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Picking robots have become an important development direction of smart agriculture, and the position detection of fruit is the key to realizing robot picking. However, the existing detection models have the shortcomings of missing detection and slow detection speed when detecting dense and occluded grape targets. Meanwhile, the parameters of the existing model are too large, which makes it difficult to deploy to the mobile terminal. In this paper, a lightweight GA-YOLO model is proposed. Firstly, a new backbone network SE-CSPGhostnet is designed, which greatly reduces the parameters of the model. Secondly, an adaptively spatial feature fusion mechanism is used to address the issues of difficult detection of dense and occluded grapes. Finally, a new loss function is constructed to improve detection efficiency. In 2022, a detection experiment was carried out on the image data collected in the Bagui rural area of Guangxi Zhuang Autonomous Region, the results demonstrate that the GA-YOLO model has an mAP of 96.87%, detection speed of 55.867 FPS and parameters of 11.003 M. In comparison to the model before improvement, the GA-YOLO model has improved mAP by 3.69% and detection speed by 20.245 FPS. Additionally, the GA-YOLO model has reduced parameters by 82.79%. GA-YOLO model not only improves the detection accuracy of dense and occluded targets but also lessens model parameters and accelerates detection speed. [ABSTRACT FROM AUTHOR]

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant health issue closely associated with multiple extrahepatic cancers. The association between MAFLD and clinical outcomes of endometrial cancer (EC) remains unknown. Methods: We retrospectively included 725 EC patients between January 2012 and December 2020. The odds ratios (ORs) were calculated using logistic regression analyses. Kaplan–Meier survival curves were used for survival analysis. Results: Among EC patients, the prevalence of MAFLD was 27.7% (201/725, 95% confidence interval (Cl) = 0.245–0.311). MAFLD was significantly associated with cervical stromal involvement (CSI) (OR = 1.974, 95% confidence interval (Cl) = 1.065–3.659, p = 0.031). There was a significant correlation between overall survival (OS) and CSI (HR = 0.31; 95%CI: 0.12–0.83; p = 0.020), while patients with MAFLD had a similar OS to those without MAFLD (p = 0.952). Moreover, MAFLD was significantly associated with CSI in the type I EC subgroup (OR = 2.092, 95% confidence interval (Cl) = 1.060–4.129, p = 0.033), but not in the type II EC subgroup (p = 0.838). Further logistic regression analysis suggested that the hepatic steatosis index (HSI) was significantly associated with CSI among type I EC patients without type 2 diabetes mellitus (T2DM) (OR = 1.079, 95% confidence interval (Cl) = 1.020–1.139, p = 0.012). Conclusions: About one-quarter of our cohort had MAFLD. MAFLD was associated with the risk of CSI in EC patients, and this association existed in type I EC patients but not in type II EC patients. Furthermore, the HSI can help predict CSI in type I EC patients without T2DM. [ABSTRACT FROM AUTHOR]

The effect of cervical cancer immunotherapy is limited. Combination therapy will be a new direction for cervical cancer. Thus, it is essential to discover a novel and available predictive biomarker to stratify patients who may benefit from immunotherapy for cervical cancer. In this study, 563 participants were enrolled. Adenylate cyclase 7 (ADCY7) mRNA was detected by real-time quantitative PCR (qPCR) with cervical cytology specimens. The relationship between ADCY7 and cervical intraepithelial neoplasia in grade 2 and higher (CIN2+) was analyzed, and the optimal cut-off values of the relative expression of ADCY7 mRNA to predict CIN2+ were calculated. In addition, the clinical significance of ADCY7 in cervical cancer was determined by the Kaplan–Meier Cox regression based on the TCGA database. The mean ADCY7 mRNA expression increased significantly with cervical lesion development, especially compared with CIN2+ (p < 0.05). Moreover, the expression of ADCY7 increased significantly in high-risk human papillomavirus (HR-HPV) infection but not in HPV-A5/6 species. The area under the receiver operating characteristic curve (AUC) of ADCY7 was 0.897, and an optimal cut-off was 0.435. Furthermore, ADCY7 had the highest OR (OR= 8.589; 95% CI (2.281–22.339)) for detecting CIN 2+, followed by HPV genotyping, TCT, and age (OR = 4.487, OR = 2.071, and OR = 1.345; 95% CI (1.156–10.518), (0.370–8.137), and (0.171–4.694), respectively). Moreover, this study indicated that higher ADCY7 levels could be a suitable predictor for poor prognosis in cervical cancer due to immune cell infiltration. A new auxiliary predictor of CIN2+ in cervical cytology specimens is ADCY7 ≥ 0.435. Furthermore, it may be a promising prognosis predictor and potential immunotherapy target for the combined treatment of cervical cancer and possibly further block HR-HPV persistent infection. [ABSTRACT FROM AUTHOR]

