Current status of magnetic resonance imaging radiomics in hepatocellular carcinoma:A quantitative review with Radiomics Quality Score

BACKGROUND Radiomics is a promising tool that may increase the value of magnetic resonance imaging(MRI)for different tasks related to the management of patients with hepatocellular carcinoma(HCC).However,its implementation in clinical practice is still far,with many issues related to the methodological quality of radiomic studies.AIM To systematically review the current status of MRI radiomic studies concerning HCC using the Radiomics Quality Score(RQS).METHODS A systematic literature search of PubMed,Google Scholar,and Web of Science databases was performed to identify original articles focusing on the use of MRI radiomics for HCC management published between 2017 and 2023.The methodological quality of radiomic studies was assessed using the RQS tool.Spearman’s correlation(ρ)analysis was performed to explore if RQS was correlated with journal metrics and characteristics of the studies.The level of statistical significance was set at P<0.05.RESULTS One hundred and twenty-seven articles were included,of which 43 focused on HCC prognosis,39 on prediction of pathological findings,16 on prediction of the expression of molecular markers outcomes,18 had a diagnostic purpose,and 11 had multiple purposes.The mean RQS was 8±6.22,and the corresponding percentage was 24.15%±15.25%(ranging from 0.0% to 58.33%).RQS was positively correlated with journal impact factor(IF;ρ=0.36,P=2.98×10^(-5)),5-years IF(ρ=0.33,P=1.56×10^(-4)),number of patients included in the study(ρ=0.51,P<9.37×10^(-10))and number of radiomics features extracted in the study(ρ=0.59,P<4.59×10^(-13)),and time of publication(ρ=-0.23,P<0.0072).CONCLUSION Although MRI radiomics in HCC represents a promising tool to develop adequate personalized treatment as a noninvasive approach in HCC patients,our study revealed that studies in this field still lack the quality required to allow its introduction into clinical practice.

What benefit can be obtained from magnetic resonance imaging diagnosis with artificial intelligence in prostate cancer compared with clinical assessments?

The present study aimed to explore the potential of artificial intelligence(AI)methodology based on magnetic resonance(MR)images to aid in the management of prostate cancer(PCa).To this end,we reviewed and summarized the studies comparing the diagnostic and predictive performance for PCa between AI and common clinical assessment methods based on MR images and/or clinical characteristics,thereby investigating whether AI methods are generally superior to common clinical assessment methods for the diagnosis and prediction fields of PCa.First,we found that,in the included studies of the present study,AI methods were generally equal to or better than the clinical assessment methods for the risk assessment of PCa,such as risk stratification of prostate lesions and the prediction of therapeutic outcomes or PCa progression.In particular,for the diagnosis of clinically significant PCa,the AI methods achieved a higher summary receiver operator characteristic curve(SROC-AUC)than that of the clinical assessment methods(0.87 vs.0.82).For the prediction of adverse pathology,the AI methods also achieved a higher SROC-AUC than that of the clinical assessment methods(0.86 vs.0.75).Second,as revealed by the radiomics quality score(RQS),the studies included in the present study presented a relatively high total average RQS of 15.2(11.0–20.0).Further,the scores of the individual RQS elements implied that the AI models in these studies were constructed with relatively perfect and standard radiomics processes,but the exact generalizability and clinical practicality of the AI models should be further validated using higher levels of evidence,such as prospective studies and open-testing datasets.

Analysis of the Effect of Different Treatment Schemes on Helicobacter Pylori Infection on Improving the Quality of Life of Patients

Objective:To analyze the effect of different treatment schemes on the quality of life of patients with Helicobacter pylori infection.Methods:From June 2019 to November 2020,96 patients with Helicobacter pylori infection were selected and randomly assigned Combined treatment with omeprazole,amoxicillin and clarithromycin was named group A;Group B was treated with omeprazole,amoxicillin,clarithromycin and colloidal bismuth pectin;Group C was given omeprazole,amoxicillin,clarithromycin and metronidazole.Results:The symptom score and gastroscope score of group B or C were lower than those of group A(P<0.05);The incidence of adverse reactions and HP eradication rate in group C were lower than those in group B,and those in group B were lower than those in group A(P<0.05);The quality of life score of group C was higher than that of group B,and that of group B was higher than that of group A,P<0.05.Conclusions:The sequential therapy of omeprazole,amoxicillin,clarithromycin and metronidazole in patients with Helicobacter pylori infection can improve the HP eradication rate,improve the quality of life of patients,which is safe and efficient.

Incorporating Variation and Quality of the Underlying Effects in Meta-Analysis

This paper proposes a model to further explore the effects of the quality information and variation of the underlying effects on the summary effect measure in meta-analysis.A shape parameter is used in this model to quantify the asymmetry of the effect sizes of studies that are included.Estimation of the proposed model parameters is carried out by the Bayesian MCMC method.Performances of the resultant estimates are examined in the simulations and empirical case with data obtained from a total of 22 meta-analyses taken from three different designs.A conclusion would be drawn that it is advisable to take the proposed model,when quality information becomes available,in particular with a situation where the underlying effects approximately follow a normal distribution.If,however,the quality information is absent,the skew-normal distribution for random effect model should be adopted.

