Hulliversen1407
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to the outbreak of coronavirus disease 2019 (COVID-19), a worldwide epidemic disease affecting increasing number of patients. Serine inhibitor Although the virus primarily targets respiratory system, cardiovascular involvement has been reported in accumulating studies. In this review, we first describe the cardiac disorders in human with various types of CoV infection, and in animals infected with coronavirus. Particularly, we will focus on the association of cardiovascular disorders upon SARS-CoV-2 infection, and prognostic cardiac biomarkers in COVID-19. Besides, we will discuss the possible mechanisms underlying cardiac injury resulted from SARS-CoV-2 infection including direct myocardial injury caused by viral infection, reduced level of ACE2, and inflammatory response during infection. Improved understandings of cardiac disorders associated with COVID-19 might predict clinical outcome and provide insights into more rational treatment responses in clinical practice.The sliding motion along the boundaries of discontinuous regions has been actively studied in B-spline free-form deformation framework. This study focusses on the sliding motion for a velocity field-based 3D+t registration. The discontinuity of the tangent direction guides the deformation of the object region, and a separate control of two regions provides a better registration accuracy. The sliding motion under the velocity field-based transformation is conducted under the [Formula see text]-Rényi entropy estimator using a minimum spanning tree (MST) topology. Moreover, a new topology changing method of the MST is proposed. The topology change is performed as follows inserting random noise, constructing the MST, and removing random noise while preserving a local connection consistency of the MST. This random noise process (RNP) prevents the [Formula see text]-Rényi entropy-based registration from degrading in sliding motion, because the RNP creates a small disturbance around special locations. Experiments were performed using two publicly available datasets the DIR-Lab dataset, which consists of 4D pulmonary computed tomography (CT) images, and a benchmarking framework dataset for cardiac 3D ultrasound. For the 4D pulmonary CT images, RNP produced a significantly improved result for the original MST with sliding motion (p less then 0.05). For the cardiac 3D ultrasound dataset, only a discontinuity-based registration indicated activity of the RNP. In contrast, the single MST without sliding motion did not show any improvement. These experiments proved the effectiveness of the RNP for sliding motion.Automatic computerized segmentation of fetal head from ultrasound images and head circumference (HC) biometric measurement is still challenging, due to the inherent characteristics of fetal ultrasound images at different semesters of pregnancy. In this paper, we proposed a new deep learning method for automatic fetal ultrasound image segmentation and HC biometry deeply supervised attention-gated (DAG) V-Net, which incorporated the attention mechanism and deep supervision strategy into V-Net models. In addition, multi-scale loss function was introduced for deep supervision. The training set of the HC18 Challenge was expanded with data augmentation to train the DAG V-Net deep learning models. The trained models were used to automatically segment fetal head from two-dimensional ultrasound images, followed by morphological processing, edge detection, and ellipse fitting. The fitted ellipses were then used for HC biometric measurement. The proposed DAG V-Net method was evaluated on the testing set of HC18 (n = 355), in terms of four performance indices Dice similarity coefficient (DSC), Hausdorff distance (HD), HC difference (DF), and HC absolute difference (ADF). Experimental results showed that DAG V-Net had a DSC of 97.93%, a DF of 0.09 ± 2.45 mm, an AD of 1.77 ± 1.69 mm, and an HD of 1.29 ± 0.79 mm. The proposed DAG V-Net method ranks fifth among the participants in the HC18 Challenge. By incorporating the attention mechanism and deep supervision, the proposed method yielded better segmentation performance than conventional U-Net and V-Net methods. Compared with published state-of-the-art methods, the proposed DAG V-Net had better or comparable segmentation performance. The proposed DAG V-Net may be used as a new method for fetal ultrasound image segmentation and HC biometry. The code of DAG V-Net will be made available publicly on https//github.com/xiaojinmao-code/ .This study compared the temporal and geographic trends of cancer in China with a specific focus on the long-term exposure to soil cadmium (Cd) pollution. The geographic information system (GIS; kriging interpolation method) was used to detect the Cd contained in the soil from the Dabaoshan area, Guangdong Province. The standard rate ratio (SRR) was calculated to describe the relationship between Cd exposure and cancer mortality risk using the low-exposure group as a reference. Eight hundred six cancer deaths (533 male and 273 female) in the total population of 972,970 were identified, and the age-standardized rate (world) was 145.64 per 100,000. Significant dose-response relationships were found using the low-exposure group as the reference group. The Cd soil levels were positively associated with the cancer mortality risk in the community population, particularly for all cancers (SRR = 3.27; 95% CI = 2.42-4.55), esophageal cancer (SRR = 5.42; 95% CI = 1.07-30.56), stomach cancer (SRR = 5.99; 95% CI = 2.00-18.66), liver cancer (SRR = 4.45; 95% CI = 2.16-10.34), and lung cancer (SRR = 2.86; 95% CI = 1.62-5.31) for the total population. Additionally, similar results were obtained when using the 2000 China standard population. Cd exposure significantly affected the standardized mortality rates (China) by age group for all cancers, esophageal cancer, stomach cancer, liver cancer, and lung cancer in the total