Peripheral nerve injury associated with JEV infection in high endemic regions, 2016-2020: a multicenter retrospective study in China.

Previously, we reported a cohort of Japanese encephalitis (JE) patients with Guillain-Barré syndrome. However, the evidence linking Japanese encephalitis virus (JEV) infection and peripheral nerve injury (PNI) remains limited, especially the epidemiology, clinical presentation, diagnosis, treatment, and outcome significantly differ from traditional JE. We performed a retrospective and multicenter study of 1626 patients with JE recorded in the surveillance system of the Chinese Center for Disease Control and Prevention, spanning the years 2016-2020. Cases were classified into type 1 and type 2 JE based on whether the JE was combined with PNI or not. A comparative analysis was conducted on demographic characteristics, clinical manifestations, imaging findings, electromyography data, laboratory results, and treatment outcomes. Among 1626 laboratory confirmed JE patients, 230 (14%) were type 2 mainly located along the Yellow River in northwest China. In addition to fever, headache, and disturbance of consciousness, type 2 patients experienced acute flaccid paralysis of the limbs, as well as severe respiratory muscle paralysis. These patients presented a greater mean length of stay in hospital (children, 22 years [range, 1-34]; adults, 25 years [range, 0-183]) and intensive care unit (children, 16 years [range, 1-30]; adults, 17 years [range, 0-102]). The mortality rate was higher in type 2 patients (36/230 [16%]) compared to type 1 (67/1396 [5%]). The clinical classification of the diagnosis of JE may play a crucial role in developing a rational treatment strategy, thereby mitigating the severity of the disease and potentially reducing disability and mortality rates among patients.

Gray matter atrophy and white matter lesions burden in delayed cognitive decline following carbon monoxide poisoning.

Gray matter (GM) atrophy and white matter (WM) lesions may contribute to cognitive decline in patients with delayed neurological sequelae (DNS) after carbon monoxide (CO) poisoning. However, there is currently a lack of evidence supporting this relationship. This study aimed to investigate the volume of GM, cortical thickness, and burden of WM lesions in 33 DNS patients with dementia, 24 DNS patients with mild cognitive impairment, and 51 healthy controls. Various methods, including voxel-based, deformation-based, surface-based, and atlas-based analyses, were used to examine GM structures. Furthermore, we explored the connection between GM volume changes, WM lesions burden, and cognitive decline. Compared to the healthy controls, both patient groups exhibited widespread GM atrophy in the cerebral cortices (for volume and cortical thickness), subcortical nuclei (for volume), and cerebellum (for volume) (p < .05 corrected for false discovery rate [FDR]). The total volume of GM atrophy in 31 subregions, which included the default mode network (DMN), visual network (VN), and cerebellar network (CN) (p < .05, FDR-corrected), independently contributed to the severity of cognitive impairment (p < .05). Additionally, WM lesions impacted cognitive decline through both direct and indirect effects, with the latter mediated by volume reduction in 16 subregions of cognitive networks (p < .05). These preliminary findings suggested that both GM atrophy and WM lesions were involved in cognitive decline in DNS patients following CO poisoning. Moreover, the reduction in the volume of DMN, VN, and posterior CN nodes mediated the WM lesions-induced cognitive decline.

Multimodal Sensors Enabled Autonomous Soft Robotic System with Self-Adaptive Manipulation.

Human hands are amazingly skilled at recognizing and handling objects of different sizes and shapes. To date, soft robots rarely demonstrate autonomy equivalent to that of humans for fine perception and dexterous operation. Here, an intelligent soft robotic system with autonomous operation and multimodal perception ability is developed by integrating capacitive sensors with triboelectric sensor. With distributed multiple sensors, our robot system can not only sense and memorize multimodal information but also enable an adaptive grasping method for robotic positioning and grasp control, during which the multimodal sensory information can be captured sensitively and fused at feature level for crossmodally recognizing objects, leading to a highly enhanced recognition capability. The proposed system, combining the performance and physical intelligence of biological systems (i.e., self-adaptive behavior and multimodal perception), will greatly advance the integration of soft actuators and robotics in many fields.

