Testing the generalizability and effectiveness of deep learning models among clinics: sperm detection as a pilot study.

BACKGROUND: Deep learning has been increasingly investigated for assisting clinical in vitro fertilization (IVF). The first technical step in many tasks is to visually detect and locate sperm, oocytes, and embryos in images. For clinical deployment of such deep learning models, different clinics use different image acquisition hardware and different sample preprocessing protocols, raising the concern over whether the reported accuracy of a deep learning model by one clinic could be reproduced in another clinic. Here we aim to investigate the effect of each imaging factor on the generalizability of object detection models, using sperm analysis as a pilot example. METHODS: Ablation studies were performed using state-of-the-art models for detecting human sperm to quantitatively assess how model precision (false-positive detection) and recall (missed detection) were affected by imaging magnification, imaging mode, and sample preprocessing protocols. The results led to the hypothesis that the richness of image acquisition conditions in a training dataset deterministically affects model generalizability. The hypothesis was tested by first enriching the training dataset with a wide range of imaging conditions, then validated through internal blind tests on new samples and external multi-center clinical validations. RESULTS: Ablation experiments revealed that removing subsets of data from the training dataset significantly reduced model precision. Removing raw sample images from the training dataset caused the largest drop in model precision, whereas removing 20x images caused the largest drop in model recall. by incorporating different imaging and sample preprocessing conditions into a rich training dataset, the model achieved an intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94-0.99) for precision, and an ICC of 0.97 (95% CI: 0.93-0.99) for recall. Multi-center clinical validation showed no significant differences in model precision or recall across different clinics and applications. CONCLUSIONS: The results validated the hypothesis that the richness of data in the training dataset is a key factor impacting model generalizability. These findings highlight the importance of diversity in a training dataset for model evaluation and suggest that future deep learning models in andrology and reproductive medicine should incorporate comprehensive feature sets for enhanced generalizability across clinics.

Development and Improvement of a Piezoelectrically Driven Miniature Robot.

In this paper, we proposed a miniature quadrupedal piezoelectric robot with a mass of 1.8 g and a body length of 4.6 cm. The robot adopts a novel spatial parallel mechanism as its transmission. Each leg of the robot has two degrees of freedom (DOFs): swing and lift. The trajectory necessary for walking is achieved by the appropriate phasing of these two DOFs. A new manufacturing method for piezoelectric actuators was developed. During the stacking process, discrete patterned PZT pieces are used to avoid dielectric failure caused by laser cutting. Copper-clad FR-4 is used as the solder pad instead of copper foil, making the connection between the pad and the actuator more reliable. The lift powertrain of the robot was modeled and the link length of the powertrain was optimized based on the model. The maximum output force of each leg can reach 26 mN under optimized design parameters, which is 1.38 times the required force for successful walking. The frequency response of the powertrain was measured and fitted to the second-order system, which enabled increased leg amplitudes near the powertrain resonance of approximately 70 Hz with adjusted drive signals. The maximum speed of the robot without load reached 48.66 cm/s (10.58 body lengths per second) and the payload capacity can reach 5.5 g (3.05 times its mass) near the powertrain resonance.

Using extracorporeal membrane oxygenation in donations after cardiac death or brain death: A single-center experience and long-term outcome.

Aims: The use of extended criteria donors is a routine practice that sometimes involves extracorporeal membrane oxygenation (ECMO) in donations after cardiac death or brain death. Methods: We performed a retrospective study in a single center from January 2006 to December 2019. The study included 90 deceased donor liver transplants. The patients were divided into three groups: the donation after brain death (DBD) group (n = 58, 64.4%), the DBD with ECMO group (n = 11, 12.2%) and the donation after cardiac death (DCD) with ECMO group (n = 21, 23.3%). Results: There were no significant differences between the DBD with ECMO group and the DBD group. When comparing the DCD with ECMO group and the DBD group, there were statistically significant differences for total warm ischemia time (p < 0.001), total cold ischemia time (p = 0.023), and split liver transplantation (p < 0.001), and there was significantly poor recovery in regard to total bilirubin level (p = 0.027) for the DCD with ECMO group by repeated measures ANOVA. The 5-year survival rates of the DBD, DBD with ECMO, and DCD with ECMO groups were 78.1%, 90.9%, and 75.6%, respectively. The survival rate was not significantly different when comparing the DBD group to either the DBD with ECMO group (p = 0.435) or the DCD with ECMO group (p = 0.310). Conclusions: Using ECMO in donations after cardiac death or brain death is a good technology, and it contributed to 35.6% of the liver graft pool.

