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To evaluate the annual effective dose per capita attributed to computed tomography (CT) examinations in 2013 and to predict the population effective dose from 2000 to 2013 in Taiwan. A CT examination database collected from 30 hospitals was divided into 22 procedures and classified into six regions: head, neck, chest, abdomen, pelvis, and other, respectively. The effective doses in different regions were evaluated by dose-length product (DLP) multiplied by conversion factors. The CT scan dose parameters were collected from 4,407 patients. For the six scanned regions, the percentages of patients scanned were: head (39.8%), neck (3.9%), chest (23.3%), abdomen (26.7%), pelvis (4.8%), and other (1.6%), respectively. The DLPs per patient (mGy·cm/patient) were head (1,071±225), neck (1,103±615), chest (724±509), abdomen (1,315±550), pelvis (1,231±620) and other (1,407±937), respectively. The number of CT examinations increased rapidly, with an average annual growth rate of 7.6%. The number of CT examinations in 2013 was 2.6 times that in 2000. The population effective dose was 0.30 mSv per capita in 2000 and increased to 0.74 mSv per capita in 2013, with an annual growth rate of 7.2%. The growth trend indicates that the effective dose will continue to rise in Taiwan. Some strategies should be applied to cope with this growth. Defining the CT dose reference level stipulated in official recommendations and encouraging the use of iterative reconstruction imaging instead of filtered back-projection imaging could be a useful method for optimizing the effective dose and image quality.

Cartilage has limited self-repair ability. The purpose of this study was to investigate the effects of different species of collagen-engineered neocartilage for the treatment of critical-size defects in the articular joint in a rabbit model. Type II and I collagen obtained from rabbits and rats was mixed to form a scaffold. The type II/I collagen scaffold was then mixed with rabbit chondrocytes to biofabricate neocartilage constructs using a rotating cell culture system [three-dimensional (3D)-bioreactor]. The rabbit chondrocytes were mixed with rabbit collagen scaffold and rat collagen scaffold to form neoRBT (neo-rabbit cartilage) and neoRAT (neo-rat cartilage) constructs, respectively. The neocartilage matrix constructs were implanted into surgically created defects in rabbit knee chondyles, and histological examinations were performed after 2 and 3 months. Cartilage-like lacunae formation surrounding the chondrocytes was noted in the cell cultures. After 3 months, both the neoRBT and neoRAT groups showed cartilage-like repair tissue covering the 5-mm circular, 4-mm-deep defects that were created in the rabbit condyle and filled with neocartilage plugs. Reparative chondrocytes were aligned as apparent clusters in both the neoRAT and neoRBT groups. Both neoRBT and neoRAT cartilage repair demonstrated integration with healthy adjacent tissue; however, more integration was obtained using the neoRAT cartilage. Our data indicate that different species of type II/I collagen matrix and 3D bioreactor cultivation can facilitate cartilage engineering in vitro for the repair of critical-size defect.

Wnts were previously shown to regulate the neurogenesis of neural stem or progenitor cells. Here, we explored the underlying molecular mechanisms through which Wnt signaling regulates neurotrophins (NTs) in the NT-induced neuronal differentiation of human mesenchymal stem cells (hMSCs). NTs can increase the expression of Wnt1 and Wnt7a in hMSCs. However, only Wnt7a enables the expression of synapsin-1, a synaptic marker in mature neurons, to be induced and triggers the formation of cholinergic and dopaminergic neurons. Human recombinant (hr)Wnt7a and general neuron makers were positively correlated in a dose- and time-dependent manner. In addition, the expression of synaptic markers and neurites was induced by Wnt7a and lithium, a glycogen synthase kinase-3β inhibitor, in the NT-induced hMSCs via the canonical/β-catenin pathway, but was inhibited by Wnt inhibitors and frizzled-5 (Frz5) blocking antibodies. In addition, hrWnt7a triggered the formation of cholinergic and dopaminergic neurons via the non-canonical/c-jun N-terminal kinase (JNK) pathway, and the formation of these neurons was inhibited by a JNK inhibitor and Frz9 blocking antibodies. In conclusion, hrWnt7a enhances the synthesis of synapse and facilitates neuronal differentiation in hMSCS through various Frz receptors. These mechanisms may be employed widely in the transdifferentiation of other adult stem cells.

Epithelial ovarian cancer (EOC) is the seventh most common cancer among women worldwide. The 5-year survival rate for women with EOC is only 30%-50%, which is largely due to the typically late diagnosis of this condition. EOC is difficult to detect in its early stage because of its asymptomatic nature. Recently, near-infrared fluorescent (NIRF) imaging has been developed as a potential tool for detecting EOC at the molecular level. In this study, a NIRF-sensitive probe was designed to detect matrix metalloproteinase (MMP) activity in ovarian cancer cells. A cyanine fluorochrome was conjugated to the amino terminus of a peptide substrate with enzymatic specificity for MMP-3. To analyze the novel MMP-3 probe, an in vivo EOC model was established by subcutaneously implanting SKOV3 cells, a serous-type EOC cell line, in mice. This novel MMP-3-sensitive probe specifically reacted with only the active MMP-3 enzyme, resulting in a significantly enhanced NIRF emission intensity. Histological analysis demonstrated that MMP-3 expression and activity were enhanced in the stromal cells surrounding the ovarian cancer cells. These studies establish a molecular imaging reporter for diagnosing early-stage EOC. Additional studies are required to confirm the early-stage activity of MMP-3 in EOC and its diagnostic and prognostic significance.

