Background To explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign ...prostatic hyperplasia (BPH) using histopathology as the reference. Methods Ninety patients with PCa and 112 patients with BPH were included in this retrospective study. Differences in whole-lesion histograms and texture parameters of ADC maps and T2W images between PCa and BPH patients were evaluated using the independent samples t-test. The diagnostic performance of ADC maps and T2W images in being able to differentiate PCa from BPH was assessed using receiver operating characteristic (ROC) curves. Results The mean, median, 5.sup.th, and 95.sup.th percentiles of ADC values in images from PCa patients were significantly lower than those from BPH patients (p < 0.05). Significant differences were observed in the means, standard deviations, medians, kurtosis, skewness, and 5.sup.th percentile values of T2W image between PCa and BPH patients (p < 0.05). The ADC.sub.5th showed the largest AUC (0.906) with a sensitivity of 83.3 % and specificity of 89.3 %. The diagnostic performance of the T2W image histogram and texture analysis was moderate and had the largest AUC of 0.634 for T2W.sub.Kurtosis with a sensitivity and specificity of 48.9% and 79.5 %, respectively. The diagnostic performance of the combined ADC.sub.5th & T2W.sub.Kurtosis parameters was also similar to that of the ADC.sub.5th & ADC.sub.Diff-Variance. Conclusions Histogram and texture parameters derived from the ADC maps and T2W images for entire prostatic lesions could be used as imaging biomarkers to differentiate PCa and BPH biologic characteristics, however, histogram parameters outperformed texture parameters in the diagnostic performance. Keywords: Prostate cancer, Prostatic Hyperplasia, Magnetic resonance imaging, Diffusion
Introduction
Dementia has become a public health priority and is irreversible. Mild cognitive impairment (MCI), an intermediate state between normal cognition and dementia, is the prime time for ...early diagnosis and intervention. The activities of daily living of dementia patients are usually insufficient. Therefore, continuing to explore the risk factors of MCI, especially the influence of physical activity on MCI and its mechanism can enrich the relevant research fields in China.
Materials and methods
For this cross-sectional study, 2,518 adults aged 60 years or older in Xinzhuang, Minhang District, Shanghai were recruited between July 2019 and April 2019, using a multistage, cluster-sampling method. A binary unconditional logistic regression model was used with MCI status as the dependent variable. Different types of physical activity were separately included in the multifactor model to test their correlations. Sensitivity analysis was performed using BADL as a stratification factor. The mediating effect of depression between physical activity and MCI was examined using the Bootstrap method.
Results
This research includes 271 (10.8%) MCI. Old age (odds ratio 2.967 95%CI 2.063∼4.269), having diabetes (1.816 1.302∼2.534), and depression (3.012 2.209∼4.108) were possible risk factors for MCI. High education level (0.722 0.523∼0.999), medium level of physical activity (0.459 0.326∼0.645), and high level of physical activity (0.396 0.270∼0.580) were possible protective factors. Medium (0.548 0.396∼0.757) and high levels (0.557 0.366∼0.846) of physical exercise and medium (0.433 0.318∼0.590) and high levels (0.487 0.296∼0.801) of household chores are possible protective factors of MCI and their significance remained in the mutually adjusted model. Sensitivity analysis showed that physical activity and household chores were possible protective factors in all strata (
P
< 0.05). Physical exercise and work-related activities showed a protective effect in fully independent older adults, but the effect disappeared in those who cannot be fully independent. Depression played a partially mediating role with an indirect effect of 6.67%.
Discussion
Overall, our results highlight that physical activity is a possible protective factor for MCI. Physical exercise and household chores have strong protective effects and future interventions could be targeted from this perspective. Depression plays a partially mediating role and more attention should be paid to the mental health of older adults.
This study examined the moderating effect of overall social support and the different types of social support on cognitive functioning in depressed older adults. We also investigated whether the ...moderating effect varied according to age.
A total of 2,500 older adults (≥60 years old) from Shanghai, China were enrolled using a multistage cluster sampling method. Weighted linear regression and multiple linear regression was utilized to analyze the moderating effect of social support on the relationship between depressive symptoms and cognitive function and to explore its differences in those aged 60-69, 70-79, and 80 years and above.
After adjusting for covariates, the results indicated that overall social support (β = 0.091,
= 0.043) and support utilization (β = 0.213,
< 0.001) moderated the relationship between depressive symptoms and cognitive function. Support utilization reduced the possibility of the cognitive decline in depressed older adults aged 60-69 years (β = 0.310,
< 0.001) and 80 years and above (β = 0.199,
< 0.001), while objective support increased the possibility of cognitive decline in depressed older people aged 70-79 years (β = -0.189,
< 0.001).