Structure of the siphophage neck-Tail complex suggests that conserved tail tip proteins facilitate receptor binding and tail assembly.

Siphophages have a long, flexible, and noncontractile tail that connects to the capsid through a neck. The phage tail is essential for host cell recognition and virus-host cell interactions; moreover, it serves as a channel for genome delivery during infection. However, the in situ high-resolution structure of the neck-tail complex of siphophages remains unknown. Here, we present the structure of the siphophage lambda "wild type," the most widely used, laboratory-adapted fiberless mutant. The neck-tail complex comprises a channel formed by stacked 12-fold and hexameric rings and a 3-fold symmetrical tip. The interactions among DNA and a total of 246 tail protein molecules forming the tail and neck have been characterized. Structural comparisons of the tail tips, the most diversified region across the lambda and other long-tailed phages or tail-like machines, suggest that their tail tip contains conserved domains, which facilitate tail assembly, receptor binding, cell adsorption, and DNA retaining/releasing. These domains are distributed in different tail tip proteins in different phages or tail-like machines. The side tail fibers are not required for the phage particle to orient itself vertically to the surface of the host cell during attachment.

Asymmetric Structure of Podophage GP4 Reveals a Novel Architecture of Three Types of Tail Fibers.

Bacteriophage tail fibers (or called tail spikes) play a critical role in the early stage of infection by binding to the bacterial surface. Podophages with known structures usually possess one or two types of fibers. Here, we resolved an asymmetric structure of the podophage GP4 to near-atomic resolution by cryo-EM. Our structure revealed a symmetry-mismatch relationship between the components of the GP4 tail with previously unseen topologies. In detail, two dodecameric adaptors (adaptors I and II), a hexameric nozzle, and a tail needle form a conserved tail body connected to a dodecameric portal occupying a unique vertex of the icosahedral head. However, five chain-like extended fibers (fiber I) and five tulip-like short fibers (fiber II) are anchored to a 15-fold symmetric fiber-tail adaptor, encircling the adaptor I, and six bamboo-like trimeric fibers (fiber III) are connected to the nozzle. Five fibers I, each composed of five dimers of the protein gp80 linked by an elongated rope protein, are attached to the five edges of the tail vertex of the icosahedral head. In this study, we identified a new structure of the podophage with three types of tail fibers, and such phages with different types of fibers may have a broad host range and/or infect host cells with considerably high efficiency, providing evolutionary advantages in harsh environments.

Remarkable Wear Resistance in a Complex Concentrated Alloy with Nanohierarchical Architecture and Composition Undulation.

Sustained wear damages on the sliding surfaces of alloys are generally the culprit responsible for the failure of various mechanical systems. Inspired by high-entropy effects, here we deliberately deploy nanohierarchical architecture with composition undulation in a Ni50(AlNbTiV)50 complex concentrated alloy, which yields ultralow wear rate within the order of 10-7 to 10-6 mm3/Nm between room temperature and 800 °C. Such remarkable wear resistance heretofore represents one of the highest wear resistance reported for the bulk alloys or composites, and originates from the multi-type adaptive friction interface protection governed by intrinsically nano-coupled grains and nanoprecipitates. This cooperative heterostructure releases gradient frictional stress in stages upon wear at room temperature through the coexistence of multiple deformation pathways while activating a dense nanocrystalline glaze layer upon wear at 800 °C to minimize adhesive and oxidative wear. Our work uncovers a practical avenue for tailoring wear properties with multicomponent heterostructures over a wide temperature range.

Restoring Voluntary Bimanual Activities of Patients with Chronic Hemiparesis through a Foot-Controlled Hand/Forearm Exoskeleton.

