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Floods are one of the most destructive disasters that cause loss of life and property worldwide every year. In this study, the aim was to find the best-performing model in flood sensitivity assessment and analyze key characteristic factors, the spatial pattern of flood sensitivity was evaluated using three machine learning (ML) models: Logistic Regression (LR), eXtreme Gradient Boosting (XGBoost), and Random Forest (RF). Suqian City in Jiangsu Province was selected as the study area, and a random sample dataset of historical flood points was constructed. Fifteen different meteorological, hydrological, and geographical spatial variables were considered in the flood sensitivity assessment, 12 variables were selected based on the multi-collinearity study. Among the results of comparing the selected ML models, the RF method had the highest AUC value, accuracy, and comprehensive evaluation effect, and is a reliable and effective flood risk assessment model. As the main output of this study, the flood sensitivity map is divided into five categories, ranging from very low to very high sensitivity. Using the RF model (i.e., the highest accuracy of the model), the high-risk area covers about 44% of the study area, mainly concentrated in the central, eastern, and southern parts of the old city area.

BackgroundNovel neuroimaging strategies have the potential to offer new insights into the mechanistic basis for trigeminal neuralgia (TN). The present study aims to conduct whole-brain morphometry analyses of TN patients and to assess the value of group-level neocortical and subcortical structural patterns as tools for diagnostic biomarker exploration.MethodsCortical thickness, surface area, and myelin levels in the neocortex were measured via magnetic resonance imaging (MRI). The radial distance and the Jacobian determinant of the subcortex in 43 TN patients and 43 matched controls were compared. Pattern learning algorithms were employed to establish the utility of group-level MRI findings as tools for predicting TN. An additional 40 control patients with hemifacial spasms were then evaluated to assess algorithm sensitivity and specificity.ResultsTN patients exhibited reductions in cortical indices in the anterior cingulate cortex (ACC), the midcingulate cortex (MCC), and the posterior cingulate cortex (PCC) relative to controls. They further presented with widespread subcortical volume reduction that was most evident in the putamen, the thalamus, the accumbens, the pallidum, and the hippocampus. Whole brain-level morphological alterations successfully enable automated TN diagnosis with high specificity (TN: 95.35 %; disease controls: 46.51 %).ConclusionsTN is associated with a distinctive whole-brain structural neuroimaging pattern, underscoring the value of machine learning as an approach to differentiating between morphological phenotypes, ultimately revealing the full spectrum of this disease and highlighting relevant diagnostic biomarkers.

The volumetric assessment and accurate grading of meningiomas before surgery are highly relevant for therapy planning and prognosis prediction. This study was to design a deep learning algorithm and evaluate the performance in detecting meningioma lesions and grade classification. In total, 5088 patients with histopathologically confirmed meningioma were retrospectively included. The pyramid scene parsing network (PSPNet) was trained to automatically detect and delineate the meningiomas. The results were compared to manual segmentations by evaluating the mean intersection over union (mIoU). The performance of grade classification was evaluated by accuracy. For the automated detection and segmentation of meningiomas, the mean pixel accuracy, tumor accuracy, background accuracy and mIoU were 99.68%, 81.36%, 99.88% and 81.36% for all patients; 99.52%, 84.86%, 99.93% and 84.86% for grade I meningiomas; 99.57%, 80.11%, 99.92% and 80.12% for grade II meningiomas; and 99.75%, 78.40%, 99.99% and 78.40% for grade III meningiomas, respectively. For grade classification, the accuracy values of the training and test datasets were 99.93% and 81.52% for all patients; 99.98% and 98.51% for grade I meningiomas; 99.91% and 66.67% for grade II meningiomas; and 99.88% and 73.91% for grade III meningiomas, respectively. The automated detection, segmentation and grade classification of meningiomas based on deep learning were accurate and reliable and may improve the monitoring and treatment of this frequently occurring tumor entity. Furthermore, the method could function as a useful tool for preassessment and preselection for radiologists, offering auxiliary information for clinical decision making in presurgical evaluation.