Posterior Circulation Mechanical Thrombectomy through Primitive Trigeminal Artery: A Case Report.

Introduction: Primitive trigeminal artery (PTA) is a rare intracranial vascular malformation, and mechanical thrombectomy and revascularization via PTA are rarely reported. Case Presentation: We reported a case of mechanical thrombectomy through PTA in a patient who presented with sudden slurred speech and had a National Institutes of Health Stroke Scale score of 12. Digital subtraction angiography of the cerebral vasculature showed PTA formation in the right internal carotid artery cavernous segment, with acute occlusion of the distal basilar artery at the PTA junction, and bilateral vertebral arteries and proximal basilar artery were underdeveloped. Therefore, we chose mechanical thrombectomy via PTA, but unfortunately, the vessel failed to recanalize. Follow-up at 1-month post-procedure indicated that the patient had passed away. We present the endovascular process and analyze and summarize the reasons for the failure to provide a reference for subsequent mechanical thrombectomy via PTA. Conclusions: PTA increases the risk of ischemic stroke and adds to the complexity of mechanical thrombectomy post-stroke. However, in certain situations, PTA can be used as a thrombectomy channel to increase the first-line possibility of timely endovascular treatment to save ischemic brain tissue.

Adaptive methods of generating complex light arrays.

Structured light arrays of various shapes have been a cornerstone in optical science, driven by the complexities of precise and adaptable generation. This study introduces an approach using a spatial light modulator (SLM) as a generator for these arrays. By projecting a holographic mask onto the SLM, it functions simultaneously as an optical convolution device, focusing mechanism, and structured light beam mask. Our approach offers unmatched versatility, allowing for the experimental fabrication of traditional beam arrays like azimuthal Laguerre-Gaussian (LG), Bessel-Gaussian (BG), and Hermite-Gauss (HG) in the far-field. Notably, it has enabled a method of generating Ince-Gauss (IG) and LG radial mode beam arrays using a convolution solution. Our system provides exceptional control over array periodicity and intensity distribution, bypassing the Talbot self-imaging phenomenon seen in traditional setups. We provide an in-depth theoretical discussion, supported by empirical evidence, of our far-field results. This method has vast potential for applications in optical communication, data processing, and multi-particle manipulation. It paves the way for rapid generation of structured light with high spatial frequencies and complex shapes, promising transformative advances in these domains.

Blame others but hurt yourself: blaming or sympathetic attitudes toward victims of COVID-19 and how it alters one's health status.

OBJECTIVE: This study explored the relationship between blame/sympathy and blamer's/sympathizer's perceived health status. DESIGN: We recruited participants via an online survey platform. Study 1 was a cross-sectional study using data (N = 3304, Mage = 28.22, SDage = 7.92, and 39.3% female) collected from 30 provinces, municipalities, and autonomous regions of China on February 3, 2020. Study 2 used the daily diary method collecting data from February 4 to 9, 2020. Sample (N = 2456, Mage = 28.49, SDage = 7.49, and 39.4% were female) was obtained by inviting participants in Study 1 on the same platform. MAIN OUTCOME MEASURES: Self-reported health status and life satisfaction. RESULTS: In Study 1, blame was negatively associated with perceived health status, while sympathy was positively associated with it. Negative emotions and risk perception are the underlying mechanisms, but neither of them has effects on the relationship between sympathy and perceived health status. Study 2 replicated these results using multilevel analysis. CONCLUSION: The results highlight the importance of people's attitudes on perceived health status. While sympathy is positively related to perceived health status, blaming has a negative association with perceived health status. Negative emotions and risk perceptions are the underlying mechanisms.

Alpha-Ketoglutarate Regulates Tnfrsf12a/Fn14 Expression via Histone Modification and Prevents Cancer-Induced Cachexia.