A significant number of stroke patients are permanently left with a hemiparetic upper limb after the poststroke six-month golden recovery period, resulting in a drastic decline in their quality of life. This study develops a novel foot-controlled hand/forearm exoskeleton that enables patients with hemiparetic hands and forearms to restore their voluntary activities of daily living. Patients can accomplish dexterous hand/arm manipulation on their own with the assistance of a foot-controlled hand/forearm exoskeleton by utilizing foot movements on the unaffected side as command signals. The proposed foot-controlled exoskeleton was first tested on a stroke patient with a chronic hemiparetic upper limb. The testing results showed that the forearm exoskeleton can assist the patient in achieving approximately 107°of voluntary forearm rotation with a static control error less than 1.7°, whereas the hand exoskeleton can assist the patient in realizing at least six different voluntary hand gestures with a success rate of 100%. Further experiments involving more patients demonstrated that the foot-controlled hand/forearm exoskeleton can help patients in restoring some of the voluntary activities of daily living with their paretic upper limb, such as picking up food to eat and opening water bottles to drink, and etc. This research implies that the foot-controlled hand/forearm exoskeleton is a viable way to restore the upper limb activities of stroke patients with chronic hemiparesis.

Apoptosis related genes mediated molecular subtypes depict the hallmarks of the tumor microenvironment and guide immunotherapy in bladder cancer.

Apoptosis has been discovered as a mechanism of cell death. The purpose of this study is to identify the diagnostic signature factors related to bladder cancer (BLCA) through apoptosis related genes (ARGs). Clinicopathological parameters and transcriptomics data of 1,440 BLCA patients were obtained from 7 datasets (GSE13507, GSE31684, GSE32548, GSE32894, GSE48075, TCGA-BLCA, and IMvigor210). We first identified prognosis-related ARGs in BLCA and used them to construct two ARGs molecular subtypes by using consensus clustering algorithm. By using principal component analysis algorithms, a ARGscore was constructed to quantify the index of individualized patient. High ARGscore correlated with progressive malignancy and poor outcomes in BLCA patients. High ARGscore was associated with higher immune cell, higher estimate scores, higher stromal scores, higher immune scores, higher immune checkpoint, and lower tumor purity, which was consistent with the "immunity tidal model theory". Preclinically, BLCA immunotherapy cohorts confirmed patients with low ARGscore demonstrated significant therapeutic advantages and clinical benefits. These findings contribute to our understanding of ARGs and immunotherapy in BLCA. The ARGscore is a potentially useful tool to predict the prognosis and immunotherapy in BLCA.

Assembly and Capsid Expansion Mechanism of Bacteriophage P22 Revealed by High-Resolution Cryo-EM Structures.

The formation of many double-stranded DNA viruses, such as herpesviruses and bacteriophages, begins with the scaffolding-protein-mediated assembly of the procapsid. Subsequently, the procapsid undergoes extensive structural rearrangement and expansion to become the mature capsid. Bacteriophage P22 is an established model system used to study virus maturation. Here, we report the cryo-electron microscopy structures of procapsid, empty procapsid, empty mature capsid, and mature capsid of phage P22 at resolutions of 2.6 Å, 3.9 Å, 2.8 Å, and 3.0 Å, respectively. The structure of the procapsid allowed us to build an accurate model of the coat protein gp5 and the C-terminal region of the scaffolding protein gp8. In addition, interactions among the gp5 subunits responsible for procapsid assembly and stabilization were identified. Two C-terminal α-helices of gp8 were observed to interact with the coat protein in the procapsid. The amino acid interactions between gp5 and gp8 in the procapsid were consistent with the results of previous biochemical studies involving mutant proteins. Our structures reveal hydrogen bonds and salt bridges between the gp5 subunits in the procapsid and the conformational changes of the gp5 domains involved in the closure of the local sixfold opening and a thinner capsid shell during capsid maturation.

Development and evaluation of a live birth prediction model for evaluating human blastocysts from a retrospective study.

