A meta-analysis of the effects of levothyroxine dose adjustment on maternal and infant outcomes in pregnant women with hypothyroidism

Objective·To evaluate the effects of levothyroxine (L-T4) dose adjustment according to the level of thyroid stimulating hormone (TSH) on maternal and infant outcomes in the pregnant women with hypothyroidism by meta-analysis.Methods·China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data Knowledge Service Platform, PubMed, Cochrane Library and Embase were retrieved to collect all the controlled studies on the treatment of pregnant women with hypothyroidism by adjusting the dose of L-T4 according to TSH level from the establishment of the databases to April 9, 2022. The references were also traced. Literature screening, data extraction, and quality evaluation were performed independently by two researchers. Cochrane evaluation was used to evaluate the quality of the included literature. Outcome indicators included gestational hypertension, gestational diabetes, postpartum hemorrhage, delivery mode, preterm birth, fetal death, neonatal asphyxia, and low birth weight infants. RevMan 5.3 was used for meta-analysis.Result·A total of 1 268 articles were retrieved from 6 databases, and 8 were included in the study, including 4 Chinese articles and 4 English articles. The overall risk of study bias was at a moderate level. Compared with the control group, the OR of gestational diabetes risk was 0.61 (95%CI 0.44‒0.86, P=0.004) and the OR of fetal death risk was 0.38 (95%CI 0.18‒0.81, P=0.010) in the experimental group with L-T4 dose adjusted according to the TSH level of the pregnant women with hypothyroidism, which were both statistically significant. However, the treatment method of adjusting L-T4 dose did not affect the risks of vaginal delivery [OR=1.82 (95%CI 0.75‒4.40, P=0.180)], gestational hypertension [OR=0.77 (95%CI 0.53‒1.12, P=0.170)], postpartum hemorrhage [OR=1.20 (95%CI 0.50‒2.92, P=0.680)], preterm birth [OR=0.72 (95%CI 0.48‒1.06, P=0.100)], low birth weight infants [OR=1.00 (95%CI 0.65‒1.54, P=0.999)], or neonatal asphyxia [OR=0.50 (95%CI 0.20‒1.27, P=0.150)] significantly.Conclusion·Adjusting the L-T4 therapeutic dose according to the TSH level may help reduce the risks of gestational diabetes and fetal death in the pregnant women with hypothyroidism

Co₃O₄@(Fe-Doped)Co(OH)₂ Microfibers: Facile Synthesis, Oriented-Assembly, Formation Mechanism, and High Electrocatalytic Activity

Cobalt oxide or hydroxide nanoarchitectures, often synthesized via solvothermal or electrodeposition or templated approaches, have wide technological applications owing to their inherent electrochemical activity and unique magnetic responsive properties. Herein, by revisiting the well-studied aqueous system of Co/NaBH₄ at room temperature, the chainlike assembly of Co₃O₄ nanoparticles is attained with the assistance of an external magnetic field; more importantly, a one-dimensional hierarchical array consisting of perpendicularly oriented and interconnected Co­(OH)₂ thin nanosheets could be constructed upon such well-aligned Co₃O₄ assembly, generating biphasic core–shell-structured Co₃O₄@Co­(OH)₂ microfibers with permanent structural integrity even upon the removal of the external magnetic field; isomorphous doping was also introduced to produce Co₃O₄@Fe–Co­(OH)₂ microfibers with similar structural merits. The cobalt-chemistry in such a Co/NaBH₄ aqueous system was illustrated to reveal the compositional and morphological evolutions of the cobalt species and the formation mechanism of the microfibers. Owing to the presence of Co₃O₄ as the core, such anisotropic Co₃O₄@(Fe-doped)­Co­(OH)₂ microfibers demonstrated interesting magnetic-responsive behaviors, which could undergo macro-scale oriented-assembly in response to a magnetic stimulus; and with the presence of a hierarchical array of weakly crystallized thin (Fe-doped) Co­(OH)₂ nanosheets with polycrystallinity as the shell, such microfibers demonstrated remarkable electrocatalytic activity toward oxygen evolution reactions in alkaline conditions

ClusterSeg : a crowd cluster pinpointed nucleus segmentation framework with cross-modality datasets

The detection and segmentation of individual cells or nuclei is often involved in image analysis across a variety of biology and biomedical applications as an indispensable prerequisite. However, the ubiquitous presence of crowd clusters with morphological variations often hinders successful instance segmentation. In this paper, nuclei cluster focused annotation strategies and frameworks are proposed to overcome this challenging practical problem. Specifically, we design a nucleus segmentation framework, namely ClusterSeg, to tackle nuclei clusters, which consists of a convolutional-transformer hybrid encoder and a 2.5-path decoder for precise predictions of nuclei instance mask, contours, and clustered-edges. Additionally, an annotation-efficient clustered-edge pointed strategy pinpoints the salient and error-prone boundaries, where a partially-supervised PS-ClusterSeg is presented using ClusterSeg as the segmentation backbone. The framework is evaluated with four privately curated image sets and two public sets with characteristic severely clustered nuclei across a variety range of image modalities, e.g., microscope, cytopathology, and histopathology images. The proposed ClusterSeg and PS-ClusterSeg are modality-independent and generalizable, and superior to current state-of-the-art approaches in multiple metrics empirically. Our collected data, the elaborate annotations to both public and private set, as well the source code, are released publicly at https://github.com/lu-yizhou/ClusterSeg