Previous studies have shown that inhibition of TNF family member FN14 (gene: TNFRSF12A) in colon tumors decreases inflammatory cytokine expression and mitigates cancer-induced cachexia. However, the molecular mechanisms underlying the regulation of FN14 expression remain unclear. Tumor microenvironments are often devoid of nutrients and oxygen, yet how the cachexic response relates to the tumor microenvironment and, importantly, nutrient stress is unknown. Here, we looked at the connections between metabolic stress and FN14 expression. We found that TNFRSF12A expression was transcriptionally induced during glutamine deprivation in cancer cell lines. We also show that the downstream glutaminolysis metabolite, alpha-ketoglutarate (aKG), is sufficient to rescue glutamine-deprivation-promoted TNFRSF12A induction. As aKG is a co-factor for histone de-methylase, we looked at histone methylation and found that histone H3K4me3 at the Tnfrsf12a promoter is increased under glutamine-deprived conditions and rescued via DM-aKG supplementation. Finally, expression of Tnfrsf12a and cachexia-induced weight loss can be inhibited in vivo by DM-aKG in a mouse cancer cachexia model. These findings highlight a connection between metabolic stress and cancer cachexia development.

A Novel Assessment of Metabolic Pathways in Peritoneal Metastases from Low-Grade Appendiceal Mucinous Neoplasms.

BACKGROUND: There is a paucity of targeted therapies for patients with pseudomyxoma peritonei (PMP) secondary to low-grade appendiceal mucinous neoplasms (LAMNs). Dysregulated metabolism has emerged as a hallmark of cancer, and the relationship of metabolomics and cancer is an area of active scientific exploration. We sought to characterize phenotypic differences found in peritoneal metastases (PM) derived from LAMN versus adenocarcinoma. METHODS: Tumors were washed with phosphate-buffered saline (PBS), microdissected, then dissociated in ice-cold methanol dried and reconstituted in pyridine. Samples were derivatized in tert-butyldimethylsilyl (TBDMS) and subjected to gas chromatography-coupled mass spectrometry. Metabolites were assessed based on a standard library. RNA sequencing was performed, with pathway and network analyses on differentially expressed genes. RESULTS: Eight peritoneal tumor samples were obtained and analyzed: LAMNs (4), and moderate to poorly differentiated adenocarcinoma (colon [1], appendix [3]). Decreases in pyroglutamate, fumarate, and cysteine in PM from LAMNs were found compared with adenocarcinoma. Analyses showed the differential gene expression was dominated by the prevalence of metabolic pathways, particularly lipid metabolism. The gene retinol saturase (RETSAT), downregulated by LAMN, was involved in the multiple metabolic pathways that involve lipids. Using network mapping, we found IL1B signaling to be a potential top-level modulation candidate. CONCLUSIONS: Distinct metabolic signatures may exist for PM from LAMN versus adenocarcinoma. A multitude of genes are differentially regulated, many of which are involved in metabolic pathways. Additional research is needed to identify the significance and applicability of targeting metabolic pathways in the potential development of novel therapeutics for these challenging tumors.

Sustained release of levobupivacaine from temperature-sensitive injectable hydrogel for long-term local anesthesia in postoperative pain management.

Postoperative pain is a major concern for most of the surgical patients, and an inadequate postoperative pain control may cause a series of complications. With an effective pain control and lesser side effects, local anesthetics are preferred for use in postoperative pain management. However, the action duration of current local anesthetics is too short to meet the requirements of postoperative analgesia. In this study, an injectable levobupivacaine (LB)-loaded thermo-sensitive hydrogel system based on biodegradable poly(D,L-lactide)-poly(ethylene glycol)-poly(D,L-lactide) (PLEL) was developed for long-acting local anesthetic, in which the soluble charged cation form of LB (LB HCl) was partly alkalified to the poorly soluble base form (LB base). This hybrid LB loaded PLEL system (hLB/PLEL) is a free flowable liquid at room temperature and changes into a semi-solid hydrogel once injection in response to the physiological temperature. Then, the dissolved LB HCl could release firstly from the hydrogel contributing to a quick work, and the insoluble LB base dissolved and released gradually as the decrease of the pH during the biodegradation of PLEL hydrogel, resulting in a long-term LB release in local. The drug release behavior, pharmacokinetic, and biocompatibility of the thermo-sensitive hLB/PLEL were studied in vitro and in vivo. The anesthetic effects of hLB/PLEL system were evaluated in the rat models of sciatic nerve block, subcutaneous infiltration anesthesia and postoperative pain as well. This hLB/PLEL system generated a significantly prolonged analgesic effect in rat models, which produced approximately 7 times longer duration than 0.75% LB HCl and effectively relieved the spontaneous pain for 3 days. In general, the presented hLB/PLEL system can not only achieve a fast-acting but also sustainably release LB to block the nerve and significantly extend the effect of local analgesia, which means a promising candidate for long-acting postoperative pain management.

