Occult peritoneal metastasis (PM) in advanced gastric cancer (AGC) patients is highly possible to be missed on computed tomography (CT) images. Patients with occult PMs are subject to late detection ...or even improper surgical treatment. We therefore aimed to develop a radiomic nomogram to preoperatively identify occult PMs in AGC patients.
A total of 554 AGC patients from 4 centers were divided into 1 training, 1 internal validation, and 2 external validation cohorts. All patients’ PM status was firstly diagnosed as negative by CT, but later confirmed by laparoscopy (PM-positive n = 122, PM-negative n = 432). Radiomic signatures reflecting phenotypes of the primary tumor (RS1) and peritoneum region (RS2) were built as predictors of PM from 266 quantitative image features. Individualized nomograms of PM status incorporating RS1, RS2, or clinical factors were developed and evaluated regarding prediction ability.
RS1, RS2, and Lauren type were significant predictors of occult PM (all P < 0.05). A nomogram of these three factors demonstrated better diagnostic accuracy than the model with RS1, RS2, or clinical factors alone (all net reclassification improvement P < 0.05). The area under curve yielded was 0.958 95% confidence interval (CI) 0.923–0.993, 0.941 (95% CI 0.904–0.977), 0.928 (95% CI 0.886–0.971), and 0.920 (95% CI 0.862–0.978) for the training, internal, and two external validation cohorts, respectively. Stratification analysis showed that this nomogram had potential generalization ability.
CT phenotypes of both primary tumor and nearby peritoneum are significantly associated with occult PM status. A nomogram of these CT phenotypes and Lauren type has an excellent prediction ability of occult PM, and may have significant clinical implications on early detection of occult PM for AGC.
Preoperative evaluation of the number of lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC). However, the routinely used preoperative ...determination method is not accurate enough.
We enrolled 730 LAGC patients from five centers in China and one center in Italy, and divided them into one primary cohort, three external validation cohorts, and one international validation cohort. A deep learning radiomic nomogram (DLRN) was built based on the images from multiphase computed tomography (CT) for preoperatively determining the number of LNM in LAGC. We comprehensively tested the DLRN and compared it with three state-of-the-art methods. Moreover, we investigated the value of the DLRN in survival analysis.
The DLRN showed good discrimination of the number of LNM on all cohorts overall C-indexes (95% confidence interval): 0.821 (0.785–0.858) in the primary cohort, 0.797 (0.771–0.823) in the external validation cohorts, and 0.822 (0.756–0.887) in the international validation cohort. The nomogram performed significantly better than the routinely used clinical N stages, tumor size, and clinical model (P < 0.05). Besides, DLRN was significantly associated with the overall survival of LAGC patients (n = 271).
A deep learning-based radiomic nomogram had good predictive value for LNM in LAGC. In staging-oriented treatment of gastric cancer, this preoperative nomogram could provide baseline information for individual treatment of LAGC.
•Evaluation of the lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC).•Deep leaning radiomic nomogram (DLRN) based on CT images can preoperatively determine the number of LNM in LAGC.•DLRN is significantly superior to the routinely used clinical N stages, tumor size, and clinical model.•DLRN is significantly associated with the overall survival of LAGC.
The past decade transformed our observational understanding of energetic particle processes in near‐Earth space. An unprecedented suite of observational systems was in operation including the Van ...Allen Probes, Arase, Magnetospheric Multiscale, Time History of Events and Macroscale Interactions during Substorms, Cluster, GPS, GOES, and Los Alamos National Laboratory‐GEO magnetospheric missions. They were supported by conjugate low‐altitude measurements on spacecraft, balloons, and ground‐based arrays. Together, these significantly improved our ability to determine and quantify the mechanisms that control the buildup and subsequent variability of energetic particle intensities in the inner magnetosphere. The high‐quality data from National Aeronautics and Space Administration's Van Allen Probes are the most comprehensive in situ measurements ever taken in the near‐Earth space radiation environment. These observations, coupled with recent advances in radiation belt theory and modeling, including dramatic increases in computational power, have ushered in a new era, perhaps a “golden era,” in radiation belt research. We have edited a Journal of Geophysical Research: Space Science Special Collection dedicated to Particle Dynamics in the Earth's Radiation Belts in which we gather the most recent scientific findings and understanding of this important region of geospace. This collection includes the results presented at the American Geophysical Union Chapman International Conference in Cascais, Portugal (March 2018) and many other recent and relevant contributions. The present article introduces and review the context, current research, and main questions that motivate modern radiation belt research divided into the following topics: (1) particle acceleration and transport, (2) particle loss, (3) the role of nonlinear processes, (4) new radiation belt modeling capabilities and the quantification of model uncertainties, and (5) laboratory plasma experiments.
