Shortening Oral Simethicone-to-Colonoscopy Interval Increases Bowel Preparation Quality.

BACKGROUND Simethicone can improve bowel preparation quality, but the optimal timing of oral simethicone before colonoscopy has not been determined. This study aimed to explore the effect of the time interval between oral simethicone and the start of colonoscopy (S-C) on bowel preparation quality. MATERIAL AND METHODS A total of 364 patients undergoing colonoscopy at our department from August 1, 2021 to November 30, 2021 were included in the training cohort, and 420 consecutive patients from December 15, 2021 to January 31, 2022 comprised the validation cohort. They were classified into short and long S-C groups according to the median S-C. Bowel preparation quality evaluated by the Boston Bowel Preparation Scale was compared between the 2 groups. Logistic regression analyses were performed to explore the correlation between S-C and bowel preparation quality, and we explored the effect of run-way time and time of starting colonoscopy on bowel preparation quality. RESULTS In the training cohort, 182 and 182 patients were classified into the short and long S-C groups, respectively; in the validation cohort, 210 and 210 patients were classified into the 2 groups, respectively. In the 2 cohorts, the short S-C group had a significantly higher rate of adequate/excellent bowel preparation than the long S-C group. Logistic regression analyses showed that shorter S-C, shorter run-way time, and colonoscopy in the morning were all correlated with adequate/excellent bowel preparation. CONCLUSIONS Bowel preparation quality may be affected by S-C, run-way time, and time of starting colonoscopy. S-C shortening should be given equal importance as run-way time shortening.

Combined pangenomics and transcriptomics reveals core and redundant virulence processes in a rapidly evolving fungal plant pathogen.

BACKGROUND: Studying genomic variation in rapidly evolving pathogens potentially enables identification of genes supporting their "core biology", being present, functional and expressed by all strains or "flexible biology", varying between strains. Genes supporting flexible biology may be considered to be "accessory", whilst the "core" gene set is likely to be important for common features of a pathogen species biology, including virulence on all host genotypes. The wheat-pathogenic fungus Zymoseptoria tritici represents one of the most rapidly evolving threats to global food security and was the focus of this study. RESULTS: We constructed a pangenome of 18 European field isolates, with 12 also subjected to RNAseq transcription profiling during infection. Combining this data, we predicted a "core" gene set comprising 9807 sequences which were (1) present in all isolates, (2) lacking inactivating polymorphisms and (3) expressed by all isolates. A large accessory genome, consisting of 45% of the total genes, was also defined. We classified genetic and genomic polymorphism at both chromosomal and individual gene scales. Proteins required for essential functions including virulence had lower-than average sequence variability amongst core genes. Both core and accessory genomes encoded many small, secreted candidate effector proteins that likely interact with plant immunity. Viral vector-mediated transient in planta overexpression of 88 candidates failed to identify any which induced leaf necrosis characteristic of disease. However, functional complementation of a non-pathogenic deletion mutant lacking five core genes demonstrated that full virulence was restored by re-introduction of the single gene exhibiting least sequence polymorphism and highest expression. CONCLUSIONS: These data support the combined use of pangenomics and transcriptomics for defining genes which represent core, and potentially exploitable, weaknesses in rapidly evolving pathogens.

Factors of easy and difficult cecal intubation during unsedated colonoscopy.