Titanium dioxide (TiO2) is a promising semiconductor for photocathodic protection, but the low efficiency of visible-light absorption and quantum restricts its application. In this study, graphene quantum dots-doped TiO2 (TiO2-GQD) nanocomposites with mesopores were prepared by a sol-gel method under ultrasonic radiation conditions. The prepared TiO2-GQD nanocomposites exhibit excellent performance in the aspects of sunlight absorption, and photocathodic protection. It can protect the active metal and reduce the corrosion rate effectively. It is expected the TiO2-GQD nanocomposites will be used in marine engineering to realize the efficient and sustainable development of marine corrosion protection. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore lymphocyte subsets for the personalized prediction of endometrioid endometrial cancer (EEC) risk and evaluated the correlation between immune cells and International Federation of Gynecology and Obstetrics (FIGO) staging in patients with EEC. Patients and Methods: A case-control study was conducted to analyze the clinical data of 421 patients admitted to Fujian Maternity and Child Health Hospital from October 2017 to December 2021. t-tests or Mann–Whitney U-tests were used to analyze the percentages and absolute counts of peripheral blood lymphocyte subsets in patients with EEC and patients without cancer. The independent risk factors for ECC and FIGO stage were analyzed via multivariate binary logistic regression. The receiver operating characteristic curve was calculated to evaluate the prediction efficacy of risk factors on ECC. Results: The CD4+ T% in the 121 patients with EEC was lower than in the 300 patients without cancer (P = 0.013). The absolute counts of peripheral CD4+ T (P = 0.002) and T cells (P = 0.007) in 37 patients with EEC were lower than in 51 patients without cancer. Multivariate binary logistic regression analysis showed that CD4+ T% and natural killer cell (NK)% were independent risk factors for FIGO staging in patients with EEC. NK% was significantly higher in patients with advanced stage (FIGO III and IV) than those with early EEC (FIGO I and II) (P = 0.004). To determine the early and advance FIGO stage of EEC, the cutoff value of NK% was calculated as 19.94%. Conclusion: With the decrease of CD4+ T counts, the immune status of patients with EEC is impaired. NK cells may help in the evaluation of the prognosis of patients with EEC and are likely to be an independent risk factor for FIGO staging in patients with EEC. [ABSTRACT FROM AUTHOR]

Immune evasion and metabolic reprogramming are two fundamental hallmarks of cancer. Interestingly, lactate closely links them together. However, lactate has long been recognized as a metabolic waste product. Lactate and the acidification of the tumor microenvironment (TME) promote key carcinogenesis processes, including angiogenesis, invasion, metastasis, and immune escape. Notably, histone lysine lactylation (Kla) was identified as a novel post-modification (PTM), providing a new perspective on the mechanism by which lactate functions and providing a promising and potential therapy for tumors target. Further studies have confirmed that protein lactylation is essential for lactate to function; it involves important life activities such as glycolysis-related cell functions and macrophage polarization. This review systematically elucidates the role of lactate as an immunosuppressive molecule from the aspects of lactate metabolism and the effects of histone lysine or non-histone lactylation on immune cells; it provides new ideas for further understanding protein lactylation in elucidating lactate regulation of cell metabolism and immune function. We explored the possibility of targeting potential targets in lactate metabolism for cancer treatment. Finally, it is promising to propose a combined strategy inhibiting the glycolytic pathway and immunotherapy. [ABSTRACT FROM AUTHOR]

