Ariadne's Thread:Using Text Prompts to Improve Segmentation of Infected Areas from Chest X-ray images

Segmentation of the infected areas of the lung is essential for quantifying the severity of lung disease like pulmonary infections. Existing medical image segmentation methods are almost uni-modal methods based on image. However, these image-only methods tend to produce inaccurate results unless trained with large amounts of annotated data. To overcome this challenge, we propose a language-driven segmentation method that uses text prompt to improve to the segmentation result. Experiments on the QaTa-COV19 dataset indicate that our method improves the Dice score by 6.09% at least compared to the uni-modal methods. Besides, our extended study reveals the flexibility of multi-modal methods in terms of the information granularity of text and demonstrates that multi-modal methods have a significant advantage over image-only methods in terms of the size of training data required.Comment: Provisional Acceptance by MICCAI 202

Patients' choice preferences for specialist outpatient online consultations: A discrete choice experiment

BackgroundInternet hospitals are multiplying with solid support from the Chinese government. In internet hospitals, specialist outpatient online consultations (SOOC) are the primary services. However, the acceptance and utilization rates of this service are still low. Thus, the study of patients' choice preferences for SOOC is needed.ObjectiveTo analyze the choice preference of patients' SOOC via a discrete choice experiment, understand the influence of each factor and promote the development of internet hospitals.MethodsVia a discrete selection experiment, a total of 162 patients from two general hospitals and three specialized hospitals in Beijing were selected for the questionnaire survey. The choice preferences were analyzed by conditional logit regression.ResultsFrom high to low, patients' willingness to pay (WTP) for the attributes of SOOC is as follows: doctors' recommendation rate (βhighly recommend = 0.999), the convenience of applying SOOC services (βConvenient = 0.760), the increasing ratio of medical insurance payment for online services compared to offline (βIncrease by 10% = 0.545), and the disease's severity (βsevere = −3.024). The results of the subgroup analysis showed differences in patient choice preference by age, whether the patients had chronic diseases, income, and medical insurance types.ConclusionBoth price and nonprice attributes influence the choice preference of SOOC for patients. Among them, patients are more inclined to choose SOOC when doctors highly recommend it, when it is convenient to apply, when medical insurance increases by 10%, and when disease severity is mild. The current findings show the government and medical institutions formulate auxiliary policies and welfare strategies by clarifying core attributes and adjusting the levels of different attributes to improve patients' acceptance of SOOC. The utility of SOOC and the further development of internet hospitals are radically promoted

Neighbourhood satisfaction in rural resettlement residential communities: the case of Suqian, China

Against the background of large-scale urbanisation and rural land expropriation, rural resettlement residential housing has been built to accommodate local rural residents in the peripheral areas of China. To explore the context-specific policy implications for improving neighbourhood satisfaction (NS) of residents in rural resettlement residential communities (RRRCs), this paper examines the determinants of NS, and their spatial effects, in rural resettlement residential neighbourhoods using Suqian, in Jiangsu Province, as a case study. This study contributes to the current literature in two ways: it constitutes the first attempt to examine NS among RRRCs; second, our spatial model helps to gain further understanding of horizontal and vertical spatial dependence effects. Our results indicate that income, gender, age, family structure, number of years living in a community, transport and architectural age all have significant effects on NS in RRRCs

Total ginsenosides extract induce autophagic cell death in NSCLC cells through activation of endoplasmic reticulum stress.

ETHNOPHARMACOLOGICAL RELEVANCE(#br)Ginseng (Panax ginseng C. A. Mey) has been widely used in Asian countries for thousands of years. It has auxiliary anticancer efficacy and its derived preparations (e.g. Shenmai injection) are prescribed for cancer patients as Traditional Chinese Medicines clinically in China.(#br)AIM OF THE STUDY(#br)The involved adjuvant anticancer mechanisms of ginseng are still unknown. The present study evaluated the anti-cancer effect of total ginsenosides extract (TGS) and determined the anticancer mechanisms of TGS-induced cell death in human non-small cell lung cancer (NSCLC) cells.(#br)MATERIALS AND METHODS(#br)The anti-cancer effect of TGS was evaluated in NSCLC by cell proliferation assay. The autophagy flux induction of TGS were tested and validated by Western blot, immunofluorescence and transmission electron microscope. The mechanisms of TGS in inducing autophagic cell death were validated by Western blot, gene knockdown and quantitative real time PCR assay.(#br)RESULTS(#br)We found TGS could induce cell death in concentration and time dependent manners, and the cell morphology of NSCLC changed from cobblestone shape to elongated spindle shape after treated with TGS. In the study of cell autophagy, we confirm that TGS could upregulate autophagy flux and induce autophagic cell death through activation endoplasmic reticulum stress. Further investigations demonstrated this process was mediated by the ATF4-CHOP-AKT1-mTOR axis in NSCLC cells.(#br)CONCLUSION(#br)Our findings suggested that TGS could induce autophagic cell death in NSCLC cells through activation of endoplasmic reticulum stress, disclosing another characteristic of TGS-induced cell death and a novel mechanism of TGS and its derived preparations in clinical treatment of cancer patients

Acute effect of particulate matter pollution on hospital admissions for cause-specific respiratory diseases among patients with and without type 2 diabetes in Beijing, China, from 2014 to 2020