BACKGROUND AND AIMS: difficulty of cecal intubation should be a main indicator for the need of sedated colonoscopy and skilled endoscopists. The present study aimed to explore the factors associated with easy and difficult cecal intubation in unsedated colonoscopy. METHODS: all consecutive patients who underwent unsedated colonoscopy at our department by the same endoscopist from December 3, 2020 to August 30, 2022 were retrospectively collected. Age, gender, body mass index (BMI), reasons for colonoscopy, position change, Boston Bowel Preparation Scale score, cecal intubation time (CIT) and major colonoscopic findings were analyzed. CIT < 5 min, CIT 5-10 min and CIT > 10 min or failed cecal intubation were defined as easy, moderate and difficult cecal intubation, respectively. Logistic regression analyses were performed to identify independent factors associated with easy and difficult cecal intubation. RESULTS: overall, 1,281 patients were included. The proportions of easy and difficult cecal intubation were 29.2 % (374/1,281) and 27.2 % (349/1,281), respectively. Multivariate logistic regression analysis found that age ≤ 50 years, male, BMI > 23.0 kg/m2 and the absence of position change were independently associated with easy cecal intubation, and that age > 50 years, female, BMI ≤ 23.0 kg/m2, position change, and insufficient bowel preparation were independently associated with difficult cecal intubation. CONCLUSIONS: some convenient factors independently associated with easy and difficult cecal intubation have been identified, which will be potentially helpful to determine whether a colonoscopy should be sedated and a skilled endoscopist should be selected. The current findings should be further validated in large-scale prospective studies.

Foxtail mosaic virus: A Viral Vector for Protein Expression in Cereals.

Rapid and cost-effective virus-derived transient expression systems for plants are invaluable in elucidating gene function and are particularly useful in plant species for which transformation-based methods are unavailable or are too time and labor demanding, such as wheat (Triticum aestivum) and maize (Zea mays). The virus-mediated overexpression (VOX) vectors based on Barley stripe mosaic virus and Wheat streak mosaic virus described previously for these species are incapable of expressing free recombinant proteins of more than 150 to 250 amino acids, are not suited for high-throughput screens, and have other limitations. In this study, we report the development of a VOX vector based on a monopartite single-stranded positive sense RNA virus, Foxtail mosaic virus (genus Potexvirus). In this vector, PV101, the gene of interest was inserted downstream of the duplicated subgenomic promoter of the viral coat protein gene, and the corresponding protein was expressed in its free form. The vector allowed the expression of a 239-amino acid-long GFP in both virus-inoculated and upper uninoculated (systemic) leaves of wheat and maize and directed the systemic expression of a larger approximately 600-amino acid protein, GUSPlus, in maize. Moreover, we demonstrated that PV101 can be used for in planta expression and functional analysis of apoplastic pathogen effector proteins such as the host-specific toxin ToxA of Parastagonospora nodorum Therefore, this VOX vector opens possibilities for functional genomics studies in two important cereal crops.

Dominant Tree Species and Soil Type Affect the Fungal Community Structure in a Boreal Peatland Forest.

Boreal peatlands play a crucial role in global carbon cycling, acting as an important carbon reservoir. However, little information is available on how peatland microbial communities are influenced by natural variability or human-induced disturbances. In this study, we have investigated the fungal diversity and community structure of both the organic soil layer and buried wood in boreal forest soils using high-throughput sequencing of the internal transcribed spacer (ITS) region. We have also compared the fungal communities during the primary colonization of wood with those of the surrounding soils. A permutational multivariate analysis of variance (PERMANOVA) confirmed that the community composition significantly differed between soil types (P< 0.001) and tree species (P< 0.001). The distance-based linear models analysis showed that environmental variables were significantly correlated with community structure (P< 0.04). The availability of soil nutrients (Ca [P= 0.002], Fe [P= 0.003], and P [P= 0.003]) within the site was an important factor in the fungal community composition. The species richness in wood was significantly lower than in the corresponding soil (P< 0.004). The results of the molecular identification were supplemented by fruiting body surveys. Seven of the genera of Agaricomycotina identified in our surveys were among the top 20 genera observed in pyrosequencing data. Our study is the first, to our knowledge, fungal high-throughput next-generation sequencing study performed on peatlands; it further provides a baseline for the investigation of the dynamics of the fungal community in the boreal peatlands.

Distributed transverse stress measurement along an optic fiber using polarimetric OFDR.

