A novel artificial intelligence model for fetal facial profile marker measurement during the first trimester.

BACKGROUND: To study the validity of an artificial intelligence (AI) model for measuring fetal facial profile markers, and to evaluate the clinical value of the AI model for identifying fetal abnormalities during the first trimester. METHODS: This retrospective study used two-dimensional mid-sagittal fetal profile images taken during singleton pregnancies at 11-13+ 6 weeks of gestation. We measured the facial profile markers, including inferior facial angle (IFA), maxilla-nasion-mandible (MNM) angle, facial-maxillary angle (FMA), frontal space (FS) distance, and profile line (PL) distance using AI and manual measurements. Semantic segmentation and landmark localization were used to develop an AI model to measure the selected markers and evaluate the diagnostic value for fetal abnormalities. The consistency between AI and manual measurements was compared using intraclass correlation coefficients (ICC). The diagnostic value of facial markers measured using the AI model during fetal abnormality screening was evaluated using receiver operating characteristic (ROC) curves. RESULTS: A total of 2372 normal fetuses and 37 with abnormalities were observed, including 18 with trisomy 21, 7 with trisomy 18, and 12 with CLP. Among them, 1872 normal fetuses were used for AI model training and validation, and the remaining 500 normal fetuses and all fetuses with abnormalities were used for clinical testing. The ICCs (95%CI) of the IFA, MNM angle, FMA, FS distance, and PL distance between the AI and manual measurement for the 500 normal fetuses were 0.812 (0.780-0.840), 0.760 (0.720-0.795), 0.766 (0.727-0.800), 0.807 (0.775-0.836), and 0.798 (0.764-0.828), respectively. IFA clinically significantly identified trisomy 21 and trisomy 18, with areas under the ROC curve (AUC) of 0.686 (95%CI, 0.585-0.788) and 0.729 (95%CI, 0.621-0.837), respectively. FMA effectively predicted trisomy 18, with an AUC of 0.904 (95%CI, 0.842-0.966). MNM angle and FS distance exhibited good predictive value in CLP, with AUCs of 0.738 (95%CI, 0.573-0.902) and 0.677 (95%CI, 0.494-0.859), respectively. CONCLUSIONS: The consistency of fetal facial profile marker measurements between the AI and manual measurement was good during the first trimester. The AI model is a convenient and effective tool for the early screen for fetal trisomy 21, trisomy 18, and CLP, which can be generalized to first-trimester scanning (FTS).

Investigating the Metabolic Model in Preterm Neonates by Tandem Mass Spectrometry: A Cohort Study.

The changes of metabolite profiles in preterm birth have been demonstrated using newborn screening data. However, little is known about the holistic metabolic model in preterm neonates. The aim was to investigate the holistic metabolic model in preterm neonates. All metabolite values were obtained from a cohort data of routine newborn screening. A total of 261 758 newborns were recruited and randomly divided into a training subset and a testing subset. Using the training subset, 949 variates were considered to establish a logistic regression model for identifying preterm birth (<37 weeks) from term birth (≥37 weeks). Sventy-two variates (age at collection, TSH, 17α-OHP, proline, tyrosine, C16:1-OH, C18:2, and 65 ratios) entered into the final metabolic model for identifying preterm birth from term birth. Among the variates entering into the final model of PTB [Leucine+Isoleucine+Proline-OH)/Valine (OR=38.36], (C3DC+C4-OH)/C12 (OR=15.58), Valine/C5 (OR=6.32), [Leucine+isoleucine+Proline-OH)/Ornithine (OR=2.509)], and Proline/C18:1 (OR=2.465) have the top five OR values, and [Leucine+Isoleucine+Proline-OH)/C5 (OR=0.05)], [Leucine+Isoleucine+Proline-OH)/Phenylalanine (OR=0.214)], proline/valine (OR=0.230), C16/C18 (OR=0.259), and Alanine/free carnitine (OR=0.279) have the five lowest OR values. The final metabolic model had a capacity of identifying preterm infants with >80% accuracy in both the training and testing subsets. When identifying neonates ≤32 weeks from those >32 weeks, it had a robust performance with nearly 95% accuracy in both subsets. In summary, we have established an excellent metabolic model in preterm neonates. These findings could provide new insights for more efficient nutrient supplements and etiology of preterm birth.

