Long-term safety and efficacy of antithymocyte globulin induction: Use of integrated national registry data to achieve ten-year follow-up of 10-10 Study participants

BACKGROUND: Rabbit antithymocyte globulin (rATG, Thymoglobulin®) is the most common induction immunosuppression therapy in kidney transplantation. We applied a database integration strategy to capture and compare long-term (10-year) outcome data for US participants in a clinical trial of rATG versus FDA-approved basiliximab. METHODS: Records for US participants in an international, 1-year, randomized clinical trial comparing rATG and basiliximab induction in deceased donor kidney transplantation were integrated with records from the US national Organ Procurement and Transplantation (OPTN) registry using center, transplant dates, recipient sex, and birthdates. The OPTN captures center-reported acute rejection, graft failure, death, and cancer events, and incorporates comprehensive death records from the Social Security Death Master File. Ten-year outcomes according to randomized induction regimen were compared by Kaplan–Meier analysis (two-sided P). Non-inferiority of rATG was assessed using a one-tailed equivalence test (a-priori equivalence margins of 0–10 %). RESULTS: Of 183 US trial participants, 89 % (n = 163) matched OPTN records exactly; the remainder were matched by extending agreement windows for transplant and birthdates. Matches were validated by donor and recipient blood types. By Kaplan–Meier analysis, 10 years post-transplant, freedom from acute rejection, graft failure, or death was 32.6 % and 24.0 % in the rATG and basiliximab arms, respectively (P = 0.09). The incidence of acute rejection with rATG versus basiliximab induction was 21.0 % versus 32.8 % (P = 0.07). Patient survival (52.5 % versus 52.2 %, P = 0.92) and graft survival (34.3 % versus 30.9 %, P = 0.56) rates were numerically and statistically similar for both arms. Comparison of the composite outcome meets non-inferiority criteria even with a 0 % equivalence margin (one-sided P = 0.04). With a 10 % equivalence margin, the odds that rATG is no worse than basiliximab for 10-year risk of the composite endpoint are >99 %. CONCLUSIONS: Ten years post-transplant, rATG induction has comparable efficacy and safety to FDA-approved basiliximab. Integration of clinical trial records with national registry data can enable long-term monitoring of trial participants in transplantation, circumventing logistical and cost barriers of extended follow-up. TRIAL REGISTRATION: ClinicalTrials.gov NCT00235300 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13063-015-0891-y) contains supplementary material, which is available to authorized users

Mental health resources and awareness of anxiety and depressive disorders in general hospitals in China

Background: Mental health disorders are common in China. There is a lack of knowledge and resources of mental health in China. Objectives: To assess the levels of psychiatric resources and services in general hospitals in China. Methods: Data regarding psychiatric departments, wards and staff were collected from 57 general hospitals in four provinces of China (Hubei, Zhejiang, Heilongjiang and Yunnan) between April 2014 and June 2014. Questionnaires were distributed to 1,200 non-psychiatric clinicians. Results: Among the 57 hospitals, 50 provided mental health services, 36 had mental health wards, and seven had neither mental health clinics nor wards. The median number of mental health clinicians was six per hospital. The median number of specialized nurses was 42 per hospital. A total of 1,152 non-psychiatric clinicians with a career duration of 9.4 ± 8.9 years returned completed questionnaires. Only 6.9% reported a good understanding of the manifestation of anxiety and depressive disorders, 4.5% reported a good understanding of the diagnostic criteria, and 3.8% reported a good understanding of the treatment protocols. Discussion: There is inadequate awareness of anxiety and depressive disorders among non-psychiatric clinicians in general hospitals in China. This awareness/understanding increased with increasing hospital level

Measurement of SiPM gain and photon detection efficiency at different temperatures and bias voltages

Gain and photon detection efficiency (PDE) of silicon photomultipliers (SiPMs) are important characteristics to understand SiPM-based detector systems in low light level applications. In this work, experimental setups are developed to quantify SiPM gain and PDE at different temperatures and bias voltages with a light source of fixed wavelength 405 nm, where a novel light-tight connected device of two integrating spheres is implemented to produce weak light onto SiPM. We present methods and results of the breakdown voltage, gain and PDE measurements for a Hamamatsu S13360-2050VE MPPC. At 25 Celsius, consistent results are obtained with the datasheet from the manufacturer. The temperature and bias voltage dependence of SiPM performances can guide its usage, such as in gain compensation at readout circuits, optical modeling of SiPMs and optimization of operating conditions of SiPM-based detectors.Comment: 9 pages, 14 figure