Key Points
We review and discuss current research and open questions relative to Earth's radiation belts
Aspects of modern radiation belt research concern particle acceleration and transport, particle loss, and the role of nonlinear processes
We also discuss new radiation belt modeling capabilities, the quantification of model uncertainties, and laboratory plasma experiments
We take advantage of climate simulations from two multimodel experiments to characterize and evaluate the cloud phase partitioning in 16 general circulation models (GCMs), specifically the vertical ...structure of the transition between liquid and ice in clouds. We base our analysis on the ratio of ice condensates to the total condensates (phase ratio, PR). Its transition at 90% (PR90) and its links with other relevant variables are evaluated using the GCM‐Oriented Cloud‐Aerosol Lidar and Infrared Pathfinder Satellite Observation Cloud Product climatology, reanalysis data, and other satellite observations. In 13 of 16 models, the PR90 transition height occurs too low (6 km to 8.4 km) and at temperatures too warm (−13.9°C to −32.5°C) compared to observations (8.6 km, −33.7°C); features consistent with a lack of supercooled liquid with respect to ice above 6.5 km. However, this bias would be slightly reduced by using the lidar simulator. In convective regimes (more humid air and precipitation), the observed cloud phase transition occurs at a warmer temperature than for subsidence regimes (less humid air and precipitation). Only few models manage to roughly replicate the observed correlations with humidity (5/16), vertical velocity (5/16), and precipitation (4/16); 3/16 perform well for all these parameters (MPI‐ESM, NCAR‐CAM5, and NCHU). Using an observation‐based Clausius‐Clapeyron phase diagram, we illustrate that the Bergeron‐Findeisen process is a necessary condition for models to represent the observed features. Finally, the best models are those that include more complex microphysics.
Key Points
Cloud phase intermodel differences are very large
Prognostic cloud phase scheme is necessary to reproduce realistic cloud phase
These results could lead to an improvement of the next generation of GCMs
Background
The Child–Pugh (CP) score is used widely to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the albumin–bilirubin (ALBI) ...score has been validated as a predictor of overall survival in these patients. This study aimed to compare the ability of the ALBI and CP scores to predict outcomes in patients with HCC after liver resection with curative intent.
Methods
Consecutive patients who underwent liver resection with curative intent for HCC between January 2007 and July 2013 were included in this retrospective study. The performance of the ALBI score in predicting postoperative liver failure (PHLF) and long‐term survival was compared with that of the CP score.
Results
A total of 1242 patients were enrolled. Of these, 166 (13·4 per cent) experienced PHLF. The area under the receiver operating characteristic (ROC) curve of the ALBI score for predicting PHLF was greater than that of the CP score (0·723 versus 0·607; P < 0·001). Similar to findings for CP grade, the incidence and severity of PHLF increased with increasing ALBI grade. The ALBI grade stratified patients into at least two distinct overall survival cohorts (P < 0·001), whereas the CP grade did not. The ALBI grade also classified patients with CP grade A disease into two distinct overall survival cohorts (P < 0·001), and overall survival rates in the group with poorer survival were similar to those in the majority of patients with CP grade B disease. Both CP and ALBI scores had low power in predicting disease‐free survival.
Conclusion
The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade.