New insights into the impact of microbiome on horizontal and vertical transmission of a tick-borne pathogen.

BACKGROUND: The impact of host skin microbiome on horizontal transmission of tick-borne pathogens , and of pathogen associated transstadial and transovarial changes in tick microbiome are largely unknown, but are important to control increasingly emerging tick-borne diseases worldwide. METHODS: Focusing on a rickettsiosis pathogen, Rickettsia raoultii, we used R. raoultii-positive and R. raoultii-negative Dermacentor spp. tick colonies to study the involvement of skin microbiota in cutaneous infection with rickettsiae in laboratory mice, and the function of the tick microbiome on maintenance of rickettsiae through all tick developmental stages (eggs, larvae, nymphs, adults) over two generations. RESULTS: We observed changes in the skin bacteria community, such as Chlamydia, not only associated with rickettsial colonization but also with tick feeding on skin. The diversity of skin microbiome differed between paired tick-bitten and un-bitten sites. For vertical transmission, significant differences in the tick microbiota between pathogenic rickettsia-positive and -negative tick chorts was observed across all developmental stages at least over two generations, which appeared to be a common pattern not only for R. raoultii but also for another pathogenic species, Candidatus Rickettsia tarasevichiae. More importantly, bacterial differences were complemented by functional shifts primed for genetic information processing during blood feeding. Specifically, the differences in tick microbiome gene repertoire between pathogenic Rickettsia-positive and -negative progenies were enriched in pathways associated with metabolism and hormone signals during vertical transmission. CONCLUSIONS: We demonstrate that host skin microbiome might be a new factor determining the transmission of rickettsial pathogens through ticks. While pathogenic rickettsiae infect vertebrate hosts during blood-feeding by the tick, they may also manipulate the maturation of the tick through changing the functional potential of its microbiota over the tick's life stages. The findings here might spur the development of new-generation control methods for ticks and tick-borne pathogens. Video Abstract.

Modular Soft Robot with Origami Skin for Versatile Applications.

Recent advances in soft robotics demonstrate the requirement of modular actuation to enable the rapid replacement of actuators for maintenance and functionality extension. There remain challenges to designing soft actuators capable of different motions with a consistent appearance for simplifying fabrication and modular connection. Origami structures reshaping along with their unique creases became a powerful tool to provide compact constraint layers for soft pneumatic actuators. Inspired by Waterbomb and Kresling origami, this article presents three types of vacuum-driven soft actuators with a cubic shape and different origami skins, featuring contraction, bending, and twisting-contraction combined motions, respectively. In addition, these modular actuators with diversified motion patterns can be directly fabricated by molding silicone shell and constraint layers together. Actuators with different geometrical parameters are characterized to optimize the structure and maximize output properties after establishing a theoretical model to predict the deformation. Owing to the shape consistency, our actuators can be further modularized to achieve modular actuation via mortise and tenon-based structures, promoting the possibility and efficiency of module connection for versatile tasks. Eventually, several types of modular soft robots are created to achieve fragile object manipulation and locomotion in various environments to show their potential applications.

Surface-based morphometry study of brain in patients with carbon monoxide poisoning.

