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GRN mutations cause frontotemporal dementia (GRN-FTD) due to deficiency in progranulin (PGRN), a lysosomal and secreted protein with unclear function. Here, we found that Grn-/- mice exhibit a global deficiency in bis(monoacylglycero)phosphate (BMP), an endolysosomal phospholipid we identified as a pH-dependent PGRN interactor as well as a redox-sensitive enhancer of lysosomal proteolysis and lipolysis. Grn-/- brains also showed an age-dependent, secondary storage of glucocerebrosidase substrate glucosylsphingosine. We investigated a protein replacement strategy by engineering protein transport vehicle (PTV):PGRN-a recombinant protein linking PGRN to a modified Fc domain that binds human transferrin receptor for enhanced CNS biodistribution. PTV:PGRN rescued various Grn-/- phenotypes in primary murine macrophages and human iPSC-derived microglia, including oxidative stress, lysosomal dysfunction, and endomembrane damage. Peripherally delivered PTV:PGRN corrected levels of BMP, glucosylsphingosine, and disease pathology in Grn-/- CNS, including microgliosis, lipofuscinosis, and neuronal damage. PTV:PGRN thus represents a potential biotherapeutic for GRN-FTD.
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Productos Biológicos/uso terapéutico , Encéfalo/metabolismo , Enfermedades por Almacenamiento Lisosomal/terapia , Progranulinas/uso terapéutico , Animales , Proteínas Morfogenéticas Óseas/metabolismo , Endosomas/metabolismo , Femenino , Demencia Frontotemporal/sangre , Demencia Frontotemporal/líquido cefalorraquídeo , Gliosis/complicaciones , Gliosis/patología , Humanos , Células Madre Pluripotentes Inducidas/metabolismo , Inflamación/patología , Metabolismo de los Lípidos , Lipofuscina/metabolismo , Lisosomas/metabolismo , Macrófagos/metabolismo , Masculino , Glicoproteínas de Membrana/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Microglía/metabolismo , Degeneración Nerviosa/patología , Fenotipo , Progranulinas/deficiencia , Progranulinas/metabolismo , Receptores Inmunológicos/metabolismo , Receptores de Transferrina/metabolismo , Distribución TisularRESUMEN
Approximately 80%-90% of hepatocellular carcinomas (HCC) occur in a premalignant environment of fibrosis and abnormal extracellular matrix (ECM), highlighting an essential role of ECM in the tumorigenesis and progress of HCC. However, the determinants of ECM in HCC are poorly defined. Here, we show that nuclear receptor RORγ is highly expressed and amplified in HCC tumors. RORγ functions as an essential activator of the matrisome program via directly driving the expression of major ECM genes in HCC cells. Elevated RORγ increases fibronectin-1 deposition, cell-matrix adhesion, and collagen production, creating a favorable microenvironment to boost liver cancer metastasis. Moreover, RORγ antagonists effectively inhibit tumor growth and metastasis in multiple HCC xenografts and immune-intact models, and they effectively sensitize HCC tumors to sorafenib therapy in mice. Notably, elevated RORγ expression is associated with ECM remodeling and metastasis in patients with HCC. Taken together, we identify RORγ as a key player of ECM remodeling in HCC and as an attractive therapeutic target for advanced HCC.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Animales , Ratones , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/metabolismo , Línea Celular Tumoral , Sorafenib , Colágeno/metabolismo , Microambiente TumoralRESUMEN
In semiconductor manufacturing, defect inspection in non-patterned wafer production lines is essential to ensure high-quality integrated circuits. However, in actual production lines, achieving both high efficiency and high sensitivity at the same time is a significant challenge due to their mutual constraints. To achieve a reasonable trade-off between detection efficiency and sensitivity, this paper integrates the time delay integration (TDI) technology into dark-field microscopy. The TDI image sensor is utilized instead of a photomultiplier tube to realize multi-point simultaneous scanning. Experiments illustrate that the increase in the number of TDI stages and reduction in the column fixed pattern noise effectively improve the signal-to-noise ratio of particle defects without sacrificing the detecting efficiency.
