Innovative approaches beyond periprocedural hydration for preventing contrast-induced acute kidney injury

Contrast-induced acute kidney injury(CI-AKI)is a major concern in clinical practice,particularly among high-risk patients with preexisting renal and cardiovascular conditions.Although periprocedural hydration has long been the primary approach for CI-AKI prevention,recent advancements have led to the development of novel approaches such as RenalGuard and contrast removal systems.This editorial explores these emerging approaches and highlights their potential for enhancing CI-AKI prevention.By incorporating the latest evidence into clinical practice,health-care professionals can more effectively maintain renal function and improve outcomes for patients undergoing contrast-enhanced procedures.

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.

Navigating nephrotoxic waters:A comprehensive overview of contrast-induced acute kidney injury prevention

Contrast-induced acute kidney injury(CI-AKI)is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality.Its pathophysiology,although not well-established,revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney.Critically ill patients,as well as those with pre-existing renal disease and cardiovascular comorbidities,are more susceptible to CI-AKI.Despite the continuous research in the field of CI-AKI prevention,clinical practice is based mostly on periprocedural hydration.In this review,all the investigated methods of prevention are presented,with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

Accuracy and Utility of Vessel Analysis Using Non-Contrast CT for Planning Endovascular Aortic Repair

Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.

Attribution of Biases of Interhemispheric Temperature Contrast in CMIP6 Models

One of the basic characteristics of Earth's modern climate is that the Northern Hemisphere(NH) is climatologically warmer than the Southern Hemisphere(SH). Here, model performances of this basic state are examined using simulation results from 26 CMIP6 models. Results show that the CMIP6 models underestimate the contrast in interhemispheric surface temperatures on average(0.8 K for CMIP6 mean versus 1.4 K for reanalysis data mean), and that there is a large intermodel spread, ranging from -0.7 K to 2.3 K. A box model energy budget analysis shows that the contrast in interhemispheric shortwave absorption at the top of the atmosphere, the contrast in interhemispheric greenhouse trapping, and the crossequatorial northward ocean heat transport, are all underestimated in the multimodel mean. By examining the intermodel spread, we find intermodel biases can be tracked back to biases in midlatitude shortwave cloud forcing in AGCMs. Models with a weaker interhemispheric temperature contrast underestimate the shortwave cloud reflection in the SH but overestimate the shortwave cloud reflection in the NH, which are respectively due to underestimation of the cloud fraction over the SH extratropical ocean and overestimation of the cloud liquid water content over the NH extratropical continents.Models that underestimate the interhemispheric temperature contrast exhibit larger double ITCZ biases, characterized by excessive precipitation in the SH tropics. Although this intermodel spread does not account for the multimodel ensemble mean biases, it highlights that improving cloud simulation in AGCMs is essential for simulating the climate realistically in coupled models.

Signal intensity changes of dentate nucleus on plain MR T1WI innasopharyngeal carcinoma patients after radiotherapy andmultiple injections of gadolinium-base contrast agent

Objective To observe changes of plain MR T1WI signal intensity of dentate nucleus in nasopharyngeal carcinoma patients after radiotherapy and multiple times of intravenous injection of gadolinium-based contrast agent(GBCA).Methods Fifty patients with pathologically confirmed nasopharyngeal carcinoma and received intensity-modulated radiotherapy were retrospectively enrolled as the nasopharyngeal carcinoma group,and 50 patients with other malignant tumors and without history of brain radiotherapy were retrospectively enrolled as the control group.All patients received yearly GBCA enhanced MR examinations for the nasopharynx or the head.T1WI signal intensities of the dentate nucleus and the pons on same plane were measured based on images in the year of confirmed diagnosis(recorded as the first year)and in the second to the fifth years.T1WI signal intensity ratio of year i(ranging from 1 to 5)was calculated with values of dentate nucleus divided by values of the pons(ΔSI i),while the percentage of relative changes of year j(ranging from 2 to 5)was calculated withΔSI j compared toΔSI 1(Rchange j).The values of these two parameters were compared,and the correlation ofΔSI and GBCA injection year-time was evaluated within each group.Results No significant difference of gender,age norΔSI 1 was found between groups(all P>0.05).The second to the fifth yearΔSI and Rchange in nasopharyngeal carcinoma group were all higher than those in control group(all P<0.05).Within both groups,ΔSI was positively correlated with GBCA injection year-time(both P<0.05).Conclusion Patients with nasopharyngeal carcinoma who underwent radiotherapy and multiple times of intravenous injection of GBCA tended to be found with gradually worsening GBCA deposition in dentate nucleus,for which radiotherapy might be a risk factor.