BACKGROUND: Scientific studies have identified various adverse effects of particulate matter (PM) on respiratory disease (RD) and type 2 diabetes (T2D). However, whether short-term exposure to PM triggers the onset of RD with T2D, compared with RD without T2D, has not been elucidated. METHODS: A two-stage time-series study was conducted to evaluate the acute adverse effects of PM on admission for RD and for RD with and without T2D in Beijing, China, from 2014 to 2020. District-specific effects of PM and PM were estimated using the over-dispersed Poisson generalized addictive model after adjusting for weather conditions, day of the week, and long-term and seasonal trends. Meta-analyses were applied to pool the overall effects on overall and cause-specific RD, while the exposure-response (E-R) curves were evaluated using a cubic regression spline. RESULTS: A total of 1550,154 admission records for RD were retrieved during the study period. Meta-analysis suggested that per interquartile range upticks in the concentration of PM corresponded to 1.91% (95% CI: 1.33-2.49%), 2.16% (95% CI: 1.08-3.25%), and 1.92% (95% CI: 1.46-2.39%) increments in admission for RD, RD with T2D, and RD without T2D, respectively, at lag 0-8 days, lag 8 days, and lag 8 days. The effect size of PM was statistically significantly higher in the T2D group than in the group without T2D (z = 3.98, P \u3c 0.01). The effect sizes of PM were 3.86% (95% CI: 2.48-5.27%), 3.73% (95% CI: 1.72-5.79%), and 3.92% (95% CI: 2.65-5.21%), respectively, at lag 0-13 days, lag 13 days, and lag 13 days, respectively, and no statistically significant difference was observed between T2D groups (z = 0.24, P = 0.81). Significant difference was not observed between T2D groups for the associations of PM and different RD and could be found between three groups for effects of PM on RD without T2D. The E-R curves varied by sex, age and T2D condition subgroups for the associations between PM and daily RD admissions. CONCLUSIONS: Short-term PM exposure was associated with increased RD admission with and without T2D, and the effect size of PM was higher in patients with T2D than those without T2D

Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment

Normal-appearing white matter (NAWM) surrounding white matter hyperintensities (WMHs), frequently known as the WMH penumbra, is associated with subtle white matter injury and has a high risk for future conversion to WMHs. The goal of this study was to define WMH penumbras and to further explore whether the diffusion and perfusion parameters of these penumbras could better reflect cognitive function alterations than WMHs in subjects with subcortical vascular mild cognitive impairment (svMCI). Seventy-three svMCI subjects underwent neuropsychological assessments and 3T MRI scans, including diffusion tensor imaging (DTI) and arterial spin labeling (ASL). To determine the extent of cerebral blood flow (CBF) and DTI penumbras. A NAWM layer mask was generated for periventricular WMHs (PVWMHs) and deep WMHs (DWMHs) separately. Mean values of CBF, fractional anisotropy (FA), mean diffusivity (MD) within the WMHs and their corresponding NAWM layer masks were computed and compared using paired t-tests. Pearson's partial correlations were used to assess the relations of the mean CBF, FA, and MD values within the corresponding penumbras with composite z-scores of global cognition and four cognitive domains controlling for age, sex, and education. For both PVWMHs and DWMHs, the CBF penumbras were wider than the DTI penumbras. Only the mean FA value of the PVWMH-FA penumbra was correlated with the composite z-scores of global cognition before correction (r = 0.268, p = 0.024), but that correlation did not survive after correcting the p-value for multiple comparisons. Our findings showed extensive white matter perfusion disturbances including white matter tissue, both with and without microstructural alterations. The imaging parameters investigated, however, did not correlate to cognition

Resting-State Activity of Prefrontal-Striatal Circuits in Internet Gaming Disorder: Changes With Cognitive Behavior Therapy and Predictors of Treatment Response

Cognitive behavior therapy (CBT) is effective for the treatment of Internet gaming disorder (IGD). However, the mechanisms by which CBT improves IGD-related clinical symptoms remain unknown. This study aimed to discover the therapeutic mechanism of CBT in IGD subjects using resting-state functional magnetic resonance imaging (rsfMRI). Twenty-six IGD subjects and 30 matched healthy controls (HCs) received rsfMRI scan and clinical assessments; 20 IGD subjects completed CBT and then were scanned again. The amplitude of low-frequency (ALFF) values and the functional connectivity (FC) between the IGD group and the HC group were compared at baseline, as well as the ALFF values and FC before and after the CBT in the IGD group. Prior to treatment, the IGD group exhibited significantly increased ALFF values in the bilateral putamen, the right medial orbitofrontal cortex (OFC), the bilateral supplementary motor area (SMA), the left postcentral gyrus, and the left anterior cingulate (ACC) compared with the HC group. The HC group showed significantly increased FC values between the left medial OFC and the putamen compared with the IGD group, the FC values of IGD group were negatively associated with the BIS-11 scores before treatment. After the CBT, the weekly gaming time was significantly shorter, and the CIAS and BIS-II scores were significantly lower. The ALFF values in the IGD subjects significantly decreased in the left superior OFC and the left putamen, and the FC between them significantly increased after the CBT. The degree of the FC changes (ΔFC/Pre−FC) was positively correlated with the scale of the CIAS scores changes (ΔCIAS/Pre−CIAS) in the IGD subjects. CBT could regulate the abnormal low-frequency fluctuations in prefrontal-striatal regions in IGD subjects and could improve IGD-related symptoms. Resting-state alternations in prefrontal-striatal regions may reveal the therapeutic mechanism of CBT in IGD subjects