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The semantic segmentation of the 3D operating environment represents the key to intelligent mining shovels' autonomous digging and loading operation. However, the complexity of the operating environment of intelligent mining shovels presents challenges, including the variety of scene targets and the uneven number of samples. This results in low accuracy of 3D semantic segmentation and reduces the autonomous operation accuracy of the intelligent mine shovels. To solve these issues, this paper proposes a 3D point cloud semantic segmentation network based on memory enhancement and lightweight attention mechanisms. This model addresses the challenges of an uneven number of sampled scene targets, insufficient extraction of key features to reduce the semantic segmentation accuracy, and an insufficient lightweight level of the model to reduce deployment capability. Firstly, we investigate the memory enhancement learning mechanism, establishing a memory module for key semantic features of the targets. Furthermore, we address the issue of forgetting non-dominant target point cloud features caused by the unbalanced number of samples and enhance the semantic segmentation accuracy. Subsequently, the channel attention mechanism is studied. An attention module based on the statistical characteristics of the channel is established. The adequacy of the expression of the key features is improved by adjusting the weights of the features. This is done in order to improve the accuracy of semantic segmentation further. Finally, the lightweight mechanism is studied by adopting the deep separable convolution instead of conventional convolution to reduce the number of model parameters. Experiments demonstrate that the proposed method can improve the accuracy of semantic segmentation in the 3D scene and reduce the model's complexity. Semantic segmentation accuracy is improved by 7.15% on average compared with the experimental control methods, which contributes to the improvement of autonomous operation accuracy and safety of intelligent mining shovels.
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In this paper, a temperature measurement system with NTC (Negative Temperature Coefficient) thermistors was designed. An MCU (Micro Control Unit) primarily operates by converting the voltage value collected by an ADC (Analog-to-Digital Converter) into the resistance value. The temperature value is then calculated, and a DAC (Digital-to-Analog Converter) outputs a current of 4 to 20 mA that is linearly related to the temperature value. The nonlinear characteristics of NTC thermistors pose a challenging problem. The nonlinear characteristics of NTC thermistors were to a great extent solved by using a resistance ratio model. The high precision of the NTC thermistor is obtained by fitting it with the Hoge equation. The results of actual measurements suggest that each module works properly, and the temperature measurement accuracy of 0.067 °C in the range from -40 °C to 120 °C has been achieved. The uncertainty of the output current is analyzed and calculated with the uncertainty of 0.0014 mA. This type of system has broad potential applications in industry fields such as the petrochemical industry.
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Herein, we firstly develop porous organic cage (POC) as an efficient platform for highly effective radioactive iodine capture under industrial operating conditions (typically ≥ 150 °C, ≤ 150 ppmv of I2). Due to the highly dispersed and readily accessible binding sites as well as sufficient accommodating space, the constructed NKPOC-DT-(I-)Me (NKPOC = Nankai porous organic cage) demonstrates a record-high I2 uptake capacity of 48.35 wt% and extraordinary adsorption capacity of unit ionic site (~1.62) at 150 °C and 150 ppmv of I2. The I2 capacity is 3.5, 1.6, and 1.3 times higher than industrial silver-based adsorbents Ag@MOR and benchmark materials of TGDM and 4F-iCOF-TpBpy-I- under the same conditions. Furthermore, NKPOC-DT-(I-)Me exhibits remarkable adsorption kinetics (k1 = 0.013 min-1), which is 1.2 and 1.6 times higher than TGDM and 4F-iCOF-TpBpy-I- under the identical conditions. NKPOC-DT-(I-)Me thus sets a new benchmark for industrial radioactive I2 adsorbents. This work not only provides a new insight for effectively enhancing the adsorption capacity of unit functional sites, but also advances POC as an efficient platform for radioiodine capture in industry.
