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There have been anecdotal reports that local hyperthermia was effective in the treatment of viral warts. We conducted a randomized, patient-blinded, placebo-controlled trial to test the effect of local hyperthermia (44 degrees C for 30 min a day for 3 consecutive days plus 2 additional days 2 weeks later) on plantar warts. By the end of 3 months, 53.57% of patients (15/28) in the treatment group and 11.54% of patients (3/26) in the control group were cured ([Formula: see text]). The effect was not influenced by patient age, duration of disease, or number or size of lesions. [ABSTRACT FROM AUTHOR]

The clinical significance of osteoporosis lies in the occurrence of fragility fractures (FFx), and the most relevant fracture site is the hip. The T-score is defined as follows: (BMD patient -BMD young adult mean )/SDy oung adult population , where BMD is bone mineral density and SD is the standard deviation. When the femoral neck (FN) is measured in adult Caucasian women, a cutpoint value of patient BMD of 2.5 SD below the young adult mean BMD results in a prevalence the same as the lifetime risk of hip FFx for Caucasian women. The FN T-score criterion for classifying osteoporosis in older Caucasian men has been provisionally recommended to be - 2.5, but debates remain. Based on a systematic literature review, we noted that older men suffer from hip FFx at a FN T-score approximately 0.5-0.6 higher than older women. While the mean hip FFx FN T-score of around - 2.9 for women lies below - 2.5, the mean hip FF FN T-score of around - 2.33 for men lies above - 2.5. This is likely associated with that older male populations have a higher mean T-score than older female populations. We propose a new category of low BMD status, osteofrailia, for older Caucasian men with T-score ≤  - 2 (T-score ≤  - 2.1 for older Chinese men) who are likely to suffer from hip FFx. The group with T-score ≤  - 2 for older Caucasian men is comparable in prevalence to the group with T-score ≤  - 2.5 for older Caucasian women. However, older men in such category on average have only half the FFx risk as that of older women with osteoporotic T-score., (© 2024. The Author(s).)

Transition metal oxides ion diffusion channels have been developed for ammonium-ion batteries (AIBs). However, the influence of microstructural features of diffusion channels on the storage and diffusion behavior of NH 4 + is not fully unveiled. In this study, by using MnCo 2 O 4 spinel as a model electrode, the asymmetric ion diffusion channels of MnCo 2 O 4 have been regulated through bond length optimization strategy and investigate the effect of channel size on the diffusion process of NH 4 + . In addition, the reducing channel size significantly decreases NH 4 + adsorption energy, thereby accelerating hydrogen bond formation/fracture kinetics and NH 4 + reversible diffusion within 3D asymmetric channels. The optimized MnCo 2 O 4 with oxygen vacancies/carbon nanotubes composite exhibits impressive specific capacity (219.2 mAh g -1 at 0.1 A g -1 ) and long-cycle stability. The full cell with 3,4,9,10-perylenetetracarboxylic diimide anode demonstrates a remarkable energy density of 52.3 Wh kg -1 and maintains 91.9% capacity after 500 cycles. This finding provides a unique approach for the development of cathode materials in AIBs., Competing Interests: Competing interests statement:The authors declare no competing interest.

