Abstract. Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application.
Abstract The relationship between humans and digital technologies has been documented extensively in the past decades, but has yet to be reviewed through the lens of the current global pandemic crisis This review synthesizes the rapidly growing literature on digital technology use during the current COVID-19 pandemic It addresses the following four topics: (1) the specific digital technologies that have been used, (2) the specific populations who have used these digital technologies, (3) the specific activities that individuals and groups have used these digital technologies, and (4) the specific effects of using these digital technologies on humans during the pandemic The 281 empirical articles we have identified suggest that (1) 28 various forms of technologies have been used, ranging from computers to artificial intelligence, (2) 8 different populations of users are using these technologies, primarily medical professionals, (3) 32 generalized types of activities are involved, including providing health services remotely, analyzing data, and communicating, and (4) 35 various effects have been observed, such as improved patient outcomes, continued education, and decreased outbreak impact Through this rapid review, we sketched an expansive, multilevel model of the current knowledge of how humans are using technology during the COVID-19 pandemic Major findings and future directions are discussed
Abstract Deep learning technology has been extensively explored in pattern recognition and image processing areas. A multi-mode medical image fusion with deep learning will be proposed, according to the characters of multi-modal medical image, medical diagnostic technology and practical implementation, according to the practical needs for medical diagnosis. It cannot be only made up for the deficiencies of MRI, CT and SPECT image fusion, but also can be implemented in different types of multi-modal medical image fusion problems in batch processing mode, and can be effectively overcome the limitation of only one-page processing. The proposed method can greatly improve the fusion effect, image detail clarity and time efficiency. The experiments on multi-modal medical images are implemented to analyze performance, algorithm stability and so on. The experimental results prove the superiority of our proposed method in terms of visual quality and a variety of quantitative evaluation criteria.
Kristina Hasselgren, Caroline Williamsson, Johanna Wennerblom
et al.
Abstract Introduction Patients with pancreatic ductal adenocarcinoma (PDAC) have a dismal prognosis. The majority of patients are diagnosed at an advanced stage, and for these patients, the only possible treatment is palliative chemotherapy. There are increasing data from retrospective studies indicating that a subgroup of patients with liver-limited metastases may benefit from surgical treatment of liver metastases. However, there is a need for prospective trials. Objective The aim of this study is to prospectively investigate the safety and feasibility of surgically treating patients who are resectable, including those with borderline venous resectable, histopathologically confirmed PDAC, and histopathologically or radiologically confirmed liver metastases. Methods Five Swedish and one Finnish hepatopancreaticobiliary (HPB) centre will participate. Eligible patients will be identified at regional multidisciplinary conferences (MDTs). Before inclusion, they will undergo computed tomography (CT), magnetic resonance imaging (MRI, ) and (positron emission tomography computed tomography)PET-CT to rule out extrahepatic metastases. To be included, patients will have to have four or fewer liver metastases, which must be no larger than 5 cm for patients planning for resection and no larger than 2 cm for patients planning for ablation. The metastases may be either synchronous or metachronous. Patients will undergo four months of chemotherapy before surgical treatment (either resection or ablation), and postoperatively, they will undergo two months of chemotherapy. For those with synchronous metastases, resection of the pancreatic tumour will be performed. Follow-up will be performed over two years postoperatively with regular CT scans and assessments of quality of life. Conclusions In conclusion, this trial will provide increased knowledge concerning whether surgical treatment of liver metastases from pancreatic cancer can result in improved survival. Clinical Trial Number Clinical.Trials.gov (NCT05271110), registered February 26th 2022
Vincent Beauchamps, Theo Vanneau, Cyprien Bourrilhon
et al.
