Automatic view plane prescription for cardiac magnetic resonance imaging via supervision by spatial relationship between views

Background: View planning for the acquisition of cardiac magnetic resonance (CMR) imaging remains a demanding task in clinical practice. Purpose: Existing approaches to its automation relied either on an additional volumetric image not typically acquired in clinic routine, or on laborious manual annotations of cardiac structural landmarks. This work presents a clinic-compatible, annotation-free system for automatic CMR view planning. Methods: The system mines the spatial relationship, more specifically, locates the intersecting lines, between the target planes and source views, and trains deep networks to regress heatmaps defined by distances from the intersecting lines. The intersection lines are the prescription lines prescribed by the technologists at the time of image acquisition using cardiac landmarks, and retrospectively identified from the spatial relationship. As the spatial relationship is self-contained in properly stored data, the need for additional manual annotation is eliminated. In addition, the interplay of multiple target planes predicted in a source view is utilized in a stacked hourglass architecture to gradually improve the regression. Then, a multi-view planning strategy is proposed to aggregate information from the predicted heatmaps for all the source views of a target plane, for a globally optimal prescription, mimicking the similar strategy practiced by skilled human prescribers. Results: The experiments include 181 CMR exams. Our system yields the mean angular difference and point-to-plane distance of 5.68 degrees and 3.12 mm, respectively. It not only achieves superior accuracy to existing approaches including conventional atlas-based and newer deep-learning-based in prescribing the four standard CMR planes but also demonstrates prescription of the first cardiac-anatomy-oriented plane(s) from the body-oriented scout.Comment: Medical Physics. arXiv admin note: text overlap with arXiv:2109.1171

Medical treatment and long-term outcome of chronic atrial fibrillation in the aged with chest distress: a retrospective analysis versus sinus rhythm

Although “chest distress” is the most frequent complication in the aged with chronic atrial frbrillation (AF) in clinical practice, there are few data on the association between chronic AF and coronary artery disease (CAD) in the aged in terms of medical treatment and long-term outcome. We assessed coronary artery lesions in such patients and evaluated the efficacy of medical treatment in long-term follow-ups. Of 315 elderly patients (mean age: 77.39 ± 6.33 years) who had undergone coronary angiography for chest distress, 297 exhibited sinus rhythm (SR), whereas 18 patients exhibited chronic AF. Patients with AF were followed for 4.22 ± 2.21 years. Average diastolic blood pressure (DBP) of AF patients was observed to be markedly less than that of patients with SR (57.33 ± 6.87 mmHg vs 71.08 ± 10.54 mmHg, t-test: P < 0.01). Compared with SR patients, severe stenosis of the coronary artery in AF patients was reduced (73.06% vs 44.44%, Chi-square test: P < 0.01). AF patients with chest distress had high CHADS2 score (3.72 ± 1.27), but only 33.3% patients received oral anticoagulants, and such patients had a significantly lower rate of revascularization (21.43% vs 55.63%, Chi-square test: P < 0.01), and higher rate of all-cause death (22.22% vs 4.38%, Chi-square test: P < 0.01) and thromboembolism (16.67% vs 1.68%, Chi-square test: P < 0.01) in the long-term follow-ups compared with SR patients. Chest distress in the aged with AF was related to insufficient coronary blood supply that was primarily due to a reduced DBP rather than to occult CAD. Adequate and safe medical therapy was difficult to achieve in these patients. Such patients typically have a poor prognosis, and optimal therapeutic strategies to treat them are urgently needed

Lyn mediates FIP1L1-PDGFRA signal pathway facilitating IL-5RA intracellular signal through FIP1L1-PDGFRA/JAK2/Lyn/Akt network complex in CEL