This study investigates age and gender differences of normative values of spleen diffusion MRI parameters.We recruited 124 volunteers with MRI conducted at 1.5T. Diffusion imaging had b-values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, 600 s/mm 2 . ADC, IVIM-Dslow, IVIM-PF, IVIM-Dfast, and DDVD (diffusion-derived vessel density) were computed. DDVD is the signal difference between the b=0 s/mm 2 image and b=2, 4 s/mm 2 image. Only images without apparent artifacts and with good curving fitting were included in the analysis. Finally, 34 females (age: 20-71 years) and 69 males (22-70 years) were measured with ADC; 20 females (20-71 years) and 48 males (22-67 years) were measured with IVIM; 32 females (20-71 years) and 65 males (22-70 years) were measured with DDVD parameter.An age-related decrease in ADC was noted for females, while such a trend was not noted for males. A very high level of heterogeneity was noted for the data for the males, with the highest ADC value being 1.710 × 10 -3 mm 2 /s and the lowest ADC value being 0.705 × 10 -3 mm 2 /s when b=0 and 600 s/mm 2 were used for ADC calculation. A male-female data comparison did not show a statistically significant difference between the ADC median value. However, ADCs > 1.3 × 10 -3 mm 2 /s were only seen among males. A very high level of heterogeneity was also noted for males' Dslow, with the highest value being 1.468 × 10 -3 mm 2 /s and the lowest value being 0.600 × 10 -3 mm 2 /s. Both PF and Dfast demonstrated a trend of age-related increase for older subjects. PF values were higher among males than females. However, no difference was noted for Dfast between males and females. DDVD did not show an age-related trend both for females and males. No difference was noted in DDVD values between males and females.Interpreting normal spleen diffusion MRI parameters should consider age and gender factors. · An age-related decrease in spleen ADC and IVIM-Dslow was seen for healthy females.. · There is a high level of heterogeneity for spleen ADC and IVIM-Dslow data for healthy males.. · IVIM modelled perfusion fraction and Dfast demonstrate an artificial trend of age-related increase for older subjects.. · Vessel density measured on diffusion imaging does not show an age-related trend.. · Yu W, Ma FZ, Huang H et al. Age and gender differences of normative values of spleen diffusion MRI parameters. Fortschr Röntgenstr 2024; DOI 10.1055/a-2357-9741., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Given the escalating demand for wearable electronics, there is an urgent need to explore cost-effective and environmentally friendly flexible energy storage devices with exceptional electrochemical properties. However, the existing types of flexible energy storage devices encounter challenges in effectively integrating mechanical and electrochemical performances. This review is intended to provide strategies for the design of components in flexible energy storage devices (electrode materials, gel electrolytes, and separators) with the aim of developing energy storage systems with excellent performance and deformability. Firstly, a concise overview is provided on the structural characteristics and properties of carbon-based materials and conductive polymer materials utilized in flexible energy storage devices. Secondly, the fabrication process and strategies for optimizing their structures are summarized. Subsequently, a comprehensive review is presented regarding the applications of carbon-based materials and conductive polymer materials in various fields of flexible energy storage, such as supercapacitors, lithium-ion batteries, and zinc-ion batteries. Finally, the challenges and future directions for next-generation flexible energy storage systems are proposed., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objectives: Increasing trend of PAS (placenta accreta spectrum disorders) incidence is a major health concern as PAS is associated with high maternal morbidity and mortality during cesarean section. Prenatal identification of PAS is crucial for delivery planning and patients management. This study aims to explore whether diffusion-derived vessel density (DDVD) computed from a simple diffusion MRI protocol differs in PAS from normal placenta., Methods: We enrolled 86 patients with PAS disorders and 40 pregnant women without PAS disorders. Each patient underwent intravoxel incoherent motion (IVIM) MRI sequence with 11 b-values. Placenta diffusion-derived vessel density (DDVD-b0b50) was the signal difference between b = 0 and b = 50 s/mm 2 images. DDVD(b0b50) A/N was calculated as [accreta lesion DDVD(b0b50)]/ [normal placenta DDVD(b0b50)]. The correlation between DDVD and gestational age was explored using Spearman rank correlation. Differences of DDVD(b0b50) A/N in patients with normal placentas and with PAS, and in patients with different subtypes of PAS were explored., Results: DDVD was negatively correlated with gestational age (p = 0.023, r = -0.359) in patients with normal placentas. DDVD(b0b50) A/N was significantly higher in patients with PAS (median:1.16, mean: 1.261) than normal placenta (median:1.02, mean: 1.032, p < 0.001) and especially higher in patients with placenta increta (median:1.14, mean: 1.278) and percreta (median: 1.20, mean: 1.396, p < 0.001)., Conclusion: As a higher DDVD indicates higher physiological volume of micro-vessels in PAS, this study suggests DDVD can be a potential biomarker to evaluate the placenta perfusion., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Diffusion-derived vessel density (DDVD) is a physiological surrogate of the area of micro-vessels per unit tissue area. DDVD is calculated according to: DDVD(b0b5) = Sb0/ROIarea0 - Sb5/ROIarea5, where Sb0 and Sb5 refer to the tissue signal when b is 0 or 5 s/mm 2 . This study applied DDVD to assess the perfusion of rectal carcinoma (RC)., Methods: MRI was performed with a 3.0-T magnet. Diffusion weighted image with b -values of 0, 5 s/mm 2 were acquired in 113 patients with non-mucinous RC and 15 patients with mucinous RC. Diffusion-derived vessel density ratio [DDVDr(b0b5)] was DDVD(b0b5) of RC divided by DDVD(b0b5) of tumor-free rectal wall., Results: The median value of the DDVDr(b0b5) for non-mucinous RCs was 1.430, with the majority of RCs showing a higher DDVD than the adjacent tumor-free wall [i.e., with DDVDr(b0b5) >1]. 90.3% (102/113) of non-mucinous RCs were hypervascular, 1.77% (2/113) were iso-vascular, and 7.96% (9/113) were hypovascular. The median value of the DDVDr(b0b5) for mucinous RCs was 1.660. 73.3% (11/15) of mucinous RCs were hypervascular, and 26.7% (4/15) were hypovascular. A trend (P=0.09) was noted that earlier clinical grades non-mucinous RCs had a higher DDVDr(b0b5) than those of the advanced clinical grades (2.245 for grade 0&I, 1.460 for grade II, 1.430 for grade III, 1.130 for grade IV). A non-significant trend was noted with well and moderately differentiated non-mucinous RCs had a higher DDVDr(b0b5)than that of poorly differentiated non-mucinous RCs (median: 1.460 vs. 1.320). A non-significant trend was noted with MRI-detected extramural vascular invasion (mrEMVI) positive non-mucinous RCs had a higher DDVDr(b0b5) than that of mrEMVI negative non-mucinous RCs (1.630 vs. 1.370)., Conclusions: DDVD results in this study approximately agree with contrast agent dynamically enhanced CT literature data., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-406/coif).Y.X.J.W. serves as the Editor-in-Chief of Quantitative Imaging in Medicine and Surgery. He is the founder of Yingran Medicals Ltd., which develops medical image-based diagnostics software. The other authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

The 1994 WHO criterion of a T-score ≤ -2.5 for densitometric osteoporosis was chosen because it results in a prevalence commensurate with the observed lifetime risk of fragility fractures in Caucasian women aged ≥ 50 years. Due to the much lower risk of fragility fracture among East Asians, the application of the conventional WHO criterion to East Asians leads to an over inflated prevalence of osteoporosis, particularly for spine osteoporosis. According to statistical modeling and when a local BMD reference is used, we tentatively recommend the cutpoint values for T-score of femoral neck, total hip, and spine to be approximately -2.7, -2.6, and -3.7 for Hong Kong Chinese women. Using radiographic osteoporotic vertebral fracture as a surrogate clinical endpoint, we empirically demonstrated that a femoral neck T-score of -2.77 for Chinese women was equivalent to -2.60 for Italian women, a spine T-score of -3.75 for Chinese women was equivalent to -2.44 for Italian women, and for Chinese men a femoral neck T-score of -2.77 corresponded to spine T-score of -3.37. For older Chinese men, we tentatively recommend the cutpoint values for T-score of femoral neck, total hip, and spine to be approximately -2.7, -2.6, and -3.2. With the BMD reference published by IKi et al. applied, T-score of femoral neck, total hip, and spine of -2.75, -3.0, and -3.9 for Japanese women will be more in line with the WHO osteoporosis definition. The revised definition of osteoporosis cutpoint T-scores for East Asians will allow a more meaningful international comparison of disease burden., (© 2023. The Author(s), under exclusive licence to International Skeletal Society (ISS).)

