The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency. Early identification of patients at risk of progression may facilitate more individually ...aligned treatment plans and optimized utilization of medical resource. Here we conducted a multicenter retrospective study involving patients with moderate COVID-19 pneumonia to investigate the utility of chest computed tomography (CT) and clinical characteristics to risk-stratify the patients. Our results show that CT severity score is associated with inflammatory levels and that older age, higher neutrophil-to-lymphocyte ratio (NLR), and CT severity score on admission are independent risk factors for short-term progression. The nomogram based on these risk factors shows good calibration and discrimination in the derivation and validation cohorts. These findings have implications for predicting the progression risk of COVID-19 pneumonia patients at the time of admission. CT examination may help risk-stratification and guide the timing of admission.
Objective
To evaluate the diagnostic performance of machine-learning based quantitative texture analysis of CT images to differentiate small (≤ 4 cm) angiomyolipoma without visible fat (AMLwvf) from ...renal cell carcinoma (RCC).
Methods
This single-institutional retrospective study included 58 patients with pathologically proven small renal mass (17 in AMLwvf and 41 in RCC groups). Texture features were extracted from the largest possible tumorous regions of interest (ROIs) by manual segmentation in preoperative three-phase CT images. Interobserver reliability and the Mann-Whitney U test were applied to select features preliminarily. Then support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were adopted to establish discriminative classifiers, and the performance of classifiers was assessed.
Results
Of the 42 extracted features, 16 candidate features showed significant intergroup differences (
P
< 0.05) and had good interobserver agreement. An optimal feature subset including 11 features was further selected by the SVM-RFE method. The SVM-RFE+SMOTE classifier achieved the best performance in discriminating between small AMLwvf and RCC, with the highest accuracy, sensitivity, specificity and AUC of 93.9 %, 87.8 %, 100 % and 0.955, respectively.
Conclusion
Machine learning analysis of CT texture features can facilitate the accurate differentiation of small AMLwvf from RCC.
Key Points
•
Although conventional CT is useful for diagnosis of SRMs, it has limitations.
•
Machine-learning based CT texture analysis facilitate differentiation of small AMLwvf from RCC.
•
The highest accuracy of SVM-RFE+SMOTE classifier reached 93.9 %.
•
Texture analysis combined with machine-learning methods might spare unnecessary surgery for AMLwvf
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Top management team (TMT) knowledge hiding, which is not only related to the normal operation of the team but also closely related to enterprise innovation performance, has been paid little attention ...to in the previous studies. Based on the theories of upper echelons, knowledge management, and innovation, this study proposed a moderated mediation model to research how TMT knowledge hiding affected enterprise innovation performance. In this model, TMT knowledge hiding was the independent variable, TMT creativity was the mediating variable, enterprise innovation performance was the dependent variable, and team competitive climate was the moderating variable. MPLUS7.0 was used for the CFAs to evaluate the discriminate validities of the key variables, and SPSS 22.0 was used to calculate the descriptive statistics, analyze the correlations between variables, make the multiple regression analysis, and process the data obtained from 612 executives in 53 TMTs. The results showed that TMT knowledge hiding had a significant negative impact on enterprise innovation performance; TMT creativity had a partial mediating effect between TMT knowledge hiding and enterprise innovation performance, and team competitive climate had a moderating effect on the relationship between TMT knowledge hiding and TMT creativity. These research results fill up the gap of the theoretical research in TMT knowledge hiding and provide scientific guidance to reasonably reduce or eliminate the phenomenon of TMT knowledge hiding and improve enterprise innovation performance.
Whether chief executive officer (CEO) turnover can improve top management team (TMT) creativity is an important issue that remains to be solved. Based on the theoretical background of CEO turnover, ...team creativity, and cross-cultural context, this study proposes a theoretical model to answer the question and introduces leadership identity as a moderator simultaneously. The multiple regression analysis of data obtained from 903 executives in 104 top management teams revealed CEO voluntary resignation/internal succession pattern, CEO voluntary resignation/external succession pattern, and CEO forced resignation/internal succession pattern separately had a significant positive impact on TMT creativity in a cross-cultural context; leadership identity partially moderated the relationship between CEO turnover and TMT creativity. According to these findings, only three patterns of CEO turnover could promote TMT creativity, and leadership identity enhanced the positive effects of CEO voluntary resignation/internal succession pattern, CEO voluntary resignation/external succession pattern, and CEO forced resignation/internal succession pattern on TMT creativity in a cross-cultural context. These made up for the lack of theoretical research on the relationships among CEO turnover, TMT creativity and leadership identity, which could provide the scientific guidance to conduct the CEO turnover practice and improve TMT creativity in a cross-cultural context.