We report a novel polarimetric optical frequency domain reflectometer (P-OFDR) that can simultaneously measure both space-resolved transverse stresses and light back-reflections along an optic fiber with sub-mm spatial resolution. By inducing transversal stresses and optical back-reflections at multiple points along a length of optic fiber, we demonstrate that our system can unambiguously distinguish the stresses from the back-reflections of a fiber with a fiber length longer than 800 m, a spatial resolution of 0.5 mm, a maximum stress level of up to 200 kpsi (1379 Mpa), a minimum stress of about 10 kpsi (69 Mpa), and a stress measurement uncertainty of 10%. We show that our P-OFDR can clearly identify the locations and magnitudes of the stresses inside a fiber coil induced during a fiber winding process. The P-OFDR can be used for fiber health monitoring for critical fiber links, fiber gyro coil characterization, and other distributed fiber sensing applications.

A cerato-platanin-like protein HaCPL2 from Heterobasidion annosum sensu stricto induces cell death in Nicotiana tabacum and Pinus sylvestris.

The cerato-platanin family is a group of small secreted cysteine-rich proteins exclusive for filamentous fungi. They have been shown to be involved in the interactions between fungi and plants. Functional characterization of members from this family has been performed mainly in Ascomycota, except Moniliophthora perniciosa. Our previous phylogenetic analysis revealed that recent gene duplication of cerato-platanins has occurred in Basidiomycota but not in Ascomycota, suggesting higher functional diversification of this protein family in Basidiomycota than in Ascomycota. In this study, we identified three cerato-platanin homologues from the basidiomycete conifer pathogen Heterobasidion annosum sensu stricto. Expression of the homologues under various conditions as well as their roles in the H. annosum s.s.-Pinus sylvestris (Scots pine) pathosystem was investigated. Results showed that HaCPL2 (cerato-platanin-like protein 2) had the highest sequence similarity to cerato-platanin from Ceratocystis platani and hacpl2 was significantly induced during nutrient starvation and necrotrophic growth. The treatment with recombinant HaCPL2 induced cell death, phytoalexin production and defense gene expression in Nicotiana tabacum. Eliciting and cell death-inducing ability accompanied by retardation of apical root growth was also demonstrated in Scots pine seedlings. Our results suggest that HaCPL2 might contribute to the virulence of H. annosum s.s. by promoting plant cell death.

[Malaria Epidemic Situation in Rudong County of Jiangsu Province during 1999-2014].

From 1999 to 2014 a total of 23 cases of malaria were reported in Rudong County, Jiangsu Province, comprising one indigenous case of vivax malaria, 9 imported cases of vivax malaria, and 13 imported cases of falciparum malaria. The imported cases accounted for 95.7%(22/23) of all cases. The first diagnosis was mainly made in town hospitals and village clinics, accounting for 60.9%. There was no obvious seasonal variation in disease onset, and all cases reported in 2004 were imported.

Transcriptomic profiles of Heterobasidion annosum under abiotic stresses and during saprotrophic growth in bark, sapwood and heartwood.

The success of many wood decaying fungi lies in their ability to overcome unfavourable environmental conditions within and outside of litter and wood debris. Although so much has been learned about the ecology, taxonomy and physiology of several wood decaying basidiomycete fungi, the molecular basis for their survival in a diverse range of substrates and ecological habitats has been very little studied. Using the wood decay fungus (Heterobasidion annosum s.s.) as a model, we investigated its transcriptomic response when exposed to several environmental stressors (high and low temperature, osmotic stress, oxidative stress and nutrient starvation) and during growth on specific pine wood compartments (bark, sapwood and heartwood). Among other genes and pathways, we documented the specific induction of the major facilitator superfamily 1 and cytochrome P450 families at low temperature, and protein kinases together with transcription factors during starvation. On the other hand, during saprotrophic growth, we observed the induction of many glycosyl hydrolases, three multi-copper oxidases (MCO), five manganese peroxidases (MnP) and one oxidoreductase which are specific for wood degradation. This is the first study providing insights on the potential mechanisms for adaptation to abiotic stresses and pine heartwood degradation in H. annosum s.s.