For liver intravoxel incoherent motion (IVIM) data acquisition, respiratory-triggering (RT) MRI is commonly used, and there are strong motivations to shorten the scan duration. For the same scan duration, more b values or higher numbers of excitations can be allowed for free-breathing (FB) imaging than for RT. We studied whether FB can be used to replace RT when careful IVIM image acquisition and image processing are conducted. MRI data of 22 healthy participants were acquired using a 3.0 T scanner. Diffusion imaging was based on a single-shot spin-echo-type echo-planar sequence and 16 b values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, and 600 s/mm 2 . Each subject attended two scan sessions with an interval of 10-20 days. For each scan session, a subject was scanned twice, first with RT and then with FB. The mean image acquisition time was 5.4 min for FB and 10.8 min for RT. IVIM parameters were calculated with bi-exponential model segmented fitting with a threshold b value of 60 s/mm 2 , and fitting started from b = 2 s/mm 2 . There was no statistically significant difference between IVIM parameters measured with FB imaging or RT imaging. Perfusion fraction ICC (intraclass correlation coefficient) for FB imaging and RT imaging in the same scan session was 0.824. For perfusion fraction, wSD (within-subject standard deviation), BA (Bland-Altman) difference, BA 95% limit, and ICC were 0.022, 0.0001, -0.0635~0.0637, and 0.687 for FB and 0.031, 0.0122, -0.0723~0.0967, and 0.611 for RT. For D slow (×10 -3  s/mm 2 ), wSD, BA difference, BA 95% limit, and ICC were 0.057, 0.0268, -0.1258~0.1793, and 0.471 for FB and 0.073, -0.0078, -0.2170-0.2014, and <0.4 for RT. The D fast coefficient of variation was 0.20 for FB imaging and 0.28 for RT imaging. All reproducibility indicators slightly favored FB imaging., (© 2023 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

The 2013 ISCD consensus recommended a Caucasian female reference database for T-score calculation in men, which says "A uniform Caucasian (non-race adjusted) female reference database should be used to calculate T-scores for men of all ethnic groups." However, this statement was recommended for the US population, and no position was taken with respect to BMD reference data or ethnicity matching outside of the USA. In East Asia, currently, a Japanese BMD reference database is universally adopted in Japan for clinical DXA diagnosis, while both local BMD and Caucasian BMD reference databases are in use in Mainland China, South Korea, Taiwan, and Singapore. In this article, we argue that an ethnicity- and gender-specific BMD database should be used for T-score calculations for East Asians, and we list the justifications why we advocate so. Use of a Caucasian BMD reference database leads to systematically lower T-scores for East Asians and an overestimation of the prevalence of osteoporosis. Using a female BMD reference database to calculate T-scores for male patients leads to higher T-score values and an underestimation of the prevalence of osteoporosis. Epidemiological evidence does not support using a female BMD reference database to calculate T-scores for men. We also note that BMD reference databases collected in Asia should be critically evaluated for their quality., (© 2023. The Author(s), under exclusive licence to International Skeletal Society (ISS).)

Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1090/coif). YXJW serves as the Editor-in-Chief of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.

Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1106/coif). YXJW serves as the Editor-in-Chief of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.

Conducting polymers with high theoretical capacitance and deformability are among the optimal candidates for compressible supercapacitor electrode materials. However, achieving both mechanical and electrochemical stabilities in a single electrode remains a great challenge. To address this issue, the "Polymer Chainmail" is proposed with reversible deformation capability and enhances stability because of the steric hindrance and charge compensation effect of doped anions. As a proof of concept, four common anions are selected as dopants for Poly(3,4-ethylenedioxythiophene) (PEDOT), and their effects on the adsorption and diffusion of H+ on PEDOT are verified using density functional theory calculations. Owing to the film formation effect, the PF-6 doped PEDOT/Nitrogen-doped carbon foam exhibits good mechanical properties. Furthermore, the composite demonstrates excellent rate performance and stability due to suitable anion doping. This finding provides new insights into the preparation of electrochemically stable conductive polymer-based compressible electrode materials., (© 2023 Wiley-VCH GmbH.)