A retrospective research on non-suicidal self-injurious behaviors among young patients diagnosed with mood disorders

BackgroundNon-suicidal self-injury (NSSI) is an emerging public concern in both clinical and non-clinical settings, especially in the background of the coronavirus disease 2019 (COVID-19) pandemic. Nevertheless, knowledge of NSSI on a certain disease entity in the later stage of the pandemic was scarce.ObjectiveThis study was conducted for the purpose of exploring the current occurrence and characteristics of NSSI in patients diagnosed with mood disorders (MDs) as well as its correlated factors in the later stage of the pandemic.MethodsThree hundred and forty-nine eligible subjects (M ± SD, 21.54 ± 7.62) admitted to a mental health center in Wuhan from 11 November 2021 to 31 January 2022 were included in our study. An umbrella questionnaire comprised of demographics, COVID-19-related factors, Yale-Brown Obsessive and Compulsive Scale (Y-BOCS), Pittsburgh Sleep Quality Index-Revised (PSQI-R), Mobile Phone Addiction Index (MPAI), and Ottawa Self-injury Inventory (OSI) was extended to each subject via shared QR code.ResultsOf 349 patients with MDs included, 151 (43.27%) reported NSSI in the recent 1 month, among whom hand, lower arm/wrist, and scalp were the most hurt body parts, and cutting, hitting, and headbanging were the most adopted methods. “Own idea” was the most common origin of NSSI. In the logistic regression model, age bracket, family monthly income, occupation, level of obsessive-compulsive disorder (OCD) symptoms, sleep duration, withdrawal reaction to the mobile phone, and habits of using a mobile phone were independently associated with NSSI.ConclusionIt was revealed by our study that NSSI was quite prevalent among patients with MDs, especially among those students, adolescents, comorbid with OCD symptoms, inadequate sleeping hours, and suffering from withdrawal reaction to mobile phones. Further research on NSSI in various psychiatric disorders and even in non-clinical settings such as the community population was in urgent need since NSSI in China was not rare

In-N-Out Generative Learning for Dense Unsupervised Video Segmentation

In this paper, we focus on the unsupervised learning for Video Object Segmentation (VOS) which learns visual correspondence (i.e., similarity between pixel-level features) from unlabeled videos. Previous methods are mainly based on the contrastive learning paradigm, which optimize either in image level or pixel level. Image-level optimization (e.g., the spatially pooled feature of ResNet) learns robust high-level semantics but is sub-optimal since the pixel-level features are optimized implicitly. By contrast, pixel-level optimization is more explicit, however, it is sensitive to the visual quality of training data and is not robust to object deformation. To complementarily perform these two levels of optimization in a unified framework, we propose the In-aNd-Out (INO) generative learning from a purely generative perspective with the help of naturally designed class tokens and patch tokens in Vision Transformer (ViT). Specifically, for image-level optimization, we force the out-view imagination from local to global views on class tokens, which helps capturing high-level semantics, and we name it as out-generative learning. As to pixel-level optimization, we perform in-view masked image modeling on patch tokens, which recovers the corrupted parts of an image via inferring its fine-grained structure, and we term it as in-generative learning. To better discover the temporal information, we additionally force the inter-frame consistency from both feature level and affinity matrix level. Extensive experiments on DAVIS-2017 val and YouTube-VOS 2018 val show that our INO outperforms previous state-of-the-art methods by significant margins

Over-expression of eukaryotic translation initiation factor 4 gamma 1 correlates with tumor progression and poor prognosis in nasopharyngeal carcinoma