High-sensitive sensor for the simultaneous determination of phenolics based on multi-walled carbon nanotube/NiCoAl hydrotalcite electrode material.

The ternary NiCoAl hydrotalcite (NiCoAl-LDH) was combined with carboxylic multi-walled carbon nanotube (MWCNT) to fabricate a novel electrochemical sensor for simultaneously determining the co-existing trace phenolic substances. The morphology, structure, and electrochemical behavior of the as-prepared materials were characterized by various techniques. Benefitting from the great conductivity of MWCNT and high electrocatalytic activity of NiCoAl-LDH for phenolic substances, the advanced MWCNT/NiCoAl-LDH sensor presented a fast response, high sensitivity, excellent stability, and satisfactory replicability. The sensor offered good linear responses in the ranges1.50~600 µM to hydroquinone (HQ), 5.00~1.03 × 103 µM to catechol (CC), and 6.00 × 10-2~250 µM to bisphenol A (BPA). The detection limits of HQ, CC, and BPA were 0.4, 0.8, and 6. × 10-3 µM (S/N = 3), respectively. In environmental water, the sensor achieved satisfactory recoveries for the simultaneous detection of HQ (98.6~101%), CC (98.0~101%), and BPA (97.5~101%), with relative standard deviations less than 4.4%.

Optimization of ZnAl/Chitosan Supra-Nano Hybrid Preparation as Efficient Antibacterial Material.

The menace of antimicrobial resistance continues to increase and hence the need to discover new antibiotics, especially alternative and effective sources such as hybrid organic-inorganic, organic-organic materials, and other combinations. In this study, an antimicrobial hybrid supra-nano material was prepared by the bi-titration synthesis method of chitosan (CS) and ZnAl layered double hydroxide. Fourier-transform infrared spectrometer (FTIR), thermogravimetric and differential thermal gravimetric (TGA/DTG), ultraviolet-visible (UV-Vis), X-ray diffraction (XRD), and scanning electron microscopy (SEM) analyses indicated that the ZnAl/CS hybrid exhibited low crystallinity with high thermal stability. The results of ZnAl/CS characterization showed the characteristic properties of the individual components ZnAl and CS, indicating a successful preparation of the ZnAl/CS hybrid. The antibacterial tests revealed that the ZnAl/CS hybrid possessed an enhanced antimicrobial effect against both Escherichia coli (E. coli, MTCC 739) and Penicilliumcyclopium (P. cyclopium, AS 3.4513). Under the central composite design (CCD) of the response surface methodology (RSM) tool, the parameters of the hybrid synthesis reaction were optimized and the result obtained was as follows: reaction pH was 11.3, reagent Zn/Al ratio was 3.27, and chitosan concentration was 1.07 g/L. After optimization, it was found that the antibacterial activity of ZnAl/CS was strengthened against E. coli as evidenced by a widening of the inhibition zone of about 41.6%. The antibacterial activity of ZnAl/CS was mainly due to the reactivation of the antibacterial activity of CS associated with the release of Zn2+ and Al3+ metal ions in addition to ZnO, Al2O3, and ZnAl2O4 compounds resulting from the method of preparation.

White blood cell count affects fetal fraction and test failure rates in noninvasive prenatal screening.

Objective: To investigate the effects of white blood cell (WBC) count on fetal fraction (FF), which is an essential quality control for obtaining reliable results, and on the rate of screen failures in noninvasive prenatal screening (NIPS). Methods: Noninvasive prenatal screening, serum lipid and liver enzyme level measurements, and WBC count were performed for 4,281 pregnancies with male fetuses. After adjusting for confounders, including the maternal characteristics and alanine aminotransferase (ALT) levels, the effect of WBC count on FF and test failure rate was measured by linear and logistic regression analyses. Results: Fetal fraction was negatively associated with BMI, ALT, IVF conceptions, and WBC count and positively correlated with gestational age in the multivariate linear regression model. Moreover, WBC count was the most important factor affecting FF after BMI according to the standardization coefficient analysis. In the 4,281 pregnancy samples with male fetuses, FF decreased with WBC count from 11.45% at ≤8 to 9.02% at >12, and FF markedly decreased to 7.40% in pregnancies with a higher WBC count (>12) and higher BMI (≥25 kg/m2). Meanwhile, the test failure rates were significantly higher in the WBC count > 12 group (4.29%) than in the WBC count ≤ 8 group (0.89%). Notably, when the BMI of pregnancies with a WBC count of >12 was >25, the rate reached 7.53%. Subsequently, multivariate logistic regression analysis further confirmed that an increased BMI and WBC count were independently and significantly associated with the test failure rates. Conclusion: An increased WBC count was associated with lower FF and higher test failure rates, suggesting that these important factors should be carefully considered during genetic counseling in pregnant women who decide to undergo blood collection or resampling.