Our findings highlight the buffering effects of support utilization on cognitive decline in depressed older adults. We suggest that age-specific measures should be taken when providing social support to depressed older adults in order to reduce the deterioration of cognitive function.
Background
Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate ...multimorbidity patterns and their association with depression in a sample of older people covered by long‐term care insurance in Shanghai, China.
Method
This was a population‐based cross‐sectional study, with 1871 participants aged ≥60 years old who are covered by Shanghai long‐term care insurance. Multimorbidity was defined as the presence of two or more chronic diseases at the same time. We collected information on chronic conditions using a self‐reported medical history, and we used the 30‐item Geriatric Depression Scale (GDS‐30) to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms.
Results
Among the participants, the prevalence of multimorbidity was 64.7%, and the prevalence of depression was 64.6%. Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataracts showed strong associations with depression when co‐occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio (AOR) 1.223; 95% confidence interval (CI) 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms.
Conclusion
Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long‐term care insurance.
We assessed the economic value of key protected species of wild fauna and flora based on the contingent valuation method. In total, 5500 questionnaires were collected, of which 4672 were valid. ...Analysis of the valid questionnaires showed that the gross willingness to pay（ WTP） was 209 yuan person-1 a-1,with fauna being 111.37 yuan person-1 a-1 and flora being 97.65 yuan person-1 a-1. The WTP was significantly different between different protection levels.Based on the national urban employment data of 2016,the gross value of all endangered species was 18. 29 × 103 billion yuan/a,with fauna being 8. 20 × 103 billion yuan/a and flora being 10. 09 × 103 billion yuan/a. Our analysis showed that economic income,education degree,knowledge,and interest in endangered species,and whether once participated in the activities aimed at endangered species’ conservation are important factors that influence WTP.
We aimed to evaluate the interscan, intraobserver, and interobserver reproducibility of basilar atherosclerotic plaque employing dark blood high-resolution magnetic resonance imaging (HR-MRI) at 3 ...Tesla.
Sixteen patients (14 males and 2 females) with > 30% basilar stenosis as identified by conventional magnetic resonance angiography were prospectively recruited for scan and rescan examinations on a 3 Tesla MRI system using T2-weighted turbo spin-echo protocol. Two observers independently measured the areas of vessels and lumens. Wall area was derived by subtracting the lumen area from the vessel area. Areas of vessels, lumens and walls were compared for the evaluation of interscan variability of basilar plaque. To assess the intraobserver variability, one observer reevaluated all the images of the first scan after a 4-week interval.
Fourteen patients were included in the final analysis. No clinically significant difference was observed for interscan, intraobserver, and interobserver measurements. The intraclass correlations for vessel, lumen, and wall areas were excellent and ranged from 0.973 to 0.981 for the interscan measurements, 0.997 to 0.998 for the intraobserver measurements and 0.979 to 0.985 for the interobserver measurements. The coefficients of variation for quantitative basilar morphology measurements were 4.31%-10.35% for the interscan measurements, 1.41%-4.62% for the intraobserver measurements and 3.79%-8.46% for the interobserver measurements. Compared with the interscan and interobserver measurements, narrow intervals of the scatterplots were observed for the intraobserver measurements by Bland-Altman plots.
Basilar atherosclerotic plaque imaging demonstrates excellent reproducibility at 3 Tesla. The study proves that dark blood HR-MRI may serve as a reliable tool for clinical studies focused on the progression and treatment response of basilar atherosclerosis.
This study aimed to compare the ability of narrow-band imaging to detect early and invasive lung cancer with that of conventional pathological analysis and white-light bronchoscopy. We searched the ...PubMed, EMBASE, Sinomed, and China National Knowledge Infrastructure databases for relevant studies. Meta-disc software was used to perform data analysis, meta-regression analysis, sensitivity analysis, and heterogeneity testing, and STATA software was used to determine if publication bias was present, as well as to calculate the relative risks for the sensitivity and specificity of narrow-band imaging vs those of white-light bronchoscopy for the detection of early and invasive lung cancer. A random-effects model was used to assess the diagnostic efficacy of the above modalities in cases in which a high degree of between-study heterogeneity was noted with respect to their diagnostic efficacies. The database search identified six studies including 578 patients. The pooled sensitivity and specificity of narrow-band imaging were 86% (95% confidence interval: 83–88%) and 81% (95% confidence interval: 77–84%), respectively, and the pooled sensitivity and specificity of white-light bronchoscopy were 70% (95% confidence interval: 66–74%) and 66% (95% confidence interval: 62–70%), respectively. The pooled relative risks for the sensitivity and specificity of narrow-band imaging vs the sensitivity and specificity of white-light bronchoscopy for the detection of early and invasive lung cancer were 1.33 (95% confidence interval: 1.07–1.67) and 1.09 (95% confidence interval: 0.84–1.42), respectively, and sensitivity analysis showed that narrow-band imaging exhibited good diagnostic efficacy with respect to detecting early and invasive lung cancer and that the results of the study were stable. Narrow-band imaging was superior to white light bronchoscopy with respect to detecting early and invasive lung cancer; however, the specificities of the two modalities did not differ significantly.