Single crystal (SC) MAPbBr3 perovskite is regarded as a promising material to fabricate high-performance photodetectors (PDs) due to its impressive optoelectronic properties and good chemical stability. Rb+ doping has been proved to be an effective method to significantly improve the optoelectronic properties of MAPbBr3 SC. However, the intrinsic effect of Rb+ on the crystal structure is still unclear. Herein, Rb-doping enhances optoelectronic performance of RbxMA(1−x)PbBr3 single crystals by lattice relaxation effect was proved. The density functional theory (DFT) calculations demonstrate that Rb-doping leads to lattice relaxation effect which is benefit to reduce trap density of RbxMA(1−x)PbBr3 SCs. And then a series RbxMA(1−x)PbBr3 SCs were grown. X-ray rocking curves (XRC) of RbxMA(1−x)PbBr3 SCs prove that appropriate Rb-doping concentration could reduce defect density effectively. X-ray photoelectron spectroscopy (XPS) measurements indicate that Rb-doping enhances the atoms interaction in RbxMA(1−x)PbBr3 lattice. Single-crystal PDs were fabricated to compare the optoelectronic properties of MAPbBr3 SCs with different Rb-doping concentration, and the 2% Rb-doped RbxMA(1−x)PbBr3 PD shows the optimum performance. [ABSTRACT FROM AUTHOR]

Titanium dioxide (TiO2) is a promising semiconductor for photocathodic protection, but the low efficiency of visible-light absorption and quantum restricts its application. In this study, graphene quantum dots-doped TiO2 (TiO2-GQD) nanocomposites with mesopores were prepared by a sol-gel method under ultrasonic radiation conditions. The prepared TiO2-GQD nanocomposites exhibit excellent performance in the aspects of sunlight absorption, and photocathodic protection. It can protect the active metal and reduce the corrosion rate effectively. It is expected the TiO2-GQD nanocomposites will be used in marine engineering to realize the efficient and sustainable development of marine corrosion protection. [ABSTRACT FROM AUTHOR]

The accurate identification of irreversible infarction and salvageable tissue is important in planning the treatments for acute ischemic stroke (AIS) patients. Computed tomographic perfusion (CTP) can be used to evaluate the ischemic core and deficit, covering most of the territories of anterior circulation, but many community hospitals and primary stroke centers do not have the capability to perform CTP scan in emergency situation. This study aimed to identify AIS lesions from widely available non-contrast computed tomography (NCCT) and CT angiography (CTA) using deep learning. A total of 345AIS patients from our emergency department were included. A multi-scale 3D convolutional neural network (CNN) was used as the predictive model with inputs of NCCT, CTA, and CTA+ (8 s delay after CTA) images. An external cohort with 108 patients was included to further validate the generalization performance of the proposed model. Strong correlations with CTP-RAPID segmentations (r = 0.84 for core, r = 0.83 for deficit) were observed when NCCT, CTA, and CTA+ images were all used in the model. The diagnostic decisions according to DEFUSE3 showed high accuracy when using NCCT, CTA, and CTA+ (0.90±0.04), followed by the combination of NCCT and CTA (0.87±0.04), CTA-alone (0.76±0.06), and NCCT-alone (0.53±0.09). [ABSTRACT FROM AUTHOR]

Neural stem cells (NSCs) have the ability to differentiate into neurons, astrocytes and oligodendrocytes. They are self-renewing and sufficient to provide large amounts of brain tissue cells. NSCs have promising application prospects for the treatment of central nervous system diseases. Spider toxins are important tools for use in neurobiology and neuropharmacology. In this study, a Cell Counting Kit (CCK-8), immunofluorescence staining, real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting were used to qualitatively and quantitatively analyse the effects of different concentrations (1, 10 and 20 μg/mL) of Chilobrachys jingzhao crude venom on the proliferation and differentiation of C17.2 cells in vitro. At low concentrations, C. jingzhao crude venom did not significantly inhibit the proliferation of NSCs; however, the highest concentration of 20 μg/mL partially inhibited the NSC proliferation. In the differentiation medium, addition of C. jingzhao crude venom effectively promoted the differentiation of NSCs towards neuronal cells, with a final concentration of 10 μg/mL having the most obvious effect. These results suggest that C. jingzhao crude venom exerts a regulatory effect on the proliferation and differentiation of C17.2 cells. Therefore, spider venom can be used as an 'ammunition library' to find factors that regulate the proliferation and differentiation of NSCs, laying the groundwork for the application of NSCs in the treatment of central nervous system diseases. [ABSTRACT FROM AUTHOR]

