Deep Learning vs. Atlas-Based Models for Fast Auto-Segmentation of the Masticatory Muscles on Head and Neck CT Images

BACKGROUND: Impaired function of masticatory muscles will lead to trismus. Routine delineation of these muscles during planning may improve dose tracking and facilitate dose reduction resulting in decreased radiation-related trismus. This study aimed to compare a deep learning model with a commercial atlas-based model for fast auto-segmentation of the masticatory muscles on head and neck computed tomography (CT) images. MATERIAL AND METHODS: Paired masseter (M), temporalis (T), medial and lateral pterygoid (MP, LP) muscles were manually segmented on 56 CT images. CT images were randomly divided into training (n = 27) and validation (n = 29) cohorts. Two methods were used for automatic delineation of masticatory muscles (MMs): Deep learning auto-segmentation (DLAS) and atlas-based auto-segmentation (ABAS). The automatic algorithms were evaluated using Dice similarity coefficient (DSC), recall, precision, Hausdorff distance (HD), HD95, and mean surface distance (MSD). A consolidated score was calculated by normalizing the metrics against interobserver variability and averaging over all patients. Differences in dose (∆Dose) to MMs for DLAS and ABAS segmentations were assessed. A paired t-test was used to compare the geometric and dosimetric difference between DLAS and ABAS methods. RESULTS: DLAS outperformed ABAS in delineating all MMs (p \u3c 0.05). The DLAS mean DSC for M, T, MP, and LP ranged from 0.83 ± 0.03 to 0.89 ± 0.02, the ABAS mean DSC ranged from 0.79 ± 0.05 to 0.85 ± 0.04. The mean value for recall, HD, HD95, MSD also improved with DLAS for auto-segmentation. Interobserver variation revealed the highest variability in DSC and MSD for both T and MP, and the highest scores were achieved for T by both automatic algorithms. With few exceptions, the mean ∆D98%, ∆D95%, ∆D50%, and ∆D2% for all structures were below 10% for DLAS and ABAS and had no detectable statistical difference (P \u3e 0.05). DLAS based contours had dose endpoints more closely matched with that of the manually segmented when compared with ABAS. CONCLUSIONS: DLAS auto-segmentation of masticatory muscles for the head and neck radiotherapy had improved segmentation accuracy compared with ABAS with no qualitative difference in dosimetric endpoints compared to manually segmented contours

Placebo devices as effective control methods in acupuncture clinical trials : a systematic review

While the use of acupuncture has been recognised by the World Health Organisation, its efficacy for many of the common clinical conditions is still undergoing validation through randomised controlled trials (RCTs). A credible placebo control for such RCTs to enable meaningful evaluation of its efficacy is to be established. While several non-penetrating acupuncture placebo devices, namely the Streitberger, the Park and the Takakura Devices, have been developed and used in RCTs, their suitability as inert placebo controls needs to be rigorously determined. This article systematically reviews these devices as placebo interventions. Electronic searches were conducted on four English and two Chinese databases from their inceptions to July 2014; hand searches of relevant references were also conducted. RCTs, in English or Chinese language, comparing acupuncture with one of the aforementioned devices as the control intervention on human participants with any clinical condition and evaluating clinically related outcomes were included. Thirty-six studies were included for qualitative analysis while 14 were in the meta-analysis. The meta-analysis does not support the notion of either the Streitberger or the Park Device being inert control interventions while none of the studies involving the Takakura Device was included in the meta-analysis. Sixteen studies reported the occurrence of adverse events, with no significant difference between verum and placebo acupuncture. Author-reported blinding credibility showed that participant blinding was successful in most cases; however, when blinding index was calculated, only one study, which utilised the Park Device, seemed to have an ideal blinding scenario. Although the blinding index could not be calculated for the Takakura Device, it was the only device reported to enable practitioner blinding. There are limitations with each of the placebo devices and more rigorous studies are needed to further evaluate their effects and blinding credibility