To compare the Self-referenced and Referenced measurement methods in assessing basilar artery (BA) atherosclerotic plaque employing dark blood high-resolution MRI at 3 Tesla.
Forty patients with > ...20% stenosis as identified by conventional MRA were recruited and evaluated on a 3 Tesla MRI system. The outer wall, inner wall and lumen areas of maximal lumen narrowing site and the outer wall and lumen areas of sites that were proximal and distal to the maximal lumen narrowing site were manually traced. Plaque area (PA), stenosis rate (SR) and percent plaque burden (PPB) were calculated using the Self-referenced and Referenced measurement methods, respectively. To assess intra-observer reproducibility, BA plaque was measured twice with a 2-week interval in between measurements.
Thirty-seven patients were included in the final analysis. There were no significant differences in PA, SR and PPB measurements between the two methods. The intra-class coefficients and coefficient of variations (CV) ranged from 0.976 to 0.990 and from 3.73 to 5.61% for the Self-referenced method and ranged from 0.928 to 0.971 and from 4.64 to 9.95% for the Referenced method, respectively. Both methods are effective in the evaluation of BA plaque. However, the CVs of the Self-referenced method is lower than the Referenced measurement method. Moreover, Bland-Altman plots showed that the Self-referenced method has a narrower interval than the Referenced measurement method.
The Self-referenced method is better and more convenient for evaluating BA plaque, and it may serve as a promising method for evaluation of basilar atherosclerotic plaque.
Automatic image segmentation is an indispensable step in medical image analysis, and it plays an important role in computer-assisted radiotherapy, disease diagnosis and treatment effect evaluation. ...The difficulty of medical image segmentation is greatly enhanced by the blurry nature of medical image, the complex shape of objects and the existence of noise. In recent years, segmentation methods based on deep learning, especially convolutional neural network, have made great progress in improving the accuracy of medical image segmentation. However, these methods also have poor ability to distinguish similar objects in different environments, because of insufficient use of the local context information of images during the process of feature extraction. To address this problem, this paper proposes a deep neural network (LCP-Net) that can perceive multi-scale context information of images. LCP-Net improves the utilization of context information of feature encoders by using Parallel Dilated Convolution (PDC) and Local Context Embedding (LCE), which are beneficial to get feature map rich in environmental information. In addition, to improve the segmentation accuracy of the model for small objects and alleviate the swing issue during training, we propose a novel improved cross-entropy loss (DDCLoss), which can adaptively adjust the weight of loss according to the certainty and deviation distance of the predicted pixel value and enable the model to focus on optimizing the sample points with low certainty and tend to be mislabeled. Experimental results on three different medical datasets demonstrate that compared with the state-of-the-art medical image segmentation models, our proposed LCP-Net can achieve better segmentation performance.
•A novel feature extraction module called LCP is proposed, which is consists of PDC and LCE.•LCP-Net that combines LCP and U-Net is designed for medical image segmentation.•An improved version of CELoss, based on certainty and deviation distance is proposed.•Experiments demonstrate that our network outperforms state-of-the-art methods.
To explore the effect of emotion management ability on the social anxiety and aggressive behavior among 4 - 6 grade pupils.
The grade four, five and six pupils from Bengbu City were investigated ...using stratified cluster random sampling. The questionnaire contents included general condition, emotion management ability, aggressive behavior and social anxiety, and the relationships of which were analyzed using partial correlation and hierarchical regression method.
The score of aggressive behavior in boys (72. 74 ± 18. 09) was higher than that in girls (66. 31 ± 17. 53) (P < 0. 01), and the aggressive behaviors in grade five students (71. 76 ± 18. 06) were higher than that in grade four (69. 24 ± 18. 95) and six students (68. 40 ± 17. 19) (P <0. 05). When gender and grade variables, the aggressive behaviors were negatively correlated with emotion management ability (r = - 0. 463, P < 0. 01) , and were positively correlated with social anxiety (r = 0. 229, P < 0. 01) , and the emotion management ability was negat
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