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Standard plane (SP) localization is essential in routine clinical ultrasound (US) diagnosis. Compared to 2D US, 3D US can acquire multiple view planes in one scan and provide complete anatomy with the addition of coronal plane. However, manually navigating SPs in 3D US is laborious and biased due to the orientation variability and huge search space. In this study, we introduce a novel reinforcement learning (RL) framework for automatic SP localization in 3D US. Our contribution is three-fold. First, we formulate SP localization in 3D US as a tangent-point-based problem in RL to restructure the action space and significantly reduce the search space. Second, we design an auxiliary task learning strategy to enhance the model's ability to recognize subtle differences crossing Non-SPs and SPs in plane search. Finally, we propose a spatial-anatomical reward to effectively guide learning trajectories by exploiting spatial and anatomical information simultaneously. We explore the efficacy of our approach on localizing four SPs on uterus and fetal brain datasets. The experiments indicate that our approach achieves a high localization accuracy as well as robust performance., Accepted by MICCAI 2022

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Additional file 1: The SPIRIT Checklist.

Additional file 2: The informed consent form.

Additional file 2: Table S1. Clinical and Sleep Characteristics of All Subjects (n = 7110).

Introduction. IgA nephropathy (IgAN) is a common issue. In China, Abelmoschus manihot (AM) is widely used in the treatment of IgAN. However, their combined effectiveness and safety for this purpose have not yet been explored. AM is an effective medicine for treating IgAN. This meta-analysis aimed to evaluate the effectiveness of AM for IgAN. Materials and Methods. The Cochrane Library, PubMed, EMBASE, Allied and Complementary Medicine Database (AMED), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database were searched from their inceptions to June 2021. Random clinical trials (RCTs) comparing the effects of AM treatment in patients with IgAN were included. The study evaluated the efficacy or effectiveness of AM for IgAN and had clear outcome data, such as total effectiveness rate or proteinuria. Results. A total of 11 RCTs with 850 participants were included in this meta-analysis. The results of the meta-analysis showed that, compared with that of the conventional therapy alone, being combined with conventional treatment was significantly more effective for the total efficacy rate (OR = 4.33; 95% CI = 2.66, 7.04; P

Membranous nephropathy (MN) is an organ-restricted autoimmune disease mainly caused by circulating autoantibodies against podocyte antigens, including the M-type phospholipase A2 receptor (PLA2R) and thrombospondin domain-containing 7A (THSD7A). Antibodies against PLA2R are present in 70%–80% and against THSD7A in 2% of adult patients, which provides a paradigm shift in molecular diagnosis and management monitoring. Both antigens share some similar characteristics: they are expressed by podocytes and have wide tissue distributions; they are bound by autoantibodies only under nonreducing conditions, and the subtype of most autoantibodies is IgG4. However, the factors triggering autoantibody production as well as the association among air pollution, malignancy, and the pathogenesis of MN remain unclear. In this review, we discuss the similarity between the pathological mechanisms triggered by disparate antigens and their associated diseases. Furthermore, we demonstrated the possibility that PM2.5, malignancy, and gene expression specifically induce exposure of these antigens through conformational changes, molecular mimicry, or increased expression eliciting autoimmune responses. Thus, this review provides novel insights into the pathological mechanism of MN.

This article describes the principle, structure, main technical characteristics and Uncertainty evaluation of the 100MN force calibration machine (FCM). The machine adopts a nested structure, that is, a small oil cylinder and a set of reference standard sensors are installed in a large oil cylinder, so that two sets of oil cylinders and reference standard sensors are used together on one machine to realize automatic range conversion. The height of the main frame is 18 m, and the total weight of the machine is 650 t. The maximum force in the compression/the tension direction is 100 MN/60 MN for large range and 1 MN/1 MN for small range. The “direct method” is used to evaluate the Uncertainty of the force value generated by the FCM. The Uncertainty of the relative force value is equal to the average of the relative uncertainty of the output of 9 sensors in parallel. The relative expanded uncertainty of the process and return force values is 0.1%, k = 2.

