Tag: pubmed

Int J Comput Assist Radiol Surg. 2024 May 8. doi: 10.1007/s11548-024-03139-6. Online ahead of print.

ABSTRACT

PURPOSE: This paper considers a new problem setting for multi-organ segmentation based on the following observations. In reality, (1) collecting a large-scale dataset from various institutes is usually impeded due to privacy issues; (2) many images are not labeled since the slice-by-slice annotation is costly; and (3) datasets may exhibit inconsistent, partial annotations across different institutes. Learning a federated model from these distributed, partially labeled, and unlabeled samples is an unexplored problem.

METHODS: To simulate this multi-organ segmentation problem, several distributed clients and a central server are maintained. The central server coordinates with clients to learn a global model using distributed private datasets, which comprise a small part of partially labeled images and a large part of unlabeled images. To address this problem, a practical framework that unifies partially supervised learning (PSL), semi-supervised learning (SSL), and federated learning (FL) paradigms with PSL, SSL, and FL modules is proposed. The PSL module manages to learn from partially labeled samples. The SSL module extracts valuable information from unlabeled data. Besides, the FL module aggregates local information from distributed clients to generate a global statistical model. With the collaboration of three modules, the presented scheme could take advantage of these distributed imperfect datasets to train a generalizable model.

RESULTS: The proposed method was extensively evaluated with multiple abdominal CT datasets, achieving an average result of 84.83% in Dice and 41.62 mm in 95HD for multi-organ (liver, spleen, and stomach) segmentation. Moreover, its efficacy in transfer learning further demonstrated its good generalization ability for downstream segmentation tasks.

CONCLUSION: This study considers a novel problem of multi-organ segmentation, which aims to develop a generalizable model using distributed, partially labeled, and unlabeled CT images. A practical framework is presented, which, through extensive validation, has proved to be an effective solution, demonstrating strong potential in addressing this challenging problem.

PMID:38720159 | DOI:10.1007/s11548-024-03139-6

Environ Monit Assess. 2024 May 9;196(6):525. doi: 10.1007/s10661-024-12649-4.

ABSTRACT

Adıyaman, a city recently affected by an earthquake, is facing significant air pollution challenges due to both anthropogenic activities and natural events. The sources of air pollution have been investigated using meteorological variables. Elevated southerly winds, especially prominent in spring and autumn, significantly contribute to dust transport, leading to a decline in local air quality as detected by the HYSPLIT model. Furthermore, using Suomi-NPP Thermal Anomaly satellite product, it is detected and analyzed for crop burning activities. Agricultural practices, including stubble burning, contribute to the exacerbation of PM₁₀ pollution during the summer months, particularly when coupled with winds from all directions except the north. In fall and winter months, heating is identified as the primary cause of pollution. The city center located north of the station is the dominant source of pollution throughout all seasons. The study established the connection between air pollutants and meteorological variables. Furthermore, the Spearman correlation coefficients reveal associations between PM₁₀ and SO₂, indicating moderate positive correlations under pressure conditions (r = 0.35, 0.52). Conversely, a negative correlation is observed with windspeed (r = -0.35, -0.50), and temperature also exhibits a negative correlation (r = -0.39, -0.54). During atmospheric conditions with high pressure, PM₁₀ and SO₂ concentrations are respectively 41.2% and 117.2% higher. Furthermore, pollutant concentration levels are 29.2% and 53.3% higher on days with low winds. Last, practical strategies for mitigating air pollution have been thoroughly discussed and proposed. It is imperative that decision-makers engaged in city planning and renovation give careful consideration to the profound impact of air pollution on both public health and the environment, particularly in the aftermath of a recent major earthquake.

PMID:38720137 | DOI:10.1007/s10661-024-12649-4

Environ Sci Pollut Res Int. 2024 May 9. doi: 10.1007/s11356-024-33574-6. Online ahead of print.

