Leveraging Historical Medical Records as a Proxy via Multimodal Modeling and Visualization to Enrich Medical Diagnostic Learning

Simulation-based Medical Education (SBME) has been developed as a cost-effective means of enhancing the diagnostic skills of novice physicians and interns, thereby mitigating the need for resource-intensive mentor-apprentice training. However, feedback provided in most SBME is often directed towards improving the operational proficiency of learners, rather than providing summative medical diagnoses that result from experience and time. Additionally, the multimodal nature of medical data during diagnosis poses significant challenges for interns and novice physicians, including the tendency to overlook or over-rely on data from certain modalities, and difficulties in comprehending potential associations between modalities. To address these challenges, we present DiagnosisAssistant, a visual analytics system that leverages historical medical records as a proxy for multimodal modeling and visualization to enhance the learning experience of interns and novice physicians. The system employs elaborately designed visualizations to explore different modality data, offer diagnostic interpretive hints based on the constructed model, and enable comparative analyses of specific patients. Our approach is validated through two case studies and expert interviews, demonstrating its effectiveness in enhancing medical training.Comment: Accepted by IEEE VIS 202

High Specific Capacitance of the Electrodeposited MnO2 on Porous Foam Nickel Soaked in Alcohol and its Dependence on Precursor Concentration

In this work, we used the mixed solution of manganese acetate and sodium sulfate to deposit manganese dioxide on the three-dimensional porous nickel foam that was previously soaked in alcohol, and then the effects of solution concentrations on their capacitance properties were investigated. The surface morphology, microstructure, elemental valence and other information of the material were observed by scanning electron microscope (SEM), Transmission Electron Microscope (TEM), X-ray photoelectron spectroscopy (XPS), etc. The electrochemical properties of the material were tested by Galvanostatic charge-discharge (GCD), Cyclic Voltammetry (CV), Chronoamperometry (CA), Electrochemical impedance spectroscopy (EIS), etc. The MnO2 electrode prepared at lower concentrations can respectively reach a specific capacitance of 529.5 F g−1 and 237.3 F g−1 at the current density of 1 A g−1 and 10 A g−1, and after 2000 cycles, the capacity retention rate was still 79.8% of the initial capacitance, and the energy density can even reach 59.4 Wh Kg−1, while at the same time, it also has a lower electrochemical impedance (Rs = 1.18 Ω, Rct = 0.84 Ω)

The complete chloroplast genome of Salsola abrotanoides (Chenopodiaceae), a desert halophyte shrub in China

Salsola abrotanoides, one of the dominant plant species of desert vegetation, adapts well to the arid, saline, and alkaline environment in the Qinghai–Tibetan Plateau. Here, we reported the complete chloroplast sequence and characters of S. abrotanoides based on the Illumina NovaSeq Platform. The chloroplast genome is 151,622 bp in length, containing a pair of inverted repeated (IR) regions of 23,701 bp, a large single copy (LSC) region of 84,658 bp, and a small single copy (SSC) region of 19,562 bp. And the chloroplast genome sequence encodes 130 genes totally, including 85 mRNA genes, 37 tRNA genes, and 8 rRNA genes. S. abrotanoides is the first species of Genus Salsola and the chloroplast sequence will provide a valuable resource for the phylogenetic studies of Chenopodiaceae

Heparin-Binding EGF-Like Growth Factor Induces Heart Interstitial Fibrosis via an Akt/mTor/p70s6k Pathway

<div><p>Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is essential for maintaining normal function of the adult heart and is known to play an important role in myocardial remodeling. In the present study, we observed that heart-specific HB-EGF transgenic (TG) mice had systolic dysfunction with decreased fractional shortening (FS%), increased end-systolic diameter (LVIDs) at 5 months of age, increased heart fibrosis, and increased mRNA expression of Col1α1 and Col3α1 at 1, 3, 5 and 7 months of age compared to nontransgenic (NTG) littermates. However, the left ventricular anterior wall thickness at end-systole (LVAWs) of the TG mice was not different than the NTG mice. Phosphorylation levels of Akt, mTor and p70s6k were increased due to HB-EGF expression in TG mice compared with the NTG mice at 3 and 7 months of age. Additionally, activated Akt, mTor and p70s6k were co-localized with vimentin to cardiac fibroblasts isolated from TG mice. Furthermore, HB-EGF significantly increased phosphorylation levels of Akt, mTor and p70s6k and increased expression of type I collagen in cultured primary cardiac fibroblasts. Rapamycin (Rapa) and CRM197, inhibitors of mTor and HB-EGF respectively, could inhibit the expression of type I collagen in the cultured primary cardiac fibroblasts and Rapa suppressed interstitial fibrosis of the heart tissues <em>in vivo</em>. In addition, a BrdU assay showed that HB-EGF increased proliferation of cardiac fibroblasts by 30% compared with cells without HB-EGF treatment. HB-EGF-induced proliferation was completely diminished in the presence of Rapa. These results suggest that HB-EGF induced heart fibrosis and proliferation of cardiac fibroblasts occurs through activation of the Akt/mTor/p70s6k pathway.</p> </div

Echocardiography and H&E staining.

<p>TG mice and their NTG littermates were analyzed using M-mode echocardiographic analyses at 1, 3, 5, and 7 months of age. Fractional shortening (FS%) was decreased by the expression of HB-EGF compared with that of NTG mice (A). The left ventricular end-systolic diameter (LVIDs) was increased by the transgenic expression of HB-EGF compared with that of NTG mice (B), while left ventricular anterior wall thickness at end-systole (LVAWs) was not different (C). The whole heart (original magnification ×4) from TG and NTG littermates were sampled and stained using H&E and observed with a microscope. Cardiomyocytes (original magnification ×400) from the same areas of the left ventricle from TG and NTG littermates were compared to detect changes of myocyte cross-section size (D). About 50 cells per sample slice were randomly selected to calculate the average area of a single cell size (E, <i>n</i> = 4). *<i>P</i><0.05 <i>vs.</i> NTG mice; <i>P</i><0.001 <i>vs.</i> NTG mice.</p

HB-EGF induced proliferation of cultured primary cardiac fibroblasts and synthesis of collagen <i>in vitro</i>.

<p>Cultured primary cardiac fibroblasts were treated with HB-EGF at various time points. Phosphorylation of Akt, mTor and p70s6k was analyzed using western immunoblot (A). The cultured primary cardiac fibroblasts were treated with DMSO (vehicle control), HB-EGF, HB-EGF + Rapa, and HB-EGF +CRM197. Expression of collagen I was then detected after treatment for 72 hr and phosphorylation of mTor was detected after treatment for 2 hr using western immunoblot (B). The cell proliferation was detected using BrdU staining and the BrdU-positive cells were counted from six sections (C, D). *<i>P</i><0.05 <i>vs.</i> NTG mice; **<i>P</i><0.001 <i>vs.</i> NTG mice.</p

Determination of the phosphorylation levels of Akt, mTor and p70s6k in heart tissues.

<p>Mice were sacrificed at 3 and 7 months of age, and heart-tissue samples were homogenized in RIPA buffer. Phosphorylation levels of Akt, mTor and p70s6k were detected using western immunoblot (A). The relative intensities were detected using Image J and compared with those of NTG mice (B). *<i>P</i><0.05 <i>vs.</i> NTG mice at 3month; **<i>P</i><0.001 <i>vs.</i> NTG mice at 3month; †<i>P</i><0.05 <i>vs.</i> NTG mice at 7month; ‡<i>P</i><0.001 <i>vs.</i> NTG mice at 7month.</p