Uncertainty-Guided Lung Nodule Segmentation with Feature-Aware Attention

Since radiologists have different training and clinical experiences, they may provide various segmentation annotations for a lung nodule. Conventional studies choose a single annotation as the learning target by default, but they waste valuable information of consensus or disagreements ingrained in the multiple annotations. This paper proposes an Uncertainty-Guided Segmentation Network (UGS-Net), which learns the rich visual features from the regions that may cause segmentation uncertainty and contributes to a better segmentation result. With an Uncertainty-Aware Module, this network can provide a Multi-Confidence Mask (MCM), pointing out regions with different segmentation uncertainty levels. Moreover, this paper introduces a Feature-Aware Attention Module to enhance the learning of the nodule boundary and density differences. Experimental results show that our method can predict the nodule regions with different uncertainty levels and achieve superior performance in LIDC-IDRI dataset.Comment: 10 pages, 4 figures, 30 reference

Identification of novel somatic fusions of ERG-VEGFA, TMPRSS2-ERG, and VEGFA-TMPRSS2 in prostate cancer treated with anlotinib and androgen deprivation therapy: A case report

The TMPRSS2-ERG fusion gene has frequently been found in prostate cancer and is associated with malignancy. Identifying novel fusions will help to stratify patients and establish patient-tailored therapies. A 78-year-old man presented to our hospital with severe symptoms of urinary urgency and frequency for 2 years, as well as severe bone pain for 1 year. He was diagnosed with metastatic prostate cancer with a Gleason score of 5 + 5. Three gene fusions, ERG_VEGFA, TMPRSS2_ERG, and VEGFA_TMPRSS2, were identified in the patient\u27s prostate cancer tissue. Notably, administration of the tyrosine kinase inhibitor, anlotinib, in combination with a gonadotropin-releasing hormone agonist (GnRHa) and abiraterone, reduced the patient\u27s bone pain and also stabilized his prostate cancer for more than 2 years. This is the first report of somatic fusions among the VEGFA, ERG, and TMPRSS2 genes in cancer tissues from a patient with prostate cancer who responded well to antiangiogenic treatment combined with a GnRHa and abiraterone

Metallothioneins Are Required for Formation of Cross-Adaptation Response to Neurobehavioral Toxicity from Lead and Mercury Exposure in Nematodes

Metallothioneins (MTs) are small, cysteine-rich polypeptides, but the role of MTs in inducing the formation of adaptive response is still largely unknown. We investigated the roles of metallothionein genes (mtl-1 and mtl-2) in the formation of cross-adaptation response to neurobehavioral toxicity from metal exposure in Caenorhabditis elegans. Pre-treatment with mild heat-shock at L2-larva stage effectively prevented the formation of the neurobehavioral defects and the activation of severe stress response in metal exposed nematodes at concentrations of 50 and 100 µM, but pre-treatment with mild heat-shock did not prevent the formation of neurobehavioral defects in 200 µM of metal exposed nematodes. During the formation of cross-adaptation response, the induction of mtl-1 and mtl-2 promoter activity and subsequent GFP gene expression were sharply increased in 50 µM or 100 µM of metal exposed Pmtl-1::GFP and Pmtl-2::GFP transgenic adult animals after mild heat-shock treatment compared with those treated with mild heat-shock or metal exposure alone. Moreover, after pre-treatment with mild heat-shock, no noticeable increase of locomotion behaviors could be observed in metal exposed mtl-1 or mtl-2 mutant nematodes compared to those without mild heat-shock pre-treatment. The defects of adaptive response to neurobehavioral toxicity induced by metal exposure formed in mtl-1 and mtl-2 mutants could be completely rescued by the expression of mtl-1 and mtl-2 with the aid of their native promoters. Furthermore, over-expression of MTL-1 and MTL-2 at the L2-larval stage significantly suppressed the toxicity on locomotion behaviors from metal exposure at all examined concentrations. Therefore, the normal formation of cross-adaptation response to neurobehavioral toxicity induced by metal exposure may need the enough accumulation of MTs protein in animal tissues

