MMMNA-Net for Overall Survival Time Prediction of Brain Tumor Patients

Overall survival (OS) time is one of the most important evaluation indices for gliomas situations. Multimodal Magnetic Resonance Imaging (MRI) scans play an important role in the study of glioma prognosis OS time. Several deep learning-based methods are proposed for the OS time prediction on multi-modal MRI problems. However, these methods usually fuse multi-modal information at the beginning or at the end of the deep learning networks and lack the fusion of features from different scales. In addition, the fusion at the end of networks always adapts global with global (eg. fully connected after concatenation of global average pooling output) or local with local (eg. bilinear pooling), which loses the information of local with global. In this paper, we propose a novel method for multi-modal OS time prediction of brain tumor patients, which contains an improved nonlocal features fusion module introduced on different scales. Our method obtains a relative 8.76% improvement over the current state-of-art method (0.6989 vs. 0.6426 on accuracy). Extensive testing demonstrates that our method could adapt to situations with missing modalities. The code is available at https://github.com/TangWen920812/mmmna-net.Comment: Accepted EMBC 202

RPLHR-CT Dataset and Transformer Baseline for Volumetric Super-Resolution from CT Scans

In clinical practice, anisotropic volumetric medical images with low through-plane resolution are commonly used due to short acquisition time and lower storage cost. Nevertheless, the coarse resolution may lead to difficulties in medical diagnosis by either physicians or computer-aided diagnosis algorithms. Deep learning-based volumetric super-resolution (SR) methods are feasible ways to improve resolution, with convolutional neural networks (CNN) at their core. Despite recent progress, these methods are limited by inherent properties of convolution operators, which ignore content relevance and cannot effectively model long-range dependencies. In addition, most of the existing methods use pseudo-paired volumes for training and evaluation, where pseudo low-resolution (LR) volumes are generated by a simple degradation of their high-resolution (HR) counterparts. However, the domain gap between pseudo- and real-LR volumes leads to the poor performance of these methods in practice. In this paper, we build the first public real-paired dataset RPLHR-CT as a benchmark for volumetric SR, and provide baseline results by re-implementing four state-of-the-art CNN-based methods. Considering the inherent shortcoming of CNN, we also propose a transformer volumetric super-resolution network (TVSRN) based on attention mechanisms, dispensing with convolutions entirely. This is the first research to use a pure transformer for CT volumetric SR. The experimental results show that TVSRN significantly outperforms all baselines on both PSNR and SSIM. Moreover, the TVSRN method achieves a better trade-off between the image quality, the number of parameters, and the running time. Data and code are available at https://github.com/smilenaxx/RPLHR-CT.Comment: Accepted MICCAI 202

Transformer Lesion Tracker

Evaluating lesion progression and treatment response via longitudinal lesion tracking plays a critical role in clinical practice. Automated approaches for this task are motivated by prohibitive labor costs and time consumption when lesion matching is done manually. Previous methods typically lack the integration of local and global information. In this work, we propose a transformer-based approach, termed Transformer Lesion Tracker (TLT). Specifically, we design a Cross Attention-based Transformer (CAT) to capture and combine both global and local information to enhance feature extraction. We also develop a Registration-based Anatomical Attention Module (RAAM) to introduce anatomical information to CAT so that it can focus on useful feature knowledge. A Sparse Selection Strategy (SSS) is presented for selecting features and reducing memory footprint in Transformer training. In addition, we use a global regression to further improve model performance. We conduct experiments on a public dataset to show the superiority of our method and find that our model performance has improved the average Euclidean center error by at least 14.3% (6mm vs. 7mm) compared with the state-of-the-art (SOTA). Code is available at https://github.com/TangWen920812/TLT.Comment: Accepted MICCAI 202

Submission to the Kidney Tumor Segmentation Challenge 2019

In this report, we present our method description of the submission to Kidney Tumor Segmentation Challenge 2019. In this challenge, the goal is to segment the kidney and kidney tumor from the CT scans. Our method is based on a common neural architecture U-Net variant, while we pay more attention to the preprocessing stage to better understand the kidney data and postprocessing stage to reduce false positives. The experiments and results show that our proposed methods increase the segmentation accuracy compared to the basic model

YUAN 2.0: A Large Language Model with Localized Filtering-based Attention

In this work, we develop and release Yuan 2.0, a series of large language models with parameters ranging from 2.1 billion to 102.6 billion. The Localized Filtering-based Attention (LFA) is introduced to incorporate prior knowledge of local dependencies of natural language into Attention. A data filtering and generating system is presented to build pre-training and fine-tuning dataset in high quality. A distributed training method with non-uniform pipeline parallel, data parallel, and optimizer parallel is proposed, which greatly reduces the bandwidth requirements of intra-node communication, and achieves good performance in large-scale distributed training. Yuan 2.0 models display impressive ability in code generation, math problem-solving, and chatting compared with existing models. The latest version of YUAN 2.0, including model weights and source code, is accessible at Github

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Background: Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes. Methods: We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment. Results: Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference − 0.40 [95% CI − 0.71 to − 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference − 1.6% [95% CI − 4.3% to 1.2%]; P = 0.42) between groups. Conclusions: In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness. Trial registration: ISRCTN, ISRCTN12233792. Registered November 20th, 2017

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.

BackgroundPrevious cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes.MethodsWe conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment.ResultsForty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups.ConclusionsIn this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness.Trial registrationISRCTN, ISRCTN12233792 . Registered November 20th, 2017