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STUDY QUESTION: Is there a relationship between pregnancy termination history and metabolic syndrome (MetS), and if so, is the relationship moderated by physical activity (PA)? SUMMARY ANSWER: Induced abortion, and both miscarriage and induced abortion, increased the risk of MetS, while leisure PA attenuated the effects of induced abortion, and both miscarriage and induced abortion, on the risk of MetS. WHAT IS KNOWN ALREADY: Pregnancy termination history is a risk factor for cardiovascular disease, but studies on women's history of pregnancy termination and MetS are limited. PA is a preventive behavior for MetS, but its modification effect on any association between pregnancy termination history and MetS is unknown. STUDY DESIGN, SIZE, DURATION: The cross-sectional study included 53 702 women (age range of 30-79 years old) from southwestern China who participated in the China Multi-Ethnic Cohort (CMEC) study from May 2018 to September 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants self-reported both the number and type of pregnancy termination. PA was assessed primarily by asking participants about the cumulative time they spent doing PA either as their occupation, transportation, housework, and leisure activity in the past year. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. MAIN RESULTS AND THE ROLE OF CHANCE: After adjusting for all confounders, the risk of MetS was significantly increased in women who experienced induced abortion alone, and both miscarriage and induced abortion, with odds ratios (ORs) of 1.08 (95% CI = 1.03-1.13) and 1.20 (95% CI = 1.08-1.33), respectively. A dose-response relationship was observed between the number of induced abortions and MetS, with the risk increasing by 3.0% for every additional induced abortion (OR = 1.03, 95% CI = 1.01-1.05). Leisure PA had a significant modification effect on the relationship between pregnancy termination history and MetS, as leisure PA attenuates the negative effects of induced abortion on MetS. LIMITATIONS, REASONS FOR CAUTION: Causality cannot be established in this study. Information on pregnancy termination and PA was collected by self-report, which might be subject to recall bias. WIDER IMPLICATIONS OF THE FINDINGS: A history of induced abortion was associated with an increased risk of MetS, and the risk increased with the number of induced abortions. Leisure PA attenuated the negative effect of induced abortion on MetS, whereas occupational and transportation PA amplified the negative effect of induced abortion on glucose. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the National Key R&D Program of China (grant no.: 2017YFC0907300) and the National Nature Science Foundation of China (grant no.: 82273745). The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.
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Aborto Inducido , Aborto Espontáneo , Síndrome Metabólico , Embarazo , Adulto , Femenino , Humanos , Persona de Mediana Edad , Anciano , Aborto Espontáneo/epidemiología , Aborto Espontáneo/etiología , Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Estudios Transversales , Pueblos del Este de Asia , Aborto Inducido/efectos adversos , Ejercicio FísicoRESUMEN
Wavefront coding (WFC) combines phase mask design and image restoration algorithm to extend the depth of field (DOF) for various applications. However, discrete design limits finding globally optimal solutions, increasing the complexity of system design, and affecting the accuracy and robustness of image restoration. An end-to-end imaging system design has emerged to break through these limitations by integrating optical design and image processing algorithms. In this study, we propose an algorithm that synchronously optimizes the optical elements and decoding algorithm in WFC using ray-tracing simulation. We also derive formulas for the optical layer's forward and backward propagation for joint optimization of the optical layer and decoding algorithm. Experimental verification demonstrates the algorithm's effectiveness in optimizing the WFC system and offers improved performance under a unified design framework.