Objective This study aimed to examine the evolution of vigilance, sleepiness and electrophysiological markers of arousal in healthy subjects exposed to moderate hyperthermia, during habitual or restricted sleep conditions.Methods Twelve healthy males (30.4 ± 7.3 yr) completed two experimental crossover sessions in a bioclimatic chamber, consisting of sequential exposure to a thermoneutral condition (TCORE = 37.0 ± 0.2 °C) then an hyperthermic condition (TCORE = 38.3 ± 0.2 °C). Sessions followed either an habitual night of sleep (>6h time in bed, TIB) or sleep restriction (<3h TIB). A 10-minute psychomotor vigilance task (PVT) and a sleepiness scale were administered under thermoneutrality and hyperthermia conditions, immediately after recording a one-minute eyes-closed resting state electroencephalogram (EEG). This allowed for the calculation of individual alpha frequency (IAF), relative spectral powers (alpha, theta and beta bands) and theta-to-alpha ratio in frontal and parieto-occipital territories.Results Moderate hyperthermia induced an increase in PVT speed and a decrease in sleepiness. This arousal response was associated with an increase of IAF, a reduction in frontal theta power and an increase in frontal alpha power, leading to a decrease in the theta/alpha ratio. In contrast, sleep restriction induced the opposite effect on PVT performances and sleepiness, as well as for EEG parameters (without influence on IAF). No significant interaction was observed for all parameters.Conclusion Sleep restriction and moderate hyperthermia induced opposite effects in our model with limited time exposure to heat. This confirms that heat can help with arousing under certain conditions, although this needs to be confirmed by further studies.
ABSTRACT Saikosaponin b1 (Ssb1), a natural oleanane‐type triterpenoid saponin, exhibits antifibrosis activity by inhibiting the activation of hepatic stellate cells (HSCs), but the specific underlying molecular mechanisms are unknown. Here, it is found that Ssb1 could directly bind with the signal transducer and activator of transcription 3 (STAT3) and effectively inhibit the activation of HSCs. Proteomic techniques and molecular simulation revealed that Ssb1 is mainly bound to the S319 residues of STAT3 in the coiled‐coil domain. Further studies indicated that Ssb1 binding with STAT3 inhibited its transcriptional activity, and regulated glioma‐associated oncogene‐1 (Gli1) expression in the Hedgehog signaling pathway. Besides, Ssb1 binding blocked interaction between STAT3 and Gli1, which promoted degradation of Gli1 protein by suppressor of fused homolog (SUFU) and the ubiquitin‐proteasome system. The loss function of Gli1 led to decreased expression of Bcl2 and promoted the apoptosis of activated HSCs. Moreover, STAT3 ablation abolished the Ssb1‐mediated antifibrotic effects. These findings show that STAT3 plays a vital role in Ssb1 treatment of liver fibrosis, and Ssb1 as a STAT3 inhibitor might be a promising therapeutic candidate for the treatment of hepatic fibrosis.
Jih-Kai Huang, Ping-Hsun Wu, Zhao-Feng Chen
et al.
Microbiota tryptophan metabolism and the biosynthesis of indole derivatives play an important role in homeostasis and pathogenesis in the human body and can be affected by the gut microbiota. However, studies on the interplay between gut microbiota and tryptophan metabolites in patients undergoing dialysis are lacking. This study aimed to identify the gut microbiota, the indole pathway in tryptophan metabolism, and significant functional differences in ESRD patients with regular hemodialysis. We performed the shotgun metagenome sequencing of stool samples from 85 hemodialysis patients. Using the linear discriminant analysis effect size (LEfSe), we examined the composition of the gut microbiota and metabolic features across varying concentrations of tryptophan and indole metabolites. Higher tryptophan levels promoted tyrosine degradation I and pectin degradation I metabolic modules; lower tryptophan levels were associated with glutamate degradation I, fructose degradation, and valine degradation modules. Higher 3-indoxyl sulfate concentrations were characterized by alanine degradation I, anaerobic fatty acid beta-oxidation, sulfate reduction, and acetyl-CoA to crotonyl-CoA. Contrarily, lower 3-indoxyl sulfate levels were related to propionate production III, arabinoxylan degradation, the Entner–Doudoroff pathway, and glutamate degradation II. The present study provides a better understanding of the interaction between tryptophan, indole metabolites, and the gut microbiota as well as their gut metabolic modules in ESRD patients with regular hemodialysis.
Acute lymphoblastic leukemia (ALL) is a prevalent malignancy affecting the hematopoietic system, encompassing both B-cell ALL (B-ALL) and T-cell ALL (T-ALL). T-ALL, characterized by the proliferation of T-cell progenitors in the bone marrow, presents significant treatment challenges, with patients often experiencing high relapse rates and poor long-term survival despite advances in chemotherapy and hematopoietic stem cell transplantation (HSCT). This review explores the pathogenesis and traditional treatment strategies of T-ALL, emphasizing the promising potential of chimeric antigen receptor (CAR) technology in overcoming current therapeutic limitations. CAR therapy, leveraging genetically modified immune cells to target leukemia-specific antigens, offers a novel and precise approach to T-ALL treatment. The review critically analyzes recent developments in CAR-T and CAR-NK cell therapies, their common targets, optimization strategies, clinical outcomes, and the associated challenges, providing a comprehensive overview of their clinical prospects in T-ALL treatment.