Ant colony optimization analysis on overall stability of high arch dam basis of field monitoring.

A dam ant colony optimization (D-ACO) analysis of the overall stability of high arch dams on complicated foundations is presented in this paper. A modified ant colony optimization (ACO) model is proposed for obtaining dam concrete and rock mechanical parameters. A typical dam parameter feedback problem is proposed for nonlinear back-analysis numerical model based on field monitoring deformation and ACO. The basic principle of the proposed model is the establishment of the objective function of optimizing real concrete and rock mechanical parameter. The feedback analysis is then implemented with a modified ant colony algorithm. The algorithm performance is satisfactory, and the accuracy is verified. The m groups of feedback parameters, used to run a nonlinear FEM code, and the displacement and stress distribution are discussed. A feedback analysis of the deformation of the Lijiaxia arch dam and based on the modified ant colony optimization method is also conducted. By considering various material parameters obtained using different analysis methods, comparative analyses were conducted on dam displacements, stress distribution characteristics, and overall dam stability. The comparison results show that the proposal model can effectively solve for feedback multiple parameters of dam concrete and rock material and basically satisfy assessment requirements for geotechnical structural engineering discipline.

Raspberry-liked Pickering emulsions based inulin microparticles for enhanced antibacterial performance of essential oils.

Pickering emulsions seem to be an effective strategy for encapsulation and stabilization of essential oils. In this work, a novel raspberry-liked Pickering emulsion (RPE) loading Mosla chinensis 'Jiangxiangru' essential oil (MJO) was successfully engineered by using ethyl lauroyl arginate (ELA) decorated nanosilica (ELA-NS) as particles emulsifier. And the ELA-NS-stabilized MJO Pickering emulsion (MJO-RPE) was further prepared into inulin-based microparticles (MJO-RPE-IMP) by spray-drying, using inulin as matrix formers. The concentration of ELA-NS could affect the formation and stabilization of MJO-RPE, and the colloidal behavior of ELA-NS could be modulated at the interfaces with concentration of ELA, thus providing unique role on stabilization of MJO-RPE. The results indicated that the MJO-RPE stabilized ELA-NS with 2 % NS modified by 0.1 % ELA had long-term stability. MJO-RPE exhibited a raspberry-liked morphology on the surface, attributed to ELA-NS covered in the droplet surface. The inulin-based matrix formers could effectively prevent MJO-RPE from agglomeration or destruction during spray-drying, and 100 % concentration of inulin based microparticles formed large composite particles with high loading capacity (98.54 ± 1.11 %) and exhibited superior thermal stability and redispersibility of MJO-RPE. The MJO-RPE exhibited strong antibacterial efficacy against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Pseudomonas aeruginosa (P. aeruginosa), owing to the adhesion to bacterial membrane dependent on the raspberry-liked surface of MJO-RPE, whose minimum inhibitory concentration (MIC) of the above three bacteria were (0.3, 0.45, and 1.2 µL/mL), respectively, lower than those (0.45, 0.6 and 1.2 µL/mL) of MJO. Therefore, the Pickering emulsion composite microparticles seemed to be a promising strategy for enhancing the stability and antibacterial activity of MJO.

Novel strategy: Identifying new markers for demyelination in diabetic distal symmetrical polyneuropathy.