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The purpose of this study was to detect the changes of P-Glycoprotein (P-GP) expression in rat brain microvessel endothelial cell line RBE4 after the action of Tetramethylpyrazine (TMP) on Carbamazepine (CBZ), so as to clarify the potential mechanism of TMP combined with CBZ against intractable epilepsy drug resistance. The RBE4 cell line was utilized for in vitro analysis. Cells were divided into control, CBZ, and CBZ-TMP group. The expression of P-GP was assessed using Western blot and reverse transcription polymerase chain reaction (RT-PCR). Intracellular concentration of CBZ was measured through high-performance liquid chromatography (HPLC). The differential expression of mRNA was evaluated by RNA sequencing. The intracellular concentration of CBZ in the CBZ-TMP group was significantly higher than that in other groups. The expression of P-GP in the CBZ group was significantly higher than that in the control group, while in the CBZ&TMP group, it was significantly lower than that in the other groups. Comparative analysis also revealed some differentially expressed genes. Compared with the CBZ group, FAM106A, SLC3A2, TENM2, etc. were upregulated most significantly in the CBZ&TMP group. ZBTB10, WDR7, STARD13, etc. were downregulated most significantly. Results suggest that TMP increases the intracellular concentration of CBZ, downregulates the expression of P-GP increased by CBZ, and modulates related cellular metabolism and signaling pathways, thus reversing the drug resistance mechanism of intractable epilepsy, providing a theoretical basis for the combination of traditional Chinese medicine and antiepileptic drugs.
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Epilepsia Refractaria , Epilepsia , Animales , Ratas , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Subfamilia B de Transportador de Casetes de Unión a ATP/genética , Células Endoteliales , Carbamazepina/farmacología , EncéfaloRESUMEN
The main manifestations of Takotsubo syndrome (TTS) are a spherical expansion of the left ventricle or near the apex and decreased systolic function. TTS is mostly thought to be induced by emotional stress, and the induction of TTS by severe infection is not often reported. A 72-year-old female patient with liver abscess reported herein was admitted due to repeated fever with a history of hypertension and impaired glucose tolerance. Her severe infection caused TTS, and her blood pressure dropped to 80/40 mmHg. IABP treatment was performed immediately and continued for 10 days, and comprehensive medication was administered. Based on her disease course and her smooth recovery, general insights and learnings may be: Adding to mental and other pathological stress reaction, serious infections from pathogenic microorganism could be of great important causation of stress reaction leading to TTS, while basic diseases such as coronary heart disease, hypertension, and diabetes were be of promoting factors; In addition to effective drug therapies for TTS, the importance of the timely using of IABP should be emphasized.
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Hipertensión , Absceso Hepático , Cardiomiopatía de Takotsubo , Humanos , Femenino , Anciano , Cardiomiopatía de Takotsubo/complicaciones , Cardiomiopatía de Takotsubo/diagnóstico por imagen , Cardiomiopatía de Takotsubo/tratamiento farmacológico , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Absceso Hepático/complicacionesRESUMEN
OBJECTIVE: Previous studies proved the effect of long-term exposure to air pollution or physical activity (PA) on the risk of systemic inflammation-induced multimorbidity (SIIM), while the evidence regarding their joint effects was rare, especially in low- and middle-income countries. Therefore, we aimed to examine the extent of interaction or joint relations of PA and air pollution with SIIM. METHODS: This study included 72,172 participants from China Multi-Ethnic Cohort.The average concentrations of ambient particulate matter pollutants (PM1, PM2.5, and PM10) were estimated using satellite-based random forest models. Self-reported information on a range of physical activities related to occupation, housework, commuting, and leisure activities was collected by an interviewer-administered questionnaire. A total of 11 chronic inflammatory systemic diseases were assessed based on self-reported lifetime diagnosis or medical examinations. SIIM was defined as having ≥ 2 chronic diseases related to systemic inflammation. Logistic regression models were used to assess the complex associations of air pollution particulate matter and PA with SIIM. RESULTS: We found positive associations between long-term air pollution particulates exposure and SIIM, with odds ratios (95%CI) of 1.07 (1.03 to 1.11), 1.18 (1.13 to 1.24), and 1.08 (1.05 to 1.12) per 10 µg/m3 increase in PM1, PM2.5, and PM10. No significant multiplicative interaction was found between ambient air pollutant exposure and PA on SIIM, whereas negative additive interaction was observed between long-term exposure to PM2.5 and PA on SIIM. The positive associations between low volume PA and SIIM were stronger among those exposed to high-level air pollution particulates. Compared with individuals engaged in high volume PA and exposed to low-level ambient air pollutants, those engaged in low volume PA and exposed to high-level ambient air pollutants had a higher risk of SIIM (OR = 1.49 in PM1 exposure, OR = 1.84 in PM2.5 exposure, OR = 1.19 in PM10 exposure). CONCLUSIONS: Long-term (3 years average) exposure to PM1, PM2.5, and PM10 was associated with an increased risk of SIIM. The associations were modified by PA, highlighting PA's importance in reducing SIIM for all people, especially those living in high-level air pollution regions.