Background: Because osteoporotic vertebral fracture (OVF) on chest radiographs is commonly missed in radiological reports, we aimed to develop a software program which offers automated detection of compressive vertebral fracture (CVF) on lateral chest radiographs, and which emphasizes CVF detection specificity with a low false positivity rate., Methods: For model training, we retrieved 3,991 spine radiograph cases and 1,979 chest radiograph cases from 16 sources, with among them in total 1,404 cases had OVF. For model testing, we retrieved 542 chest radiograph cases and 162 spine radiograph cases from four independent clinics, with among them 215 cases had OVF. All cases were female subjects, and except for 31 training data cases which were spine trauma cases, all the remaining cases were post-menopausal women. Image data included DICOM (Digital Imaging and Communications in Medicine) format, hard film scanned PNG (Portable Network Graphics) format, DICOM exported PNG format, and PACS (Picture Archiving and Communication System) downloaded resolution reduced DICOM format. OVF classification included: minimal and mild grades with <20% or ≥20-25% vertebral height loss respectively, moderate grade with ≥25-40% vertebral height loss, severe grade with ≥40%-2/3 vertebral height loss, and collapsed grade with ≥2/3 vertebral height loss. The CVF detection base model was mainly composed of convolution layers that include convolution kernels of different sizes, pooling layers, up-sampling layers, feature merging layers, and residual modules. When the model loss function could not be further decreased with additional training, the model was considered to be optimal and termed 'base-model 1.0'. A user-friendly interface was also developed, with the synthesized software termed 'Ofeye 1.0'., Results: Counting cases and with minimal and mild OVFs included, base-model 1.0 demonstrated a specificity of 97.1%, a sensitivity of 86%, and an accuracy of 93.9% for the 704 testing cases. In total, 33 OVFs in 30 cases had a false negative reading, which constituted a false negative rate of 14.0% (30/215) by counting all OVF cases. Eighteen OVFs in 15 cases had OVFs of ≥ moderate grades missed, which constituted a false negative rate of 7.0% (15/215, i.e., sensitivity 93%) if only counting cases with ≥ moderate grade OVFs missed. False positive reading was recorded in 13 vertebrae in 13 cases (one vertebra in each case), which constituted a false positivity rate of 2.7% (13/489). These vertebrae with false positivity labeling could be readily differentiated from a true OVF by a human reader. The software Ofeye 1.0 allows 'batch processing', for example, 100 radiographs can be processed in a single operation. This software can be integrated into hospital PACS, or installed in a standalone personal computer., Conclusions: A user-friendly software program was developed for CVF detection on elderly women's lateral chest radiographs. It has an overall low false positivity rate, and for moderate and severe CVFs an acceptably low false negativity rate. The integration of this software into radiological practice is expected to improve osteoporosis management for elderly women., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-433/coif). YXJW serves as the Editor-in-Chief of Quantitative Imaging in Medicine and Surgery. YXJW is the founder of Yingran Medicals Ltd, which develops medical image-based diagnostics software, including Ofeye. BHX and MSYZ contributed to the development of Ofeye 1.0. The other authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: A prerequisite to translating intravoxel incoherent motion (IVIM) imaging into meaningful clinical applications is sufficient scan-rescan reproducibility. This study aims to confirm the hypothesis that IVIM data fitting by not using b =0 images will improve the stability of liver IVIM measurement., Methods: Healthy volunteers' liver IVIM images were prospectively acquired using a 1.5-T magnet or a 3.0 T with 16 b -values. Repeatability study subjects were scanned twice during the same session, resulted in 35 paired scans for 35 subjects (11 men, mean age: 41.82 years, range: 32-60 years; 24 women, mean age: 42.67 years, range: 20-71 years). IVIM analysis was performed with full-fitting and segmented-fitting with a threshold b -value of 60 s/mm 2 , and fitting started from b =0 s/mm 2 or from b =2 s/mm 2 . Reproducibility study subjects were scanned and then rescanned with an interval of 5-18 days, resulted in 20 paired scans for 11 subjects (4 men, mean age: 26.25 years, range: 25-27 years; 7 women, mean age: 25.57 years, range: 24-27 years). IVIM analysis was performed with segmented-fitting with a threshold b -value of 50 s/mm 2 , and fitting started from b =0 s/mm 2 or from b =3 s/mm 2 ., Results: Fitting without b =0 data generally improved the repeatability and reproducibility for both PF and D slow , and particularly so for PF. For with b =0 data segmented fitting repeatability, PF had within-subject standard deviation of 0.019, bland-Atman 75% agreement limit of -31.52% to 28.35%, and ICC of 0.647, while these values were 0.009, -20.78% to 16.86%, and 0.837 for without b =0 analysis. Though the repeatability and reproducibility for D fast generally also improved, they remained suboptimal. Measurement stability was better for repeatability than for reproducibility., Conclusions: Scan-rescan repeatability and reproducibility of liver IVIM parameters can be improved by fitting without b =0 data, which is particularly so for PF., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-2022-02/coif). Author YXJW serves as the Editor-in-Chief of Quantitative Imaging in Medicine and Surgery. Author YXJW is the founder of Yingran Medicals Co., Ltd., which develops medical image-based diagnostics software. The other authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Spleen micro-perfusion level can be evaluated by DDVD (diffusion derived vessel density): DDVD (unit: au/pixel) = Sb0/ROIarea0 - Sb2/ROIarea2, where Sb0 and Sb2 refer to the spleen signal when b is 0 or 2 (s/mm 2 ) and ROI is 'region-of-interest'. This study investigated whether spleen DDVD is altered in patients with viral hepatitis-b (VHB) liver fibrosis. Three datasets were retrospectively analysed. Shenzhen data-1 had 25 healthy volunteers and 15 VHB liver fibrosis patients. Changsha data had 24 healthy volunteers and 31 patients with VHB liver fibrosis. Shenzhen data-2 had 67 healthy volunteers. Shenzhen data-2 were measured by reader-1. Shenzhen data-1 were measured by reader-1 and reader-2. For Changsha data, reader-1 measured all subjects, while Reader-2 measured a random selection of 10 healthy volunteers and two patients from each liver fibrosis grade (total=8). Shenzhen data-2 showed in healthy volunteers there was no age-dependent change of spleen DDVD during 20 ∼71 years old, and women had higher spleen DDVD values than those of men's (16.17±7.34 vs. 12.88±5.91, p=0.04). Changsha data by reader-1 showed patients with liver fibrosis had lower spleen DDVD values than those of healthy volunteers (median=16.24 vs. 23.54, p=0.0031). Results of reader-2 showed the same trend (median=11.64 vs. 23.33, p=0.0165). Shenzhen data-1 measured by reader-1 showed medians of spleen DDVD for patients and volunteers were 8.535 and 12.33 respectively; and those measured by reader-2 were 13.89 and 14.31 respectively. We conclude that diffusion MRI shows spleen DDVD, i.e., micro-circulation per volume tissue, is decreased in VHB liver fibrosis patients., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interests., (Copyright © 2022. Published by Elsevier Inc.)