The signal transducer and activator of transcription 3 (STAT3) is constitutively activated in certain cancer cells. Therefore, blocking the aberrant activity of STAT3 in tumor cells is a validated therapeutic strategy. To discover novel inhibitors of STAT3 activity, we report the salicylanilide derivatives as a new small molecule inhibitor of the STAT3 signaling pathway. The N-(3-chloro-4-fluorophenyl)-2-hydroxy-4-(3-(piperidin-1-yl)propoxy) benzamide potently inhibited the activation and transcriptional function of STAT3. These studies further validate STAT3 as a drug discovery target and provide evidence that pharmacological agents that can selectively reduce the phospho-STAT3 levels in human cancer cells result in tumor apoptosis and growth inhibition.

Supplemental Digital Content is available in the text, Digoxin is still commonly used in atrial fibrillation (AF) patients with and without heart failure (HF) for heart rate control. Studies concerning the detrimental effects of digoxin therapy in AF patients are inconsistent. This updated meta-analysis examined the association of digoxin therapy with all-cause mortality in AF patients, stratified by heart function status. We included observational studies with multivariate-adjusted data on digoxin and all-cause mortality in the analysis. The relative risks (RRs) of all-cause mortality were calculated and reported with 95% confidence intervals (95% CIs). Seventeen studies comprising 408,660 patients were included. Overall, in AF patients, digoxin treatment was associated with a significant increase in all-cause mortality after multivariate-adjustment (RR = 1.22; 95% CI 1.15–1.30). When stratified by heart function status, digoxin treatment was associated with a 14% increase in all-cause mortality in AF patients with HF (RR = 1.14, 95% CI 1.04–1.24), and a 36% increase in those without HF (RR = 1.36, 95% CI 1.18–1.56). The increased risk of all-cause mortality was significantly higher in AF patients without HF compared with those with HF (P for interaction = 0.04). This meta-analysis demonstrates that digoxin therapy was associated with a significant increase in all-cause mortality in AF patients, especially in those without HF. Given other available options, digoxin should be avoided as a first-line agent for heart rate control in AF patients.

This study aims at enhancing cavitation heating by using dual-frequency modes of second-harmonic and third-harmonic superimposition for high-efficient focused-ultrasound surgery. By controlling the ratio of dual-frequency acoustic powers, the superimposing of two frequency pressures result in split foci along beam axial within confocal region, and the maximal peak intensity of split focus can reach about 2 times the sum of two frequency intensities, indicating strong wave interference. The 1.1 MHz/3.3 MHz and 1.1 MHz/2.2 MHz experiments implemented in BSA gel-phantom, and lesion inception time is about 0.3 s, which is 10 times shorter than that in single frequency mode. The boiling bubbles occur frequently in each lesion formation, beneficiating increase the lesion size. In 1.1 MHz/3.3 MHz modes, lesions developed in a symmetrical manner in ellipsoid shapes. The 12-s lesion size of 1.1 MHz/3.3 MHz modes is nearly two times as large as the lesion size of 1.1 MHz/2.2 MHz modes. Although in 20% DC case, the acoustic power dose is only a half that used in 80% DC case, the 12-s lesion size with 20% DC is nearly same as that with 80% DC for both 1.1 MHz/3.3 MHz and 1.1 MHz/2.2 MHz conditions. The inertial-cavitation-energy waveforms reveal that the strong inertial-cavitation activities involve in all cases.

A modified Monte Carlo model of speckle tracking of shear wave propagation in scattering media is proposed. The established Monte Carlo model mainly concerns the variations of optical electric field and speckle. The two-dimensional intensity distribution and the time evolution of speckles in different probe locations are obtained. The fluctuation of speckle intensity tracks the acoustic-radiation-force shear wave propagation, and especially the reduction of speckle intensity implies attenuation of shear wave. Then, the shear wave velocity is estimated quantitatively on the basis of the time-to-peak algorithm and linear regression processing. The results reveal that a smaller sampling interval yields higher estimation precision and the shear wave velocity is estimated more efficiently by using speckle intensity difference than by using speckle contrast difference according to the estimation error. Hence, the shear wave velocity is estimated to be 2.25 m/s with relatively high accuracy for the estimation error reaches the minimum (0.071).

Canpopy interception, evapotranspiration, runoff yield and concentration constitute primary hydrologic processes, which mathematic modeling contributes an important way to study hydrologic regularity. Jialingjiang hilly areas is an important ecological barriers and economic zone of Yangtyz river. In this paper, a tipical small watershed-Lizixi basin is selected to simulate main hydrology processes of Jialingjiang hilly small watershed. Results of model show that the model uncertainty factor meets the precision requirements of B and relative error is below 15%, which indicates that the model reflects the actual hydrologic process basically and the model is effective.