Healthy Lifestyle and Cancer Survival:A Multinational Cohort Study

Lifestyle factors after a cancer diagnosis could influence the survival of cancer 60 survivors. To examine the independent and joint associations of healthy lifestyle factors with mortality outcomes among cancer survivors, four prospective cohorts (National Health and Nutrition Examination Survey [NHANES], National Health Interview Survey [NHIS], UK Biobank [UKB] and Kailuan study) across three countries. A healthy lifestyle score (HLS) was defined based on five common lifestyle factors (smoking, alcohol drinking, diet, physical activity and body mass index) that related to cancer survival. We used Cox proportional hazards regression to estimate the hazard ratios (HRs) for the associations of individual lifestyle factors and HLS with all-cause and cancer mortality among cancer survivors. During the follow-up period of 37,095 cancer survivors, 8927 all-cause mortality events were accrued in four cohorts and 4449 cancer death events were documented in the UK and US cohorts. Never smoking (adjusted HR = 0.77, 95% CI: 0.69–0.86), light alcohol consumption (adjusted HR = 0.86, 95% CI: 0.82–0.90), adequate physical activity (adjusted HR = 0.90, 95% CI: 0.85–0.94), a healthy diet (adjusted HR = 0.69, 95% CI: 0.61–0.78) and optimal BMI (adjusted HR = 0.89, 95% CI: 0.85–0.93) were significantly associated with a lower risk of all-cause mortality. In the joint analyses of HLS, the HR of all-cause and cancer mortality for cancer survivors with a favorable HLS (4 and 5 healthy lifestyle factors) were 0.55 (95% CI 0.42–0.64) and 0.57 (95% CI 0.44–0.72), respectively. This multicohort study of cancer survivors from the United States, the United Kingdom and China found that greater adherence to a healthy lifestyle might be beneficial in improving cancer prognosis

New early oligocene zircon U-Pb dates for the ‘Miocene’ Wenshan Basin, Yunnan, China: Biodiversity and paleoenvironment

The sedimentary basins of Yunnan, Southwest China, record detailed histories of Cenozoic paleoenvironmental change. They track regional tectonic and palaeobiological evolution, both of which are critically important for the development of modern floral diversity in southwestern China and throughout Asia more generally. However, to be useful, the sedimentary archives within the basins have to be placed within a well-constrained timeframe independent of biostratigraphy. Using high resolution U-Pb dating, we redefine the age of fossil-bearing strata in the Wenshan Basin. Regarded as Miocene for the last half century, these basin sediments encompass 30±2 and 32±1 Ma early Oligocene tuffaceous horizons, thus indicating a significantly greater antiquity than previously recognized. Together with other regional age revisions our result points to widespread Yunnan basin and orographic development as largely having taken place by the end Paleogene. This age revision provides an important new perspective on the preserved biotas and their evolution in Yunnan, and especially our understanding of the origin of Asian biodiversity which, regionally, had a near-modern composition by the early Oligocene. Crucially, this revised age evidences late Eocene-early Oligocene regional tectonism, pointing to the rise of eastern Tibet and the Hengduan Mountains before the growth of the Himalaya, and that Asia's high plant diversity has a Paleogene origin

New early oligocene zircon U-Pb dates for the ‘Miocene’ Wenshan Basin, Yunnan, China: Biodiversity and paleoenvironment

The sedimentary basins of Yunnan, Southwest China, record detailed histories of Cenozoic paleoenvironmental change. They track regional tectonic and palaeobiological evolution, both of which are critically important for the development of modern floral diversity in southwestern China and throughout Asia more generally. However, to be useful, the sedimentary archives within the basins have to be placed within a well-constrained timeframe independent of biostratigraphy. Using high resolution U-Pb dating, we redefine the age of fossil-bearing strata in the Wenshan Basin. Regarded as Miocene for the last half century, these basin sediments encompass 30±2 and 32±1 Ma early Oligocene tuffaceous horizons, thus indicating a significantly greater antiquity than previously recognized. Together with other regional age revisions our result points to widespread Yunnan basin and orographic development as largely having taken place by the end Paleogene. This age revision provides an important new perspective on the preserved biotas and their evolution in Yunnan, and especially our understanding of the origin of Asian biodiversity which, regionally, had a near-modern composition by the early Oligocene. Crucially, this revised age evidences late Eocene-early Oligocene regional tectonism, pointing to the rise of eastern Tibet and the Hengduan Mountains before the growth of the Himalaya, and that Asia's high plant diversity has a Paleogene origin