Background. Esophageal cancer (ESCA) is a common gastrointestinal tumor, and China is one of the regions with a high incidence. Tumor immune-related cells play important roles in the tumorigenesis and development of ESCA. However, the role of tumor immune-related genes in the development of ESCA has not been established. Methods. In this study, weighted gene coexpression network analysis (WGCNA) was used to analyze ESCA gene expression using data from The Cancer Genome Atlas (TCGA) database. Gene expression was associated with clinical traits, and modules related to CD8+T cells, dendritic cells, and regulatory T cells (Tregs) were obtained. Results. The GO analysis showed that inflammatory chemotaxis networks were activated by cell chemotaxis, chemokine activity, and chemokine binding receptor. Three hub genes (IL17C, TNFSF15, and MIA) related to tumor immunity and metastasis were identified by WGCNA, and the abnormal expression of each hub gene in ESCA has a poor prognosis, especially in patients with high expression ( P < 0.05 ). The risk assessment analysis also showed that tumor stage was positively correlated with tumor risk in ESCA ( P < 0.05 ). Therefore, more than 50 pairs of tumor tissues from the T1–T3 stages with different degrees of differentiation and paracancerous tissues were selected to confirm the expression of the three genes using RT-qPCR and immunofluorescence (IF). The infiltration of CD8+ T cells in tumor tissues was lower than that in normal tissues. According to the RT-qPCR, the expressions of IL17 C, TNFSF15, and MIA in moderately and poorly differentiated tissues were significantly higher than those in normal tissues ( P < 0.05 ). In contrast, their expressions were decreased in high differentiated tissues ( P < 0.05 ). Furthermore, IL17C, TNFSF15, and MIA were all positively correlated with immune checkpoint PD-1; TNFSF15 and MIA were also positively correlated with CTLA4, TIGIT, and CD96. Conclusion. In summary, IL17C, TNFSF15, and MIA may act as biomarkers for prognosis in moderately and poorly differentiated ESCAs, and they may be used as predictive genes of immunotherapy associated with CD8+ T cell and Tregs invasion in ESCAs.
Behnaz Ahrabi, Hojjat Allah Abbaszadeh, Abbas Piryaei
et al.
Introduction: Chronic and progressive damage to the kidney by inflammatory processes, may lead to an increase in the extracellular matrix production, a condition known as renal fibrosis. The current study aims to evaluate if the extracellular vesicles (EVs) derived from autophagic adipose-derived mesenchymal stem cells (ADMSCs) can reduce the inflammation and extracellular matrix accumulation in damaged kidney tissue. Methods: Autophagy was induced in ADMSCs using 2µM concentration curcumin and was confirmed by evaluating LC3B, ATG7, and Beclin1 using real-time polymerase chain reaction (PCR) and Western blot. An in vitro renal fibrotic model was established in HEK-293 cells exposed to H2O2 (0.8mM) for 24 and 72 hours. The fibrotic model was confirmed through evaluation of collagen I, transforming growth factor-beta 1 (TGF-β1), E-cadherin, and vimentin genes expression using real-time PCR, collagen I protein by ELISA. After induction of fibrosis for 24 and 72 hours, the HEK cells were treated with NEVs (non-autophagy EVs) (50µM) or AEVs (autophagy EVs) (50µM) at 48, 96, and 124 hours, and then the samples were collected at 72 and 148 hours. Expression of collagen I, TGF-β1, E-cadherin, and vimentin Genes was evaluated via RT-PCR, and protein levels of IL1, TNF-α, IL4, IL10 using ELISA. Results: Induction of autophagy using curcumin (2µM) for 24 hours significantly increased LC3B, Beclin1, and ATG7 in the ADMSCs. Upregulation in anti-fibrotic (E-cadherin) and anti-inflammatory (IL4, IL10) gene expression was significantly different in the fibrotic model treated by AEVs compared to NEVs. Also, the downregulation of fibrotic (TGF-β1, vimentin, collagen I) and pro-inflammatory (IL1, TNFα) gene expression was significantly different in AEVs compared with those treated by NEVs. Conclusion: Our findings suggest that AEVs can be considered as a therapeutic modality for renal fibrosis in the future.