Objective: To develop a novel strategy for identifying acquired demyelination in diabetic distal symmetrical polyneuropathy (DSP). Background: Motor nerve conduction velocity (CV) slowing in diabetic DSP exceeds expectations for pure axonal loss thus implicating superimposed acquired demyelination. Methods: After establishing demyelination confidence intervals by regression analysis of nerve conduction data from chronic inflammatory demyelinating polyneuropathy (CIDP), we prospectively studied CV slowing in 90 diabetic DSP patients with and without at least one motor nerve exhibiting CV slowing (groups A and B) into the demyelination range by American Academy of Neurology (AAN) criteria respectively and 95 amyotrophic lateral sclerosis (ALS) patients. Simultaneously, secretory phospholipase A2 (sPLA2) activity was assessed in both diabetic groups and 46 healthy controls. Results: No ALS patient exhibited CV slowing in more than two motor nerves based on AAN criteria or the confidence intervals. Group A demonstrated a significantly higher percentage of patients as compared to group B fulfilling the above criteria, with an additional criterion of at least one motor nerve exhibiting CV slowing in the demyelinating range and a corresponding F response in the demyelinating range by AAN criteria (70.3 % vs. 1.9 %; p < 0.0001). Urine sPLA2 activity was increased significantly in diabetic groups as compared to healthy controls (942.9 ± 978.0 vs. 591.6 ± 390.2 pmol/min/ml, p < 0.05), and in group A compared to Group B (1328.3 ± 1274.2 vs. 673.8 ± 576.9 pmol/min/ml, p < 0.01). More patients with elevated sPLA2 activity and more than 2 motor nerves with CV slowing in the AAN or the confidence intervals were identified in group A as compared to group B (35.1 % vs. 5.7 %, p < 0.001). Furthermore, 13.5 % of patients in diabetic DSP Group A, and no patients in diabetic DSP Group B, fulfilled an additional criterion of more than one motor nerve with CV slowing into the demyelinating range with its corresponding F response into the demyelinating range by AAN criteria. Conclusion: A combination of regression analysis of electrodiagnostic data and a urine biological marker of systemic inflammation identifies a subgroup of diabetic DSP with superimposed acquired demyelination that may respond favorably to immunomodulatory therapy.

Association of echocardiography-related parameters with the prognosis of decompensated cirrhosis: a retrospective cohort study.

BACKGROUND: Cardiac morphology and function, which are conventionally evaluated by echocardiography, are often abnormal in decompensated cirrhosis. We aimed to evaluate the association of echocardiography-related parameters with prognosis in cirrhosis. METHODS: This retrospective study included 104 decompensated cirrhotic patients, in whom cardiac structure and function were measured by echocardiography, including mitral inflow early diastolic velocity/mitral inflow late diastolic velocity (E/A), left atrium diameter, left ventricular end-diastolic dimension, interventricular septal thickness, left ventricular posterior wall thickness, right atrial transverse diameter, right atrial longitudinal diameter, right ventricular dimension (RVD), stroke volume, cardiac output, left ventricular ejection fraction, and fractional shortening. Cox regression and competing risk analyses and Kaplan-Meier and Nelson-Aalen cumulative risk curves were used to evaluate their associations with further decompensation and death in cirrhotic patients, if appropriate. RESULTS: Lower RVD was a predictor of further decompensation in Cox regression (adjusted by Child-Pugh score: p = 0.138; adjusted by MELD score: p = 0.034) and competing risk analyses (p = 0.003), and RVD ≤17 mm was significantly associated with higher cumulative incidence of further decompensation in Kaplan-Meier (p = 0.002) and Nelson-Aalen cumulative risk curves (p = 0.002). E/A ≤ 0.8 was a significant predictor of death in Cox regression (adjusted by Child-Pugh score: p = 0.041; adjusted by MELD score: p = 0.045) and competing risk analyses (p = 0.024), and E/A ≤ 0.8 was significantly associated with higher cumulative incidence of death in Kaplan-Meier (p = 0.023) and Nelson-Aalen cumulative risk curves (p = 0.024). Other echocardiography-related parameters were not significantly associated with further decompensation or death. CONCLUSION: RVD and E/A may be considered for the prognostic assessment of decompensated cirrhosis.

Evolutionary analysis of hydrophobin gene family in two wood-degrading basidiomycetes, Phlebia brevispora and Heterobasidion annosum s.l.