Objectives: Liver vessel density can be evaluated by DDVD (diffusion derived vessel density): DDVD (b0b1)  = Sb0/ROIarea0 - Sb1/ROIarea1, where Sb0 and Sb1 refer to the liver signal when b is 0 or 1 s/mm 2 . Sb1 and ROIarea1 may be replaced by other b-values. With a rat biliary duct ligation (BDL) model, this study assesses the usefulness of liver DDVD computed from a simplified IVIM imaging protocol using b = 25 and b = 50 to replace b = 1 s/mm 2 , alone and in combination with other IVIM parameters., Methods: Male Sprague-Dawley rats were used. The rat number was 5, 5, 5, and 3 respectively, for the timepoints of 7, 14, 21, 28 days post-BDL surgery. 12 rats had partial biliary duct recanalization performed after the rats had BDL for 7 days and then again followed-up for a mean of 14 days. Liver diffusion MRIs were acquired at 3.0 T with a b-value distribution of 0, 25, 50, 75, 100, 150, 300, 700, 1000 s/mm 2 . DDVD mean (control rats n = 6) was the mean of DDVD (b0b25) and DDVD (b0b50) . IVIM fitting started from b = 0 s/mm 2 with segmented fitting and a threshold b of 50 s/mm 2 (n = 5 for control rats). Three 3-D spaces were constructed using a combination of the four diffusion parameters., Results: The control rats and BDL rats (n = 18) had a liver DDVD mean of 84.0 ± 26.2 and 44.7 ± 14.4 au/pixel (p < 0.001). All 3-D spaces totally separated healthy livers and all fibrotic livers (n = 30, BDL rats and recanalization rats). The mean relative distance between healthy liver cluster and fibrotic liver cluster was 0.331 for PF, D slow , and D fast ; 0.381 for PF, D fast , and DDVD mean ; and 0.384 for PF, D slow , and DDVD mean ., Conclusion: A combination of PF, D slow , and D fast allows total separation of healthy livers and fibrotic livers and the integration of DDVD improved the separation., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To collect and evaluate the diagnostic approach of inflammatory bowel disease (IBD) guidelines and provide useful feedback for guideline developers and evidence-based clinical information to help physicians make decisions., Methods: Diagnostic guidelines for IBD were retrieved by performing systemic and manual searches. Qualified clinical practice guidelines (CPGs) were included and then evaluated by four well-trained evaluators using the AGREE II instrument. To reduce the bias generated in this process, we used the Measurement Scale of Rate of Agreement (MSRA) tool to interpret the results. Guidelines with good recommendation distributions among the diagnostic field were further reclassified and evaluated., Results: Fifteen diagnostic CPGs for IBD were identified and evaluated, and 70.3% (11/15) of the CPGs were above the recommended level. We observed heterogeneity among the diagnostic CPGs for IBD and discrepancies among different domains in one specific guideline. Potential improvements were identified in the fields of stakeholder involvement, rigour of development and applicability. By further analysing the heterogeneity of the recommendations and evidence in 5 UC-CPGs, we found the following issues: no discussion of diagnosing severe complications of UC, disputed significance of serologic and genetic diagnoses of UC, insufficient attention towards medical histories/physical examinations/differential diagnoses and discrepancy in classification criteria., Conclusion: The included diagnostic CPGs for IBD were generally of good quality, but heterogeneity was identified. Addressing these issues will provide useful feedback for the guideline updating process, and it will also benefit current clinical practice and eventually patient outcome., (© 2021 John Wiley & Sons Ltd.)

Diffusion-weighted imaging (DWI) is sensitive to the mobility of water molecule at cellular and macromolecular level, much smaller than the spatial resolution of the images. It is commonly based on single shot echo-planar imaging sequence with the addition of motion-probing gradient pulses and fat suppression. DWI is increasingly incorporated into routine body magnetic resonance imaging protocols. However, the liver is particularly affected by physiological motions such as respiration; the left liver is also affected by cardiac motion artifacts and susceptibility artefact due to contents in the stomach. Intravoxel incoherent motion (IVIM) DWI data analysis requires high-quality data acquisition using multiple b -values and confidence in the measurements at low b -values. This article reviews the technical developments of DWI and its applications in the liver. Challenges and some solutions for the quantification of apparent diffusion coefficient and intravoxel incoherent motion are discussed. Currently, acquisition protocols vary between research groups; patient preparation and data post-processing are not standardized. Increased standardization, both in data acquisition and in image analysis, is imperative so to allow generation of reliable DW-MRI biomarker measures that are broadly applicable., Competing Interests: None., (AJNMMI Copyright © 2021.)