This study explored whether body specificity unconsciously influenced preferences for certain people. Participants were presented pictures of the heads of 2 persons who were described as having the similar personality, profession and family background. They were instructed to choose 1 in each pair as the preferred date, preferred friend, more charismatic boss or as the better national leader. The results showed body specificity had an influence on the selection preference on first impression. Participants tended to choose the character on their dominant‐hand side. This study not only provided the first social psychological evidence for the body‐specificity hypothesis, but also first demonstrated a role for body specificity in impression formation and selection preference. [ABSTRACT FROM AUTHOR]

Previous neuropsychological studies have demonstrated that liver transplantation (LT) is an effective method for improving the cognitive function of cirrhotic patients. However, the neural basis underlying the effects of LT is still unclear. Neuroimaging studies investigating changes in brain structures or functional networks mainly focus on patients without overt hepatic encephalopathy (HE). In this study, we recruited patients with and without overt HE and studied alterations in resting-state brain activity by quantizing the amplitude of low-frequency fluctuation (ALFF) before and 1 month after LT to study the short-term effect of LT in each group. Neuropsychological analyses indicated significant improvement of cognitive function in both groups. ALFF analysis showed that the brain activity in regions regulating motor function, vision, attention, and working memory were restored in both groups, reflecting the neuroplasticity of the brain. However, some persistent impairments and new-onset impairments in other regions related to these cognitive functions were observed in each group. Between-group comparison showed that although cognitive performance improved in both groups, the specific neural basis of LT in each group was different. The significant correlations of altered brain activity in regions showing LT and group effect with altered performance in neuropsychological and biochemical tests suggest a possible neuroimaging marker for the monitoring of short-term recovery of HE and the difference in individual recovery of cognitive performance. The findings in the present study help us further understand the neural effect of LT in patients with and without overt HE. [ABSTRACT FROM AUTHOR]

In tissue engineering, scaffolding plays an important role in accommodating and stimulating new tissue growth. Chitosan and alginate are two widely used natural polymers in tissue engineering. Here, we prepared the chitosan-alginate (Chi-Alg) hydrogel from naturally derived chitosan and alginate polymers. The Fourier-transformed infrared spectroscopy and X-ray diffraction results demonstrated that a chitosan-alginate hydrogel was constructed due to the strong ionic interaction between the positively charged amino groups of chitosan and the negatively charged carboxyl groups of alginate. The scanning electron microscopy and contact angle results showed the inner porous structure and highly hydrophilic property of chitosan-alginate hydrogel. As the two most promising cell types in nerve tissue engineering, both olfactory ensheathing cells and neural stem cells proliferated well on the chitosan-alginate hydrogel. All results indicated the good potential application of a chitosan-alginate hydrogel for neural tissue engineering. [ABSTRACT FROM AUTHOR]

The composite thin film photodetector in this study combines the characteristics of MAPbI 3 material for near-ultraviolet-visible light and PDPP3T:PC71BM material for near-infrared light absorption, resulting in efficient light harvesting. To fabricate high-performance photodetectors, we optimized the photodetector structure, thin film fabrication process, solute concentration, and photoactive layer thickness. Finally, we obtained a photodetector with a broad spectral detection range in the near-ultraviolet-visible-near-infrared (UV–vis–NIR). The detectivity (D*) of our prepared UV–vis–NIR photodetector at 380 nm, 655 nm and 848 nm is 1.24 × 1013 jones, 2.13 × 1013 jones and 1.59 × 1013 jones, respectively. This is one of the best performances among polymer photodetectors reported so far and is comparable to commercial inorganic silicon-based PDs. In addition, the optimal composite thin film photodetector exhibits a fast response speed (t rise /t fall = 109/49 μs), a linear dynamic range of 100 dB, and excellent stability. Furthermore, the PDPP3T:PC71BM active layer can effectively suppress the leakage current in the reverse biased region, which enables the device to obtain an ultra-low dark current density (J dark) of 8.58 × 10−10 A cm−2. This study explores a new avenue for high-performance photodetectors based on mixtures of perovskites and low-bandgap photoactive polymers. [ABSTRACT FROM AUTHOR]

