CBEAF-Adapting: Enhanced Continual Pretraining for Building Chinese Biomedical Language Model

Continual pretraining is a standard way of building a domain-specific pretrained language model from a general-domain language model. However, sequential task training may cause catastrophic forgetting, which affects the model performance in downstream tasks. In this paper, we propose a continual pretraining method for the BERT-based model, named CBEAF-Adapting (Chinese Biomedical Enhanced Attention-FFN Adapting). Its main idea is to introduce a small number of attention heads and hidden units inside each self-attention layer and feed-forward network. Using the Chinese biomedical domain as a running example, we trained a domain-specific language model named CBEAF-RoBERTa. We conduct experiments by applying models to downstream tasks. The results demonstrate that with only about 3% of model parameters trained, our method could achieve about 0.5%, 2% average performance gain compared to the best performing model in baseline and the domain-specific model, PCL-MedBERT, respectively. We also examine the forgetting problem of different pretraining methods. Our method alleviates the problem by about 13% compared to fine-tuning

Spinal nerve segmentation method and dataset construction in endoscopic surgical scenarios

Endoscopic surgery is currently an important treatment method in the field of spinal surgery and avoiding damage to the spinal nerves through video guidance is a key challenge. This paper presents the first real-time segmentation method for spinal nerves in endoscopic surgery, which provides crucial navigational information for surgeons. A finely annotated segmentation dataset of approximately 10,000 consec-utive frames recorded during surgery is constructed for the first time for this field, addressing the problem of semantic segmentation. Based on this dataset, we propose FUnet (Frame-Unet), which achieves state-of-the-art performance by utilizing inter-frame information and self-attention mechanisms. We also conduct extended exper-iments on a similar polyp endoscopy video dataset and show that the model has good generalization ability with advantageous performance. The dataset and code of this work are presented at: https://github.com/zzzzzzpc/FUnet .Comment: Accepted by MICCAI 202

Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study

Objective This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles

The Applications of Finite Element Analysis in Proximal Humeral Fractures

Proximal humeral fractures are common and most challenging, due to the complexity of the glenohumeral joint, especially in the geriatric population with impacted fractures, that the development of implants continues because currently the problems with their fixation are not solved. Pre-, intra-, and postoperative assessments are crucial in management of those patients. Finite element analysis, as one of the valuable tools, has been implemented as an effective and noninvasive method to analyze proximal humeral fractures, providing solid evidence for management of troublesome patients. However, no review article about the applications and effects of finite element analysis in assessing proximal humeral fractures has been reported yet. This review article summarized the applications, contribution, and clinical significance of finite element analysis in assessing proximal humeral fractures. Furthermore, the limitations of finite element analysis, the difficulties of more realistic simulation, and the validation and also the creation of validated FE models were discussed. We concluded that although some advancements in proximal humeral fractures researches have been made by using finite element analysis, utility of this powerful tool for routine clinical management and adequate simulation requires more state-of-the-art studies to provide evidence and bases

Potential metabolic mechanism of girls' central precocious puberty: a network analysis on urine metabonomics data

BACKGROUND: Central precocious puberty (CPP) is a common pediatric endocrine disease caused by early activation of hypothalamic-putuitary-gonadal (HPG) axis, yet the exact mechanism was poorly understood. Although there were some proofs that an altered metabolic profile was involved in CPP, interpreting the biological implications at a systematic level is still in pressing need. To gain a systematic understanding of the biological implications, this paper analyzed the CPP differential urine metabolites from a network point of view. RESULTS: In this study, differential urine metabolites between CPP girls and age-matched normal ones were identified by LC-MS. Their basic topological parameters were calculated in the background network. The network decomposition suggested that CPP differential urine metabolites were most relevant to amino acid metabolism. Further proximity analysis of CPP differential urine metabolites and neuro-endocrine metabolites showed a close relationship between CPP metabolism and neuro-endocrine system. Then the core metabolic network of CPP was successfully constructed among all these differential urine metabolites. As can be demonstrated in the core network, abnormal aromatic amino acid metabolism might influence the activity of HPG and hypothalamic pituitary adrenal (HPA) axis. Several adjustments to the early activation of puberty in CPP girls could also be revealed by urine metabonomics. CONCLUSIONS: The present article demonstrated the ability of urine metabonomics to provide several potential metabolic clues for CPP's mechanism. It was revealed that abnormal metabolism of amino acid, especially aromatic amino acid, might have a close correlation with CPP's pathogenesis by activating HPG axis and suppressing HPA axis. Such a method of network-based analysis could also be applied to other metabonomics analysis to provide an overall perspective at a systematic level