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Contaminantes Atmosféricos , Contaminación del Aire , Adulto , Humanos , Estudios de Cohortes , Multimorbilidad , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Contaminación del Aire/análisis , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Material Particulado/efectos adversos , Material Particulado/análisis , Inflamación/epidemiología , Polvo , China/epidemiología , Ejercicio Físico , Dióxido de Nitrógeno/análisisRESUMEN
Existing diagnosis methods for bearing faults often neglect the temporal correlation of signals, resulting in easy loss of crucial information. Moreover, these methods struggle to adapt to complex working conditions for bearing fault feature extraction. To address these issues, this paper proposes an intelligent diagnosis method for compound faults in metro traction motor bearings. This method combines multisignal fusion, Markov transition field (MTF), and an optimized deep residual network (ResNet) to enhance the accuracy and effectiveness of diagnosis in the presence of complex working conditions. At the outset, the acquired vibration and acoustic emission signals are encoded into two-dimensional color feature images with temporal relevance by Markov transition field. Subsequently, the image features are extracted and fused into a set of comprehensive feature images with the aid of the image fusion framework based on a convolutional neural network (IFCNN). Afterwards, samples representing different fault types are presented as inputs to the optimized ResNet model during the training phase. Through this process, the model's ability to achieve intelligent diagnosis of compound faults in variable working conditions is realized. The results of the experimental analysis verify that the proposed method can effectively extract comprehensive fault features while working in complex conditions, enhancing the efficiency of the detection process and achieving a high accuracy rate for the diagnosis of compound faults.
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The larval stage of the helminthic cestode Echinococcus multilocularis can inflict tumor-like hepatic lesions that cause the parasitic disease alveolar echinococcosis in humans, with high mortality in untreated patients. Opportunistic properties of the disease have been established based on the increased incidence in immunocompromised patients and mouse models, indicating that an appropriate adaptive immune response is required for the control of the disease. However, cellular interactions and the kinetics of the local hepatic immune responses during the different stages of infection with E. multilocularis remain unknown. In a mouse model of oral infection that mimics the normal infection route in human patients, the networks of the hepatic immune response were assessed using single-cell RNA sequencing (scRNA-seq) of isolated hepatic CD3+ T cells at different infection stages. We observed an early and sustained significant increase in natural killer T (NKT) cells and regulatory T cells (Tregs). Early tumor necrosis factor (TNF)- and integrin-dependent interactions between these two cell types promote the formation of hepatic lesions. At late time points, downregulation of programmed cell death protein 1 (PD-1) and ectonucleoside triphosphate diphosphohydrolase 1 (ENTPD1)-dependent signaling suppress the resolution of parasite-induced pathology. The obtained data provide fresh insight into the adaptive immune responses and local regulatory pathways at different infection stages of E. multilocularis in mice.