population, particularly in the age groups of 35-54, 55-74, and ≥ 75 years, respectively. Cd soil level is likely positively associated with increased cancer mortality of all cancer types and esophageal, stomach, liver, and lung cancers but not for other specific categories of cancer.Corona virus disease-19 (covid-19) is caused by a coronavirus that is also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and is generally characterized by fever, respiratory inflammation, and multi-organ failure in susceptible hosts. One of the first things during inflammation is the response by acute phase proteins coupled with coagulation. The angiotensinogen (a substrate for hypertension) is one such acute phase protein and goes on to explain an association of covid-19 with that of angiotensin-converting enzyme-2 (ACE2, a metallopeptidase). Therefore, it is advisable to administer, and test the efficacy of specific blocker(s) of angiotensinogen such as siRNAs or antibodies to covid-19 subjects. Covid-19 activates neutrophils, macrophages, but decreases T-helper cells activity. The metalloproteinases promote the activation of these inflammatory immune cells, therefore; we surmise that doxycycline (a metalloproteinase inhibitor, and a safer antibiotic) would benefit the covid-19 subjects. Along these lines, an anti-acid has also been suggested for mitigation of the covid-19 complications. Interestingly, there are three primary vegetables (celery, carrot, and long-squash) which are alkaline in their pH-range as compared to many others. Hence, treatment with fresh juice (without any preservative) from these vegies or the antioxidants derived from purple carrot and cabbage together with appropriate anti-coagulants may also help prevent or lessen the detrimental effects of the covid-19 pathological outcomes. These suggested remedies might be included in the list of putative interventions that are currently being investigated towards mitigating the multi-organ damage by Covid-19 during the ongoing pandemic.
Fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX, FFX) and gemcitabine plus nab-paclitaxel (GnP) are considered standard treatments for patients with metastatic pancreatic cancer. Direct comparisons are not available that establish which is optimal.
We conducted a propensity score-adjusted analysis of patients with metastatic pancreatic cancer to identify the therapeutic advantages of these standard therapies. We used clinical data as part of a multicenter retrospective study of patients with unresectable or recurrent pancreatic cancer treated with FFX or GnP (NAPOLEON study).
FFX and GnP were initially administered to 102 and 153 patients, respectively. The GnP group comprised more patients of advanced age, worse performance status, lower body mass index, recurrence, and lower albumin concentrations. Median overall survival (OS) and progression-free survival (PFS) were 11.5months and 5.8months in the FFX group and 11.1months and 5.9months in the GnP group, respectively. Propensity score-adjusted analysis indicated that the administration of FFX or GnP was not independently associated with OS (adjusted hazard ratio [HR] 1.06; 95% confidence interval [CI] 0.76-1.47; P = 0.73). Similarly, the difference in PFS was not significant between groups (adjusted HR 0.93; 95% CI 0.68-1.26; P = 0.62). Gastrointestinal disorders were more common in the FFX group, whereas the frequencies of hematological, nervous system, and skin disorders were higher in the GnP group.
The efficacies of FFX and GnP were comparable, although safety profiles differed and should be considered in selecting treatment.
The efficacies of FFX and GnP were comparable, although safety profiles differed and should be considered in selecting treatment.
We aimed to determine the patient and screening-level factors that are associated with non-attendance in the Irish National Diabetic Retinal screening programme (Diabetic RetinaScreen). To accomplish this, we modelled a selection of predictors derived from the historical screening records of patients with diabetes.
In this cohort study, appointment data from the national diabetic retinopathy screening programme (RetinaScreen) were extracted and augmented using publicly available meteorological and geospatial data. A total of 653,969 appointments from 158,655 patients were included for analysis. Mixed-effects models (univariable and multivariable) were used to estimate the influence of several variables on non-attendance to screening appointments.
All variables considered for analysis were statistically significant. Variables of note, with meaningful effect, were age (OR 1.23 per decade away from 70; 95% CI [1.22-1.24]), type 2 diabetes (OR 1.10; 95% CI [1.06-1.14]) and socio-economic deprivation (OR 1.1onstrate that weather may influence attendance. This research provides unique insight to guide the implementation of an optimal and cost-effective intervention strategy to improve attendance.
A recent large cardiovascular outcome trial in patients with type 2 diabetes (T2DM) demonstrated excess heart failure hospitalization with saxagliptin. We sought to evaluate the impact of saxagliptin on cardiac structure and function using cardiac magnetic resonance imaging (CMR) in patients with T2DM without pre-existing heart failure.
In this prospective study, patients with T2DM without heart failure were prescribed saxagliptin as part of routine guideline-directed management. Clinical assessment, CMR imaging and biomarkers were assessed in a blinded fashion and compared following 6months of continued treatment. The primary outcome was the change in left ventricular (LV) ejection fraction (LVEF) after 6months of therapy. Key secondary outcomes included changes in LV and right ventricular (RV) end-diastolic volume, ventricular mass, LV global strain and cardiac biomarkers [N terminal pro B-type natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hsCRP)] over 6 months.
The cohort (n = 16) had a mean age of 59.