Contrastive Consistency and Attentive Complementarity for Deep Multi-View Subspace Clustering

Deep multi-view subspace clustering (DMVSC) based on self-expression has attracted increasing attention dueto its outstanding performance and nonlinear application. However, most existing methods neglect that viewprivatemeaningless information or noise may interfere with the learning of self-expression, which may lead to thedegeneration of clustering performance. In this paper, we propose a novel framework of Contrastive Consistencyand Attentive Complementarity (CCAC) for DMVsSC. CCAC aligns all the self-expressions of multiple viewsand fuses them based on their discrimination, so that it can effectively explore consistent and complementaryinformation for achieving precise clustering. Specifically, the view-specific self-expression is learned by a selfexpressionlayer embedded into the auto-encoder network for each view. To guarantee consistency across views andreduce the effect of view-private information or noise, we align all the view-specific self-expressions by contrastivelearning. The aligned self-expressions are assigned adaptive weights by channel attention mechanism according totheir discrimination. Then they are fused by convolution kernel to obtain consensus self-expression withmaximumcomplementarity ofmultiple views. Extensive experimental results on four benchmark datasets and one large-scaledataset of the CCAC method outperformother state-of-the-artmethods, demonstrating its clustering effectiveness.

Optical design of a novel near-infrared phase contrast imaging(NI-PCI)diagnostic on the HL-2A tokamak

The optical design of near-infrared phase contrast imaging(NI-PCI)diagnosis on HL-2A is introduced in this paper.This scheme benefits from the great progress of near-infrared laser technology and is a broadening of traditional phase contrast technology.This diagnostic can work as a keen tool to measure plasma wavenumber spectra by inferring string-integrated plasma density fluctuations.Design of both the front optical path which is the path before the laser transmitting into the tokamak plasma and the rear optics which is the path after the laser passing through the plasma is detailed.The 1550 nm laser is chosen as the probe beam and highprecision optical components are designed to fit the laser beam,in which a phase plate with a 194-nm-deep silver groove is the key.Compared with the conventional 10.6μm laser-based PCI system on HL-2A,NI-PCI significantly overcomes the unwanted phase scintillation effect and promotes the measurement capability of high-wavenumber turbulence with an increased maximal measurable wavenumber from 15 cm^(-1)to 32.6 cm^(-1).

Recommendation Method for Contrastive Enhancement of Neighborhood Information

Knowledge graph can assist in improving recommendation performance and is widely applied in various person-alized recommendation domains.However,existing knowledge-aware recommendation methods face challenges such as weak user-item interaction supervisory signals and noise in the knowledge graph.To tackle these issues,this paper proposes a neighbor information contrast-enhanced recommendation method by adding subtle noise to construct contrast views and employing contrastive learning to strengthen supervisory signals and reduce knowledge noise.Specifically,first,this paper adopts heterogeneous propagation and knowledge-aware attention networks to obtain multi-order neighbor embedding of users and items,mining the high-order neighbor informa-tion of users and items.Next,in the neighbor information,this paper introduces weak noise following a uniform distribution to construct neighbor contrast views,effectively reducing the time overhead of view construction.This paper then performs contrastive learning between neighbor views to promote the uniformity of view information,adjusting the neighbor structure,and achieving the goal of reducing the knowledge noise in the knowledge graph.Finally,this paper introduces multi-task learning to mitigate the problem of weak supervisory signals.To validate the effectiveness of our method,experiments are conducted on theMovieLens-1M,MovieLens-20M,Book-Crossing,and Last-FM datasets.The results showthat compared to the best baselines,our method shows significant improvements in AUC and F1.

Laser speckle contrast imaging to predict the effect of temporary spinal cord stimulation in postherpetic neuralgia patients: A prospective observational study

Temporary spinal cord stimulation(tSCS)can effectively reduce the pain and severity of postherpetic neuralgia(PHN).However,there are no effective and objective methods for predicting the effects of tSCS on PHN.Laser speckle contrast imaging(LSCI)is frequently used in neurology to evaluate the effectiveness of treatment.To assess the accuracy of LSCI in predicting the impact of tSCS on PHN,14 adult patients receiving tSCS treatments for spinal nerve-innervated(C6-T2)PHN participated in this observational study.Visual analog scale(VAS)assessments and LSCI bloodflow images of the-ngers were recorded after the tSCS procedure.The results showed that the VAS scores of all patients decreased signi-cantly.Moreover,the bloodflow index(BFI)values were signi-cantly higher than they were before the procedure.Increased bloodflow and pain alleviation were positively correlated.The-ndings indicated that spinal nerve PHN(C6-T2)was signi-cantly reduced by tSCS.Pain alleviation by tSCS was positively correlated with increased bloodflow in the hand.The effect of tSCS on PHN may thus be predicted using an independent and consistent indicator such as LSCI.