Background: In infertility treatment, blastocyst morphological grading is commonly used in clinical practice for blastocyst evaluation and selection, but has shown limited predictive power on live birth outcomes of blastocysts. To improve live birth prediction, a number of artificial intelligence (AI) models have been established. Most existing AI models for blastocyst evaluation only used images for live birth prediction, and the area under the receiver operating characteristic (ROC) curve (AUC) achieved by these models has plateaued at ~0.65. Methods: This study proposed a multimodal blastocyst evaluation method using both blastocyst images and patient couple's clinical features (e.g., maternal age, hormone profiles, endometrium thickness, and semen quality) to predict live birth outcomes of human blastocysts. To utilize the multimodal data, we developed a new AI model consisting of a convolutional neural network (CNN) to process blastocyst images and a multilayer perceptron to process patient couple's clinical features. The data set used in this study consists of 17,580 blastocysts with known live birth outcomes, blastocyst images, and patient couple's clinical features. Results: This study achieved an AUC of 0.77 for live birth prediction, which significantly outperforms related works in the literature. Sixteen out of 103 clinical features were identified to be predictors of live birth outcomes and helped improve live birth prediction. Among these features, maternal age, the day of blastocyst transfer, antral follicle count, retrieved oocyte number, and endometrium thickness measured before transfer are the top five features contributing to live birth prediction. Heatmaps showed that the CNN in the AI model mainly focuses on image regions of inner cell mass and trophectoderm (TE) for live birth prediction, and the contribution of TE-related features was greater in the CNN trained with the inclusion of patient couple's clinical features compared with the CNN trained with blastocyst images alone. Conclusions: The results suggest that the inclusion of patient couple's clinical features along with blastocyst images increases live birth prediction accuracy. Funding: Natural Sciences and Engineering Research Council of Canada and the Canada Research Chairs Program.

More than 50 million couples worldwide experience infertility. The most common treatment is in vitro fertilization (IVF). Fertility specialists collect eggs and sperm from the prospective parents. They combine the egg and sperm in a laboratory and allow the fertilized eggs to develop for five days into a multi-celled blastocyst. Then, the specialists select the healthiest blastocysts and return them to the patient's uterus. Since 1978, more than 8 million children have been conceived through IVF. Yet, only about 30% of IVF attempts result in a successful birth. As a result, fertility patients often undergo multiple rounds of IVF, which can be expensive and emotionally draining. Several factors determine IVF success, one of which is the health of the blastocysts selected for transfer to the uterus. Specialists select the blastocysts using several criteria. But these human assessments are subjective and inconsistent in predicting which ones are most likely to result in a successful birth. Recent studies suggest artificial intelligence technology may help select blastocysts. Liu et al. show that using artificial intelligence to assess blastocysts and fertility patient characteristics leads to more accurate predictions about which blastocysts are likely to result in a successful birth. In the experiments, the researchers trained an artificial intelligence computer program using pictures of 17,580 blastocysts with known birth outcomes and the parents' clinical characteristics. The model identified 16 parental factors associated with birth outcomes. The top 5 most predictive parental factors were maternal age, the day of blastocyst transfer to the uterus, how many eggs were present in the ovaries, the number of eggs retrieved and the thickness of the uterus lining. The program achieved the highest prediction of healthy births so far, compared to success rates listed in other studies. Artificial intelligence-aided blastocyte selection using patient and blastocyst characteristics may improve IVF success rates and reduce the number of treatment cycles patient couples undergo. Before specialists can use artificial intelligence in their clinics, they must conduct confirmatory clinical studies that enroll patient couples to compare conventional methods and artificial intelligence.

The Depression Prevalence in Chinese Patients with Rheumatoid Arthritis: A Systematic Review and Meta-analysis.