[Clinical study on naoxintong capsule for stroke recovery of Qi-deficiency and blood-stasis syndrome].

OBJECTIVE: To study the efficacy and safety of Naoxintong capsule treatment of stroke recovery with Qi-deficiency and blood-stasis syndrome (cerebral infarction), and to compared the non-inferiority analysis with the positive drug Tongxinluo capsule. METHOD: Taking Tongxinluo capsules as control, randomized, double-blind, controlled, multi-center clinical experiments were studied. The evaluating indexes included the decrease of integral value of stroke patients, changes in traditional Chinese medicine, the improvement of the patient viability status (disability level), Chinese stroke scale (CSS), activities of daily living (DAL) scale and barthel index (BI ) points. RESULT: The total effect of the two groups, Chinese and other symptoms, showed no significant statistical significance. CONCLUSION: Naoxintong capsule stroke recovery, with Qi-deficiency and blood-stasis syndrome (cerebral infarction) has a therapeutic effect, and more secure.

Enhanced efficiency in isolation and expansion of hAMSCs via dual enzyme digestion and micro-carrier.

A two-stage method of obtaining viable human amniotic stem cells (hAMSCs) in large-scale is described. First, human amniotic stem cells are isolated via dual enzyme (collagenase II and DNAase I) digestion. Next, relying on a culture of the cells from porous chitosan-based microspheres in vitro, high purity hAMSCs are obtained in large-scale. Dual enzymatic (collagenase II and DNase I) digestion provides a primary cell culture and first subculture with a lower contamination rate, higher purity and a larger number of isolated cells. The obtained hAMSCs were seeded onto chitosan microspheres (CM), gelatin-chitosan microspheres (GCM) and collagen-chitosan microspheres (CCM) to produce large numbers of hAMSCs for clinical trials. Growth activity measurement and differentiation essays of hAMSCs were realized. Within 2 weeks of culturing, GCMs achieved over 1.28 ± 0.06 × 107 hAMSCs whereas CCMs and CMs achieved 7.86 ± 0.11 × 106 and 1.98 ± 0.86 × 106 respectively within this time. In conclusion, hAMSCs showed excellent attachment and viability on GCM-chitosan microspheres, matching the hAMSCs' normal culture medium. Therefore, dual enzyme (collagenase II and DNAase I) digestion may be a more useful isolation process and culture of hAMSCs on porous GCM in vitro as an ideal environment for the large-scale expansion of highly functional hAMSCs for eventual use in stem cell-based therapy.

An Advanced NiCoFeO/Polyaniline Composite for High-Performance Supercapacitors.

To reduce the charge-transfer resistance of supercapacitors and achieve faster reversible redox reactions, ternary Ni-Co-Fe layered double hydroxide was prepared by using the urea method and then calcined to give NiCoFe oxide (NiCoFeO). To enhance conductivity, a polyaniline (PANI) conductive layer was assembled on the surface of the NiCoFeO particles by in situ oxidative polymerization of aniline monomers. The as-prepared NiCoFeO/PANI composite was successful employed as a supercapacitor electrode. It was found that the NiCoFeO/PANI composite displayed good cycling stability, with a capacity loss of only 29.54 % after 5000 cycles. Furthermore, the NiCoFeO/PANI composite also exhibited excellent supercapacitor performance, with a high specific capacity of 843 F g-1 at a current density of 2 A g-1 , whereas NiCoFeO showed a specific capacity of only 478 F g-1 . This result was attributed to the synergistic effect between NiCoFeO and PANI. The facile synthesis strategy and excellent electrochemical performance suggest that NiCoFeO/PANI is a promising economical electrode material for applications in supercapacitors.

Preparation of the Hybrids of Hydrotalcites and Chitosan by Urea Method and Their Antimicrobial Activities.