Unified Multi-Modal Image Synthesis for Missing Modality Imputation

Multi-modal medical images provide complementary soft-tissue characteristics that aid in the screening and diagnosis of diseases. However, limited scanning time, image corruption and various imaging protocols often result in incomplete multi-modal images, thus limiting the usage of multi-modal data for clinical purposes. To address this issue, in this paper, we propose a novel unified multi-modal image synthesis method for missing modality imputation. Our method overall takes a generative adversarial architecture, which aims to synthesize missing modalities from any combination of available ones with a single model. To this end, we specifically design a Commonality- and Discrepancy-Sensitive Encoder for the generator to exploit both modality-invariant and specific information contained in input modalities. The incorporation of both types of information facilitates the generation of images with consistent anatomy and realistic details of the desired distribution. Besides, we propose a Dynamic Feature Unification Module to integrate information from a varying number of available modalities, which enables the network to be robust to random missing modalities. The module performs both hard integration and soft integration, ensuring the effectiveness of feature combination while avoiding information loss. Verified on two public multi-modal magnetic resonance datasets, the proposed method is effective in handling various synthesis tasks and shows superior performance compared to previous methods.Comment: 10 pages, 9 figure

Petrogenesis of the Northwest Africa 4734 basaltic lunar meteorite

We report the petrography, mineralogy, trace element abundance geochemistry, and Pb–Pb geochronology of the lunar meteorite Northwest Africa (NWA) 4734 and make a comparison with the LaPaz Icefield (LAP) 02205/02224 low-Ti lunar basaltic meteorites. NWA 4734 is an unbrecciated low-Ti mare basalt composed mainly of subophitic-textured pyroxene (60 vol%) and plagioclase (30%). Pyroxene, plagioclase, and olivine exhibit large compositional variations and intra-grain chemical zoning. Pyroxene and plagioclase in NWA 4734 have rare earth element (REE) concentrations and patterns similar to those of the LAPs. The crystallization age of NWA 4734, determined in situ in baddeleyite, is 3073 ± 15 Ma (2σ), nearly identical to that of the LAPs (3039 ± 12 Ma). NWA 4734 and the LAPs have similar textures, modal abundances, mineral chemistry, and crystallization ages, and are most likely source-crater paired on the Moon. One baddeleyite grain in LAP 02224 displays distinctively older and spatially variable ages, from 3349 ± 62 to 3611 ± 62 Ma (2σ), similar to another baddeleyite grain (3109 ± 29 to 3547 ± 21 Ma) reported by Zhang et al. (2010) for the same meteorite. Raman spectra, cathodoluminescence, and stoichiometric studies of the baddeleyite suggest that the two older grains were not endogenic but were trapped by the parental magma. Equilibrium partition calculation shows that the parental melt from which the NWA 4734 plagioclase crystallized has much lower REE contents than its whole rock, indicating an open system during magma evolution. NWA 4734 could have originated from a parental melt with REE concentrations similar to that of the Apollo 12 olivine basalt. The magma likely assimilated a small amount (∼4 wt%) of KREEP-rich material during its ascent through the lunar crust

Germline Mutations in Patients With Early-Onset Prostate Cancer.

Objective: To investigate the inherited mutations and their association with clinical features and treatment response in young-onset prostate cancer patients. Method: Targeted gene sequencing on 139 tumor susceptibility genes was conducted with a total of 24 patients diagnosed with PCa under the age of 63 years old. Meanwhile, the related clinical information of those patients is collected and analyzed. Results: Sixty-two germline mutations in 45 genes were verified in 22 patients. Conclusion: Mutations in DRGs are more prevalent in early-onset PCa with advanced clinical stages, and these patients had shorter progression-free survival. ADT Combined with either radiotherapy or chemotherapy may be effective in treating PCa caused by HRR-related gene mutations

Lung Nodule Segmentation and Uncertain Region Prediction with an Uncertainty-Aware Attention Mechanism