ABSTRACT

As a powerful engine for economic reform and curbing carbon emissions, digital inclusive finance provides solid support for achieving the goal of digital carbon neutrality. This study reveals the positive effect of digital inclusive finance on carbon emission reduction and the deeper reasons behind it by digging deeper into the panel data of 213 cities in China. The study adopts advanced empirical analysis methods to rigorously test the association between digital inclusive finance and carbon emissions. The results show that there is a strong positive correlation between the booming development of digital inclusive finance and the significant decline in carbon emissions. This finding remains solid after several rounds of robustness tests, which fully proves the reliability of the research results. Further mechanism analysis reveals the multiple paths of digital financial inclusion on carbon emission reduction. First, it promotes the optimization and upgrading of industrial structure by optimizing the allocation of financial resources, thus reducing the proportion of high-carbon emission industries. Second, digital inclusive finance attracts more foreign capital inflows and introduces advanced low-carbon technologies and management experience, further promoting the development of low-carbon economy. In addition, the study also found that the differences between different cities in terms of geographic location and city size have a significant impact on the carbon emission reduction effect of digital inclusive finance. In particular, the carbon emission reduction effect of digital inclusive finance is particularly significant in western regions, central cities, and first-tier cities. In response to these findings, this paper proposes a series of targeted policy recommendations. First, the financial service system should be further optimized to increase the coverage and penetration of digital inclusive finance, especially in less developed regions and small- and medium-sized cities. Second, regional policy synergies should be strengthened to form a strong synergy to promote the development of a low-carbon economy. In addition, it should guide capital flows to low-carbon industries and encourage enterprises to increase green technology research and development and application, while actively promoting low-carbon consumption concepts and guiding consumers to form green consumption habits. Through the implementation of these measures, it is expected that the potential of digital inclusive finance in the development of a low-carbon economy will be further stimulated, making a greater contribution to the realization of the goals of carbon peaking and carbon neutrality.

PMID:38720127 | DOI:10.1007/s11356-024-33574-6

Environ Sci Pollut Res Int. 2024 May 8. doi: 10.1007/s11356-024-33560-y. Online ahead of print.

ABSTRACT

The impact of climate change has malformed the world’s ecosystem, thus making humans call for environmental protection. Climate change, the biggest trauma of the twenty-first century, has made humans switch towards natural consumption. In this regard, the growing phenomenon of industrialization has spurred consumers to invest more in ecological products. Consuming eco-friendly products has several benefits; however, countries are still unable to satisfy the consumer’s concern for the environment. The current study presents literature on environmental concerns, psychological well-being, willingness to pay for pro-environmental products, pro-environmental self-identity, and pro-environmental consumer behavior, which are required to ensure the consumer’s organic behavior. The research used a questionnaire-driven methodology to gather data from 379 participants. Data analysis was conducted using statistical software packages, specifically SPSS (Version: 4.1.0.0). The suitability of the measurement model was evaluated through structural equation modeling (SEM), which was performed utilizing the SmartPLS. According to the research findings, there is a positive relationship between variables in the study, and individuals with greater levels of psychological well-being are more likely to engage in behaviors that promote sustainable consumption. In order to foster more sustainable consumption patterns in society, policymakers, marketers, and educators may find these findings to be valuable insights. As a result of its empirical exploration of these relationships, the study contributes to the growing body of literature on environmental psychology and sustainable marketing, emphasizing the important role psychological factors play in promoting a greener environment.

PMID:38720125 | DOI:10.1007/s11356-024-33560-y

Aesthetic Plast Surg. 2024 May 8. doi: 10.1007/s00266-024-04048-4. Online ahead of print.

ABSTRACT

BACKGROUND: Macromastia is a physically and psychologically distressing condition for adolescents. While reduction mammaplasty is often the best treatment, risk factors for adolescent wound complications remain unclear. This study aims to investigate the impact of obesity and other predictors of postoperative wound complications following adolescent reduction mammaplasty using a national database.

METHODS: The 2012-2019 National Surgical Quality Improvement Program Pediatric (NSQIP-P) databases were reviewed to identify primary reduction mammaplasty encounters. World Health Organization Body Mass Index (BMI), alongside patient and case characteristics, were assessed for association for 30-day wound disruption or surgical site complications. Statistical analyses were performed to identify independent predictors for complications and determine a potential BMI cutoff for risk stratification.

RESULTS: There were 1215 patients with an average age of 16.6 years. The average BMI was 30.7 kg/m², and 593 (48.8%) patients were nonobese while 622 (51.2%) were obese. The incidence of complications was 5.27%. Independent predictors of complications included a BMI 35-39.9, BMI > 40, and an American Society of Anesthesiologists (ASA) Classification > 3. A receiver operating characteristic curve determined that a BMI of 34.6 can be a potential cutoff for increased complication risk.

CONCLUSIONS: Higher obesity increases risk of wound complications; however, complication rates remain low. A BMI of 34.6 is a potential screening metric for counseling and monitoring patients. Reduction mammaplasty should remain a viable option as it can significantly improve quality of life.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:38720101 | DOI:10.1007/s00266-024-04048-4

Neuroradiology. 2024 May 8. doi: 10.1007/s00234-024-03373-4. Online ahead of print.