<p>Abstract</p> <p>Background</p> <p>The aim of the present study was to analyze the expression of eukaryotic translation initiation factor 4 gamma 1 (<it>EIF4G1</it>) in nasopharyngeal carcinoma (NPC) and its correlation with clinicopathologic features, including patients' survival time.</p> <p>Methods</p> <p>Using real-time PCR, we detected the expression of <it>EIF4G1 </it>in normal nasopharyngeal tissues, immortalized nasopharyngeal epithelial cell lines NP69, NPC tissues and cell lines. <it>EIF4G1 </it>protein expression in NPC tissues was examined using immunohistochemistry. Survival analysis was performed using Kaplan-Meier method. The effect of <it>EIF4G1 </it>on cell invasion and tumorigenesis were investigated.</p> <p>Results</p> <p>The expression levels of <it>EIF4G1 </it>mRNA were significantly greater in NPC tissues and cell lines than those in the normal nasopharyngeal tissues and NP69 cells (<it>P </it>< 0.001). Immunohistochemical analysis revealed that the expression of <it>EIF4G1 </it>protein was higher in NPC tissues than that in the nasopharyngeal tissues (<it>P </it>< 0.001). In addition, the levels of <it>EIF4G1 </it>protein in tumors were positively correlated with tumor T classification (<it>P </it>= 0.039), lymph node involvement (N classification, <it>P </it>= 0.008), and the clinical stages (<it>P </it>= 0.003) of NPC patients. Patients with higher <it>EIF4G</it>1 expression had shorter overall survival time (<it>P </it>= 0.019). Multivariate analysis showed that <it>EIF4G1 </it>expression was an independent prognostic indicator for the overall survival of NPC patients. Using shRNA to knock down the expression of <it>EIF4G1 </it>not only markedly inhibited cell cycle progression, proliferation, migration, invasion, and colony formation, but also dramatically suppressed <it>in vivo </it>xenograft tumor growth.</p> <p>Conclusion</p> <p>Our data suggest that <it>EIF4G1 </it>can serve as a biomarker for the prognosis of NPC patients.</p

Racial variation in medical outcomes among living kidney donors

BACKGROUND: Data regarding health outcomes among living kidney donors are lacking, especially among nonwhite persons. METHODS: We linked identifiers from the Organ Procurement and Transplantation Network (OPTN) with administrative data of a private U.S. health insurer and performed a retrospective study of 4650 persons who had been living kidney donors from October 1987 through July 2007 and who had post-donation nephrectomy benefits with this insurer at some point from 2000 through 2007. We ascertained post-nephrectomy medical diagnoses and conditions requiring medical treatment from billing claims. Cox regression analyses with left and right censoring to account for observed periods of insurance benefits were used to estimate absolute prevalence and prevalence ratios for diagnoses after nephrectomy. We then compared prevalence patterns with those in the 2005–2006 National Health and Nutrition Examination Survey (NHANES) for the general population. RESULTS: Among the donors, 76.3% were white, 13.1% black, 8.2% Hispanic, and 2.4% another race or ethnic group. The median time from donation to the end of insurance benefits was 7.7 years. After kidney donation, black donors, as compared with white donors, had an increased risk of hypertension (adjusted hazard ratio, 1.52; 95% confidence interval [CI], 1.23 to 1.88), diabetes mellitus requiring drug therapy (adjusted hazard ratio, 2.31; 95% CI, 1.33 to 3.98), and chronic kidney disease (adjusted hazard ratio, 2.32; 95% CI, 1.48 to 3.62); findings were similar for Hispanic donors. The absolute prevalence of diabetes among all donors did not exceed that in the general population, but the prevalence of hypertension exceeded NHANES estimates in some subgroups. End-stage renal disease was identified in less than 1% of donors but was more common among black donors than among white donors. CONCLUSIONS: As in the general U.S. population, racial disparities in medical conditions occur among living kidney donors. Increased attention to health outcomes among demographically diverse kidney donors is needed. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.

Bearing surface defect detection based on improved convolutional neural network

This paper addresses the issue of artificial visual inspection being overly reliant on subjective experience and the difficulty for the human eye to accurately identify dense and non-significant defects. To solve this problem, we have implemented an automatic object detection algorithm based on an improved version of YOLOv5.First, we use the K-means++ clustering algorithm to automatically calculate the Anchor of the model to reduce the effect of the close location of the initial clustering centers on the clustering of the sample data.Second, we add the Coordinate Attention (CA) attention mechanism to the model to allow the model to better capture and understand important features in the images. Then, we add a new detection layer with a downsampling multiplier of 4 to the Neck network to improve the precision of the model. Finally, we use the lightweight network MobileNetV3 instead of YOLOv5's backbone network to reduce the model detection time overhead.Our model achieves 85.87% mAP, which is 6.44% better than the YOLOv5 network, and the detection time for a single image is only 54ms, which is 50% faster than the YOLOv5 network. After testing, we have proven that our proposed algorithm can quickly and accurately detect the condition of bearing appearance defects, improving detection efficiency and reducing costs