A Second-Order Image Denoising Model for Contrast Preservation

In this work,we propose a second-order model for image denoising by employing a novel potential function recently developed in Zhu(J Sci Comput 88:46,2021)for the design of a regularization term.Due to this new second-order derivative based regularizer,the model is able to alleviate the staircase effect and preserve image contrast.The augmented Lagrangian method(ALM)is utilized to minimize the associated functional and convergence analysis is established for the proposed algorithm.Numerical experiments are presented to demonstrate the features of the proposed model.

Improved Weighted Local Contrast Method for Infrared Small Target Detection

In order to address the problem of high false alarm rate and low probabilities of infrared small target detection in complex low-altitude background,an infrared small target detection method based on improved weighted local contrast is proposed in this paper.First,the ratio information between the target and local background is utilized as an enhancement factor.The local contrast is calculated by incorporating the heterogeneity between the target and local background.Then,a local product weighted method is designed based on the spatial dissimilarity between target and background to further enhance target while suppressing background.Finally,the location of target is obtained by adaptive threshold segmentation.As experimental results demonstrate,the method shows superior performance in several evaluation metrics compared with six existing algorithms on different datasets containing targets such as unmanned aerial vehicles(UAV).

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

Region-Aware Fashion Contrastive Learning for Unified Attribute Recognition and Composed Retrieval

Clothing attribute recognition has become an essential technology,which enables users to automatically identify the characteristics of clothes and search for clothing images with similar attributes.However,existing methods cannot recognize newly added attributes and may fail to capture region-level visual features.To address the aforementioned issues,a region-aware fashion contrastive language-image pre-training(RaF-CLIP)model was proposed.This model aligned cropped and segmented images with category and multiple fine-grained attribute texts,achieving the matching of fashion region and corresponding texts through contrastive learning.Clothing retrieval found suitable clothing based on the user-specified clothing categories and attributes,and to further improve the accuracy of retrieval,an attribute-guided composed network(AGCN)as an additional component on RaF-CLIP was introduced,specifically designed for composed image retrieval.This task aimed to modify the reference image based on textual expressions to retrieve the expected target.By adopting a transformer-based bidirectional attention and gating mechanism,it realized the fusion and selection of image features and attribute text features.Experimental results show that the proposed model achieves a mean precision of 0.6633 for attribute recognition tasks and a recall@10(recall@k is defined as the percentage of correct samples appearing in the top k retrieval results)of 39.18 for composed image retrieval task,satisfying user needs for freely searching for clothing through images and texts.

Relationship of inflammatory indices with left atrial appendage thrombus or spontaneous echo contrast in patients with atrial fibrillation

BACKGROUND Inflammatory indices derived from complete blood tests have been reported to be associated with poor outcomes in patients with atrial fibrillation(AF).The data about the relationship between inflammatory indices and left atrial appendage thrombus(LAAT)or dense spontaneous echo contrast(SEC)are limited.AIM To explore the value of inflammatory indices for predicting the presence of LAAT or dense SEC in nonvalvular AF patients.METHODS A total of 406 patients with nonvalvular AF who underwent transesophageal echocardiography were included and divided into two groups based on the presence(study group)or absence(control group)of LAAT or dense SEC.Inflammatory indices,including the neutrophil-to-lymphocyte ratio(NLR),platelet–tolymphocyte ratio(PLR),and lymphocyte-to-monocyte ratio(LMR),were calculated from complete blood analysis.The associations of inflammatory indices RESULTS LAAT and dense SEC were detected in 11(2.7%)and 42(10.3%)patients,respectively.The PLR only showed an association with LAAT/dense SEC in the univariate model.Elevated NLR(odds ratio[OR]=1.48,95%confidence interval[CI]:1.11-1.98,P=0.007)and reduced LMR(OR=0.59,95%CI:0.41-0.83,P=0.003)were found to be independent risk factors for the presence of LAAT/dense SEC.The areas under the NLR and LMR curves for predicting LAAT/dense SEC were 0.73(95%CI:0.66-0.80,P<0.001)and 0.73(95%CI:0.65-0.81,P<0.001),respectively,while the cutoff values were 2.8(sensitivity:69.8%;specificity:64.0%)and 2.4(sensitivity:71.7%;specificity:60.6%),respectively.CONCLUSION Increased NLR and decreased LMR may predict LAAT/dense SEC in patients with nonvalvular AF.

Is it a normal phenomenon for pediatric patients to have brain leptomeningeal contrast enhancement on 3-tesla magnetic resonance imaging?

Determining whether sevoflurane sedation in children leads to“pseudo”prominent leptomeningeal contrast enhancement(pLMCE)on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clarify the pathophysiological changes of pLMCE.