The present study proposes a new process for synthesis of alkali-activated materials (AAM)-supported analcime-C foam materials (AFs), utilizing a by-product of the lithium carbonate industry. This material has great application value as a bulk-type solid adsorbent. Characterization analyses show that the alkaline activator modulus greatly affects the crystallinity of analcime-C in AFs. Furthermore, the compressive strength, zeolite yield, and microstructure of AFs are significantly affected by the saturated steam parameters, including crystallization pressure, temperature, and time. The synthesized materials comprise pores of different sizes (micro to macro). They combine the functional micro-porosity of the analcime-C, the meso-porosity of the gel matrix, and the macro-porosity of the foamed AAM. The maximum compressive strength, density, total porosity, and Pb2+ adsorption capacity of AFs investigated in this study are 1.15 MPa, 350 kg/m3, 76.5%, and 69.3 mg/g Pb2+, respectively. Unlike many granular adsorbents, the bulk AFs adsorbent produced by this process is easy to recycle. In addition, it also contributes to the comprehensive utilization of a by-product of the lithium carbonate industry. [ABSTRACT FROM AUTHOR]

Surface plasmon (SP) enhancement of photoluminescence (PL) from a green-emitting InGaN/GaN quantum well (QW) using nanoparticles (NPs) made of different metals and their combinations was investigated. The NPs were formed by annealing the metal films in N2 followed by rapid cooling. Four-fold enhancement in PL intensity was achieved using random metal NPs made of Cu on Mg (Cu-Mg) double metal film that was more than two folds of the enhancement observed by AgNPs. Reversing the order of metal film deposition (Mg on Cu) resulted in much lower PL intensity due to significantly different NPs size distribution as the given annealing conditions did not cause homogeneous alloying of the two metals. The results pave the way for the application of NPs of relatively low-cost unconventional metals and their combinations in the SP enhancement of LEDs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the importance of an MRI-based radiomics nomogram in predicting the progression-free survival (PFS) of endometrial cancer. Methods: Based on clinicopathological and radiomic characteristics, we established three models (clinical, radiomics and combined model) and developed a nomogram for the combined model. The Kaplan-Meier method was utilized to evaluate the association between nomogram-based risk scores and PFS. Results: The nomogram had a strong predictive ability in calculating PFS with areas under the curve (ROC) of 0.905 and 0.901 at 1 and 3 years, respectively. The high-risk groups identified by the nomogram-based scores had shorter PFS compared with the low-risk groups. Conclusion: The radiomics nomogram has the potential to serve as a noninvasive imaging biomarker for predicting individual PFS of endometrial cancer.

The prevalence of soluble aluminum (Al) ions is one of the major limitations to crop production worldwide on acid soils. Therefore, understanding the Al tolerance mechanism of rice and applying Al tolerance functional genes in sensitive plants can significantly improve Al stress resistance. In this study, transcriptomics and metabolomics analyses were performed to reveal the mechanism of Al tolerance differences between two rice landraces (Al-tolerant genotype Shibanzhan (KR) and Al-sensitive genotype Hekedanuo (MR) with different Al tolerance. The results showed that DEG related to phenylpropanoid biosynthesis was highly enriched in KR and MR after Al stress, indicating that phenylpropanoid biosynthesis may be closely related to Al tolerance. E1.11.1.7 (peroxidase) was the most significant enzyme of phenylpropanoid biosynthesis in KR and MR under Al stress and is regulated by multiple genes. We further identified that two candidate genes Os02g0770800 and Os06g0521900 may be involved in the regulation of Al tolerance in rice. Our results not only reveal the resistance mechanism of rice to Al stress to some extent, but also provide a useful reference for the molecular mechanism of different effects of Al poisoning on plants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Su, Cui, Huang, Gu, Jiang, Feng, Xu, Zhang, Jiang and Zhao.)