BACKGROUND: The chronic course and recurring acute episodes of rheumatoid arthritis (RA) can significantly affect the psychological and mental health of patients. This study aimed to investigate the prevalence of depression in Chinese patients with rheumatoid arthritis (RA) through a systematic review and meta-analysis. METHODS: We conducted a comprehensive literature search on electronic databases from the inception of the database to April 2023. The inclusion criteria included cross-sectional or case-control studies on depression prevalence with a sample size of at least 50 participants. The data was extracted from the included studies and analyzed to calculate the pooled depression prevalence, along with a 95% confidence interval (CI), using Review Manager 5.3 software (Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). RESULTS: Thirteen studies (n = 29,113) were included, with females accounting for over 50% of all participants. Based on the data pooled from all 13 studies, the observed depression prevalence in Chinese individuals with RA was 37% (95% CI: 28-46%; I2 = 95%; p < 0.0001). A subsequent subgroup analysis was conducted on scale types, age, and gender. Regarding scale types, the depression prevalence was assessed using various scales included the Hospital Anxiety and Depression Scale (HAMD), Hamilton Depression Scale (HADS), Center for Epidemiologic Studies Depression (CES-D) scale, Diagnostic and Statistical Manual of Mental Disorder (fourth edition DSM.IV) diagnostic criteria, and Self-rating Depression Scale (SDS) were 50%, 35%, 58%, 39%, and 41%, respectively. Based on mean age, five studies researched RA individuals <50 years old, establishing a depression prevalence of 48% (95% CI: 32-65%). In contrast, eight studies researched RA individuals ≥50 years old, establishing a depression prevalence of 41% (95% CI: 32-51%). Gender-based analysis indicated a depression prevalence in female RA individuals of 45% (95% CI: 37-55%) and 39% (95% CI: 29-48%) among male RA patients. Depression prevalence established significant correlations with specific scales, including the HAMD scale (odds ratio (OR) 4.93, 95% CI: 1.79-10.2), CES-D scale (OR 2.83, 95% CI: 1.71-4.65), DSM.IV criteria (OR 0.75, 95% CI: 0.38-1.51), and SDS (OR 0.95, 95% CI: 0.32-2.16). Additionally, depression prevalence was associated with age categories (age ≥50: OR 1.25, 95% CI: 0.59-2.70; age <50: OR 1.99, 95% CI: 0.93-3.81), as well as gender (female: OR 1.63, 95% CI: 0.64-4.57; male: OR 1.07, 95% CI: 0.38-3.03), although some associations did not reach statistical significance. CONCLUSION: The depression prevalence was high in Chinese individuals with RA, especially in females and patients under 50 years old. These findings suggest the need for improving detection and management of depression in RA patients.

Tumor-intrinsic RGS1 potentiates checkpoint blockade response via ATF3-IFNGR1 axis.

Background: Non-responsiveness is a major barrier in current cancer immune checkpoint blockade therapies, and the mechanism has not been elucidated yet. Therefore, it is necessary to discover the mechanism and biomarkers of tumor immunotherapeutic resistance. Methods: Bioinformatics analysis was performed based on CD8+ T cell infiltration in multiple tumor databases to screen out genes related to anti-tumor immunity. Associations between Regulator of G-protein signaling 1 (RGS1) and IFNγ-STAT1 signaling, and MHCI antigen presentation pathway were examined by RT-qPCR, western blotting, and flow cytometry. The modulatory mechanisms of RGS1 were investigated via CHIP-qPCR and dual-luciferase assay. The clinical and therapeutic implications of RGS1 were comprehensively investigated using tumor cell lines, mouse models, and clinical samples receiving immunotherapy. Results: RGS1 was identified as the highest gene positively correlated with immunogenicity among RGS family. Inhibition of RGS1 in neoplastic cells dampened anti-tumor immune response and elicited resistance to immunotherapy in both renal and lung murine subcutaneous tumors. Mechanistically, RGS1 enhanced the binding of activating transcription factor 3 (ATF3) to the promoter of interferon gamma receptor 1 (IFNGR1), activated STAT1 and the subsequent expression of IFNγ-inducible genes, especially CXCL9 and MHC class I (MHCI), thereby influenced CD8+ T cell infiltration and antigen presentation and processing. Clinically, lower expression level of RGS1 was associated with resistance of PD1 inhibition therapy and shortened progression-free survival among 21 NSCLC patients receiving immunotherapy. Conclusions: Together, these findings uncover a novel mechanism that elicits immunotherapy resistance and highlight the function of tumor-intrinsic RGS1, which brings new insights for future strategies to sensitize anti-PD1 immunotherapy.

A Capsid Structure of Ralstonia solanacearum podoviridae GP4 with a Triangulation Number T = 9.

GP4, a new Ralstonia solanacearum phage, is a short-tailed phage. Few structures of Ralstonia solanacearum phages have been resolved to near-atomic resolution until now. Here, we present a 3.7 Å resolution structure of the GP4 head by cryo-electron microscopy (cryo-EM). The GP4 head contains 540 copies of major capsid protein (MCP) gp2 and 540 copies of cement protein (CP) gp1 arranged in an icosahedral shell with a triangulation number T = 9. The structures of gp2 and gp1 show a canonical HK97-like fold and an Ig-like fold, respectively. The trimeric CPs stick on the surface of the head along the quasi-threefold axis of the icosahedron generating a sandwiched three-layer electrostatic complementary potential, thereby enhancing the head stability. The assembly pattern of the GP4 head provides a platform for the further exploration of the interaction between Ralstonia solanacearum and corresponding phages.