The Inheritance and Application of Chinese Reverse Contrast Typeface Style

This paper discusses the inheritance and application of Chinese character reverse contrast typeface style.It begins by analyzing the visual features of Western reverse contrast typeface styles,with a focus on Caslon Italian and French Clarendon,providing a Western perspective reference for subsequent Chinese character reverse contrast typeface style designs.The paper then traces the origins of the Chinese reverse contrast style,from the calligraphy style"Lacquer Script"to the earliest printing type"フワンテール形",exploring the historical background and cultural significance of the Chinese reverse contrast style.In the methodology section of Chinese character reverse contrast typeface style design,the discussion is conducted from two dimensions:inheritance and application.In terms of inheritance,through an in-depth analysis of"Lacquer Script"and"フワンテール形"typeface style,the paper summarizes three basic theories for modern Chinese character reverse contrast typeface style design.In the application section,it examines in detail the two most influential recent typeface styles,"Ribaasu"and"Basic Artistic",outlining three directions of application:extreme horizontal stroke variations,exaggerated contrast,and diverse decorative strokes,showcasing new directions and possibilities for Chinese character reverse contrast typeface style design.This paper not only reviews the developmental history of the Chinese character reverse contrast typeface style but also analyzes the design methodology of Chinese character reverse contrast typeface style through specific case studies.

Near-Infrared Fluorescence Imaging Contrast Agents for Clinical Research: Limitations and Alternatives

Introduction: Near-infrared fluorescence imaging is a technique that will establish itself in the short term at the international level because it is recognized for its potential to improve the performance of surgical interventions, its moderate investment and operating costs and its portability. Although the technology is now mature, there is currently the problem of the availability of contrast agents to be injected IV. The aim of this methodology article is to propose an alternative solution to the need for contrast agents for clinical research, particularly in oncology. Methodology: They consist of coupling a fluorescent marker in the form of an NHS derivative, such as IR DYE manufactured in compliance with GMP, with therapeutic monoclonal antibodies having marketing authorization for molecular imaging. For a given antibody, the marking procedure must be the subject of a validation file on the final preparation filtered on a sterilizing membrane at 0.22 μm. Once the procedure has been validated, it would be unnecessary to repeat the tests before each clinical research examination. A check of the marking by thin-layer chromatography (TLC) and place it in a sample bank at +4˚C for 1 month of each injected formulation would be sufficient for additional tests if necessary. Conclusion: Molecular near-infrared fluorescence imaging is experiencing development, the process of which could be accelerated by greater availability of clinical contrast agents. Alternative solutions are therefore necessary to promote clinical research in this area. These methods must be shared to make it easier for researchers.

Binary Phase Shaping and SHG Contrast Ratios

Finding binary sequences with Large SHG ratios is very important in the field of ultrafast science, biomedical optics, high-resolution microscopy and label-free imaging. In this paper, we have demonstrated the relation between the SHG contrast ratio and the traditional Merit Factor values. And in the light from known results in Merit Factor Problems, we have shown that Legendre Sequences or Jacobi Sequences, are still the best candidates to obtain binary sequences with large SHG contrast ratios. The authors also discussed the SHG behaviors on some sequences obtained from cyclotomic classes over the finite field GF (2l) .

Ultrasound-guided carotid angioplasty and stenting in a patient with iodinated contrast allergy:A case report

BACKGROUND Ischemic stroke is an entity with high incidence,morbidity,and mortality rates.Carotid artery stenosis is an important and independent risk factor for ischemic stroke.The three current approaches for treating carotid artery stenosis are drug treatment,carotid endarterectomy(CEA),carotid angioplasty and stenting(CAS).The approach is chosen based on the degree of stenosis.CEA or CAS could have been chosen for the current patient,who had severe carotid stenosis and an iodinated contrast allergy.After thoroughly communicating with the patient,the patient chose CAS for treatment.Therefore,we performed ultrasound-guided CAS to avoid the use of iodinated contrast.CASE SUMMARY The main symptoms of the patient were numbness and weakness of the left limb.Computed tomography angiography of the head and neck at another hospital indicated multiple sites of stenosis in the arteries of the head and neck.The patient requested CAS for treatment but was allergic to iodinated contrast media.Thus,routine digital subtraction angiography(DSA)with iodinated contrast could not be used for the procedure.The diagnosis of this patient was as follows:(1)Right parietal lobe cerebral infarction;(2)multiple sites of stenosis in the arteries of the head and neck(severe stenosis of the right internal carotid artery,severe stenosis of the right subclavian artery);(3)right subclavian steal syndrome;and(4)hypertension(stage 3,high risk).The interventions included routine treatment for cerebral infarction,oral administration of clopidogrel(75 mg qd)and aspirin(100 mg qd),ultrasound-guided CAS,and postoperative follow-up.Postoperative color Doppler ultrasound and cerebrovascular magnetic resonance angiography of the carotid artery showed good vascular recovery,and the postoperative follow-up indicated a good prognosis.CONCLUSION This case study suggests that ultrasound-guided endovascular treatment is a potential option for patients with contraindications to the iodinated contrast agents used in DSA-guided surgery,although excellent surgical operating skills are needed.