Abstract Background Childhood brain tumor (BT) survivors have an increased risk of treatment-related late effects, which can reduce health-related quality of life and increase morbidity. This study aimed to investigate lumbar disc degeneration in magnetic resonance imaging (MRI) in adult survivors of radiotherapy-treated childhood BT compared to age and sex-matched population controls. Methods In this cross-sectional comparative study, 127 survivors were identified from hospital registries. After a mean follow-up of 20.7 years (range 5–33.1), 67 survivors (mean age 28.4, range 16.2–43.5) were investigated with MRI and compared to 75 sex-matched population-based controls. Evaluated MRI phenotypes included Pfirrmann grading, , intervertebral disc protrusions, extrusions, and high-intensity-zone-lesions (HIZ). Groups were also compared for known risk factors of lumbar intervertebral disc (IVD) degeneration. Results Childhood BT survivors had higher Pfirrmann grades than controls at all lumbar levels (all p < 0.001). Lumbar disc protrusions at L4-5 (p = 0.02) and extrusions at L3-4 (p = 0.04), L4-5 (p = 0.004), and L5-S1 (p = 0.01) were significantly more common in the BT group compared to the control. The survivor cohort also had significantly more HIZ-lesons than the controls (n=13 and n=1, p=0.003). Age at diagnosis was associated with lower degree of IVD degeneration (p < 0.01). Blood pressure correlated with IVD degeneration (P < 0.05). Conclusions Signs of early disc degeneration related to tumor treatment can be seen in the IVDs of survivors. Disc degeneration was more severe in children treated in adolescence.
Studies comparing the ocular toxicity potential between legacy and alternative PFAS are lacking. To address this research gap, zebrafish larvae were exposed to both legacy PFAS (i.e., perfluorooctanesulfonic acid [PFOS] and perfluorooctanoic acid [PFOA]) and their corresponding alternatives (i.e., perfluorobutanesulfonic acid [PFBS] and perfluorobutanoic acid [PFBA]). Alterations in their visual behaviors, such as phototactic and optomotor responses (OMR), were assessed at sublethal concentrations. Gene expression variations in visual function-associated pathways were also measured. Visual behavioral assessment revealed that PFOS exposure resulted in concentration-dependent reductions in phototactic responses at 10–1000 μg/L, with PFOA exerting reduction effects only at 100 mg/L. However, their two alternatives had no effect at all tested concentrations. Following an improved contrast-OMR (C-OMR) assessment, PFOS decreased the OMR to a water flow stimulus at 10, 100, and 1000 μg/L. The gene expression analysis revealed that PFOS exposure markedly downregulated most genes involved in the opsins in the photoreceptor and phototransduction cascade, which explains the observed visual behavior changes well. Our findings indicate that PFOS is the most likely PFAS to cause visual toxicity, with PFOA present but less likely, and their substitutes, PFBS and PFBA, cannot be classified as visually toxic to zebrafish.
Abstract Circulating tumor DNA (ctDNA) is naked DNA molecules shed from the tumor cells into the peripheral blood circulation. They contain tumor‐specific gene mutations and other valuable information. ctDNA is considered to be one of the most significant analytes in liquid biopsies. Over the past decades, numerous researchers have developed various detection strategies to perform quantitative or qualitative ctDNA analysis, including PCR‐based detection and sequencing‐based detection. More and more studies have illustrated the great value of ctDNA as a biomarker in the diagnosis, prognosis and heterogeneity of tumor. In this review, we first outlined the development of digital PCR (dPCR)‐based and next generation sequencing (NGS)‐based ctDNA detection systems. Besides, we presented the introduction of the emerging ctDNA analysis strategies based on various biosensors, such as electrochemical biosensors, fluorescent biosensors, surface plasmon resonance and Raman spectroscopy, as well as their applications in the field of biomedicine. Finally, we summarized the essentials of the preceding discussions, and the existing challenges and prospects for the future are also involved.
B. K. Shreyamsha Kumar, K. C. Anandakrishan, Manish Sumant
et al.