Cancer precision medicine (CPM) could tailor the best treatment for individual cancer patients, while imaging techniques play important roles in its application. With the characteristics of ...noninvasion, nonionized, radiation-free, multidimensional imaging function, and real-time monitoring, magnetic resonance imaging (MRI) is an effective way for early tumor detection, and it has become a tower of strength in CPM imaging techniques. Due to linkage with nephrogenic systemic fibrosis (NSF), gadolinium (Gd)-based contrast agent (CA), which was long used in MRI, has been restricted by the Food and Drug Administration (FDA). In this review, we would like to introduce the manganese (Mn)-based CAs that could significantly increase the safety of MRI CAs by realizing more superior performance and functions simultaneously in the diagnosis and treatment of tumors. Also, recent advances in Mn-based hybrid nanomaterials for CPM are summarized and discussed.
Multimodal imaging‐guided photothermal therapy (PTT), for the therapy of cancer, based on a ferritin (FRT) nanocage loaded with the near‐infrared dye IR820 (designated DFRT) is demonstrated. The dual ...roles of DFRT (in imaging and PTT) are successfully balanced by using two different excitation wavelengths: 550 nm for high quantum‐yield fluorescence imaging on the one hand and 808 nm for photoacoustic imaging and PTT with high photothermal conversion efficiency on the other.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in December 2019 with staggering economic fallout and human suffering. The unique ...structure of SARS-CoV-2 and its underlying pathogenic mechanism were responsible for the global pandemic. In addition to the direct damage caused by the virus, SARS-CoV-2 triggers an abnormal immune response leading to a cytokine storm, culminating in acute respiratory distress syndrome and other fatal diseases that pose a significant challenge to clinicians. Therefore, potential treatments should focus not only on eliminating the virus but also on alleviating or controlling acute immune/inflammatory responses. Current management strategies for COVID-19 include preventative measures and supportive care, while the role of the host immune/inflammatory response in disease progression has largely been overlooked. Understanding the interaction between SARS-CoV-2 and its receptors, as well as the underlying pathogenesis, has proven to be helpful for disease prevention, early recognition of disease progression, vaccine development, and interventions aimed at reducing immunopathology have been shown to reduce adverse clinical outcomes and improve prognosis. Moreover, several key mutations in the SARS-CoV-2 genome sequence result in an enhanced binding affinity to the host cell receptor, or produce immune escape, leading to either increased virus transmissibility or virulence of variants that carry these mutations. This review characterizes the structural features of SARS-CoV-2, its variants, and their interaction with the immune system, emphasizing the role of dysfunctional immune responses and cytokine storm in disease progression. Additionally, potential therapeutic options are reviewed, providing critical insights into disease management, exploring effective approaches to deal with the public health crises caused by SARS-CoV-2.
The complex tumor microenvironment (TME) plays a vital role in cancer development and dramatically determines the efficacy of immunotherapy. Tertiary lymphoid structures (TLSs) within the TME are ...well recognized and consist of T cell-rich areas containing dendritic cells (DCs) and B cell-rich areas containing germinal centers (GCs). Accumulating research has indicated that there is a close association between tumor-associated TLSs and favorable clinical outcomes in most types of cancers, though a minority of studies have reported an association between TLSs and a poor prognosis. Overall, the double-edged sword role of TLSs in the TME and potential mechanisms need to be further investigated, which will provide novel therapeutic perspectives for antitumor immunoregulation. In this review, we focus on discussing the main functions of TLSs in the TME and recent advances in the therapeutic manipulation of TLSs through multiple strategies to enhance local antitumor immunity.
As a DNA receptor, cyclic GMP-AMP synthase (cGAS) plays a crucial role in the immune system by recognizing abnormal DNA in the cytoplasm and activating the stimulator of interferon genes (STING) ...signaling pathway. This signaling cascade reaction leads to an immune response produced by type I interferon and other immune mediators. Recent advances in research have enhanced our current understanding of the potential role of the cGAS/STING pathway in anticancer therapy; however, in some cases, chronic STING activation may promote tumorigenesis. The present review article discusses the biological mechanisms of the cGAS/STING pathway, its dichotomous role in tumors, and the latest advances with respect to STING agonists and antagonists.
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