BACKGROUND: Hydrophobins are small secreted cysteine-rich proteins that play diverse roles during different phases of fungal life cycle. In basidiomycetes, hydrophobin-encoding genes often form large multigene families with up to 40 members. The evolutionary forces driving hydrophobin gene expansion and diversification in basidiomycetes are poorly understood. The functional roles of individual genes within such gene families also remain unclear. The relationship between the hydrophobin gene number, the genome size and the lifestyle of respective fungal species has not yet been thoroughly investigated. Here, we present results of our survey of hydrophobin gene families in two species of wood-degrading basidiomycetes, Phlebia brevispora and Heterobasidion annosum s.l. We have also investigated the regulatory pattern of hydrophobin-encoding genes from H. annosum s.s. during saprotrophic growth on pine wood as well as on culture filtrate from Phlebiopsis gigantea using micro-arrays. These data are supplemented by results of the protein structure modeling for a representative set of hydrophobins. RESULTS: We have identified hydrophobin genes from the genomes of two wood-degrading species of basidiomycetes, Heterobasidion irregulare, representing one of the microspecies within the aggregate H. annosum s.l., and Phlebia brevispora. Although a high number of hydrophobin-encoding genes were observed in H. irregulare (16 copies), a remarkable expansion of these genes was recorded in P. brevispora (26 copies). A significant expansion of hydrophobin-encoding genes in other analyzed basidiomycetes was also documented (1-40 copies), whereas contraction through gene loss was observed among the analyzed ascomycetes (1-11 copies). Our phylogenetic analysis confirmed the important role of gene duplication events in the evolution of hydrophobins in basidiomycetes. Increased number of hydrophobin-encoding genes appears to have been linked to the species' ecological strategy, with the non-pathogenic fungi having increased numbers of hydrophobins compared with their pathogenic counterparts. However, there was no significant relationship between the number of hydrophobin-encoding genes and genome size. Furthermore, our results revealed significant differences in the expression levels of the 16 H. annosum s.s. hydrophobin-encoding genes which suggest possible differences in their regulatory patterns. CONCLUSIONS: A considerable expansion of the hydrophobin-encoding genes in basidiomycetes has been observed. The distribution and number of hydrophobin-encoding genes in the analyzed species may be connected to their ecological preferences. Results of our analysis also have shown that H. annosum s.l. hydrophobin-encoding genes may be under positive selection. Our gene expression analysis revealed differential expression of H. annosum s.s. hydrophobin genes under different growth conditions, indicating their possible functional diversification.

Compensation of laser frequency tuning nonlinearity of a long range OFDR using deskew filter.

We present a simple and effective method to compensate the optical frequency tuning nonlinearity of a tunable laser source (TLS) in a long range optical frequency-domain reflectometry (OFDR) by using the deskew filter, where a frequency tuning nonlinear phase obtained from an auxiliary interferometer is used to compensate the nonlinearity effect on the beating signals generated from a main OFDR interferometer. The method can be applied to the entire spatial domain of the OFDR signals at once with a high computational efficiency. With our proposed method we experimentally demonstrated a factor of 93 times improvement in spatial resolution by comparing the results of an OFDR system with and without nonlinearity compensation. In particular we achieved a measurement range of 80 km and a spatial resolution of 20 cm and 1.6 m at distances of 10 km and 80 km, respectively with a short signal processing time of less than 1 s for 5 × 10(6) data points. The improved performance of the OFDR with a high spatial resolution, a long measurement range and a short process time will lead to practical applications in the real-time monitoring, test and measurement of fiber optical communication networks and sensing systems.

Distribution and bioinformatic analysis of the cerato-platanin protein family in Dikarya.