To quantify image quality and radiation doses in regions adjacent to and distant from bismuth shields in computed tomography (CT). An American College of Radiology accreditation phantom with four solid rods embedded in a water-like background was scanned to verify CT number (CTN) accuracy when using bismuth shields. CTNs, image noise, and contrast-to-noise ratios (CNRs) were determined in the phantom at 80-140 kVp. Image quality was investigated on image portions in the zones adjacent (A zone) to and distant (D zone) from a bismuth shield. Surface radiation doses were measured using thermoluminescent dosimeters. Streak artefacts were graded on a 3-point-scale. Changes in CTN caused by a bismuth shield resulted in changes in X-ray spectra. CTN changes were more apparent in the A zone than in the D zone, particularly for a low tube voltage. The degrees of CTN changes and image noise were proportional to the thickness of the bismuth shields. A 1-ply bismuth shield reduced surface radiation doses by 7.2%-15.5%. The overall CNRs were slightly degraded, and streak artefacts were acceptable. Using a bismuth shield could result in significant CTN changes and perceivable artefacts, particularly for a superficial organ close to the shield, and is not recommended for quantification CT examinations or follow-up CT examinations.

A previous study demonstrated that the reconstituted type I collagen matrix extracted from rabbit tendons enabled the TMJ disc to regenerate in the rabbit. The aim of this study was to investigate changes in the extracellular matrix (ECM) and mechanisms of regeneration in the TMJ disc. In 36 New Zealand rabbits that underwent a partial discectomy, discs were replaced with reconstituted collagen templates for 3 months. A histological analysis showed that moderate to severe degeneration appeared in partially discectomized joints without implantation. In contrast, discs experienced regeneration of reconstituted collagen template implantation and the joint returned to normal function. Cells in the regenerative tissue expressed ECM, and fibers became regular and compact due to tissue remodeling over time. Reparative cells differentiated into chondroblasts, and showed highly dense pericellular fibers. The morphology and collagen composition of the disc and condyle in the 3-month experimental group were similar to those of normal tissues. In conclusion, the reconstituted collagen template facilitated the regeneration of surgically discectomized discs. Type I and type II collagens play a crucial role in the regeneration of articular discs.

Gastroesophageal reflux disease (GERD) is a common digestive tract disease, and most physicians use the Los Angeles classification and diagnose the severity of the disease to provide appropriate treatment. With the advancement of artificial intelligence, deep learning models have been used successfully to help physicians with clinical diagnosis. This study combines deep learning and machine learning techniques and proposes a two-stage process for endoscopic classification in GERD, including transfer learning techniques applied to the target dataset to extract more precise image features and machine learning algorithms to build the best classification model. The experimental results demonstrate that the performance of the GerdNet-RF model proposed in this work is better than that of previous studies. Test accuracy can be improved from 78.8% ± 8.5% to 92.5% ± 2.1%. By enhancing the automated diagnostic capabilities of AI models, patient health care will be more assured.

[This corrects the article DOI: 10.1371/journal.pone.0192047.].

[This corrects the article DOI: 10.1371/journal.pone.0196779.].

To investigate the organ dose, effective dose (ED), conversion factor, and the C-arm rotation angle effects on dose variations of abdominal C-arm cone-beam computed tomography (CBCT) during transarterial chemoembolization (TACE). The organ doses and EDs for abdominal C-arm CBCT were retrospectively calculated according to a Monte Carlo technique for 80 patients. Dose variations from projections, ED to dose-area product (DAP) ratios, and effects of body mass index (BMI) on the ED and ED to DAP ratios were also analyzed. The kidney received the highest dose (14.6 ± 1.2 mSv). Organ dose deviations among C-arm rotation angles was highest for stomach (CV = 0.71). The mean ED of the the CBCT run during TACE was 3.5 ± 0.5 mSv, and decreased with increased BMI (R  = 0.45, p < 0.001). The mean ED to DAP ratio was 0.27 ± 0.04 mSv·Gy ·cm and tended to decrease with increased BMI (R  = 0.55, p < 0.001). The mean ED to DAP ratios were 0.29 ± 0.02, 0.26 ± 0.02, and 0.23 ± 0.03 mSv·Gy ·cm for patients with BMI < 25 kg/m , 25-30 kg/m , and ≥30 kg/m , respectively. Suitable conversion factors for C-arm CBCT facilitate the use of DAPs for estimating the ED. The patient dose can be varied by adjusting the CBCT rotation angle setting, and dose reduction strategies can be further manipulated.