Radiologists possess diverse training and clinical experiences, leading to variations in the segmentation annotations of lung nodules and resulting in segmentation uncertainty.Conventional methods typically select a single annotation as the learning target or attempt to learn a latent space comprising multiple annotations. However, these approaches fail to leverage the valuable information inherent in the consensus and disagreements among the multiple annotations. In this paper, we propose an Uncertainty-Aware Attention Mechanism (UAAM) that utilizes consensus and disagreements among multiple annotations to facilitate better segmentation. To this end, we introduce the Multi-Confidence Mask (MCM), which combines a Low-Confidence (LC) Mask and a High-Confidence (HC) Mask.The LC mask indicates regions with low segmentation confidence, where radiologists may have different segmentation choices. Following UAAM, we further design an Uncertainty-Guide Multi-Confidence Segmentation Network (UGMCS-Net), which contains three modules: a Feature Extracting Module that captures a general feature of a lung nodule, an Uncertainty-Aware Module that produces three features for the the annotations' union, intersection, and annotation set, and an Intersection-Union Constraining Module that uses distances between the three features to balance the predictions of final segmentation and MCM. To comprehensively demonstrate the performance of our method, we propose a Complex Nodule Validation on LIDC-IDRI, which tests UGMCS-Net's segmentation performance on lung nodules that are difficult to segment using common methods. Experimental results demonstrate that our method can significantly improve the segmentation performance on nodules that are difficult to segment using conventional methods.Comment: 10 pages, 10 figures. We have reported a preliminary version of this work in MICCAI 202

Correlation between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and Left Ventricular Hypertrophy in Older Patients with Hypertension

Introduction: Hypertension and left ventricular hypertrophy (LVH) have emerged as significant risk factors for cardiovascular events and all-cause mortality. Inflammation and nutrition play critical roles in the development of hypertension and damage to target organs. The HALP Score, which assesses levels of hemoglobin, albumin, lymphocytes, and platelets, is an index closely associated with inflammation and nutrition, and has been demonstrated to be particularly effective in the older population. Hence, the objective of this study was to examine the correlation between the HALP Score and LVH in older patients with hypertension. Methods: We collected and retrospectively analyzed data from 234 older patients, including clinical data, and routine blood, liver function, kidney function, and cardiac ultrasound parameters. All patients were categorized into a non-left ventricular hypertrophy (NLVH) group (n = 131) or an LVH group (n = 103). The association between the HALP Score and LVH was investigated, and potential influencing factors were considered. Results: The LVH group had a significantly lower HALP Score than the NLVH group. Logistic regression analysis revealed that a lower HALP Score and female sex were independent factors associated with LVH in older patients with hypertension (OR = 0.944, 9.962, 95% CI: 0.910–0.979, 3.866–24.300, P = 0.002, <0.001). The area under the curve for the HALP Score in diagnosing LVH in older patients with hypertension was 0.708 (95% CI: 0.641–0.776, P = 0.002). Conclusion: The HALP Score is significantly associated with LVH in older patients with hypertension: lower scores indicate a greater likelihood of LVH. The HALP Score has moderate diagnostic value for LVH in this population

The “Groundwater Benefit Zone”, Proposals, Contributions and New Scientific Issues

The groundwater has great potential for water resource utilization, accounting for about a quarter of vegetation transpiration globally and contributing up to 84% in shallow groundwater areas. However, in irrigated agricultural regions or coastal areas with shallow groundwater levels, due to the high groundwater salinity, the contribution of groundwater to transpiration is small and even harmful. This paper proposes a new conception of groundwater benefit zone in the groundwater-soil–plant-atmosphere continuum (GSPAC) system. Firstly, it analyzes the mutual feedback processes of the underground hydrological process and aboveground farmland ecosystem. Secondly, it elaborates on the regional water and salt movement model proposed vital technologies based on the optimal regulation of the groundwater benefit zone and is committed to building a synergy that considers soil salt control and groundwater yield subsidies. Finally, based on the GSPAC system water-salt coupling transport mechanism, quantitative model of groundwater benefit zone, and technical parameters of regional water-salt regulation and control, the scientific problems and development opportunities related to the conception of groundwater benefit zone have been prospected