ALBI score may be better
Blue LUminous Events (BLUEs) are transient corona discharges occurring in thunderclouds and characterized by strong 337.0 nm light flashes with absent (or weak) 777.4 nm component. We present the ...first nighttime climatology of BLUEs as detected by the Modular Multispectral Imaging Array of the Atmosphere‐Space Interaction Monitor showing their worldwide geographical and seasonal distribution. A total (land and ocean) of ∼11 BLUEs occur around the globe every second at local midnight and the average BLUE land/sea ratio is ∼7:4. The northwest region of Colombia shows an annual nighttime peak. Globally, BLUEs are maximized during the boreal summer‐autumn, contrary to lightning which is maximed in the boreal summer. The geographical distribution of nighttime BLUEs shows three main regions in, by order of importance, the Americas, Europe/Africa and Asia/Australia.
Plain Language Summary
Blue LUminous Events (BLUEs) are transient corona discharges occurring in thunderclouds and characterized by their distinct 337.0 nm light flashes with absent (or negligible) 777.4 nm component. We present the first two year nighttime climatology of BLUEs as detected by the Modular Multispectral Imaging Array of the Atmosphere‐Space Interaction Monitor on board the International Space Station that shows distinct worldwide geographical and seasonal distributions.
Key Points
The first nighttime two‐year climatology of streamer corona discharges (blue luminous events) in thunderclouds is presented
Globally, the rate of blue luminous events at local midnight is ∼11 per second
Zonal and meridional distributions of blue luminous events peak in the northern tropic and the Americas, respectively
Human and animal studies have converged to suggest that caffeine consumption prevents memory deficits in aging and Alzheimer's disease through the antagonism of adenosine A2A receptors (A2ARs). To ...test if A2AR activation in the hippocampus is actually sufficient to impair memory function and to begin elucidating the intracellular pathways operated by A2AR, we have developed a chimeric rhodopsin-A2AR protein (optoA2AR), which retains the extracellular and transmembrane domains of rhodopsin (conferring light responsiveness and eliminating adenosine-binding pockets) fused to the intracellular loop of A2AR to confer specific A2AR signaling. The specificity of the optoA2AR signaling was confirmed by light-induced selective enhancement of cAMP and phospho-mitogen-activated protein kinase (p-MAPK) (but not cGMP) levels in human embryonic kidney 293 (HEK293) cells, which was abolished by a point mutation at the C terminal of A2AR. Supporting its physiological relevance, optoA2AR activation and the A2AR agonist CGS21680 produced similar activation of cAMP and p-MAPK signaling in HEK293 cells, of p-MAPK in the nucleus accumbens and of c-Fos/phosphorylated-CREB (p-CREB) in the hippocampus, and similarly enhanced long-term potentiation in the hippocampus. Remarkably, optoA2AR activation triggered a preferential p-CREB signaling in the hippocampus and impaired spatial memory performance, while optoA2AR activation in the nucleus accumbens triggered MAPK signaling and modulated locomotor activity. This shows that the recruitment of intracellular A2AR signaling in the hippocampus is sufficient to trigger memory dysfunction. Furthermore, the demonstration that the biased A2AR signaling and functions depend on intracellular A2AR loops prompts the possibility of targeting the intracellular A2AR-interacting partners to selectively control different neuropsychiatric behaviors.
We present X-ray timing results of the new black hole candidate MAXI J1535−571 during its 2017 outburst from Hard X-ray Modulation Telescope (Insight-HXMT) observations taken from 2017 September 6 to ...23. Following the definitions given by Belloni, we find that the source exhibits transitions from the low/hard state to the hard intermediate state, and eventually to the soft intermediate state. Quasi-periodic oscillations (QPOs) are found in the intermediate states, which suggest different types of QPOs. With the large effective area of Insight-HXMT at high energies, we are able to present the energy dependence of the QPO amplitude and centroid frequency up to 100 keV, which has rarely been explored by previous satellites. We also find that the phase lag at the type-C QPOs centroid frequency is negative (soft lag) and strongly correlated with the centroid frequency. Assuming a geometrical origin of type-C QPOs, the source is consistent with being a high-inclination system.
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