ABSTRACT

PURPOSE: To describe fetal brain Magnetic Resonance Imaging (MRI) findings in a large series of monochorionic (MC) pregnancies complicated by Twin Anemia-Polycythemia Sequence (TAPS) prenatally diagnosed, so to characterize the potential intracranial complications associated with this condition, their frequency and potential treatment options.

METHODS: This is a retrospective study of MC twin pregnancies complicated by TAPS and undergone fetal MRI in a single institution from 2006 to 2023. MRI control was performed and post-natal ultrasound (US) or MRI were available.

RESULTS: 1250 MC pregnancies were evaluated in our institution. 50 pregnancies (4%) were diagnosed with TAPS, 29 underwent a fetal brain MRI. 13/29 pregnancies (44.8%) demonstrated brain findings at MRI in at least a twin. Neuroradiological findings were detected in 14/57 twins (24.6%). We detected four main categories of findings: hemorrhagic lesions, T2-weighted white-matter hyperintensities (WMH), brain edema-swelling and venous congestion. Nineteen findings were present in the anemic and three in the polycythemic twins, with a statistically significant ratio between the two groups (p-value = 0.01). Intrauterine MRI follow-up demonstrated the sequalae of hemorrhagic lesions. A complete regression of brain swelling, veins prominence and T2-WMHs was demonstrated after treatment. Postnatal imaging confirmed prenatal features.

CONCLUSIONS: Our work demonstrates that TAPS-related MRI anomalies consisted in edematous/hemorrhagic lesions that occur mostly in anemic rather than in polycythemic twins. Fetoscopic laser surgery could have a potential decongestant role. Therefore, prenatal MRI may help in counselling and management in TAPS pregnancies, especially for the planning of therapy and the monitoring of its efficacy.

PMID:38720066 | DOI:10.1007/s00234-024-03373-4

Nat Methods. 2024 May 8. doi: 10.1038/s41592-024-02268-9. Online ahead of print.

ABSTRACT

The spatial distribution of cell surface proteins governs vital processes of the immune system such as intercellular communication and mobility. However, fluorescence microscopy has limited scalability in the multiplexing and throughput needed to drive spatial proteomics discoveries at subcellular level. We present Molecular Pixelation (MPX), an optics-free, DNA sequence-based method for spatial proteomics of single cells using antibody-oligonucleotide conjugates (AOCs) and DNA-based, nanometer-sized molecular pixels. The relative locations of AOCs are inferred by sequentially associating them into local neighborhoods using the sequence-unique DNA pixels, forming >1,000 spatially connected zones per cell in 3D. For each single cell, DNA-sequencing reads are computationally arranged into spatial proteomics networks for 76 proteins. By studying immune cell dynamics using spatial statistics on graph representations of the data, we identify known and new patterns of spatial organization of proteins on chemokine-stimulated T cells, highlighting the potential of MPX in defining cell states by the spatial arrangement of proteins.

PMID:38720062 | DOI:10.1038/s41592-024-02268-9

Ann Nucl Med. 2024 May 8. doi: 10.1007/s12149-024-01932-6. Online ahead of print.

ABSTRACT

OBJECTIVE: ¹¹C-Methionine positron emission tomography (MET-PET) is used for stereotactic radiotherapy planning in meningioma patients. The role of MET-PET during subsequent follow-up (FU) is unclear. We analyzed the uptake of ¹¹C-Methionine before and after stereotactic radiotherapy (SRT) in patients with a complex meningioma and investigated if there was a difference between patients with progressive disease (PD) and stable disease (SD) during FU.

METHODS: This retrospective study investigates 62 MET-PETs in 29 complex meningioma patients. Standardized uptake value (SUV)_max and SUV_peak tumor-to-normal ratios (T/N-ratios) were calculated, comparing the tumor region with both the mirroring intracranial area and the right frontal gray matter. The difference in ¹¹C-Methionine uptake pre- and post-SRT was analyzed, as well as the change in uptake between PD or SD.

RESULTS: Median (IQR) FU duration was 67 months (50.5-91.0). The uptake of ¹¹C-Methionine in meningiomas remained increased after SRT. Neither a statistically significant difference between MET-PETs before and after SRT was encountered, nor a significant difference in one of the four T/N-ratios between patients with SD versus PD with median (IQR) SUV_max T/N_{R front} 2.65 (2.13-3.68) vs 2.97 (1.55-3.54) [p = 0.66]; SUV_max T/N_mirror 2.92 (2.19-3.71) vs 2.95 (1.74-3.60) [p = 0.61]; SUV_peak T/N_{R front} 2.35 (1.64-3.40) vs 2.25 (1.44-3.74) [p = 0.80]; SUV_peak T/N_mirror 2.38 (1.91-3.36) vs 2.35 (1.56-3.72) [p = 0.95].