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Equinococosis , Echinococcus multilocularis , Células T Asesinas Naturales , Linfocitos T Reguladores , Animales , Humanos , Hígado/fisiología , RatonesRESUMEN
The pattern of blood fluid shear stress (FSS) is considered the main factor that affects ciliogenesis in human umbilical vein endothelial cells (hUVECs), the underlying mechanism is unclear. Microfluidic chamber experiments were carried out to load hUVECs with low fluid shear stress (LSS, 0.1 dynes/cm2) or high fluid shear stress (HSS, 15 dynes/cm2). Van Gogh2 (Vangl2), a core protein in the planar cell polarity (PCP) pathway, was silenced and overexpressed in hUVECs. Immunofluorescence analysis showed that primary cilia assemble under LSS while disassembling under HSS. Vangl2 expression was consistent with cilia assembly, and its localization showed a polar distribution under LSS. Furthermore, the average number of ciliated cells and primary cilia length were increased in the Vangl2 overexpressing cell lines (the OE group) but decreased in the Vangl2 silenced cell lines (the SH group). When these cells were loaded with different FSS, more ciliated cells with longest primary cilia were observed in the LSS loaded OE group compared with those in the other groups. Immunoprecipitation showed that the interaction between Bardet-Biedl syndrome 8 (BBS8) and Vangl2 was enhanced following LSS loading compared to that under HSS. However, the interactions between phosphorylated dishevelled segment polarity protein 2 (pDvl2), kinesin family member 2a (Kif2a), and polo-like kinase 1 (Plk1) and Vangl2 were restrained following LSS loading. Overall, the results indicated that Vangl2 played a significant role during LSS-induced primary cilia assembly by recruiting BBS to promote the apical docking of basal bodies and by restraining Dvl2 phosphorylation from reducing primary cilia disassembly.
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Cilios/metabolismo , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Proteínas de la Membrana/metabolismo , Factores de Transcripción/metabolismo , Humanos , Resistencia al CorteRESUMEN
Simultaneous localization and mapping (SLAM) is widely used in autonomous driving and intelligent robot positioning and navigation. In order to overcome the defects of traditional visual SLAM in rapid motion and bidirectional loop detection, we present a feature-based PAL-SLAM system for a panoramic-annular-lens (PAL) camera in this paper. We use a mask to extract and match features in the annular effective area of the images. A PAL-camera model, based on precise calibration, is used to transform the matched features onto a unit vector for subsequent processing, and a prominent inlier-checking metric is designed as an epipolar constraint in the initialization. After testing on large-scale indoor and outdoor PAL image dataset sequences, comprising of more than 12,000 images, the accuracy of PAL-SLAM is measured as typically below 1 cm. This result holds consistent in conditions when the camera rotates rapidly, or the Global Navigation Satellite System (GNSS) signals are blocked. PAL-SLAM can also detect unidirectional and bidirectional loop closures. Hence it can be used as a supplement or alternative to expensive commercial navigation systems, especially in urban environments where there are many signal obstructions such as buildings and bridges.
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Wavefront coding (WFC) techniques, including optical coding and digital image processing stages, enable significant capabilities for extending the depth of field of imaging systems. In this study, we demonstrated a deeply learned far-infrared WFC camera with an extended depth of field. We designed and optimized a high-order polynomial phase mask by a genetic algorithm, exhibiting a higher defocus consistency of the modulated transfer functions than works published previously. Additionally, we trained a generative adversarial network based on a synthesized WFC dataset for the digital processing part, which is more effective and robust than conventional decoding methods. Furthermore, we captured real-world infrared images using the WFC camera with far, middle, and near object distances. Their results after wavefront coding/decoding showed that the model of deeply learned networks improves the image quality and signal-to-noise ratio significantly and quickly. Therefore, we construct a novel artificial intelligent method of deeply learned WFC optical imaging by applying infrared wavelengths, but not limited to, and provide good potential for its practical application in "smart" imaging and large range target detection.
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Phase measuring deflectometry is a powerful measuring method for complex optical surfaces, which captures the reflected fringe images encoded on the screen under the premise of focusing the measured specular surface. Due to the limited depth of field of the camera, the captured images and the measured surface cannot be focused at the same time. To solve the position-angle uncertainty issue, in this Letter, the wavefront coding technology is used to modulate the imaging wavefront of the deflectometry, thereby making the measuring system insensitive to the defocus and other low-order aberration including astigmatism, field curvature, and so on. To obtain the accurate phase, the captured fringe images are deconvoluted using the modulated point spread function to reduce the phase error. Demonstrated with a highly curved spherical surface, the measurement accuracy can be improved by four times. Experiments demonstrate that the proposed method can successfully reconstruct the complex surfaces defocusing the captured images, which can greatly release the focusing requirement and improve measurement accuracy.
