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Urban trees are essential elements in outdoor scenes recorded via terrestrial laser scanning. Although considerable interest has been centered on tree detection and reconstruction in recent years, trees cannot be easily extracted from dense and unorganized data because of the complexity and diversity of trees. In this paper, we present a top-down approach for detecting trees from point cloud data acquired for dense urban areas. Appropriate feature subsets are chosen, and then the candidate tree clusters are selected via a binary classification. After distinguishing the 3D points belonging to tree-like objects, individual trees are extracted by spectral clustering. Furthermore, a weighted constraint rule is proposed to refine the individual tree clusters. The methodology is tested on five real-world datasets that include different varieties of trees. The results reveal that most of the individual trees can be correctly detected and extracted. The results are quantitatively evaluated and reveal a global F1 value of approximately 97 percent and a precision of approximately 98 percent. Comparative analysis on the datasets is also provided to prove the effectiveness of our proposed method.

Jingliang Wu,1,* Qiao Lu,1,2,* Jialin Zhao,3,* Wendi Wu,3 Zhihua Wang,1 Guohua Yu,4 Guixiang Tian,2 Zhiqin Gao,2 Qing Wang5 1School of Medicine, Weifang University of Science and Technology, Weifang, 262700, People’s Republic of China; 2School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, People’s Republic of China; 3School of Clinical Medicine, Shandong Second Medical University, Weifang, 261053, People’s Republic of China; 4Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China; 5Department of Stomatology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qing Wang, Department of Stomatology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China, Tel +86 158 6362 6389, Email wfwq8899@163.comPurpose: Breast cancer is a prevalent malignancy among women worldwide, and malignancy is closely linked to the tumor microenvironment (TME). Here, we prepared mixed nano-sized formulations composed of pH-sensitive liposomes (Ber/Ru486@CLPs) and small-sized nano-micelles (Dox@CLGs). These liposomes and nano-micelles were modified by chondroitin sulfate (CS) to selectively target breast cancer cells.Methods: Ber/Ru486@CLPs and Dox@CLGs were prepared by thin-film dispersion and ethanol injection, respectively. To mimic actual TME, the in vitro “condition medium of fibroblasts + MCF-7” cell model and in vivo “ 4T1/NIH-3T3” co-implantation mice model were established to evaluate the anti-tumor effect of drugs.Results: The physicochemical properties showed that Dox@CLGs and Ber/Ru486@CLPs were 28 nm and 100 nm in particle size, respectively. In vitro experiments showed that the mixed formulations significantly improved drug uptake and inhibited cell proliferation and migration. The in vivo anti-tumor studies further confirmed the enhanced anti-tumor capabilities of Dox@CLGs + Ber/Ru486@CLPs, including smaller tumor volumes, weak collagen deposition, and low expression levels of α-SMA and CD31 proteins, leading to a superior anti-tumor effect.Conclusion: In brief, this combination therapy based on Dox@CLGs and Ber/Ru486@CLPs could effectively inhibit tumor development, which provides a promising approach for the treatment of breast cancer.Keywords: drug delivery, cancer-associated fibroblasts, glucocorticoids, combination therapy

Jinpeng Xu,1 Guomei Tian,2 Jingran He,1 Fangmin Deng,1 Fangting Chen,1 Qi Shi,1 Jian Liu,1 Hongyu Zhang,1 Ting Zhang,1 Qunhong Wu,1 Zheng Kang1 1School of Health Management, Harbin Medical University, Harbin, People’s Republic of China; 2Department of Nuclear Medicine, the Fourth Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Zheng Kang, School of Health Management, Harbin Medical University, Harbin, People’s Republic of China, Email kangzheng@hrbmu.edu.cnPurpose: To understand the public’s self-willingness to report medical insurance fraud and their expectations on others, to provide a reference for the government to do a good job in medical insurance anti-fraud.Methods: Data were obtained from a questionnaire survey of 846 respondents in China. Descriptive statistical analyses and multinomial logistic regression were used to analyze the different subjective attitudes of the public toward different subjects when faced with medical insurance fraud and the influencing factors.Results: 511 (60.40%) respondents were willing to report medical insurance fraud, while 739 (87.35%) respondents expected others to report it. 485 (57.33%) respondents were willing and expected others to report medical insurance fraud, followed by those who were not willing but expected others to report it (254, 30.02%). Compared to those who were unwilling to report themselves and did not want others to report, those who believe their reporting is useless (OR=3.13, 95% CI=1.15– 8.33) and those who fear for their safety after reporting (OR=2.96, 95% CI=1.66– 5.26) were more likely to expect others to report. Self-reporting willingness was stronger among the public who were satisfied with the government’s protective measures for the safety of whistleblowers (OR=4.43, 95% CI=1.38– 14.17). The public who believe that both themselves and others have responsibilities to report medical insurance fraud were willing to report and expect others to do the same.Conclusion: The public had a “self-avoidance” and “other-reliance” mentality in medical insurance anti-fraud. The free-rider mentality, lack of empathy, concerns about own risk after reporting, and the interference of decentralized responsibility were important factors contributing to this public mentality. At this stage, the government should prevent the public’s “collective indifference” in medical insurance anti-fraud efforts. Improving the safety and protection of whistleblowers and making everyone feel more responsible and valued may be effective incentives to enhance the public’s willingness to report.Keywords: medical insurance, anti-fraud, whistleblower, subjective attitudes