CONCLUSIONS: Our data do not support use of MET-PET during FU of complex intracranial meningiomas after SRT. MET-PET could not differentiate between progressive or stable disease.

PMID:38720053 | DOI:10.1007/s12149-024-01932-6

Intern Emerg Med. 2024 May 8. doi: 10.1007/s11739-024-03633-4. Online ahead of print.

ABSTRACT

Perfusion index (PI) is a promising indicator for monitoring peripheral perfusion. The present study aimed to compare the efficiency of PI and PESI score in estimating the 30-day mortality and treatment needs of patients diagnosed with pulmonary embolism in the emergency department. This study was prospective and observational. The demographic features of the patients, comorbidities, vital signs, PESI score, PI, treatment applied to the patient and airway management, right ventricular diameter/left ventricular diameter ratio, length of hospital stay, outcome, and 30-day mortality were recorded. A total of 94 patients were included. All patients’ vital signs and PI values were recorded on admission. The mean pulse rate (p = 0.001) and shock index (p = 0.017) values of deceased patients were statistically significantly higher, while the mean PI (p = 0.034) was statistically significantly lower. PESI score and PI were statistically significant to predict the need for mechanical ventilation (PI, p = 0.004; PESI score, p < 0.001), inotropic treatment (PI, p = 0.047; PESI score p = 0.005), and thrombolytic therapy (PI, p = 0.035; PESI score p = 0.003). According to the ROC curve, the mortality prediction power of both PESI (AUC: 0.787, 95% CI 0.688-0.886, cutoff: 109.5, p < 0.001) and PI index (AUC: 0.668, 95% CI 0.543-0.793, cutoff: 1, p = 0.011) were determined as statistically significant. PI might be helpful in clinical practice as a tool that can be applied to predict mortality and treatment needs in PE.

PMID:38720051 | DOI:10.1007/s11739-024-03633-4

Evid Based Dent. 2024 May 8. doi: 10.1038/s41432-024-01011-9. Online ahead of print.

ABSTRACT

STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVE: To assess the impact of antibiotic prophylaxis on postoperative recovery and implant short-term survival in clinically healthy patients who underwent placement of 2-4 dental implants by inexperienced operators.

METHODS: The study adhered to the ethical guidelines of the Helsinki declaration, and followed the CONSORT protocol for randomized controlled trials (RCTs). Signed consent forms were provided by all patients. Included were healthy individuals aged over 18 years, with sufficient and fully healed alveolar ridge (undergone extraction at least 3 months prior), requiring placement of 2-4 dental implants, and were classified as ASA I or II. Exclusion criteria were: systemic diseases, hypersensitivity to penicillin, pregnancy or lactation, smoking, recent antibiotic usage, and history of periodontitis. Patients were randomly allocated into 2 groups: the antibiotic group received 1 g of amoxicillin one hour before surgery, while the placebo group was given starch-filled capsules that looked identical to the antibiotic. All implants were installed through 2-stage procedures by students of a specialization course in implant surgery, employing a standardized procedure and armamentarium. Each patient was evaluated preoperatively, and at 2 days and 7 days postoperatively, for the following parameters: mouth opening, experienced pain (using a visual analog scale), and signs of infection (fistula, wound ulceration, tissue necrosis, flap dehiscence, and purulent exudates). Implant survival was monitored for up to 90 days after implant surgery.

RESULTS: A total of 90 patients (224 implants) were included: 43 patients (108 implants) in the antibiotic group, and 47 patients (116 implants) in the placebo group. Overall, there were 58 women and 32 men, aged from 23 to 70 years old. In terms of mouth opening, pain, and infection parameters, no statistically significant differences were observed between the groups at any of the time points evaluated. Similarly, there was no statistically significant difference regarding antibiotic usage and implant loss at the patient level (p = 0.06). However, at the implant level, significantly higher implant loss rate was noted in the placebo group (14.9%) compared to the antibiotic group (2.3%) [p < 0.05].

CONCLUSION: Prophylactic antibiotic administration effectively reduced the occurrence of implant loss after implant surgery performed by inexperienced practitioners.

PMID:38720022 | DOI:10.1038/s41432-024-01011-9