A systematic review of microbial markers for risk prediction of colorectal neoplasia

BACKGROUND: Substantial evidence indicates that dysbiosis of the gut microbial community is associated with colorectal neoplasia. This review aims to systematically summarise the microbial markers associated with colorectal neoplasia and to assess their predictive performance. METHODS: A comprehensive literature search of MEDLINE and EMBASE databases was performed to identify eligible studies. Observational studies exploring the associations between microbial biomarkers and colorectal neoplasia were included. We also included prediction studies that constructed models using microbial markers to predict CRC and adenomas. Risk of bias for included observational and prediction studies was assessed. RESULTS: Forty-five studies were included to assess the associations between microbial markers and colorectal neoplasia. Nine faecal microbiotas (i.e., Fusobacterium, Enterococcus, Porphyromonas, Salmonella, Pseudomonas, Peptostreptococcus, Actinomyces, Bifidobacterium and Roseburia), two oral pathogens (i.e., Treponema denticola and Prevotella intermedia) and serum antibody levels response to Streptococcus gallolyticus subspecies gallolyticus were found to be consistently associated with colorectal neoplasia. Thirty studies reported prediction models using microbial markers, and 83.3% of these models had acceptable-to-good discrimination (AUROC > 0.75). The results of predictive performance were promising, but most of the studies were limited to small number of cases (range: 9–485 cases) and lack of independent external validation (76.7%). CONCLUSIONS: This review provides insight into the evidence supporting the association between different types of microbial species and their predictive value for colorectal neoplasia. Prediction models developed from case-control studies require further external validation in high-quality prospective studies. Further studies should assess the feasibility and impact of incorporating microbial biomarkers in CRC screening programme

Al-based Nano-sized Composite Energetic Materials (Nano-CEMs): Preparation, Characterization and Performance

As one of the new types of functional materials, nano-sized composite energetic materials (nano-CEMs) possess many advantages and broad application prospects in the research field of explosives and propellants. The recent progress in the preparation and performance characterization of Al-based nano-CEMs has been reviewed. The preparation methods and properties of Al-based nano-CEMs are emphatically analyzed. Special emphasis is focused on the improved performances of Al-based nano-CEMs, which are different from those of conventional micro-sized composite energetic materials (micro-CEMs), such as thermal decomposition and hazardous properties. The existing problems and challenges for the future work on Al-based nano-CEMs are discussed

COVID-19 causes record decline in global CO2 emissions

The considerable cessation of human activities during the COVID-19 pandemic has affected global energy use and CO2 emissions. Here we show the unprecedented decrease in global fossil CO2 emissions from January to April 2020 was of 7.8% (938 Mt CO2 with a +6.8% of 2-{\sigma} uncertainty) when compared with the period last year. In addition other emerging estimates of COVID impacts based on monthly energy supply or estimated parameters, this study contributes to another step that constructed the near-real-time daily CO2 emission inventories based on activity from power generation (for 29 countries), industry (for 73 countries), road transportation (for 406 cities), aviation and maritime transportation and commercial and residential sectors emissions (for 206 countries). The estimates distinguished the decline of CO2 due to COVID-19 from the daily, weekly and seasonal variations as well as the holiday events. The COVID-related decreases in CO2 emissions in road transportation (340.4 Mt CO2, -15.5%), power (292.5 Mt CO2, -6.4% compared to 2019), industry (136.2 Mt CO2, -4.4%), aviation (92.8 Mt CO2, -28.9%), residential (43.4 Mt CO2, -2.7%), and international shipping (35.9Mt CO2, -15%). Regionally, decreases in China were the largest and earliest (234.5 Mt CO2,-6.9%), followed by Europe (EU-27 & UK) (138.3 Mt CO2, -12.0%) and the U.S. (162.4 Mt CO2, -9.5%). The declines of CO2 are consistent with regional nitrogen oxides concentrations observed by satellites and ground-based networks, but the calculated signal of emissions decreases (about 1Gt CO2) will have little impacts (less than 0.13ppm by April 30, 2020) on the overserved global CO2 concertation. However, with observed fast CO2 recovery in China and partial re-opening globally, our findings suggest the longer-term effects on CO2 emissions are unknown and should be carefully monitored using multiple measures