Li Huang,1– 3,* Jingyang Tang,1– 3,* Gang Tian,1– 3 Hualin Tao,1– 3 Zhaoyinqian Li1– 3 1Department of Laboratory Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 2Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, People’s Republic of China; 3Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhaoyinqian Li, Department of Laboratory Medicine, the Affiliated Hospital of Southwest Medical University, No. 25, Taiping Street, Jiangyang District, Luzhou, Sichuan, 646000, People’s Republic of China, Tel/Fax +86 08303165731, Email lizhaoyinqian@swmu.edu.cnPurpose: Acinetobacter baumannii has evolved to become a major pathogen of nosocomial infections, resulting in increased morbidity and mortality. This study aimed to investigate the risk factors, outcomes, and predictions of extensively drug-resistant (XDR)-A. baumannii nosocomial infections in patients with nervous system diseases (NSDs).Methods: A retrospective study of patients infected with XDR-A. baumannii admitted to the Affiliated Hospital of Southwest Medical University (Luzhou, China) from January 2021 to December 2022 was conducted. Three multivariate regression models were used to assess the risk factors and predictive value for specific diagnostic and prognostic subgroups.Results: A total of 190 patients were included, of which 84 were diagnosed with NSDs and 80% of those were due to stroke. The overall rates of all-cause mortality for XDR-A. baumannii nosocomial infections and those in NSDs were 38.9% and 40.5%, respectively. Firstly, hypertension, indwelling gastric tube, tracheotomy, deep puncture, bladder irrigation, and pulmonary infections were independent risk factors for XDR-A. baumannii nosocomial infections in patients with NSDs. Moreover, pulmonary infections, the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, and the neutrophil-to-lymphocyte ratio (NLR) were significantly associated with increased mortality rates in patients with nosocomial infections caused by XDR-A. baumannii. Thirdly, NLR and cardiovascular diseases accounted for a high risk of mortality for XDR-A. baumannii nosocomial infections in patients with NSDs. The area under the curves of results from each multivariate regression model were 0.827, 0.811, and 0.853, respectively.Conclusion: This study reveals the risk factors of XDR-A. baumannii nosocomial infections in patients with NSDs, and proves their reliable predictive value. Early recognition of patients at high risk, sterilizing medical tools, and regular blood monitoring are all critical aspects for minimizing the nosocomial spread and mortality of A. baumannii infections.Keywords: risk factors, mortality, prediction, extensively drug-resistant Acinetobacter baumannii, nosocomial infection, nervous system diseases

Hongyu Zhang,1,* Ting Zhang,1,* Qi Shi,1,* Jian Liu,1 Jinpeng Xu,1 Bokai Zhang,1 Haixin Wang,1 Guomei Tian,2,* Qunhong Wu,1 Zheng Kang1 1School of Health Management, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China; 2Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zheng Kang, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China, Email kangzheng@hrbmu.edu.cnPurpose: An individual’s willingness to report is largely related to whether he or she is a direct victim. This study takes two scenarios of whether medical insurance fraud results in a direct loss of personal benefit and explores the differences in individuals’ willingness to report and influencing factors in the two scenarios.Methods: In this study, questionnaires were used and participants were selected from 571 individuals in eastern, central, and western China. Analysis was performed using descriptive statistics and logistic regression models.Results: 51.0% of individuals were willing to report when no direct loss of personal benefit was caused, and conversely, 78.3% of individuals were willing to report when direct loss of personal benefit was caused. The factors influencing the attitude dimension of individuals toward whistleblowing behavior were consistent in the two scenarios. In contrast, there were significant differences among the influences in the perceived behavioral control, consequence perception, and subjective norm dimensions.Conclusion: There were significant differences in the willingness of individuals to report medical insurance fraud and the factors influencing it in both scenarios. The most significantly influencing factor difference was perceived behavioral control, a dimension that had an effect only when it did not result in a direct loss of personal benefit. When an individual’s direct interests are at stake, the individual’s fear for his or her safety is not a deterrent to his or her willingness to report. And when there is no loss of direct personal benefit, individuals care more about government measures to protect whistleblowers. There are differences in the subjects that influence individuals’ willingness to report in the two scenarios. The factors influencing the attitude dimension are the same in both scenarios, and the more supportive the attitude toward the whistleblower, the stronger the individual’s willingness to report will be.Keywords: whistleblowing willingness, loss of direct benefits, medical insurance fraud, individual