This review aimed at assessing current guidelines' methodological quality systematically for pancreatic cancer's diagnosis and to reveal the heterogeneity of the recommendations among the evaluated guidelines. A systematic search was conducted to find the latest guidelines for pancreatic cancer's diagnosis. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to assess the qualified guidelines' feature. We extracted the main recommendations for the diagnosis of pancreatic cancer from the guidelines and performed a heterogeneity evaluation. The highest-level evidence that supported these recommendations was further extracted and analysed. Nine guidelines for the diagnosis of pancreatic cancer were included in this study. Four of the guidelines had an overall score of more than 60% and thus are recommended for clinical use. Further analysis of the heterogeneity of the main recommendations for the diagnosis of pancreatic cancer in the guidelines revealed that the recommendations vary greatly among the different guidelines. The main reasons for the great differences include the neglect of symptoms and signs, great differences in the items involved in recommendations for the diagnosis of pancreatic cancer, inconsistent recommendations for some indicators (carbohydrate antigen 19-9 and ERCP), the unreasonable citation of evidence, and the failure of some recommendations to provide evidence supporting the recommendations. For most recommendations, there was a low level of evidence and a dearth of high-quality study evidence. Recommendations for pancreatic cancer diagnosis have been significantly inconsistent over the past five years. The quality of the guidelines for diagnosing pancreatic cancer also varies. The improvement by the guideline creators of the factors that contribute to the differences mentioned above will be a shortcut to update the guidelines for the diagnosis of pancreatic cancer., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-676). The authors declare that they have no competing interests., (2021 Gland Surgery. All rights reserved.)

Liver vessel density can be evaluated by an imaging biomarker diffusion-derived vessel density (DDVD): DDVD/area(b0b2) = Sb0/ROIarea0 - Sb2/ROIarea2, where Sb0 and Sb2 refer to the liver signal when b is 0 or 2 (s/mm 2 ); ROIarea0 and ROIarea2 refer to the region of interest (ROI) on b = 0 or 2 images; and Sb2 may be replaced by Sb15 ( b = 15). This concept was validated in this study. Liver diffusion images were acquired at 1.5 T. For a scan-rescan repeatability study of six subjects, b values of 0 and 2 were used. The validation study was composed of 26 healthy volunteers and 19 consecutive suspected chronic viral hepatitis B patients, and diffusion images with b values of 0, 2, 15, 20, 30, 45, 50, 60, 80, 100, 200, 300, 600, and 800 were acquired. Four patients did not have liver fibrosis, and the rest were four stage 1, three stage 2, four stage 3, and one stage 4 patients, respectively. The intraclass correlation coefficient for repeatability was 0.994 for DDVD/area(Sb0Sb2) and 0.978 for DDVD/area(Sb0Sb15). In the validation study, DDVD/area(Sb0Sb2) and area(Sb0Sb15) were 14.80 ± 3.06 and 26.58 ± 3.97 for healthy volunteers, 10.51 ± 1.51 and 20.15 ± 2.21 for stage 1-2 fibrosis patients, and 9.42 ± 0.87 and 19.42 ± 1.89 for stage 3-4 fibrosis patients. For 16 patients where IVIM analysis was performed, a combination of DDVD/area, PF, and Dfast achieved the best differentiation for nonfibrotic livers and fibrotic livers. DDVD/area were weakly correlated with PF or Dfast. Both DDVD/area(Sb0Sb2) and area(Sb0Sb15) are useful imaging biomarkers to separate fibrotic and nonfibrotic livers, with fibrotic livers having lower measurements.

Bacterial infection is a common wound complication that can significantly delay healing. Classical local therapies for infected wounds are expensive and are frequently ineffective. One alternative therapy is photodynamic therapy (PDT). We conducted a systematic review to clarify whether PDT is useful for bacteria-infected wounds in animal models. PubMed and Medline were searched for articles on PDT in infected skin wounds in animals. The language was limited to English. Nineteen articles met the inclusion criteria. The overall study methodological quality was moderate, with a low-moderate risk of bias. The animal models were mice and rats. The wounds were excisional, burn, and abrasion wounds. Wound size ranged from 6 mm in diameter to 1.5 × 1.5 cm 2 . Most studies inoculated the wounds with Pseudomonas aeruginosa or methicillin-resistant Staphylococcus aureus. Eleven and 17 studies showed that the PDT of infected wounds significantly decreased wound size and bacterial counts, respectively. Six, four, and two studies examined the effect of PDT on infected wound-cytokine levels, wound-healing time, and body weight, respectively. Most indicated that PDT had beneficial effects on these variables. PDT accelerated bacteria-infected wound healing in animals by promoting wound closure and killing bacteria., (© 2019 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Background: Recently a small cohort study demonstrated that intravoxel incoherent motion (IVIM) diffusion MRI can detect early stage liver fibrosis. Using modified IVIM data acquisition parameters, the current study aims to confirm this finding., Methods: Twenty-six healthy volunteers, three patients of chronic viral hepatitis-b but without fibrosis and one mild liver steatosis subject, and 12 viral hepatitis-b patients with fibrosis (stage 1-2=7, stage 3-4=5) were included in this study. With a 1.5-T MR scanner and respiration-gating, IVIM diffusion imaging was acquired using a single-shot echo-planar sequence with a b -value series of 2, 0, 1, 15, 20, 30, 45, 50, 60, 80, 100, 200, 300, 600, 800 s/mm 2 . Signal measurement was performed on right liver parenchyma. The first three very low b -values were excluded to improve the curve fitting stability, and bi-exponential segmented fitting was performed using the 12 b -values of 15~800 s/mm 2 . Both threshold b -values of 60 s/mm 2 and 200 s/mm 2 were tested. With a 3-dimensional tool, Dslow ( D ), PF ( f ) and Dfast ( D* ) values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate healthy volunteers from liver fibrosis patients., Results: Threshold b -value of 60 s/mm 2 was preferred over 200 s/mm 2 for separating healthy volunteers and liver fibrosis patients. The IVIM measures of the four patients without fibrosis resembled those of healthy volunteers. When threshold b -value =60 s/mm 2 was applied, PF (PF <6.49%) could differentiate healthy livers and all fibrotic livers with 100% sensitivity and specificity. For the patients' measurement, PF and Dfast were highly correlated with a Pearson correlation coefficient r of 0.865 (P<0.001); while the correlations between slow diffusion compartment (Dslow) and fast diffusion compartment (Dfast or PF) were not statistically significant., Conclusions: This study confirms previous report that IVIM diffusion MRI has high diagnostic performance in detecting viral hepatitis-b induced liver fibrosis., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

