essential for early neural differentiation in human.
Abstract Background The plasma uric acid to albumin ratio (UAR) is considered as a novel indicator for Inflammation. However, the association between UAR and coronary slow flow phenomenon (CSFP) ...remains unclear. Methods A total of 1328 individuals with chronic coronary syndrome (CCS) receiving coronary angiography (CAG) and found no obvious obstructive stenosis (< 40%) were included in this study. 79 individuals developed CSFP and were divided into CSFP group. The 1:2 age-matched patients with normal coronary blood flow were allocated to the control group ( n = 158). The clinical characteristics, laboratory parameters including uric acid, albumin ratio, UAR and the angiographic characteristics were compared between the two groups. Results Patients with CSFP had a higher level of uric acid (392.3 ± 85.3 vs. 273.8 ± 71.5, P < 0.001), UAR (10.7 ± 2.2 vs. 7.2 ± 1.9, P < 0.001), but a lower level of plasma albumin (36.9 ± 4.2 vs. 38.5 ± 3.6, P = 0.003). Moreover, UAR increased as the numbers of vessels involved in CSFP increased. The logistic regression analysis demonstrated that UAR was independent predictors for CSFP. The Receiver operating characteristic (ROC) curve analysis showed that when UAR was more than 7.9, the AUC was 0.883 (95% CI: 0.840–0.927, p < 0.001), with the sensitivity and specificity were 78.2% and 88.2% respectively. Conclusion Combined uric acid with plasma albumin, UAR could serve as an independent predictor for CSFP.
The freedom from efficiency droop motivates monochromatic lasers to progress in general lighting applications due to the demand for more efficient and sustainable light sources. Still, a white light ...based on monochromatic lasers with high lighting quality, such as a high color rendering ability, an angle-independent output, and a speckle-free illumination, has not yet been fabricated nor demonstrated. Random lasers, with the special mechanism caused by multiple scattering, the angle-free emission, and the uncomplicated fabrication processes, inspire us to investigate the feasibility of utilizing them in general lighting. In this work, a white random laser with a high color rendering index (CRI) value, regardless of pumping energy and observing direction, was performed and discussed. We also investigated the stability of white RL as its CIE chromaticity coordinates exhibit negligible differences with increasing pump energy density, retaining its high-CRI measurement. Also, it exhibits angle-independent emission while having a high color rendering ability. After passing through a scattering film, it generated no speckles compared to the conventional laser. We demonstrated the advances in white laser illumination, showing that a white random laser is promising to be applied for high-brightness illumination, biological-friendly lighting, accurate color selections, and medical sensing.
With the superiority of laser-level intensity, narrow spectral line width, and broad-angular emission, random lasers (RLs) have drawn considerable research interests for their potential to carry out ...a variety of applications. In this work, the applications associated with optical-encoded technologies, including security printing, military friend or foe identification (FFI), and anticounterfeiting of documents are highlighted, and the concept of a transient RL “smart ink” has been proposed. The proof-of-concept was demonstrated as invisible signatures, which encoded the messages through the spectral difference of spontaneous emission and RL under specified conditions. Next, the possibility of encoding the data with multibit signals was further confirmed by exploiting the threshold tunability of RLs. Moreover, the transient characteristic of this smart ink and its capability to be attached on freeform surfaces of different materials were also shown. With the advantages of a facile manufacturing process and multiple purposes, it is expected that this ink can soon be carried out in a variety of practical utilities.
Efficient photocatalytic dye degradation has been realized based on the first attempt of using a random laser. In previous studies, most photocatalytic dye degradation was conducted by using ...broad-angular emission lamps, light-emitting diodes, and conventional lasers. However, these types of light sources could be restricted by some disadvantages, such as weak intensity or high directionality. Unlike traditional lasers, random lasers obviate the need for the cavity. The advantage of broad-angular emission lights and the feature of laser-level intensity make random lasers a promising light source for many potential applications. In this study, an ultraviolet random laser (UVRL) derived from zinc oxide (ZnO) was used in the photocatalytic dye degradation experiment. It is found that the degradation efficiency of the UVRL is much better than that of conventional lasers and ultraviolet light-emitting diodes. The success of applying random laser systems in the photocatalytic reaction is expected to expand the applications of random lasers.
Patients with coronary chronic total occlusion (CTO) require effective antiplatelet therapy after percutaneous coronary intervention (PCI). Ticagrelor has more pronounced platelet inhibition than ...clopidogrel. However, the most appropriate dose of ticagrelor in East Asian populations remains unclear.
We compared ticagrelor (180 mg loading dose, 90 mg twice daily thereafter and 120 mg loading dose, 60 mg twice daily thereafter) and clopidogrel (300 mg loading dose, 75 mg daily thereafter) for prevention of cardiovascular events in 525patients with CTO undergoing PCI.
The rate of in-hospital major adverse cardiac and cerebral events (MACCE) was not different between the groups. At 1-year follow-up, target vessel revascularization (TVR) in both ticagrelor groups were significantly lower than that in the clopidogrel group (p = 0.047); TVR was significantly decreased in 60 mg ticagrelor compared to standard dose clopidogrel (p = 0.046). At 1-year follow-up, overall MACCE in both ticagrelor groups were significantly lower than that in the clopidogrel group (p = 0.023). Kaplan-Meier analysis showed MACCE-free survival was significantly higher in both ticagrelor groups than in the clopidogrel group (p = 0.024). During hospitalization, minor bleeding was significant increased in the 90 mg ticagrelor group (p = 0.021). At 1-year follow-up, risk of major and minor bleeding were significantly increased in the 90 mg ticagrelor group.
In East Asian patients with CTO undergoing PCI, 60 mg ticagrelor was as effective as 90 mg, at the same time significantly reduced risk of bleeding.
Objectives. To assess the effectiveness and safety of ARW for vascular recanalization in CTO patients. Background. Chronic total occlusion (CTO) of coronary artery accompanied with large branch ...distal to the occluded segment (<2 mm) is one of the challenges physicians are facing during the coronary intervention. In cases where the antegrade wire passed the occluded segment reaching the branch vessel, but could not access the main vessel through various adjustments, application of active antegrade reverse wire technique (ARW) could be considered. Patients and Methods. A total of 301 consecutive CTO patients who received the antegrade percutaneous coronary intervention (PCI) between December 2015 and December 2019 at our institution were included, of whom 11 were treated with ARW (10 successfully) for vascular recanalization. The applicability and safety of ARW were assessed. Results. Among the 301 CTO patients who received antegrade vascular recanalization, 11 were treated with ARW. ARW was successful in 10 patients as follows: from the diagonal branch (D) to anterior descending branch (LAD) in 4 patients; from the septal branch (S) to LAD in 1 patient; from D to S and LAD in 1 patient; from the circumflex branch (LCX) to obtuse marginal branch (OM) in 1 patient; from OM to LCX in 1 patient; from a posterior descending artery (PDA) to the posterior lateral vein (PLV) in 2 patients. Yet, ARW in patient with RCAm CTO failed, while the consequent retrograde PCI succeeded. The mean J-CTO score of the 11 patients was 2.7 ± 0.65, among whom eight were accompanied with calcifications. Sion Black and Fielder XTR reverse wires were used in 9 and 2 patients, respectively. No loss of side branches or severe procedure-related complications occurred in 11 patients. Conclusion. Therefore, ARW can improve procedural efficiency and should be popularized for further application.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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