PURPOSE: Although cortical volume abnormalities are frequently detected in patients with carbon monoxide poisoning (COP), particularly delayed neurological sequelae (DNS), the associated changes in cortical thickness and shape patterns remain unknown. MATERIALS & METHODS: Using surface-based morphometry, we investigated the differences in cortical thickness and shape indices between a COP group (n = 44) vs healthy controls (HCs, n = 36), and between the DNS (n = 21) vs non-DNS (n = 23) subgroups. Additionally, the influence of cortical damage on neurological disorders was explored. RESULTS: The COP group exhibited significant cortical thinning mainly in the bilateral fronto-parietal lobes (P < 0.05, family-wise error corrected). When cortical thinning in the bilateral parietal lobes, bilateral primary motor areas, left primary sensory areas, and bilateral paracentral lobules was explored in the DNS subgroups compared to the non-DNS subgroup (P < 0.05, FWE corrected), no differences in shape indices between the two subgroups were noted. In the COP group, there were significant positive correlations between the Mini-Mental State Examination (MMSE) score and cortical thickness in the right superior frontal gyrus (SFG) and bilateral rostral middle frontal gyrus (rMFG) (P < 0.05, false discovery rate corrected). There was no any significant correlation between cortical thickness and Neuropsychiatric inventory (NPI), UPDRS III scores (P > 0.05, FDR-corrected). CONCLUSION: Cortical thickness is a more sensitive index than shape for measuring cortical damage in patients with COP exposure, as cortical thinning in the right SFG and bilateral rMFG is related to cognitive impairment.

Scoring-Based Genetic Algorithm for Wavefront Shaping to Optimize Multiple Objectives.

We present a scoring-based genetic algorithm (SBGA) for wavefront shaping to optimize multiple objectives at a time. The algorithm is able to find one feasible solution despite having to optimize multiple objectives. We employ the algorithm to generate multiple focus points simultaneously and allocate their intensities as desired. We then introduce a third objective to confine light focusing only to desired targets and prevent irradiation in neighboring regions. Through simulations and experiments, we demonstrate the algorithm's ease of implementation and flexibility to control the search direction. This algorithm can potentially be applied to improve biomedical imaging, optogenetics, and optical trapping.

Early gray matter atrophy and neurological deficits in patients with carbon monoxide poisoning.

PURPOSE: To investigate early neurological deficits-related change patterns in gray matter (GM) volume in patients with carbon monoxide poisoning (COP) and GM volume differences between patients with and without delayed neurological sequelae (DNS) and those with and without T2 hyperintense lesions after COP. METHODS: Forty-one COP patients (24 patients with DNS) and 36 sex- and age-matched healthy controls (HC) were enrolled in this study. The neurological assessments were administered within 24 h after MRI scans. Voxel-based morphometry analysis was used to detect regional GM volume change. RESULTS: The COP group had statistically significant GM atrophy in the bilateral prefrontal and temporal lobes, anterior cingulate (ACC), thalamus, posterior cerebellum, and right hippocampus compared to the HC group. Atrophy in the left medial orbital superior frontal gyrus (SFG), bilateral ACC, and bilateral thalamus were related to lower Mini-Mental State Examination (MMSE) scores and higher Unified Parkinson's Disease Rating Scale subsection III and neuro-psychiatric inventory scores. Atrophy in the hippocampus and posterior cerebellum were also related to decrease MMSE scores. The DNS subgroup had greater GM atrophy in the limbic system than the non-DNS subgroup. Compared to the subgroup without T2 hyperintense lesions, greater GM atrophy in the limbic system, motor and visual cortex, and default network was observed in the subgroup with T2 hyperintense lesions. CONCLUSION: GM atrophy in the medial orbital SFG, ACC, thalamus, hippocampus, and posterior cerebellum is associated with early neurological deficits in patients with COP. Greater atrophy occurred in patients with DNS and those with T2 hyperintense lesions.

Object Relocation Visual Tracking Based on Histogram Filter and Siamese Network in Intelligent Transportation.

Target detection and tracking algorithms are one of the key technologies in the field of autonomous driving in intelligent transportation, providing important sensing capabilities for vehicle localization and path planning. Siamese network-based trackers formulate the visual tracking mission as an image-matching process by regression and classification branches, which simplifies the network structure and improves the tracking accuracy. However, there remain many problems, as described below. (1) The lightweight neural networks decrease the feature representation ability. It is easy for the tracker to fail under the disturbing distractors (e.g., deformation and similar objects) or large changes in the viewing angle. (2) The tracker cannot adapt to variations of the object. (3) The tracker cannot reposition the object that has failed to track. To address these issues, we first propose a novel match filter arbiter based on the Euclidean distance histogram between the centers of multiple candidate objects to automatically determine whether the tracker fails. Secondly, the Hopcroft-Karp algorithm is introduced to select the winners from the dynamic template set through the backtracking process, and object relocation is achieved by comparing the Gradient Magnitude Similarity Deviation between the template and the winners. The experiments show that our method obtains better performance on several tracking benchmarks, i.e., OTB100, VOT2018, GOT-10k, and LaSOT, compared with state-of-the-art methods.