The cerato-platanin family is a group of small cysteine-rich fungal proteins new to science. They usually are abundantly secreted extracellularly and are involved in fungus-host interactions. With the advance of available fungal genome sequences, we performed a genomewide study of the distribution of this family in fungi and analyzed the common characteristics of the protein sequences. A total of 55 fungal genomes, including 27 from Ascomycota and 28 from Basidiomycota, were used. A total of 130 cerato-platanin homolog protein sequences were obtained and analyzed. Our results showed that cerato-platanin homologs existed in both Ascomycota and Basidiomycota but were lost in early branches of jelly fungi as well as in some groups with yeast or yeast-like forms in their life cycle. Homolog numbers varied considerably between Ascomycota and Basidiomycota. Phylogenetic analysis suggested that the ancestor of the Dikarya possessed multiple copies of cerato-platanins, which sorted differently in Ascomycota and Basidiomycota, and that this gene family might have expanded in the Basidiomycota. Almost all homologs contained signal peptide sequences, and the length of mature proteins were mainly 105-134 amino acids. Four cysteines involved in forming two disulfide bridges and signature sequences (CSD or CSN) were highly conserved in most homologs. These results indicated a higher diversity of the cerato-platanin family in Basidiomycota than Ascomycota.

Inhibition of ANGPT2 activates autophagy during hypertrophic scar formation via PI3K/AKT/mTOR pathway.

BACKGROUND: Hypertrophic scar (HS), a fibroproliferative disorder caused by aberrant wound healing following skin injuries such as burns, lacerations and surgery, is characterized by invasive proliferation of fibroblasts and excessive extracellular matrix (ECM) accumulation. The dysregulation of autophagy is the pathological basis of HS formation. Previously, angiopoietin-2 (ANGPT2) was found to be overexpressed in HS fibroblasts (HSFs) compared with normal skin fibroblasts. However, whether ANGPT2 participates in the process of HS formation and the potential molecular mechanisms are not clear. OBJECTIVE: This study is intended to figure out the role of ANGPT2 and ANGPT2-mediated autophagy during the development of HS. METHODS: RT-qPCR was used to detect ANGPT2 expression in HS tissues and HSFs. HSFs were transfected with sh-ANGPT2 to knock down ANGPT2 expression and then treated with MHT1485, the mTOR agonist. The effects of sh-ANGPT2 or MHT1485 on the proliferation, migration, autophagy and ECM accumulation of HSFs were evaluated by CCK-8 assay, Transwell assay and western blotting. The expression of PI3K/Akt/mTOR pathway-related molecules (p-PI3K, p-Akt and p-mTOR) was assessed by western blotting. RESULTS: ANGPT2 expression was markedly upregulated in HS tissues and HSFs. ANGPT2 knockdown decreased the expression of p-PI3K, p-Akt and p-mTOR. ANGPT2 knockdown activated autophagy and inhibited the proliferation, migration, and ECM accumulation of HSFs. Additionally, the treatment of MHT1485, the mTOR agonist, on ANGPT2-downregulated HSFs, partially reversed the influence of ANGPT2 knockdown on HSFs. STUDY LIMITATIONS: The study lacks the establishment of more stable in vivo animal models of HS for investigating the effects of ANGPT2 on HS formation in experimental animals. CONCLUSIONS: ANGPT2 downregulation represses growth, migration, and ECM accumulation of HSFs via autophagy activation by suppressing the PI3K/Akt/mTOR pathway. Our study provides a novel potential therapeutic target for HS.

Fully automating LI-RADS on MRI with deep learning-guided lesion segmentation, feature characterization, and score inference.

