Selective Automatic Image Feature Detection

To allow automatic assessment of computed tomography (CT) images of long bones, the identification of the location of regions of interest is important. The distance between the distal and proximal styloids may act as reference points for bone length; however, the locations of the distal and proximal growth plates represent further important reference features. The current methods to locate these feature positions are manual. In this project, we attempt to find these feature positions automatically. A CT data set was split into two subsets, a development set, and a validation set. We first extracted basic information from the stack and re-sequenced the slices from proximal to distal in the pre-task. A calibration phantom and its compartments are automatically located. Calibration equations are used to adjust all intensity information to a common scale. For segmentation, three methods were used to detect the region of interest (tibia and radius): Search-Box, Search-Outline and Center Compare-Outline. These methods track the bone of interest from midshaft to both distal and proximal styloids with an outline and extract information such as slice-based region of interest (ROI) area, intensity, intensity standard deviation, trabecular bone density, center of bone etc. Using this information, with the assumption that the area relationship between inner growth plate and midshaft won\u27t change much, the position of the end of the growth plate directed to the midshaft is detected. Further, the position of the styloids relative to the growth-plate position is estimated. The contour success rates for the ROI for Search-Box, Search-Outline and Center Compare-Outline were 81.9%, 84.7% and 91.5% for legs and 63%, 83% and 89.3% for arms, respectively. The success rates for the growth-plate position estimation for Search-Box, Search-Outline and Center Compare-Outline were 20%, 77.5% and 85% for the leg development set and 10.5%, 64% and 74% for the leg validation set. The success rates for the arm development set was 11%, 67% and 53% and for the arm validation set 6%, 50% and 45%, respectively. The Center Compare-Outline is the best method for its high success rate for contour and feature position estimation. It doesn\u27t rely on the orientation of the bone as the other methods do. The whole stack gets analyzed satisfactorily while only one threshold based on the center slice is used. One strength of our method is its automaticity. It only requires a small amount of manual input to assign the distal-proximal direction and to give each bone a seed point; the rest is done automatically. Sometimes there are errors in the growth-plate search process, so visual assessment of the result with possible manual correction is still needed

Scleral buckling-a brief historical overview and current indications.

The key to successful management of rhegmatogenous retinal detachment (RRD) is to find and seal all of the retinal breaks, and the two main surgical techniques used to achieve this are scleral bucking (SB) or pars plana vitrectomy (PPV). Techniques for SB have remained mostly unchanged for the last 60 years, whilst PPV techniques and instruments have developed substantially over that time and have greatly contributed to increased success rate for types and configurations of retinal detachments unsuitable or difficult to manage with buckling alone. However, there is a growing dependency to rely on PPV as the sole and only approach for repair of all types of retinal detachment, such that some centres are no longer offering training in scleral buckling. There are also many studies comparing SB with PPV, but many of these lack information on the type, technique or rationale for deployment of the buckle. Many studies deploy the same scleral buckle technique without customising it to the type, position or number of tears being treated. Scleral buckling is not a one-size-fits-all technique. It requires careful patient selection and careful buckle selection and orientation tailored to the tear(s) to ensure success. When used appropriately, it is a simple and highly effective technique, particularly for retinal dialyses, round retinal hole detachments and selected cases of retinal detachment associated with horseshoe retinal tears. There is no doubt that for some more complex cases, such as multiple large breaks, giant retinal tears, bullous detachments and cases complicated by proliferative retinopathy, PPV offers a safer and more effective management. However, SB remains an important and relevant surgical technique, and for the right cases, the results can be superior to PPV with reduced comorbidity

Thermal decomposition of n-hexane in organic Rankine cycle: a study combined ReaxFF reactive molecular dynamic and density functional theory

The thermal decomposition mechanism of n-hexane is investigated by using density functional theory and ReaxFF force field. The initial decomposition reactions, the effect of temperature on thermal decomposition and first-order kinetics are analyzed. The results show that the C-C bonds in n-hexane molecule are more easily decomposed than that of C-H bonds, and the breakage of C3-C4 bond is the main initial decomposition reaction. The main decomposition products of n-hexane are H2, CH4, C2H2, C2H4, C2H6, and C3H6. The decomposition rate of n-hexane is accelerated by temperature. The apparent activation energy and pre-exponential factor of n-hexane thermal decomposition are 209.8 kJ mol−1 and 1.1 × 1013 s−1, respectively

Isolation, Purification, Identification and Hypolipidemic Activity of Lipase Inhibitory Peptide from Chlorella pyrenoidosa

In this study, pancrelipase inhibitory peptides (PES) from an enzymatic protein hydrolysate of Chlorella pyrenoidosa were isolated and purified by ultrafiltration and Sephadex gel chromatography. The in vivo hypolipidemic activity of PES was evaluated by fat deposition and the levels of triglyceride (TG) and total cholesterol (TC) in Caenorhabditis elegans fed a high sugar diet. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify the peptide sequence of PES, and molecular docking was used to select potential pancreatic lipase inhibitory peptides, and the pancreatic lipase inhibitory activity of the synthesized peptides was verified. The results showed that PES had good hypolipidemic activity at a concentration of 1 mg/mL; it inhibited lipid deposition by 22.5%, and reduced the levels of TG and TC by 27.4% and 29.4%, respectively. In total, 999 peptides were identified, and four potential lipase inhibitory peptides were obtained. Among them, FLGPF had the best inhibitory effect on pancreatic lipase, with an inhibition rate of 50.12% at 8 mg/mL. The inhibition was reversible and non-competitive, with an inhibition constant of 5.23 mg/mL. Molecular docking showed that FLGPF could better bind to human pancreatic triacylglycerol lipase (PTL) via π-hydrogen, π-cation and hydrogen bond interactions. This study can provide a theoretical reference for the development and utilization of C. pyrenoidosa protein-derived hypolipidemic peptide