In the clinic, vitiligo is characterized by two stages: Stable and progressive. The pathogenesis of vitiligo is still not clear. Here, we identified serum markers of vitiligo by screening for differentially expressed proteins in patients with vitiligo compared to healthy individuals. Serum samples were collected from patients with vitiligo (n=10 for both the stable and progressive stages) and healthy individuals (n=10). Two‑dimensional gel electrophoresis followed by matrix‑assisted laser desorption/ionization time‑of‑flight mass spectrometry and western blotting were used to validate the differential expression of the proteins in the serum (n=20 each, at both stages for patients and healthy individuals). A total of 48 differentially expressed proteins were identified by gel image analysis. There were 28 differentially expressed proteins in patients with progressive vitiligo (PV) and 13 differentially expressed proteins in patients with stable vitiligo (SV) compared with that in healthy individuals. Additionally, 7 differentially expressed proteins were identified in patients with PV compared with those in patients with SV. The western blotting results showed that Peroxiredoxin‑6, apolipoprotein L1, apolipoprotein E and mannose‑binding protein were differentially expressed in patients with different stages of vitiligo. Our results showed that change serum levels of several proteins might be useful as biomarkers or in understanding the pathogenesis of vitiligo.

The complete mitochondrial genome sequence of Palinura homarus was obtained using PCR amplification and walking sequencing (GenBank accession no. JN&#95;542716). The complete mitochondrial genome of P. homarus was 15,665 bp long and showed significant AT bias (67% AT content, 33% GC content). The A + T-rich region included copy-related control information and a poly (dT) structure that related to replication and transcription. In this study, the gene arrangement was consistent with other Palinura mitochondrial genomes and the sequence was strikingly similar to Panulirus ornatus , which would be useful in species identification and natural resources conservation., Competing Interests: This study was supported by Science and Technology Planning Project of Guangdong Province (No. 2010B020308004). The authors report no conflicts of interest, and are solely responsible for all content and writing., (© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Abnormality of glutathione peroxidase (GPx) is involved in the etiology and pathogenesis of vitiligo. However, the results were controversial. Aim. The purpose of this meta-analysis is to compare the levels of GPx between vitiligo patients and healthy controls. Methods. Relevant published articles were searched according to eligibility criteria. A meta-analysis was conducted to pool estimates of the standardized mean difference (SMD) with 95% confidence interval (CI). Results. Twenty-three studies with a total of 1076 vitiligo patients and 770 healthy controls were included. The pooled meta-analysis showed that patients with vitiligo had equivalent levels of GPx with the healthy controls (SMD = -0.47, 95% CI: -1.03 to 0.08, and p = 0.095). Further subgroup analysis showed that the GPx levels of Asian patients or segmental vitiligo patients were, respectively, lower than those of healthy controls (Asian: SMD = -0.47, 95% CI: -1.08 to 0.14, and p = 0.001; segmental: SMD = -3.59, 95% CI: -6.38 to -0.80, and p = 0.012). Furthermore, the GPx levels in serum/plasma were significantly decreased in either stable or active vitiligo patients, comparing to healthy controls (stable: SMD = -2.01, 95% CI: -3.52 to -0.49, and p = 0.009; active: SMD = -2.34, 95% CI: -4.07 to -0.61, and p = 0.008). Conclusion. This meta-analysis showed a significant association between low GPx level and vitiligo.

Characters, which are man-made symbols composed of strokes arranged in a certain structure, could provide semantic information and play an indispensable role in our daily life. In this paper, we try to make use of the intrinsic characteristics of characters and explore the stroke and structure-based methods for character recognition. First, we introduce two existing part-based models to recognize characters by detecting the elastic strokelike parts. In order to utilize strokes of various scales, we propose to learn the discriminative multi-scale stroke detector-based representation (DMSDR) for characters. However, the part-based models and DMSDR need to manually label the parts or key points for training. In order to learn the discriminative stroke detectors automatically, we further propose the discriminative spatiality embedded dictionary learning-based representation (DSEDR) for character recognition. We make a comparative study of the performance of the tree-structured model (TSM), mixtures-of-parts TSM, DMSDR, and DSEDR for character recognition on three challenging scene character recognition (SCR) data sets as well as two handwritten digits recognition data sets. A series of experiments is done on these data sets with various experimental setup. The experimental results demonstrate the suitability of stroke detector-based models for recognizing characters with deformations and distortions, especially in the case of limited training samples.