(1) Background: Follow-up infarct volume (FIV) may have implications for prognostication in acute ischemic stroke patients. Factors predicting the discrepancy between FIV and 90-day outcomes are poorly understood. We aimed to develop a comprehensive predictive model of FIV and explore factors associated with the discrepancy. (2) Methods: Patients with acute anterior circulation large vessel occlusion were included. Baseline clinical and CT features were extracted and analyzed, including the CTP-based hypoperfusion index (HI) and the NCCT-based e-ASPECT, measured by automated software. FIV was assessed on follow-up NCCT at 3−7 days. Multiple linear regression was used to construct the predictive model. Subgroup analysis was performed to explore factors associated with poor outcomes (90-mRS scores 3−6) in small FIV (<70 mL). (3) Results: There were 170 patients included. Baseline e-ASPECT, infarct core volume, hypoperfusion volume, HI, baseline international normalized ratio, and successful recanalization were associated with FIV and included in constructing the predictive model. Baseline NIHSS, baseline hypertension, stroke history, and current tobacco use were associated with poor outcomes in small FIV. (4) Conclusions: A comprehensive predictive model (including HI) of FIV was constructed. We also emphasized the importance of hypertension and smoking status at baseline for the functional outcomes in patients with a small FIV.

Nickel oxide (NiO x ), a typical p-type semiconductor, is emerging as the most promising hole transport layer material. However, the inferior interfacial contact of the NiO x /perovskite interface has limited the improvement of the performance of photodetectors (PDs). In this work, 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (F4-TCNQ) is introduced to modify the NiO x /perovskite interface to prepare high-performance PDs. This study shows that the F4-TCNQ layer interacts with the NiO x /perovskite layers. It can increase the Ni 3+ /Ni 2+ ratio and then enhance the hole extraction and charge carrier mobility; on the contrary, it can form a new Lewis adduct and passivate the undercoordinated Pb 2+ ions. Furthermore, with the F4-TCNQ modification, the perovskite film exhibits good thermal stability and photostability. The PDs demonstrate excellent photoelectric properties and long-term stability in the atmosphere. This finding provides a simple and efficient way to further develop the NiO x /perovskite interface.

BACKGROUND. Automated software-based Alberta Stroke Program Early CT Score (ASPECTS) on unenhanced CT is associated with clinical outcomes after acute stroke. However, encephalomalacia or white matter hyperintensities (WMH) may result in a falsely low automated ASPECTS if such findings are interpreted as early ischemia. OBJECTIVE. The purpose of this study was to assess the impact of encephalomalacia and WMH on the automated ASPECTS in patients with acute stroke, in comparison with the radiologist-derived ASPECTS and clinical outcomes. METHODS. This retrospective three-center study included 459 patients (322 men, 137 women; median age, 65 years) with acute ischemic stroke treated by IV thrombolysis who underwent baseline unenhanced CT within 6 hours after symptom onset and MRI within 24 hours after treatment. ASPECTS was determined by automated software and by three radiologists in consensus. Presence of encephalomalacia and extent of WMH (categorized using the modified Scheltens score [mSS]) were also determined using MRI. Kappa coefficients were used to compare the ASPECTS between automated- and radiologist-derived methods. Multivariable logistic regression analyses and ROC analyses were performed to explore the predictive utility of the baseline ASPECTS for unfavorable clinical outcomes (90-day modified Rankin score of 3-6) after thrombolysis. RESULTS. The median automated software-derived ASPECTS was 9, and the median radiologist consensus-derived ASPECTS was 10. Agreement between automated and radiologist-consensus ASPECTS, expressed as kappa, was 0.68, though agreement was 0.76 in patients without encephalomalacia and 0.08 in patients with encephalomalacia. In patients without encephalomalacia, agreement decreased as the mSS increased (e.g., 0.78 in subgroup with mSS < 10 vs 0.19 in subgroup with mSS > 20). By anatomic region, agreement was highest for the lateral middle cerebral artery (κ, 0.52) and lowest for the internal capsule (κ, 0.18). In multivariable analyses, both the automated (odds ratio, 0.69) and the radiologist-consensus (odds ratio, 0.57) ASPECTS independently predicted an unfavorable clinical outcome. For unfavorable outcome, the automated ASPECTS had an AUC of 0.70, sensitivity of 60.4%, and specificity of 70.7%, whereas the radiologist-consensus ASPECTS had an AUC of 0.72, sensitivity of 60.4%, and specificity of 80.5%. CONCLUSION. Presence of encephalomalacia or extensive WMH results in a lower automated than radiologist-consensus ASPECTS, which may impact predictive utility of automated ASPECTS. CLINICAL IMPACT. When using an automated software-derived ASPECTS, radiologists should manually confirm the score in patients with encephalomalacia or extensive leukoencephalopathy.