The Fip1-like1 (FIP1L1)–platelet-derived growth factor receptor alpha (PDGFRA) (F/P) oncogene can cause chronic eosinophilic leukemia (CEL), but requires IL-5 cytokine participation. In this study, we investigate the mechanism of F/P in collaboration with IL-5 in CEL. The results showed that Lyn, a key effector in the IL-5-motivated eosinophil production, is extensively activated in F/P-positive CEL cells. Lyn can associate and phosphorylate IL-5 receptor α (IL-5RA) in F/P-positive cells. Moreover, the activation of Lyn and IL-5R kinase were strengthened when the cells were stimulated by IL-5. Lyn inhibition in F/P-positive CEL cells attenuated cellular proliferation, induced apoptosis, and blocked cell migration and major basic protein (MBP) release. We identified the FIP1L1-PDGFRA/JAK2/Lyn/Akt complex in the F/P-expressing cells which can be disrupted by dual inhibition of JAK2 and Lyn, repressing cell proliferation in both EOL-1(F/P-positive human eosinophilic cell line) and imatinib-resistance (IR) cells. Altogether, our data demonstrate that Lyn is a vital downstream kinase activated by F/P converged with IL-5 signals in CEL cells. Lyn activate and expand IL-5RA intracellular signaling through FIP1L1-PDGFRA/JAK2/Lyn/Akt network complex, provoking eosinophils proliferation and exaggerated activation manifested as CEL

Carbon Emission Reduction Effect of China&rsquo;s Financial Decentralization

Due to a lack of focus on China&rsquo;s financial decentralization system, the existing research does not pay attention to the beneficial contribution of Chinese local governments to carbon emission reduction through their actions in the financial field. In this study, we collected 16 years of data from 30 provinces in China and utilized a two-way fixed-effects model to empirically test the impact of China&rsquo;s financial decentralization on carbon emission reduction. The regression results show that China&rsquo;s financial decentralization system has a significant carbon-emission reduction effect. A heterogeneity analysis shows that this effect is common in different regions of China and that fiscal decentralization will negatively moderate it. A mechanism analysis shows that under China&rsquo;s financial decentralization system, the active intervention of local governments in local finance will significantly upgrade the energy consumption structure and ease the financing constraints of enterprises. The regression results of the spatial econometric model show that the carbon emission reduction effect of China&rsquo;s financial decentralization still has a spatial spillover effect. Finally, we put forward corresponding policy recommendations

Carbon Emission Reduction Effect of China’s Financial Decentralization

Due to a lack of focus on China’s financial decentralization system, the existing research does not pay attention to the beneficial contribution of Chinese local governments to carbon emission reduction through their actions in the financial field. In this study, we collected 16 years of data from 30 provinces in China and utilized a two-way fixed-effects model to empirically test the impact of China’s financial decentralization on carbon emission reduction. The regression results show that China’s financial decentralization system has a significant carbon-emission reduction effect. A heterogeneity analysis shows that this effect is common in different regions of China and that fiscal decentralization will negatively moderate it. A mechanism analysis shows that under China’s financial decentralization system, the active intervention of local governments in local finance will significantly upgrade the energy consumption structure and ease the financing constraints of enterprises. The regression results of the spatial econometric model show that the carbon emission reduction effect of China’s financial decentralization still has a spatial spillover effect. Finally, we put forward corresponding policy recommendations

Evaluation of water environmental carrying capacity of city in Huaihe River Basin based on the AHP method: A case in Huai'an City

There is abundant rainfall in Huaihe River Basin as a land flowing with milk and honey, however it is also one of the high incidence areas with flood disaster. As a core city in Huaihe River Basin, Huai'an was selected for the study on carrying capacity of water environment from 2005 to 2014 using a method of analytic hierarchy process (AHP). And the paper combined water environment condition with the characteristics of regional socio-economy and environment in Huaihe River Basin. The results showed that water environment carrying capacity appeared an upward tendency. In three index layers, social factors had significant impact on the carrying capacity of water environment, and their changes were relatively consistent, total population, urbanization rate and residents living water were major constraints to water environment carrying capacity in Huai'an City