Objective: To assess the effect and safety of NB-UVB for vitiligo using an evidence-based approach., Methods: Randomized controlled trials (RCTs) on the treatment of vitiligo with NB-UVB were identified by searching PubMed and the Cochrane Library. The primary outcome was re-pigmentation degree., Results: A total of seven RCTs involving 232 participants with vitiligo were included in this systematic review. The methodological qualities of included studies were generally moderate. Two trials compared narrow-band ultraviolet B (NB-UVB) with UVA control, showing no significant differences between two methods on the number of patients who achieved >60% re-pigmentation [relative risk (RR) = 2.50, 95% confidence interval (CI): 0.11-56.97, p > 0.05]. Two trials compared NB-UVB with psoralens plus UVA (PUVA) control, and no difference was seen between the two treatments on the number of patients who achieved >50 re-pigmentation (RR = 1.16, 95% CI: 0.64-2.11, p > 0.05) or >75% re-pigmentation (RR = 2.00, 95% CI: 0.89-4.48, p > 0.05). Three trials compared NB-UVB with 308-nm excimer light/laser (EL) control, and again no significant difference was found between the two methods (p > 0.05). The adverse events of NB-UVB in the included studies were slight and tolerated., Conclusion: NB-UVB showed equivalent efficacies to UVA, PUVA or 308-nm EL control in the treatment of vitiligo. Side effects of NB-UVB were acceptable. More RCTs were needed to validate the results.

Genital warts acquired during pregnancy tend to grow fast, and management is challenging. We treated two cases of primipara with extensive genital warts by local hyperthermia at 44°C for 30 minutes a day for 3 consecutive days plus 2 additional days 1 week later, then once a week till there showed signs of clinical regression. The warty lesions in the patients resolved in 5 and 7 weeks, respectively. There was no sign of recurrence during a 6-month follow-up. This suggests that local hyperthermia seems to be a promising method for treating genital warts in pregnant women., (© 2013 China Medical University. ; Dermatologic Therapy © 2013 Wiley Periodicals, Inc.)

The data of 72 cases of advanced schistosomiasis portal hypertension patients who received surgical treatment were retrospectively analyzed in the Fifth People's Hospital of Changde City from January, 1999 to January, 2011. Postoperative complications occurred in 17 cases, and the rate was 23.6%, including intra-abdominal bleeding in 2 cases, postoperative infection in 5 cases, recent upper gastrointestinal bleeding in 3 cases, massive ascites in 2 cases, persistent fever in 3 cases, and unusual increase of platelets and portal vein thrombosis in 2 cases.

Objective: To study the secondary metabolites of coastal seaweed endophytic fungi ZJ27., Methods: The compounds were isolated by chromatographic technique. The structures were identified by comprehensive physic-chemical properties and spectral methods., Results: Five compounds were isolated and identified as sclerotiorin (1), ochrephilone (2), 6-((3E, 5E)-5,7-dimethyl-2-methylenenona-3,5-dienyl)-2,4-dihydroxy-3-methylbenzaldehyde (3),(2E,4E)-4,6-dimethylocta-2,4-dienoic acid (4), pencolide (5)., Conclusion: 11 g of the compound 1 and 66 mg of the compound 2 were isolated from this fungi indicate that it may develop to be medical source microorganism.

Objective: To observe the inhibitory effects of crescent euphorbia on tumor growth, immunoregulation, the side effect on the mice blood system, cell cycle and to investigate its effect on apoptosis of tumor cells., Method: Crescent euphorbia was administered gastrally to C57BL/6J mouse implanted with Lewis lung cancer for 12 days. Inhibition on tumor growth, immunoregulation,the side effect on the mice blood system and cell cycle were observed and its effect on apoptosis of lung cancer cells were investigated., Result: (1) Inhibitory rates of crescent euphorbia at doses of 7.5, 15, 30 g x kg(-1) and 60 g x kg(-1) were 0.61%, 16.93%, 32.81% and 58.26% respectively, significant differenel with those of controls at doses of 30 g x kg(-1) and 60 g x kg(-1)(P < 0.05). (2) Although no effect on thymus index in normal mouse at all dose of crescent euphorbia was found, spleen index in tumor-bear mice was reduced significantly at dose of 60 g x kg(-1)(P < 0.05). (3) No side effect on the miceblood system was found. (4) The percentage of S phase of cell cycle was increased in the group of crescent euphorbia at dose of 30 g x kg(-1), 60 g x kg(-1) and the apoptotic rate was (16.43 +/- 18.69)% and (24.37 +/- 15.48)% by flow eytometry (P < 0.05). The apoptotic index (AI)of these two groups were (4.00 +/- 7.50)% and (5.93 +/- 5.96)% by TUNEL, however apoptosis was found in the group at doses of 60 g kg(-1) (P < 0.01)., Conclusion: Crescent euphorbia can inhibit the growth of Lewis lung cancer in mice, no side effection for the mice blood system and the effect might be associated with induction of apoptosis on cancer cells.

Objective: To establish a method for HPLC fingerprint determination of different growing areas on Fructus Aurantii fried with bran., Method: HPLC chromatographic experiment was carried out by ultrasonic distilment of acetacetic ester, gradient elution mode and the detection wavelength of 320 nm. The column temperature was set at 30 degrees C, and flow rate is 1.0 mL x min(-1). Naringin served as the reference standard. Ten batches of Fructus Aurantii fried with bran in the different places were analyzed. Similarity evaluation system for chromatographic fingerprint of TCM proceeded the evaluation, The correlation coefficients between ten batches were used to define the similarity., Result: There were eleven characteristic peaks in Fructus Aurantii fried with bran by HPLC fingerprint which constituted fingerprint characters. Both the reproducibility and stability on HPLC fingerprint were proper., Conclusion: The method was accurate and simple. It can be applied to the analysis on Fructus Aurantii fried with bran. The fingerprint spectrum can be used to distinguish Fructus Aurantii fried with bran and to be its quality control.