Core Planar Cell Polarity Genes VANGL1 and VANGL2 in Predisposition to Congenital Vertebral Malformations

Congenital scoliosis (CS) is the most common congenital spinal disorder caused by congenital vertebral malformations (CVMs), influenced by genetic and environmental factors and exhibiting diverse clinical presentations. Here, we identified the critical roles of Vangl1 and Vangl2, two core components in the Wnt/planar cell polarity (Wnt/PCP) signaling pathway, in vertebral development and in predisposition to CVMs in CS patients. We found that in Vangl mutant mouse models, the CVMs present in a Vangl gene dose- and gestational hypoxia-dependent manner. Our studies reveal a complex etiology of CS and its association with Wnt/PCP signaling

A Novel Pyroptosis-Associated Gene Signature to Predict Prognosis in Patients with Colorectal Cancer

Background. Pyroptosis is a form of cell death characterized by cell swelling and plasma membrane bubbling in association with inflammatory and immune responses. To date, the association between pyroptosis and colorectal cancer remains unclear. We aimed to establish a novel pyroptosis-associated model for the prognosis of colorectal cancer. Methods. Pyroptosis-related genes were extracted using Gene Set Enrichment Analysis. A least absolute shrinkage and selection operator regression model was constructed to identify a pyroptosis-related gene signature using the Cancer Genome Atlas and Gene Expression Omnibus databases. Then, Kyoto Encyclopedia of Genes and Genomes and Gene Ontology and GSEA were performed to better understand the potential mechanisms and the functional pathways associated with pyroptosis involved in colorectal cancer. The relationship between the pyroptosis-related signature and immune infiltration was investigated using Cell-Type Identification by Estimating Relative Subsets of RNA Transcripts and MCPcounter. Results. A 12 pyroptosis-related gene signature was identified. Then, patients were classified into high- and low-risk groups. Kaplan–Meier and receiver operating characteristic analyses confirmed that the high-risk groups showed worse overall survival, progression-free survival, or relapse-free survival probability. Functional enrichment analysis showed that pyroptosis was associated with extracellular matrix-related pathways. Furthermore, the pyroptosis risk score was associated with immune infiltration. The low-risk group exhibited a higher percentage of plasma cells, CD4 T cells, activated dendritic cells, and activated mast cells. M2 macrophages and M0 macrophages were positively related to the risk score. Conclusion. Our research yielded a novel pyroptosis-related prognostic signature for colorectal cancer that was related to immune cell infiltration, and it provided an immunological perspective for developing personalized therapies.</jats:p

The Optimal Time for Blood Glucose Measurements in Patients Who Underwent Primary or Revision Total Joint Arthroplasty: A Retrospective Review

Abstract Background Perioperative hyperglycemia is a risk factor for postoperative complications after total joint arthroplasty (TJA). However, the most optimal timing to detect blood glucose and the extent of elevation of postoperative glucose remain unknown. Our study investigated differences in perioperative blood glucose fluctuations between primary and revision groups to determine optimal timing for glycemic control. Methods We retrospectively evaluated medical records of 1,788 TJA patients from October 2013 to November 2018. We examined blood glucose values collected within 6 days perioperatively. Each time point’s findings were evaluated with descriptive statistics. Glucose variability was assessed by coefficient of variation (CV). Differences in glucose levels were compared between primary and revision groups. Results The final cohort included medical records of 1,480 patients (1,417 primary, 63 revision). Mean glucose values were highest on postoperative day 1 (117±35 and 132±50 mg/dL) in primary and revision groups, respectively ( P &lt;0.001). Postoperative day 1 included the highest number of hyperglycemic patients (glucose &gt;100 mg/dL) with 66.4% and 75.5% in primary and revision groups, respectively. The CV of primary and revision group nondiabetic and diabetic patients was 6.85% and 9.02% and 12.83% and 15.31%, respectively. Conclusions Postoperative day 1 was the most sensitive time for glucose control. Hyperglycemia occurred on postoperative day 1 in most patients who underwent TJA in both groups. Primary group diabetics and revision group had higher postoperative glycemic fluctuations than primary group nondiabetics. Our results reveal the need for specialized protocols for clinicians to detect and monitor hyperglycemia in patients under different situations.</jats:p