PurposeNon-alcoholic fatty liver disease (NAFLD) is an increasing global health concern, with a prevalence of 25% worldwide. The rising incidence of NAFLD, an asymptomatic condition, reinforces the need for systematic screening strategies in primary care. We present the use of non-expert acquired point-of-care ultrasound (POCUS) B-mode images for the development of an automated steatosis classification algorithm.ApproachWe obtained a Health Insurance Portability and Accountability Act compliant dataset consisting of 478 patients [body mass index 23.60 ± 3.55, age 40.97 ± 10.61], imaged with POCUS by non-expert health care personnel. A U-Net deep learning (DL) model was used for liver segmentation in the POCUS B-mode images, followed by 224 × 224 patch extraction of liver parenchyma. Several DL models including VGG-16, ResNet-50, Inception V3, and DenseNet-121 were trained for binary classification of steatosis. All layers of each tested model were unfrozen, and the final layer was replaced with a custom classifier. Majority voting was applied for patient-level results.ResultsOn a hold-out test set of 81 patients, the final DenseNet-121 model yielded an area under the receiver operator characteristic curve of 90.1%, sensitivity of 95.0%, and specificity of 85.2% for the detection of liver steatosis. Average cross-validation performance in models using patches of liver parenchyma as input outperformed methods using complete B-mode frames.ConclusionsDespite minimal POCUS acquisition training, and low-quality B-mode images, it is possible to detect steatosis using DL algorithms. Implementation of this algorithm in POCUS software may offer an accessible, low-cost steatosis screening technology, for use by non-expert health care personnel.

Background: This study aimed to investigate the relationship between echocardiography results and lung ultrasound score (LUS) in coronavirus disease 2019 (COVID-19) pneumonia patients and evaluate the impact of the combined application of these techniques in the evaluation of COVID-19 pneumonia. Methods: Hospitalized COVID-19 pneumonia patients who underwent daily lung ultrasound and echocardiography were included in this study. Patients with tricuspid regurgitation within three days of admission were enrolled. Moreover, the correlation and differences between their pulmonary artery pressure (PAP) and LUS on days 3, 8, and 13 were analyzed. The inner diameter of the pulmonary artery root as well as the size of the atria and ventricles were also considered. Results: The PAP on days 3, 8, and 13 of hospitalization was positively correlated with the LUS (r = 0.448, p = 0.003; r = 0.738, p < 0.001; r = 0.325, p = 0.036, respectively). On day 8, the values of both PAP and LUS were higher than on days 3 and 13 (p < 0.01). Similarly, PAP and LUS were significantly increased in 92.9% (39/42) and 90.5% (38/42) of patients, respectively, and at least one of these two values was positive in 97.6% (41/42) of cases. The inner diameters of the right atrium, right ventricle, and pulmonary artery also differed significantly from their corresponding values on days 3 and 13 (p < 0.05). Conclusions: PAP is positively correlated with LUS in COVID-19 pneumonia. The two values could be combined for a more precise assessment of disease progression and recovery status.

Numerous studies have demonstrated the important roles of epigenetic modifications in tumorigenesis, progression and prognosis. However, in hepatocellular carcinoma, the potential link between N⁷-methylguanosine (m⁷G) modification and molecular heterogeneity and tumor microenvironment (TME) remains unclear.Method: We performed a comprehensive evaluation of m⁷G modification patterns in 816 hepatocellular carcinoma samples based on 24 m⁷G regulatory factors, identified different m⁷G modification patterns, and made a systematic correlation of these modification patterns with the infiltration characteristics of immunocytes. Then, we built and validated a scoring tool called m⁷G score.Results: In this study, we revealed the presence of three distinct m⁷G modification patterns in liver cancer, with remarkable differences in the immunocyte infiltration characteristics of these three subtypes. The m⁷G scoring system of this study could assess m⁷G modification patterns in individual hepatocellular carcinoma patients, could predict TME infiltration characteristics, genetic variants and patient prognosis. We also found that the m⁷G scoring system may be useful in guiding patients’ clinical use of medications.Conclusions: This study revealed that m⁷G methylation modifications exerted a significant role in formation of TME in hepatocellular carcinoma. Assessing the m⁷G modification patterns of single patients would help enhance our perception of TME infiltration characteristics and give significant insights into immunotherapy efficacy.

Background: This study aimed to investigate the relationship between echocardiography results and lung ultrasound score (LUS) in coronavirus diseases 2019 (COVID-19) pneumonia patients and to evaluate the impact of their combined application in the diagnosis and treatment of COVID-19 pneumonia.Methods: Hospitalized COVID-19 pneumonia patients who underwent lung ultrasound and echocardiography daily were included in this study. Patients with tricuspid regurgitation within 3 days of admission were enrolled, and the correlation and differences between their pulmonary artery pressure (PAP) and LUS on days 3, 8, and 13 were compared. The inner diameter of the pulmonary artery root and the size of the atria and ventricles were also observed.Results: Pulmonary artery pressure within 3 days (on day 3, 8 and 13) of admission was positively correlated with LUS (r = 0.448, p = 0.003; r = 0.738, p = 0.000; r = 0.325, p = 0.036). On day 8 the values of both PAP and LUS were higher than their corresponding values on days 3 and 13 (p < 0.01). On day 8 the positive rate for increased PAP and LUS was 92.9% (39/42) and 90.5% (38/42), respectively, and the combined positive rate for these two was 97.6% (41/42). On day 8 the inner diameters of the right atrium, right ventricle, and pulmonary artery differed significantly from their corresponding values on days 3 and 13 (p < 0.05).Conclusions: PAP is positively correlated with LUS. The two should be combined for a more informative assessment of the status of recovery from COVID-19 pneumonia.