BACKGROUND . The recently released Myeloma Response Assessment and Diagnosis System (MY-RADS) for multiple myeloma (MM) evaluation using whole-body MRI (WB-MRI) describes the total burden score. However, assessment is confounded by red bone marrow hyperplasia in anemia. OBJECTIVE . The purpose of this study is to assess the utility of the MY-RADS total burden score, ADC, and fat fraction (FF) from WB-MRI in predicting early treatment response in patients with newly diagnosed MM and to compare the utility of these measures between patients with and without anemia. METHODS . This retrospective study included 56 patients (40 men, 16 women; mean age, 57.4 ± 9.6 [SD] years) with newly diagnosed MM who underwent baseline WB-MRI including DWI and modified Dixon sequences. Two radiologists recorded total burden score using MY-RADS and measured the ADC and FF of diffuse and focal disease sites. Mean values across sites were derived. Interobserver agreement was evaluated, and the mean assessments of the readers were used for further analyses. Presence of deep response after four cycles of induction chemotherapy was recorded. Patients were classified as having anemia if their hemoglobin level was less than 100 g/L. The utility of WBMRI parameters in predicting deep response was assessed. RESULTS . A total of 24 of 56 patients showed deep response, and 25 of 56 patients had anemia. Interobserver agreement, which was expressed using intraclass correlation coefficients, ranged from 0.95 to 0.99. Among patients without anemia, those with deep response compared with those without deep response had a lower total burden score (9.0 vs 18.0), a lower ADC (0.79 × 10 -3 mm 2 /s vs 1.08 × 10 -3 mm 2 /s), and a higher FF (0.21 vs 0.10) (all p < .001). The combination of these three parameters (optimal cutoffs: ≤ 15 for total burden score, ≤ 0.84 × 10 -3 mm 2 /s for ADC, and > 0.16 for FF) achieved sensitivity of 93.8%, specificity of 93.3%, and accuracy of 93.5% for predicting deep response. In patients with anemia, none of the three parameters were significantly different between patients with and without deep response (all p > .05), and the combination of parameters achieved sensitivity of 56.3%, specificity of 100.0%, and accuracy of 72.0%. CONCLUSION . Low total burden score, low ADC, and high FF from WB-MRI may predict deep response in patients with MM, although only among those without anemia. CLINICAL IMPACT . WB-MRI findings may help guide determination of prognosis and initial treatment selection in MM.

Objective: To develop and validate an individualized risk prediction model for the need for central cervical lymph node dissection in patients with clinical N0 papillary thyroid carcinoma (PTC) diagnosed using ultrasound., Methods: Upon retrospective review, derivation and internal validation cohorts comprised 1585 consecutive patients with PTC treated from January 2017 to December 2019 at hospital A. The external validation cohort consisted of 406 consecutive patients treated at hospital B from January 2016 to June 2020. Independent risk factors for central cervical lymph node metastasis (CLNM) were determined through univariable and multivariable logistic regression analysis. An individualized risk prediction model was constructed and illustrated as a nomogram, which was internally and externally validated., Results: The following risk factors of CLNM were established: a solitary primary thyroid nodule's diameter, shape, calcification, and capsular abutment-to-lesion perimeter ratio. The areas under the receiver operating characteristic curves of the risk prediction model for the internal and external validation cohorts were 0.921 and 0.923, respectively. The calibration curve showed good agreement between the nomogram-estimated probability of CLNM and the actual CLNM rates in the 3 cohorts. The decision curve analysis confirmed the clinical usefulness of the nomogram., Conclusion: This study developed and validated a model for predicting the risk of CLNM in individual patients with clinical N0 PTC, which should be an efficient tool for guiding clinical treatment., (Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved.)