Wound care is a critical aspect of healthcare that involves treating and managing various types of wounds, typically caused by injuries, surgery, or chronic diseases such as diabetes. Chronic wounds can be particularly challenging to manage and often require 3 to 6 months of long-term care. In a few instances, healing durations are highly unpredictable and can vary depending on the severity of the wound, the patient’s overall health, and other factors such as medication, nutrition, age, comorbidity, environment, etiology, and immune system function. A chronic wound can significantly impact the quality of life, causing pain, discomfort, limited mobility, higher healthcare cost, and even mortality in severe cases. Effective wound care is crucial for promoting complete and timely healing and reducing the risk of complications that may lead to amputation, infection, and other potentially life-threatening outcomes. This work aims to develop a system that automizes to determine the wound boundaries leveraging the DeepLabV3+SE, measures the wound characteristics such as size and area, and wound shape using a pipeline of morphological operations and connected component analysis modules. The proposed system’s performance was evaluated using the publicly available dataset. Results demonstrate that the DeepLabV3+SE has outperformed with significantly high dice and IOU scores of 0.923 and 0.924, respectively, compared with several state-of-the-art methods.
Abstract. Unsatisfactory results of treatment of severe patients with pelvic trauma in medical institutions are explained by a number of reasons, which can be divided into three groups: organizational, medical-diagnostic and tactical. Primary disability in severe pelvic injuries averages 14%, and in patients with a combination of pelvic and acetabular injuries complete social rehabilitation is achieved in no more than half of cases. pelvic bones and ways to prevent them. Materials and methods. In the period from 2013 to 2018, 155 patients with pelvic fractures were treated. Results. Refusal of surgical treatment for fractures of the posterior-upper edge of the acetabulum with rotation of the fragment and dislocation of the thigh and other fractures of the pelvic bones, which are difficult to exercise and poorly maintained, is extremely dangerous. In such cases, it is impossible to eliminate the displacement by conservative methods and the refusal of surgical treatment entails improper fracture fusion and disability. Conclusions. Active surgical tactics of primary care for patients with pelvic fractures reduces the risk of death, allows to transport the patient to pelvic surgery clinics. Careful preoperative planning reduces the risk of tactical errors. Postoperative rehabilitation should be aimed at the prevention of osteoarthritis and aseptic necrosis of the femoral head.
The results of treatment of 79 patients with pyogenic liver abscesses (AP) were analyzed. Sepsis was diagnosed in 10 (16.1%) patients. Procalcitonin (PCT) levels were used to diagnose sepsis. The duration of antibacterial therapy (ABT) was based on the determination of PCT and the patient's clinical condition. The decision to prescribe or abstain from ABT should be reviewed within the next 6-24 hours based on the patient's clinical condition and PCT level. These values should also be taken into account in the decision-making process regarding the duration of ABT, as well as the clinical course of the disease. There were no fatalities in the treatment of AP.
 Purpose of the study. To determine the diagnostic and prognostic significance of procalcitonin in patients with pyogenic liver abscesses.
 Materials and methods. The results of treatment of 79 patients with pyogenic liver abscesses were analyzed. The mean age of patients was 48.4 ± 4.7 years, with men predominating (62.9%). The inclusion criterion was the presence of pyogenic liver abscesses, the exclusion criteria were cholangiogenic and specific abscesses. The main group consisted of 44 patients who received comprehensive conservative therapy, taking into account antibacterial treatment, the duration of which was determined by determining the level of PСT. Patients in the control group (35 patients) did not differ from the main in age, sex, comorbidities, severity of the disease and the results of microbiological examination, but received conventional ABT.
 Results. Carrying out adequate combined antibiotic therapy in patients with AP by determining PKT, along with surgery, reduced the recovery time of patients: 2-3 days normalization of body temperature (t = 5.66176; P <0.000001) and leukocyte formula (t = 8,56860; P <0,000001) patients of the main group compared with control patients
 Conclusion. Conducting ABT by determining the level of PСT contributed to a probable reduction in the length of stay in the hospital for 3 days (t = 3.95561; P = 0.000116).
Abstract Precision medicine in hepatocellular carcinoma (HCC) relies on validated biomarkers that help subgroup patients for targeted treatment. Here, we identified a novel candidate oncogene, ribosomal protein L22-like1 (RPL22L1), which was markedly elevated in HCC, contributed to HCC malignancy and adverse patient survival. Functional studies indicated RPL22L1 overexpression accelerated cell proliferation, migration, invasion and sorafenib resistance. Mechanism studies revealed that RPL22L1 activated ERK to induce atypical epithelial-to-mesenchymal transition (EMT) progress. Importantly, the ERK inhibitor (ERKi) could potentiate sorafenib efficiency in RPL22L1-high HCC cells. In summary, these data uncover RPL22L1 is a potential marker to guide precision therapy for utilizing ERKi to enhance the sorafenib efficacy in RPL22L1-high HCC patients.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Cytology