This study investigates the network mechanisms of temporal lobe epilepsy (TLE) using MEG data, focusing on directed connectivity networks across different frequency bands. Unlike previous studies that primarily localize epileptogenic zones, this research aims to explore whole-brain network differences between left TLE (lTLE), right TLE (rTLE), and healthy controls (HCs). MEG data from 13 lTLE patients, 21 rTLE patients, and 14 HCs were source-reconstructed to 116 brain regions (AAL116). Directed Transfer Function (DTF) was used to construct directed connectivity networks, followed by networks and graph-theoretical analyses. The results indicate that, compared to HCs, TLE subjects exhibited a significant increase in average connectivity strength in the Low Gamma band. The connectivity patterns across frequency bands in TLE patients were found to be unstable. Both HC and TLE subjects demonstrated left hemisphere lateralization. In the mid-to-low frequency bands, TLE subjects showed increases in global clustering coefficient (GCC), global characteristic path length (GCPL), and local efficiency (LE) compared to HCs, which is attributed to enhanced synchronization between local brain regions in TLE subjects.

In order to make the sponge city construction model more consistent with the inherent characteristics of the city, this paper constructs classification of the sponge city construction index system. We carry out multivariate statistical and cluster analysis based on geographic information system (GIS) and classify the different regions of mainland China, putting forward key points of construction for different types of regions. The results show that climatic factor, hydrological factor and soil factor are the main factors affecting sponge city construction, followed by city scale and level of urban economic development; the third is underlying surface type and geomorphological type. The cities are classified into ten clusters, and they present a continuously zonal or flaky distribution from northeast to southwest on the whole; more than 80% of cities obviously present a continuously zonal or flaky distribution. Each of the nine clusters has at least one pilot city, which can be used as a reference for construction.

Background Albumin infusion is the primary therapeutic strategy for septic patients with liver cirrhosis. Although recent studies have investigated the efficacy of albumin in the resuscitation stage of septic patients with liver cirrhosis, it remains unclear whether daily albumin administration can improve outcomes. Furthermore, the indications for initiating albumin therapy are not well defined. Methods Septic patients with liver cirrhosis were obtained from the Medical Information Mart for Intensive Care (MIMIC-IV 2.0) database. Marginal structural Cox models were employed to investigate the association between daily albumin infusion and 28-day mortality. We also aimed to explore under what circumstances enrolled patients could benefit most from albumin administration, based on the clinical parameters collected on the day of albumin infusion, including serum albumin concentration, serum lactate concentration, mean arterial pressure (MAP), and vasopressor dosage. Results A total of 2265 patients were included in the final analysis, of whom 1093 (48.3%) had received albumin treatment at least once. The overall 28-day mortality was 29.6%. After marginal structural modeling, daily albumin infusion was associated with a reduced risk of 28-day death (hazard ratio, 0.76; 95% CI 0.61–0.94). We found that patients benefit most from albumin infusion when initiated on the day of serum albumin concentration between 2.5 and 3.0 g/dL, serum lactate concentration greater than or equal to 2 mmol/L, MAP less than 60 mmHg, or vasopressor dosage between 0.2 and 0.3 mcg/kg/min (norepinephrine equivalent, NEE). Conclusions Albumin infusion is associated with a reduction in mortality in septic patients with liver cirrhosis under specific circumstances. Serum albumin concentration, serum lactate, MAP, and vasopressor dosage were found to be modifiers of treatment effectiveness and should be considered when deciding to initial albumin infusion.

Temporal lobe epilepsy (TLE) is considered a network disorder rather than a localized lesion, making it essential to study the network mechanisms underlying TLE. In this study, we constructed directed brain networks based on clinical MEG data using the Granger Causality Analysis (GCA) method, aiming to provide new insights into the network mechanisms of TLE. MEG data from 13 lTLE and 21 rTLE patients and 14 healthy controls (HCs) were analyzed. The preprocessed MEG data were used to construct directed brain networks using the GCA method and undirected brain networks using the Pearson Correlation Coefficient (PCC) method. Graph theoretical analysis extracted global and local topologies from the binary matrix, and SVM classified topologies with significant differences (p < 0.05). Comparative studies were performed on connectivity strengths, graph theory metrics, and SVM classifications between GCA and PCC, with an additional analysis of GCA-weighted network connectivity. The results show that TLE patients showed significantly increased functional connectivity based on GCA compared to the control group; similarities of the hub brain regions between lTLE and rTLE patients and the cortical–limbic–thalamic–cortical loop were identified; TLE patients exhibited a significant increase in GCA-based Global Clustering Coefficient (GCC) and Global Local Efficiency (GLE); most brain regions with abnormal local topological properties in TLE patients overlapped with their hub regions. The directionality of brain connectivity has played a significantly more pivotal role in research on TLE. GCA may be a potential tool in MEG analysis to distinguish TLE patients and HC effectively.

