Patterns of Lymph Node Metastasis and Optimal Surgical Strategy in Small (≤20 mm) Gastroenteropancreatic Neuroendocrine Tumors

BackgroundRegional lymph node metastasis (LNM) is crucial for planning additional lymphadenectomy, and is directly correlated with poor prognosis in gastroenteropancreatic neuroendocrine tumors (GEP-NETs). However, the patterns of LNM for small (≤20 mm) GEP-NETs remain unclear. This population-based study aimed at evaluating LNM patterns and identifying optimal surgical strategies from the standpoint of lymph node dissemination.MethodsThis retrospective cohort study retrieved data from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database for 17,308 patients diagnosed as having localized well-differentiated GEP-NETs ≤ 20 mm between January 1, 2004, and December 31, 2017. The patterns of LNM were characterized in 6,622 patients who underwent extended resection for adequate lymph node harvest.ResultsOf 6,622 patients with localized small GEP-NETs in the current study, 2,380 (36%) presented with LNM after regional lymphadenectomy. Nodal involvement was observed in approximately 7.4%, 49.1%, 13.6%, 53.7%, 13.8%, 7.8%, and 15.4% of gastric (g-), small intestinal (si-), appendiceal (a-), colonic (c-), rectal (r-), non-functional pancreatic (nfp-), and functional pancreatic (fp-) NETs ≤ 20 mm. Patients with younger age, larger tumor size, and muscularis invasion were more likely to present with LNM. Additional lymphadenectomy conferred a significant survival advantage in NETs (≤10 mm: HR, 0.47; 95% CI, 0.33–0.66; p < 0.001; 11–20 mm: HR, 0.54; 95% CI, 0.34–0.85; p = 0.008) and fp-NETs ≤ 20 mm (HR, 0.08; 95% CI, 0.02–0.36; p = 0.001), as well as g-NETs (HR, 0.39; 95% CI, 0.16–0.96; p = 0.041) and c-NETs of 11–20 mm (HR, 0.07; 95% CI, 0.01–0.48; p = 0.007). Survival benefits of additional lymphadenectomy were not found in a-NETs, r-NETs, and nfp-NETs with a small size.ConclusionsGiven the increased risk for nodal metastasis, primary tumor resection with regional lymphadenectomy is a potential optimal surgical strategy for si-NETs and fp-NETs ≤ 20 mm, as well as g-NETs and c-NETs of 11–20 mm. Local resection is an appropriate and reliable surgical approach for a-NETs, r-NETs, and nfp-NETs ≤ 20 mm

AD-AutoGPT: An Autonomous GPT for Alzheimer's Disease Infodemiology

In this pioneering study, inspired by AutoGPT, the state-of-the-art open-source application based on the GPT-4 large language model, we develop a novel tool called AD-AutoGPT which can conduct data collection, processing, and analysis about complex health narratives of Alzheimer's Disease in an autonomous manner via users' textual prompts. We collated comprehensive data from a variety of news sources, including the Alzheimer's Association, BBC, Mayo Clinic, and the National Institute on Aging since June 2022, leading to the autonomous execution of robust trend analyses, intertopic distance maps visualization, and identification of salient terms pertinent to Alzheimer's Disease. This approach has yielded not only a quantifiable metric of relevant discourse but also valuable insights into public focus on Alzheimer's Disease. This application of AD-AutoGPT in public health signifies the transformative potential of AI in facilitating a data-rich understanding of complex health narratives like Alzheimer's Disease in an autonomous manner, setting the groundwork for future AI-driven investigations in global health landscapes.Comment: 20 pages, 4 figure

Nitrogen-Reduction in Intensive Cultivation Improved Nitrogen Fertilizer Utilization Efficiency and Soil Nitrogen Mineralization of Double-Cropped Rice

Under the current rice cropping system, excessive nitrogen application has become a major issue that needs to be changed, and nitrogen reduction has become a hot research topic in recent years. The use of optimum planting density is becoming a common agronomic management system in addition to nitrogen reduction, especially under double cropping rice systems. In this paper, changes in rice yield, nitrogen-use efficiency (NUE) and net N mineralization under dense planting with a reduced nitrogen rate (DPRN) were studied. By comparing DPRN with high-nitrogen sparse planting (SPHN), we found that the population tiller number (tiller number per unit area) increased by 9–27% under DPRN cultivation. Nitrogen accumulation under DPRN treatment of double-cropped rice was basically stable. NUE under DPRN was significantly higher by 1.3–22.7% compared to SPHN. The partial factor productivity of applied N (PFPN) was significantly higher than that of SPHN, with an increase of 4.3–22.8%. The net N mineralized of double-cropped rice under DPRN increased at different stages, and the increase in late-season rice (LSR) was greater than that of early-season rice (ESR). The highest net N mineralized in double cropping rice at different stages was found in the dense planting treatment (DP) and N2 (120 kg N h−1). In conclusion, DPRN cultivation of double-cropped rice could be accepted as a proper management strategy for reducing nitrogen input, improving NUE and promoting soil nitrogen mineralization under given conditions

Dense Planting with Reducing Nitrogen Rate Increased Nitrogen Use Efficiency and Translocated Nitrogen in Grains in Double-Cropped Rice