Use of Auricular Acupressure to Improve the Quality of Life in Diabetic Patients with Chronic Kidney Diseases: A Prospective Randomized Controlled Trial

Background. Diabetic patients with chronic kidney disease (CKD) suffer from low quality of life (QOL). We aim to assess the effectiveness of auricular acupressure for QOL improvement in these patients. Materials and Methods. Sixty-two participants were randomly assigned to an auricular or a control arm in a randomized controlled trial. Participants in the auricular arm were instructed to perform auricular acupressure 3–5 times per day for 3 months, when they were receiving conventional treatments. Participants in the control arm received conventional treatments only. The primary outcome was the summarized score of Kidney Disease and Quality of Life Short-Form (KDQOL-SF) at 3 months after randomization. The secondary outcomes included the 36-Item Short Form Health Survey (SF-36), glycosylated hemoglobin (HbA1c), and estimated glomerular filtration rate (eGFR). Results. The summarized KDQOL differed significantly between the acupressure (76.6, 95% CI, 72.2 to 81.0) and the control group (61.8, 95% CI, 57.7 to 65.9). Similar results were found in the SF-36 scores. HbA1c and eGFR were not found to be significantly different between the arms and neither were the adverse events. Conclusion. Auricular acupressure was well tolerated in diabetic patients with chronic kidney diseases receiving hemodialysis. Future research is needed to confirm these results

Whole exome sequencing of insulinoma reveals recurrent T372R mutations in YY1

Functional pancreatic neuroendocrine tumours (PNETs) are mainly represented by insulinoma, which secrete insulin independent of glucose and cause hypoglycaemia. The major genetic alterations in sporadic insulinomas are still unknown. Here we identify recurrent somatic T372R mutations in YY1 by whole exome sequencing of 10 sporadic insulinomas. Further screening in 103 additional insulinomas reveals this hotspot mutation in 30% (34/113) of all tumours. T372R mutation alters the expression of YY1 target genes in insulinomas. Clinically, the T372R mutation is associated with the later onset of tumours. Genotyping of YY1, a target of mTOR inhibitors, may contribute to medical treatment of insulinomas. Our findings highlight the importance of YY1 in pancreatic β-cells and may provide therapeutic targets for PNETs

Family-clinician shared decision making in intensive care units : cluster randomized trial in China

We thank the China Medical Board, which financially supported our study.Objective To investigate if a Family-Clinician Shared Decision-Making (FCSDM) intervention benefits patients, families and intensive care units (ICUs) clinicians.  Methods Six ICUs in China were allocated to intervention or usual care. 548 patients with critical illness, 548 family members and 387 ICU clinicians were included into the study. Structured FCSDM family meetings were held in the intervention group. Scales of SSDM, HADS, QoL2 and CSACD were used to assess families’ satisfaction and distress, patients’ quality of life, and clinicians’ collaboration respectively.  Results Comparing the intervention group with the control group at post-intervention, there were significant differences in the families’ satisfaction (P =0.0001), depression level (P =0.005), and patients’ quality of life (P =0.0007). The clinicians’ mean CSCAD score was more positive in the intervention group than controls (P < 0.05). There was no significant between-group differences on ICU daily medical cost, but the intervention group demonstrated shorter number of days’ stay in ICU (P=0.0004).  Conclusion The FCSDM intervention improved families’ satisfaction and depression, shortened patients’ duration of ICU stay, and enhanced ICU clinicians’ collaboration.  Practice implications Further improvement and promotion of the FCSDM model are needed to provide more evidence to this field in China.Publisher PDFPeer reviewe

Nurse educators perceptions of simulation teaching in Chinese context: benefits and barriers

Background Although simulated teaching was introduced to China in the 1990s, it remains underused in nursing education. Determining how Chinese nurse educators feel about using simulation in their institutions is very important for faculty training and has the potential to influence simulation implementation. Method This cross-sectional descriptive study was undertaken to identify the nurse educators’ experiences in the use of simulation from various regions of China. One hundred and thirty-six nurse educators provided demographic data and information about simulation implementation within their institutions and explored the perceived barriers and benefits of simulation usage. Results The survey data shows that 108 participants have used simulation in their work, but less than 92 (67.6%) of the respondents had used this teaching strategy more than ten times in last year. The study identified four factors hindering nurse faculty from simulation adoption: (1) concerns with student readiness; (2) the need for faculty team-building for simulation teaching; (3) lack of adequate simulation resources; and (4) thoughtful integration of simulation into nursing curricula. Conclusions Study data suggest that faculty training programs for simulation should be based on the nurse educators’ training needs, including systematically designed training topics, and the provision of hands-on learning simulation activities with expert feedback to help nurse educators achieve the competencies required for effective simulation-based education