Microneedle technologies have the potential for expanding the capabilities of wearable health monitoring from physiology to biochemistry. This paper presents the fabrication of silicon hollow microneedles by a deep-reactive ion etching (DRIE) process, with the aim of exploring the feasibility of microneedle-based in-vivo monitoring of biomarkers in skin fluid. Such devices shall have the ability to allow the sensing elements to be integrated either within the needle borehole or on the backside of the device, relying on capillary filling of the borehole with dermal interstitial fluid (ISF) for transporting clinically relevant biomarkers to the sensor sites. The modified DRIE process was utilized for the anisotropic etching of circular holes with diameters as small as 30 μm to a depth of >300 μm by enhancing ion bombardment to efficiently remove the fluorocarbon passivation polymer. Afterward, isotropic wet and/or dry etching was utilized to sharpen the needle due to faster etching at the pillar top, achieving tip radii as small as 5 μm. Such sharp microneedles have been demonstrated to be sufficiently robust to penetrate porcine skin without needing any aids such as an impact-insertion applicator, with the needles remaining mechanically intact after repetitive penetrations. The capillary filling of DRIE-etched through-wafer holes with water has also been demonstrated, showing the feasibility of use to transport the analyte to the target sites.

We studied the temporal dynamics of activity within and across functional MRI (fMRI)–derived nodes of intrinsic resting-state networks of the human brain using intracranial electroencephalography (iEEG) and repeated single-pulse electrical stimulation (SPES) in neurosurgical subjects implanted with intracranial electrodes. We stimulated and recorded from 2,133 and 2,372 sites, respectively, in 29 subjects. We found that N1 and N2 segments of the evoked responses are associated with intra- and internetwork communications, respectively. In a separate cognitive experiment, evoked electrophysiological responses to visual target stimuli occurred with less temporal separation across pairs of electrodes that were located within the same fMRI-defined resting-state networks compared with those located across different resting-state networks. Our results suggest intranetwork prior to internetwork information processing at the subsecond timescale.

Early and reliable identification of patients with sepsis who are at high risk of mortality is important to improve clinical outcomes. However, 3 major barriers to artificial intelligence (AI) models, including the lack of interpretability, the difficulty in generalizability, and the risk of automation bias, hinder the widespread adoption of AI models for use in clinical practice. This study aimed to develop and validate (internally and externally) a conformal predictor of sepsis mortality risk in patients who are critically ill, leveraging AI-assisted prediction modeling. The proposed approach enables explaining the model output and assessing its confidence level. We retrospectively extracted data on adult patients with sepsis from a database collected in a teaching hospital at Beth Israel Deaconess Medical Center for model training and internal validation. A large multicenter critical care database from the Philips eICU Research Institute was used for external validation. A total of 103 clinical features were extracted from the first day after admission. We developed an AI model using gradient-boosting machines to predict the mortality risk of sepsis and used Mondrian conformal prediction to estimate the prediction uncertainty. The Shapley additive explanation method was used to explain the model. A total of 16,746 (80%) patients from Beth Israel Deaconess Medical Center were used to train the model. When tested on the internal validation population of 4187 (20%) patients, the model achieved an area under the receiver operating characteristic curve of 0.858 (95% CI 0.845-0.871), which was reduced to 0.800 (95% CI 0.789-0.811) when externally validated on 10,362 patients from the Philips eICU database. At a specified confidence level of 90% for the internal validation cohort the percentage of error predictions (n=438) out of all predictions (n=4187) was 10.5%, with 1229 (29.4%) predictions requiring clinician review. In contrast, the AI model without conformal prediction made 1449 (34.6%) errors. When externally validated, more predictions (n=4004, 38.6%) were flagged for clinician review due to interdatabase heterogeneity. Nevertheless, the model still produced significantly lower error rates compared to the point predictions by AI (n=1221, 11.8% vs n=4540, 43.8%). The most important predictors identified in this predictive model were Acute Physiology Score III, age, urine output, vasopressors, and pulmonary infection. Clinically relevant risk factors contributing to a single patient were also examined to show how the risk arose. By combining model explanation and conformal prediction, AI-based systems can be better translated into medical practice for clinical decision-making.