Staining-free, Automated Sperm Analysis for In Vitro Fertilization Lab Use.

PURPOSE: Computer-aided sperm analysis is typically used in andrology labs, not in in vitro fertilization labs, which requires staining for sperm morphology measurement. In in vitro fertilization labs, sperm analysis still relies on manual observation and suffers from subjectivity and inconsistency. We developed a system for automated measurement of sperm concentration, motility, and morphology without the need for sperm staining. The reproducibility and reliability of the system were evaluated. MATERIALS AND METHODS: Thirty-five fresh semen and 25 washed samples were obtained from male partners attending for fertility investigations. Sperm concentration, motility, and morphology were automatically measured simultaneously, leveraging robust sperm tracking for concentration and motility measurement and low contrast image segmentation for morphology measurement of live sperm. Reproducibility of sperm measurements was evaluated by intraclass correlation coefficients. Reliability of sperm measurement was evaluated by Passing and Bablok regression analysis and Bland-Altman analysis. RESULTS: Automated measurement of concentration, motility, and morphology had intraclass correlation coefficients higher than 0.97. The regression and Bland-Altman analysis indicated that automated measurement and off-line manual benchmarking with zoomed-in images were interchangeable. Further analysis on semen and washed samples and the measurement on progressive and nonprogressive motility also showed high reproducibility and reliability. CONCLUSIONS: Automated sperm analysis revealed high reproducibility and reliability. The system is designed for routine use in in vitro fertilization labs to perform quantitative sperm analysis on live samples.

Environmental exposure to microcystin-LR increases the risks of urinary bladder proliferation and carcinogenesis: Evidence from case control, animal, and in vitro studies.

To date, no reported studies have explored the impacts of microcystin-LR (MC-LR) on bladder tissues, and even the occurrence of bladder cancer. The current study explores the role of MC-LR in the development of bladder cancer through human observation and experimental research. In the population study, the odds ratio of bladder cancer for MC-LR was 6.073 (95 % CI, 2.117-17.422) after adjusting interference confounders. MC-LR is mainly located in the nucleus of epithelial cells in bladder cancer tissues instead of normal tissues. A positive association was observed between MC-LR and advanced tumor stage in serum and tissues. The animal study confirmed that prolonged MC-LR treatment promoted the bladder cancer phenotype accompanied by urinary bladder proliferation. In vitro, we indicated that MC-LR activated the PI3K/AKT/GSK3ß/Cyclin D1 and JAK2/STAT3/Bcl2 signaling pathways to induce the growth of SV-HUC-1 cells. Moreover, MC-LR promoted the angiogenesis of SV-HUC-1 cells through PI3K/AKT/mTOR/HIF-1α/VEGF pathway. Our study provided the first evidence that prolonged MC-LR treatment increases the incidence of bladder cancer from human investigations, mice models, and in vitro studies, implying the profound importance of the investigation of MC-LR for public health.

Structural changes in bacteriophage T7 upon receptor-induced genome ejection.

Many tailed bacteriophages assemble ejection proteins and a portal-tail complex at a unique vertex of the capsid. The ejection proteins form a transenvelope channel extending the portal-tail channel for the delivery of genomic DNA in cell infection. Here, we report the structure of the mature bacteriophage T7, including the ejection proteins, as well as the structures of the full and empty T7 particles in complex with their cell receptor lipopolysaccharide. Our near-atomic-resolution reconstruction shows that the ejection proteins in the mature T7 assemble into a core, which comprises a fourfold gene product 16 (gp16) ring, an eightfold gp15 ring, and a putative eightfold gp14 ring. The gp15 and gp16 are mainly composed of helix bundles, and gp16 harbors a lytic transglycosylase domain for degrading the bacterial peptidoglycan layer. When interacting with the lipopolysaccharide, the T7 tail nozzle opens. Six copies of gp14 anchor to the tail nozzle, extending the nozzle across the lipopolysaccharide lipid bilayer. The structures of gp15 and gp16 in the mature T7 suggest that they should undergo remarkable conformational changes to form the transenvelope channel. Hydrophobic α-helices were observed in gp16 but not in gp15, suggesting that gp15 forms the channel in the hydrophilic periplasm and gp16 forms the channel in the cytoplasmic membrane.