Multigene manipulation of photosynthetic carbon metabolism enhances the photosynthetic capacity and biomass yield of cucumber under low-CO2 environment.

Solar greenhouses are important in the vegetable production and widely used for the counter-season production in the world. However, the CO2 consumed by crops for photosynthesis after sunrise is not supplemented and becomes chronically deficient due to the airtight structure of solar greenhouses. Vegetable crops cannot effectively utilize light resources under low-CO2 environment, and this incapability results in reduced photosynthetic efficiency and crop yield. We used cucumber as a model plant and generated several sets of transgenic cucumber plants overexpressing individual genes, including ß-carbonic anhydrase 1 (CsßCA1), ß-carbonic anhydrase 4 (CsßCA4), and sedoheptulose-1,7-bisphosphatase (CsSBP); fructose-1,6-bisphosphate aldolase (CsFBA), and CsßCA1 co-expressing plants; CsßCA4, CsSBP, and CsFBA co-expressing plants (14SF). The results showed that the overexpression of CsßCA1, CsßCA4, and 14SF exhibited higher photosynthetic and biomass yield in transgenic cucumber plants under low-CO2 environment. Further enhancements in photosynthesis and biomass yield were observed in 14SF transgenic plants under low-CO2 environment. The net photosynthesis biomass yield and photosynthetic rate increased by 49% and 79% compared with those of the WT. However, the transgenic cucumbers of overexpressing CsFBA and CsSBP showed insignificant differences in photosynthesis and biomass yield compared with the WT under low-CO2.environment. Photosynthesis, fluorescence parameters, and enzymatic measurements indicated that CsßCA1, CsßCA4, CsSBP, and CsFBA had cumulative effects in photosynthetic carbon assimilation under low-CO2 environment. Co-expression of this four genes (CsßCA1, CsßCA4, CsSBP, and CsFBA) can increase the carboxylation activity of RuBisCO and promote the regeneration of RuBP. As a result, the 14SF transgenic plants showed a higher net photosynthetic rate and biomass yield even under low-CO2environment.These findings demonstrate the possibility of cultivating crops with high photosynthetic efficiency by manipulating genes involved in the photosynthetic carbon assimilation metabolic pathway.

Real Time Ultrasound-Guided Thoracic Epidural Catheterization with Patients in the Lateral Decubitus Position without Flexion of Knees and Neck: A Preliminary Investigation.

Objectives: For some patients, such as pregnant women, it can be difficult to maintain the ideal "forehead to knees" position for several minutes for epidural catheter placement. We conducted this study to investigate the feasibility of real-time ultrasound-guided (US) epidural catheterization under a comfortable lateral position without flexion of knees and neck. Materials and Methods: 60 patients aged 18-80 years with a body mass index of 18-30 kg/m2 after general surgery were included. In a comfortable left lateral position, thoracic epidural catheterization was performed under real-time US for postoperative analgesia. The visibility of the neuraxial structures, procedural time from needle insertion to loss of resistance in the epidural space, the number of needle redirections, success rate of epidural catheter placement and postoperative analgesic effect were recorded. Results: In the paramedian oblique sagittal view, the well visible of vertebral lamina, intervertebral space and posterior complex under ultrasound were as high as 93.33%, 81.67% and 70.00%, respectively. The success rate of thoracic epidural catheterization was as high as 91.67%, and the satisfactory postoperative analgesic effect was 98.2% for patients without nausea, pruritus and other discomfort. Discussion: Thoracic epidural catheterization with patients in the lateral position without flexion of knees and neck under real time ultrasound guidance has a high success rate and strong feasibility. This visual manipulation makes epidural catheterization not only "easier" to perform, but also reduces the requirements of the procedure.