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BACKGROUND: X-ray fluoroscopy has been the primary cardiac imaging modality in permanent pacemaker implantation (PPI) operations, but it inevitably results in radiation exposure for both operators and patients. Fluoroscopy is considered a contraindication, especially in certain circumstances, such as gestation, during which the fetus is most sensitive to radiation exposure. Therefore, measures to avoid radiation exposure are necessary, and a more safe and feasible approach is needed for this procedure. Since the EnSite NavX mapping system (ENMS) can create the required geometric contours of those relevant cardiac structures and chambers, it can be used as an alternative to X-ray fluoroscopy in PPI. In addition, because the displacement of atrial leads is a common complication of PPI, lead displacement may occur more readily without fluoroscopic guidance. Therefore, reliable measures are required to prevent leads from displacement. CASE INTRODUCTION: A 41-year-old woman at the 15th week of gestation was referred to our department with recurrent episodes of syncope and amaurosis fugax for 2 years. Holter monitoring showed sinus rhythm, Mobitz Type II atrioventricular block and high-grade atrioventricular block with ventricular arrest up to 4945 ms. A dual-chamber PPI was performed successfully for the patient under the guidance of the ENMS instead of fluoroscopy. Displacement of atrial lead was effectively avoided by bending the top of atrial lead before implantation and making it a U-shape during operation, which left space for possible subsequent external pulling stress. CONCLUSIONS: For PPI, ENMS is a feasible and reliable alternative to traditional X-ray fluoroscopy, especially when performing operations on pregnant patients. By bending the top of the active-fixation atrial lead into a U-shape during operation, the displacement of atrial lead may be avoided.
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Bloqueo Atrioventricular , Marcapaso Artificial , Adulto , Bloqueo Atrioventricular/diagnóstico , Bloqueo Atrioventricular/etiología , Bloqueo Atrioventricular/terapia , Femenino , Fluoroscopía/métodos , Estudios de Seguimiento , Humanos , Embarazo , Mujeres EmbarazadasRESUMEN
BACKGROUND: Farmers are the integral members of rural communities. In the present study, we determined the association between occupational physical activity (OPA) of farmers and dyslipidaemia. METHODS: We included 7649 farmers from The China Multi-Ethnic Cohort (CMEC) Study. The working modes of all farmers were divided into four types according to their self-reported seasonal changes in farming work and/or other job changes (1: no change; 2: changing job; 3: seasonal changes; and 4: seasonal and job changes). OPA was self-reported, and the OPA levels in the four groups were classified as Q1, Q2-Q3, and Q4 by quantile. Dyslipidaemia was defined as the presence of abnormalities in lipid indicators. Binary logistic regression was used to estimate the association between OPA and dyslipidaemia. RESULTS: Compared with those in the no change group, the participants in other three groups were younger with lower level of education, annual income, and leisure-time physical activity (LTPA). Active OPA could reduce the risk of dyslipidaemia in the no change [men: odds ratios (OR) = 0.21, 95% confidence intervals (CI): 0.07-0.64; women: OR = 0.43, 95% CI: 0.20-0.93] and seasonal change (men: OR = 0.46, 95% CI: 0.27-0.77; women: OR = 0.59, 95% CI: 0.41-0.86) groups. However, in the seasonal and job change group (men: OR = 3.23, 95% CI: 1.06-9.80; women: OR = 3.24, 95% CI: 1.42-7.41), active OPA increased the risk of dyslipidaemia. CONCLUSIONS: Different OPA levels might lead to differences in association with blood lipid levels. Thus, OPA guidelines must be developed for farmers, especially for those who experience seasonal changes in farming work and job changes.