The effect of the quality of vital sign recording on clinical decision making in a regional acute care trauma ward

Purpose： Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score （MEWS） uses vital signs to categorise the severity of a patient＇s physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making. Methods： Vital signs recorded by the nursing staff of all trauma patients in the acute care trauma wards at a regional hospital in South Africa were collected from January 2013 to February 2013. Investigator- measured values taken within 2 hours of the routine observations and baseline patient information were also recorded. A MEWS for each patient was calculated from the routine and investigator-measured observations. Basic descriptive statistics were performed using EXCEL Results： The details of lgl newly admitted patients were collected. Completion of recordings was 81% for heart rate, 88~; for respiratory rate, 98~; for blood pressure, 92% for temperature and 41~ for GCS. The recorded heart rate was positively correlated with the investigator＇s measurement （Pearson＇s correlation coefficient of 0.76）; while the respiratory rate did not correlate （Pearson＇s correlation coefficient of 0.02）. In 59~ of patients the recorded respiratory rate （RR） was exactly 20 breaths per minute and 27~ had a recorded RR of exactly 15. Seven percent of patients had aberrant Glasgow Coma Scale readings above the maximum value of 15. The average MEWS was 2 for both the recorded （MEWS（R）） and investigator （MEWS（1）） vitals, with the range of MEWS（R） 0-7 and MEWS（1） 0-9. Analysis showed 59% of the MEWS（R） underestimated the physiological derangement （scores were lower than the MEWS（1））; 80%; of patients had a MEWS（R） requiring 4 hourly checks which was only completed in 2%;; 86% of patients had a MEWS（R） of less than three （i.e. not necessitating escalation of care）, but 33% of these showed a MEWS（1） greater than three （i.e. actually necessitating escalation of care）. Conclusion： Documentation of vital signs aids management decisions, indicating the physiological derangement of a patient and dictating treatment. This study showed that there was a poor quality of vital sign recording in this acute care trauma setting, which led to underestimation of patients＇ physi- ological derangement and an inability to detect deteriorating patients. The MEWS could be a powerful tool to empower nurses to become involved in the diagnosis and detection of deteriorating patients, as well as providing a framework to communicate the severity of derangement between health workers. However, it requires a number of strategies to improve the quality of vital sign recording, including continuing education, increasing the numbers of competent staff and administrative changes in vital sign charts.

FUNCTIONAL ANALYSIS OF THE RANGE-FINDERS OF CET-4 COMPOSITIONS

Four samples were chosen by systematic sampling from the range-finders between 1987 and 2003 to test the range-finders’ representativeness of the scoring criteria of CET-4 compositions. The samples were analyzed from the perspectives of transitivity, modality, thematic structure and cohesion. Fisher's Exact Test from the SAS system was used to compare two-sidedly the correct rate and the constituent ratio of these functional usages between two neighboring levels. Statistical results indicate that it is the quality, not the quantity of these functional usages that distinguishes two neighboring levels. The range-finders can basically represent the abstract scoring criteria as far as the four functional systems are concerned. However, the validity of CET-4 writing needs to be improved.

Evaluation of morbidity in Schistosoma mansoni-positive primary and secondary school children after four years of mass drug administration of praziquantel in western Kenya

Background:World Health Organization guidelines recommend preventive chemotherapy with praziquantel to control morbidity due to schistosomiasis.The primary aim of this cross-sectional study was to determine if 4 years of annual mass drug administration(MDA)in primary and secondary schools lowered potential markers of morbidity in infected children 1 year after the final MDA compared to infected children prior to initial MDA intervention.Methods:Between 2012 and 2016 all students in two primary and three secondary schools within three kilometers of Lake Victoria in western Kenya received annual mass praziquantel administration.To evaluate potential changes in morbidity we measured height,weight,mid-upper arm circumference,hemoglobin levels,abdominal ultrasound,and quality of life in children in these schools.This study compared two cross-sectional samples of Schistosoma mansoni egg-positive children:one at baseline and one at year five,1 year after the fourth annual MDA.Data were analyzed for all ages(6–18 years old)and stratified by primary(6–12 years old)and secondary(12–18 years old)school groups.Results:The prevalence of multiple potential morbidity markers did not differ significantly between the egg-positive participants at baseline and those at 5 years by Mann Whitney nonparametric analysis and Fisher’s exact test for continuous and categorical data,respectively.There was a small but significantly higher score in school-related quality of life assessment by year five compared to baseline by Mann Whitney analysis(P=0.048)in 13–18 year olds where malaria-negative.However,anemia was not positively impacted by four annual rounds of MDA,but registered a significant negative outcome.Conclusions:We did not detect differences in morbidity markers measured in a population of those infected or re-infected after multiple MDA.This could have been due to their relative insensitivity or a failure of MDA to prevent morbidity among those who remain infected.High malaria transmission in this area and/or a lack of suitable methods to measure the more subtle functional morbidities caused by schistosomiasis could be a factor.Further research is needed to identify and develop well-defined,easily quantifiable S.mansoni morbidity markers for this age group.