Effective control of skyrmion rotation is of significant importance in designing skyrmion-based nano-oscillators. In this work, we numerically study the optical vortex-driven skyrmion rotation in frustrated magnets using the Landau–Lifshitz–Gilbert simulations. The skyrmion rotation is induced by the orbital angular momentum (OAM) transfer from the optical vortex to the skyrmion, which is regardless of the sign of the OAM quantum number m due to the helicity degree of freedom of the frustrated skyrmion. This property highly broadens the parameter range of the optical vortex in controlling the skyrmion rotation. The direction of the rotation is determined by the sign of m, and the radius and angular velocity depend on the magnitude of m, light polarization, and intensity. Interestingly, the helicity oscillation induced by the linearly polarized beam is much slower than that driven by the circularly polarized beam with a same intensity, resulting in a faster rotation of the skyrmion. This phenomenon demonstrates the advantage of the linearly polarized beam in controlling the dynamics of the frustrated skyrmion, benefiting energy-saving and high-efficient device design. [ABSTRACT FROM AUTHOR]

Background: The amide proton transfer‐weighted (APTw) imaging for kidney diseases is important. However, the breathing patterns on APTw imaging remains unexplored. Purpose: This study aimed to investigate the effects of intermittent breath‐hold (IBH) and free breathing (FB) on renal 3D‐APTw imaging. Study Type: Healthy volunteers were enrolled prospectively, and renal clear cell carcinoma (RCCC) patients were included retrospectively. Population: 58 healthy volunteers and 10 RCCC patients. Field Strength/Sequence: 3‐T, turbo spin echo, and fast field echo. Assessment: 3D‐APTw imaging was scanned using the IBH and FB methods in volunteers and using the IBH method in RCCC patients. The image quality was evaluated by three observers according to the 5‐point Likert scale. Optimal images rated at three points or higher were used to measure the APT values. Statistical Analysis: The measurement repeatability was assessed using the intraclass correlation coefficient (ICC) and the Bland–Altman plot. The APT values were analyzed using McNemar's test, one‐way analysis of variance, and t test. Results: 50 healthy volunteers and 8 RCCC patients were enrolled. Renal 3D‐APTw imaging using the IBH method revealed a higher success rate (88% vs 78%). The ICCs were excellent in the IBH group (ICCs > 0.74) and were good in the FB group (ICCs < 0.74). No significant differences in the APT values among various zones using the IBH (P = 0.263) or FB method (P = 0.506). The mean APT value using the IBH method (2.091% ± 0.388%) was slightly lower than the FB method (2.176% ± 0.292%), but no significant difference (P = 0.233). The APT value of RCCC (4.832% ± 1.361%) was considerably higher than normal renal using the IBH method. Conclusions: The study demonstrated that the IBH method substantially increased the image quality of renal 3D‐APTw imaging. Furthermore, APT values may vary between normal and tumor tissues. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

The NCCN Guidelines for Hepatobiliary Cancers provide treatment recommendations for cancers of the liver, gallbladder, and bile ducts. The NCCN Hepatobiliary Cancers Panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding locoregional therapy for treatment of patients with hepatocellular carcinoma.

Purpose This two-part, first-in-human study was initiated in patients with advanced solid tumors harboring genetic alterations in fibroblast growth factor receptors (FGFRs) to determine the maximum tolerated dose (MTD), the recommended phase II dose (RP2D), and the schedule, safety, pharmacokinetics, pharmacodynamics, and antitumor activity of oral BGJ398, a selective FGFR1-3 tyrosine kinase inhibitor. Patients and Methods Adult patients were treated with escalating dosages of BGJ398 5 to 150 mg once daily or 50 mg twice daily continuously in 28-day cycles. During expansion at the MTD, patients with FGFR1-amplified squamous cell non-small-cell lung cancer (sqNSCLC; arm 1) or other solid tumors with FGFR genetic alterations (mutations/amplifications/fusions) received BGJ398 daily on a continuous schedule (arm 2), or on a 3-weeks-on/1-week-off schedule (arm 3). Results Data in 132 patients from the escalation and expansion arms are reported (May 15, 2015, cutoff). The MTD, 125 mg daily, was determined on the basis of dose-limiting toxicities in four patients (100 mg, grade 3 aminotransferase elevations [n = 1]; 125 mg, hyperphosphatemia [n = 1]; 150 mg, grade 1 corneal toxicity [n = 1] and grade 3 aminotransferase elevations [n = 1]). Common adverse events in patients treated at the MTD (n = 57) included hyperphosphatemia (82.5%), constipation (50.9%), decreased appetite (45.6%), and stomatitis (45.6%). A similar safety profile was observed using the 3-weeks-on/1-week-off schedule (RP2D). However, adverse event-related dose adjustments/interruptions were less frequent with the 3-weeks-on/1-week-off (50.0%) versus the continuous (73.7%) schedule. Antitumor activity (seven partial responses [six confirmed]) was demonstrated with BGJ398 doses ≥ 100 mg in patients with FGFR1-amplified sqNSCLC and FGFR3-mutant bladder/urothelial cancer. Conclusion BGJ398 at the MTD/RP2D had a tolerable and manageable safety profile and showed antitumor activity in several tumor types, including FGFR1-amplified sqNSCLC and FGFR3-mutant bladder/urothelial cancers.