Efficient DNA-Driven Nanocavities for Approaching Quasi-Deterministic Strong Coupling to a Few Fluorophores.

Strong coupling between light and matter is the foundation of promising quantum photonic devices such as deterministic single photon sources, single atom lasers, and photonic quantum gates, which consist of an atom and a photonic cavity. Unlike atom-based systems, a strong coupling unit based on an emitter-plasmonic nanocavity system has the potential to bring these devices to the microchip scale at ambient conditions. However, efficiently and precisely positioning a single or a few emitters into a plasmonic nanocavity is challenging. In addition, placing a strong coupling unit on a designated substrate location is a demanding task. Here, fluorophore-modified DNA strands are utilized to drive the formation of particle-on-film plasmonic nanocavities and simultaneously integrate the fluorophores into the high field region of the nanocavities. High cavity yield and fluorophore coupling yield are demonstrated. This method is then combined with e-beam lithography to position the strong coupling units on designated locations of a substrate. Furthermore, polariton energy under the detuning of fluorophore embedded nanocavities can fit into a model consisting of three sets of two-level systems, implying vibronic modes may be involved in the strong coupling. Our system makes strong coupling units more practical on the microchip scale and at ambient conditions and provides a stable platform for investigating fluorophore-plasmonic nanocavity interaction.

Evaluation of Clinical Neuropathy After Living Donor Liver Transplant.

OBJECTIVES: Neurologic complications are more common in liver transplants than in other solid-organ transplants. One such neurologic complication, peripheral neuropathy, may cause functional limitations for recipients and have a negative effect on posttransplant quality of life. We aimed to examine the risk factors associated with the occurrence of clinical neuropathy after liver transplant and to investigate the frequency of sensory deficits. MATERIALS AND METHODS: In this case-control study, we analyzed factors from medical records of 63 recipients who underwent living donor liver transplant during the period from January 2010 to December 2016. A neuropathy symptom score was assigned to identify the patients who had clinical neuropathy (case group) and the patients without clinical neuropathy (control group). Quantitative sensory testing was performed to measure the warm and cold detection thresholds, and the difference between the 2 groups was examined. RESULTS: Compared with controls, patients with clinical neuropathy were older (61.0 vs 55.4 years; P = .028), had higher rates of diabetes (46.2% vs 16.0%; P = .03), and were taking antiviral agents against hepatitis B (100% vs 62%; P = .006). Patients with neuropathic symptoms had significantly increased frequencies of impairment of warm and cold detection thresholds. In addition, the greater severity of symptoms showed higher detection thresholds of warm (control, 40.7℃; mild-to-moderate, 43.8 ℃; severe, 46.0 ℃; P = .007) and cold (control, 28.8℃ ; mild-to-moderate, 27.0 ℃; severe, 21.8 ℃ ; P = .008). CONCLUSIONS: Our findings show that older age, diabetes, and treatment with oral antiviral agents against hepatitis B virus were more likely to be associated with the occurrence of clinical neuropathy after liver transplant. Early awareness and careful monitoring are warranted.

Inactivation and sensitization of Pseudomonas aeruginosa by microplasma jet array for treating otitis media.

Otitis media (OM), known as a middle ear infection, is the leading cause of antibiotic prescriptions for children. With wide-spread use of antibiotics in OM, resistance to antibiotics continues to decrease the efficacy of the treatment. Furthermore, as the presence of a middle ear biofilm has contributed to this reduced susceptibility to antimicrobials, effective interventions are necessary. A miniaturized 3D-printed microplasma jet array has been developed to inactivate Pseudomonas aeruginosa, a common bacterial strain associated with OM. The experiments demonstrate the disruption of planktonic and biofilm P. aeruginosa by long-lived molecular species generated by microplasma, as well as the synergy of combining microplasma treatment with antibiotic therapy. In addition, a middle ear phantom model was developed with an excised rat eardrum to investigate the antimicrobial effects of microplasma on bacteria located behind the eardrum, as in a patient-relevant setup. These results suggest the potential for microplasma as a new treatment paradigm for OM.