Evaluation of a deep learning model on coronary CT angiography for automatic stenosis detection

PurposeThe purpose of this study was to evaluate a deep-learning model (DLM) for classifying coronary arteries on coronary computed tomography -angiography (CCTA) using the Coronary Artery Disease-Reporting and Data System (CAD-RADS).Materials and methodsThe DLM was trained with 10,800 curved multiplanar reformatted (cMPR) CCTA images classified by an expert radiologist using the CAD-RADS. For each of the three main coronary arteries, nine cMPR images 40° apart acquired around each arterial circumference were then classified by the DLM using the highest probability. For the validation set composed of 159 arteries from 53 consecutive patients, the images were read by two senior and two junior readers; consensus of the two seniors was the reference standard. With the DLM, the majority vote for the nine images was used to classify each artery. Three groups (CAD-RADS 0, 1–2, or 3–4–5) and 2 groups CAD-RADS 0–1–2 or 3–4–5 (<50% vs. ≥50% stenosis) were used for comparisons with readers and consensus. Performance of the model and readers was compared to the consensus reading using the intraclass coefficient (ICC) and Cohen's kappa coefficient at the artery and patient levels.ResultsWith the three groups at the artery level, the ICC of the DLM was 0.82 (95% CI: 0.75–0.88) and not significantly different from those of 3/4 readers; accuracy was 81%. With the binary classification, Cohen kappa coefficient of the DLM was 0.85 (95% CI: 0.69–0.94) and not significantly different from that of 3/4 readers; accuracy was 96%. At the patient level, sensitivity and specificity were 93% and 97% respectively, and the negative predictive value was 97%.ConclusionThe DLM detected ≥50% stenoses with performances similar to those achieved by senior radiologists.     

An epidemiologic study of sleep-disordered breathing in a large sample of Chinese adolescents

Journal of Public Health - Sleep-disordered breathing (SDB) is common among adolescents and is associated with short- and long-term consequences. Data on the prevalence and epidemiologic...     

Bone Metabolism Discrepancy in Type 2 Diabetes Mellitus Patients With and Without Non-Alcoholic Fatty Liver Disease

To explore the distribution of several bone metabolic indicators in type 2 diabetes patients (T2DM) with and without non-alcoholic fatty liver disease (NAFLD) and to preliminarily evaluate the relationship of bone metabolism with NAFLD in patients with T2DM. The hospitalized patients with T2DM were divided into the group of T2DM complicated with NAFLD and the group of T2DM alone according to the results of ultrasonic diagnosis. The general information and laboratory test data such as bone metabolism indexes of these patients were collected and the differences of the indexes between the 2 groups were compared. Furthermore, the independent influencing factors of NAFLD in patients with T2DM were analyzed. A total of 186 patients were included in the study. Compared with patients with T2DM only, patients with T2DM combined with NAFLD were characterized with younger age (p < 0.001), higher BMI (p = 0.016), ALT (p = 0.001), TG (p = 0.005), HOMA-IR (p = 0.005), and lower HDL-C (p = 0.031). Significant discrepancy of age (OR 1.052, p = 0.001), ALT (OR 0.964, p = 0.047), HOMA-IR (OR 0.801, p = 0.005), and T-PINP (OR 1.022, p = 0.008) was found using multivariate logistic regression model. Significant discrepancy of T-PINP was found in T2DM patients with and without NAFLD. Further studies are needed to explore whether T-PINP could be used as a predictor of fatty liver disease, osteoporosis, and other related complications in patients with T2DM.     

The BlastGen study: a randomized controlled trial of blastocyst media supplemented with granulocyte–macrophage colony-stimulating factor

Research questionDoes Embryogen®/BlastGen™ culture medium improve live birth rates compared with standard culture medium for women undergoing IVF and intracytoplasmic sperm injection (ICSI) with poor prognosis.DesignRandomized clinical trial. A total of 100 couples undergoing IVF/ICSI were randomly allocated to having their inseminated oocytes incubated in either Embryogen®/BlastGen™ sequential culture media or standard Cleavage/Blastocyst sequential culture media for 5 days (ClinicalTrials.gov Identifier: NCT02305420).ResultsNo statistically significant difference in live birth rate was found between the control group and the Embryogen®/BlastGen™ group (17 [34%] versus 11 [22%], respectively) (OR 0.55; 95% CI 0.22 to 1.32; P = 0.18). After adjustment for maternal age, body mass index and fertilization procedure, the blastulation rate reduced (40.6 ± 26.5 versus 24.6 ± 26.7; RR 0.70, CI 0.52 to 0.95; P < 0.05), and grade of the embryo transferred (OR 0.35, CI 0.16 to 0.77; P < 0.01) when Embryogen®/BlastGen™ medium was used.ConclusionA significant reduction in day-5 embryo outcome parameters was found using Embryogen®/BlastGen™ compared with standard medium, and insufficient evidence of a difference in pregnancy outcomes. Taking into consideration the small samples size, study limitations and strict inclusion criteria of this single-centre study, further research is needed to determine the efficacy of Embryogen®/BlastGen™ medium in couples undergoing IVF/ICSI.