Introduction: Leveraging deep learning in the radiology community has great potential and practical significance. To explore the potential of fitting deep learning methods into the current Liver Imaging Reporting and Data System (LI-RADS) system, this paper provides a complete and fully automatic deep learning solution for the LI-RADS system and investigates its model performance in liver lesion segmentation and classification. Methods: To achieve this, a deep learning study design process is formulated, including clinical problem formulation, corresponding deep learning task identification, data acquisition, data preprocessing, and algorithm validation. On top of segmentation, a UNet++-based segmentation approach with supervised learning was performed by using 33,078 raw images obtained from 111 patients, which are collected from 2010 to 2017. The key innovation is that the proposed framework introduces one more step called feature characterization before LI-RADS score classification in comparison to prior work. In this step, a feature characterization network with multi-task learning and joint training strategy was proposed, followed by an inference module to generate the final LI-RADS score. Results: Both liver segmentation and feature characterization models were evaluated, and comprehensive statistical analysis was conducted with detailed discussions. Median DICE of liver lesion segmentation was able to achieve 0.879. Based on different thresholds, recall changes within a range of 0.7 to 0.9, and precision always stays high greater than 0.9. Segmentation model performance was also evaluated on the patient level and lesion level, and the evaluation results of (precision, recall) on the patient level were much better at approximately (1, 0.9). Lesion classification was evaluated to have an overall accuracy of 76%, and most mis-classification cases happen in the neighboring categories, which is reasonable since it is naturally difficult to distinguish LI-RADS 4 from LI-RADS 5. Discussion: In addition to investigating the performance of the proposed model itself, extensive comparison experiment was also conducted. This study shows that our proposed framework with feature characterization greatly improves the diagnostic performance which also validates the effectiveness of the added feature characterization step. Since this step could output the feature characterization results instead of simply generating a final score, it is able to unbox the black-box for the proposed algorithm thus improves the explainability.

Treatment of ileal Dieulafoy's lesion by hemostatic clips under double-balloon enteroscopy: a case report.

Background: Small intestinal Dieulafoy's lesion (DL) is a rare cause of life-threatening gastrointestinal bleeding. Based on previous case reports, the diagnostic approaches for DL located in jejunum and ileum are different. In addition, there is no available consensus regarding the treatment of DL, and previous case reports suggest that surgery is the preferable choice for small intestinal DL compared to endoscopic treatment. Notably, our case report indicates that double-balloon enteroscopy (DBE) should be an effective diagnostic and therapeutic approach for small intestinal DL. Case Description: A 66-year-old female was transferred to the Department of Gastroenterology due to hematochezia and abdominal distension and pain for more than 10 days. She had a history of diabetes, hypertension, coronary heart disease, atrial fibrillation, mitral insufficiency, and acute cerebral infarction. Conventional diagnostic approaches, including gastroduodenoscopy, colonoscopy, and even angiogram, did not show any definite source of bleeding, and then a capsule endoscopy was performed and suggested that the bleeding may be located in ileum. Finally, she was successfully treated by hemostatic clips under DBE via anal route. And there is no recurrence after endoscopic treatment was observed in our case during a 4-month follow-up. Conclusions: Although small intestinal DL is rare and difficult to be detected by conventional approaches, DL still needs to be considered as a differential diagnosis for gastrointestinal bleeding. In addition, DBE should be considered as a preferred choice for the diagnosis and treatment of small intestinal DL due to lower invasiveness and cost as compared to surgery.

Prediction ofπ-electrons mediated high-temperature superconductivity in monolayer LiC12.

Prediction and synthesis of two-dimensional high transition temperature (TC) superconductors is an area of extensive research. Based on calculations of the electronic structures and lattice dynamics, we predict that graphene-like layered monolayer LiC12is aπ-electrons mediated Bardeen-Cooper-Schrieffer-type superconductor. Monolayer LiC12is theoretically stable and expected to be synthesized experimentally. From the band structures and the phonon dispersion spectrum, it is found that the saddle point ofπ-bonding bands induces large density of states at the Fermi energy level. There is strongly coupled between the vibration mode in the in-plane direction of the lithium atoms and theπ-electrons of carbon atoms, which induces the high-TCsuperconductivity in LiC12. TheTCcan reach to 41 K under an applied 10% biaxial tensile strain based on the anisotropic Eliashberg equation. Our results show that monolayer LiC12is a good candidate asπ-electrons mediated electron-phonon coupling high-TCsuperconductor.