Hybrid nano-supra molecular structured materials can boost the functionalityof nano- or supra-molecular materials by providing increased reactivity and conductivity, or by simply improving theirmechanical stability. Herein, the studies in materials science exploring hybrid systems are investigated from the perspective of two important related applications: healthcare andfood safety.Interfacing phase strategy was applied, and ZnAl layered double hydroxide-chitosan hybrids, prepared by the urea method (U-LDH/CS), were successfully synthesized under the conditions of different chitosan(CS) concentrations with a Zn/Al molar ratio of 5.0. The structure and surface properties of the U-LDH/CS hybrids were characterized by X-ray diffraction (XRD), Fourier-transform infrared spectrometer(FTIR), scanningelectronmicroscopy(SEM), ultravioletvisible(UV-Vis), and zero point charge (ZPC) techniques, where the effect of CS concentration on the structure and surface properties was investigated. The use of the U-LDH/CS hybrids as antimicrobial agents against Escherichia coli, Staphylococcus aureus,and Penicilliumcyclopiumwasinvestigated in order to clarify the relationship between microstructure and antimicrobial ability. The hybrid prepared in a CS concentration of 1.0 g∙L-1 (U-LDH/CS1) exhibited the best antimicrobial activity and exhibited average inhibition zones of 24.2, 30.4, and 22.3mm against Escherichia coli, Staphylococcus aureus, and Penicilliumcyclopium, respectively. The results showed that the appropriate addition of CS molecules could increase antimicrobial ability against microorganisms.

Microwave Pretreatment and Enzymolysis Optimization of the Lotus Seed Protein.

Pretreatment with a microwave was conducted before enzymolysis and shown to enhance the enzymolysis, which changed the secondary structure of the lotus seed protein. Under high-power microwave irradiation, sub bonds of the protein were broken, causing disaggregation and unfolding of the secondary structure, namely a decrease in the intermolecular aggregate structure and increase in the random coil structure, making the protein bonds susceptible to papain in the enzymolysis. On the other hand, a response surface methodology (RSM) was launched to investigate the influence of the enzymolysis process variables on the DH (degree of hydrolysis). The statistical analysis revealed that the optimized conditions were a protein substrate concentration of 15 g/L, pH of 5.5, enzymolysis temperature of 57 °C, papain amount of 0.5 g/L, and enzymolysis time of 45 min, for which the predicted value of the DH was 35.64%. The results indicated that a microwave also had better potential for applications in the enzymolysis of foods.

Preparation of a NiAl-Oxide@Polypyrrole Composite for High-Performance Supercapacitors.

A core-shell NiAlO@polypyrrole composite (NiAlO@PPy) with a 3D "sand rose"-like morphology was prepared via a facile in situ oxidative polymerization of pyrrole monomer, where the role of PPy coating thickness was investigated for high-performance supercapacitors. Microstructure analyses indicated that the PPy was successfully coated onto the NiAlO surface to form a core-shell structure. The NiAlO@PPy exhibited a better electrochemical performance than pure NiAlO, and the moderate thickness of the PPy shell layer was beneficial for expediting the electron transfer in the redox reaction. It was found that the NiAlO@PPy5 prepared at 5.0 mL L-1 addition amount of pyrrole monomer demonstrated the best electrochemical performance with a high specific capacitance of 883.2 F g-1 at a current density of 1 A g-1 and excellent capacitance retention of 91.82 % of its initial capacitance after 1000 cycles at 3 A g-1 . The outstanding electrochemical performance of NiAlO@PPy5 were due to the synergistic effect of NiAlO and PPy, where the uniform network-like PPy shell with the optimal thickness made electrolyte ions more easily accessible for faradic reactions. This work provided a simple approach for designing organic-inorganic core-shell materials as high-performance electrode materials for electrochemical supercapacitors.

TCM treatment of rheumatoid arthritis by supplementing the kidney and invigorating the blood circulation.

The therapeutic effects in treating the intermediate and late rheumatoid arthritis by supplementing the kidney and invigorating blood circulation were observed. In the 43 cases of the treatment group, No. 2 Qu Feng Shi Ling capsules and Fenbid were prescribed, while in the 39 cases of the control group Lei Gong Teng Tablets and Fenbid were given. The results showed that the total effective rate in the treatment group was more satisfactory than that in the control (P<0.05 or P<0.01). With less toxic effects, the former could better improve the local swelling and lower the blood viscosity.