Nitrogen fertilization and planting density are two key factors that influence the yield of rice. Reducing nitrogen fertilizer input and increasing planting density will help to improve nitrogen use efficiency and stabilize yield. Field and 15N tracer method in plot experiments were conducted to study the trends of yield, nitrogen use efficiency (NUE) and nitrogen transfer of hybrid rice and conventional rice under dense planting with a reduced nitrogen rate (DPRN) and sparse planting with a high nitrogen rate (SPHN). Among the nitrogen in rice plants, the proportion of nitrogen from fertilizer under the DPRN was reduced by 1.8–13%. The late-season rice (LSR) had a higher rate of decrease compared with the early-season rice (ESR). The uptake efficiency of nitrogen fertilizer was significantly higher under the DPRN than that under the SPHN, with an increase of 7.7–21.9%. The accumulated nitrogen and translocated ratio under the DPRN before the heading stage were 6.1–10.8% and 2.0–9.6% higher than those under the SPHN, respectively. The yield did not change under different treatments. Those findings suggest that the DPRN could guarantee a stabilized yield while increasing the NUE and the amount of translocated nitrogen in the double-cropped rice system

Nitrogen-Reduction in Intensive Cultivation Improved Nitrogen Fertilizer Utilization Efficiency and Soil Nitrogen Mineralization of Double-Cropped Rice

Under the current rice cropping system, excessive nitrogen application has become a major issue that needs to be changed, and nitrogen reduction has become a hot research topic in recent years. The use of optimum planting density is becoming a common agronomic management system in addition to nitrogen reduction, especially under double cropping rice systems. In this paper, changes in rice yield, nitrogen-use efficiency (NUE) and net N mineralization under dense planting with a reduced nitrogen rate (DPRN) were studied. By comparing DPRN with high-nitrogen sparse planting (SPHN), we found that the population tiller number (tiller number per unit area) increased by 9–27% under DPRN cultivation. Nitrogen accumulation under DPRN treatment of double-cropped rice was basically stable. NUE under DPRN was significantly higher by 1.3–22.7% compared to SPHN. The partial factor productivity of applied N (PFPN) was significantly higher than that of SPHN, with an increase of 4.3–22.8%. The net N mineralized of double-cropped rice under DPRN increased at different stages, and the increase in late-season rice (LSR) was greater than that of early-season rice (ESR). The highest net N mineralized in double cropping rice at different stages was found in the dense planting treatment (DP) and N2 (120 kg N h−1). In conclusion, DPRN cultivation of double-cropped rice could be accepted as a proper management strategy for reducing nitrogen input, improving NUE and promoting soil nitrogen mineralization under given conditions

Spatial-temporal V-Net for automatic segmentation and quantification of right ventricle on gated myocardial perfusion SPECT images

Background: Functional assessment of right ventricle (RV) using gated myocardial perfusion single-photon emission computed tomography (MPS) heavily relies on the precise extraction of right ventricular contours. Purpose: In this paper, we present a new deep-learning-based model integrating both the spatial and temporal features in gated MPS images to perform the segmentation of the RV epicardium and endocardium. Methods: By integrating the spatial features from each cardiac frame of the gated MPS and the temporal features from the sequential cardiac frames of the gated MPS, we developed a Spatial-Temporal V-Net (ST-VNet) for automatic extraction of RV endocardial and epicardial contours. In the ST-VNet, a V-Net is employed to hierarchically extract spatial features, and convolutional long-term short-term memory (ConvLSTM) units are added to the skip-connection pathway to extract the temporal features. The input of the ST-VNet is ECG-gated sequential frames of the MPS images and the output is the probability map of the epicardial or endocardial masks. A Dice similarity coefficient (DSC) loss which penalizes the discrepancy between the model prediction and the manual annotation was adopted to optimize the segmentation model. Results: Our segmentation model was trained and validated on a retrospective dataset with 45 subjects, and the cardiac cycle of each subject was divided into eight gates. The proposed ST-VNet achieved a DSC of 0.8914 and 0.8157 for the RV epicardium and endocardium segmentation, respectively. The mean absolute error, the mean squared error, and the Pearson correlation coefficient of the RV ejection fraction (RVEF) between the manual annotation and the model prediction were 0.0609, 0.0830, and 0.6985. Conclusion: Our proposed ST-VNet is an effective model for RV segmentation. It has great promise for clinical use in RV functional assessment

Long-term Pleistocene aridification and possible linkage to high-latitude forcing: New evidence from grain size and magnetic susceptibility proxies from loess-paleosol record in northeastern China

Loess deposits are regarded as good indicators of the inception and development of arid and semi-arid climate in central Asia and northern China during the late Cenozoic. In northeastern China extensive loess deposits are found surrounding the Horqin and Otindag sand fields, and they have great potential for reconstructing the long-term aridification history of the region. However, these loess deposits are currently poorly understood. Here, we present a high-resolution magnetic susceptibility (MS) and grain-size record spanning the last 1.0 Ma from a 36.6-m-thick loess-paleosol sequence at Niuyangzigou site (NYZG) in NE China. The grain-size record reveals a long-term drying trend in NE China since ca. 1.0 Ma, punctuated by two significant abrupt drying events at similar to 0.65 Ma and similar to 0.3 Ma. These results demonstrate a process of stepwise intensification of drying in NE China over the past 1 Ma, and lend support to the hypothesis that global ice volume/temperature changes were the major driver of the long-term aridification of Asian dust source areas. However, unlike the widely studied loess deposits on the central Chinese Loess Plateau (CLP), the MS record in paleosol units Sl, S2 and S4 from the NYZG site do not show evidence of enhanced monsoon precipitation resulting from decreased global ice volume and the prolonged episodes of interglaciation after the Mid-Pleistocene Transition evident in the ice volume record. We hypothesize that this may be due to differences in the climatic sensitivity of the MS of Chinese loess deposits on a regional scale, rather than to in regional differences in monsoon intensity. (C) 2017 Elsevier B.V. All rights reserved