Peak detection in intracranial pressure signal waveforms: a comparative study.

BACKGROUND: The monitoring and analysis of quasi-periodic biological signals such as electrocardiography (ECG), intracranial pressure (ICP), and cerebral blood flow velocity (CBFV) waveforms plays an important role in the early detection of adverse patient events and contributes to improved care management in the intensive care unit (ICU). This work quantitatively evaluates existing computational frameworks for automatically extracting peaks within ICP waveforms. METHODS: Peak detection techniques based on state-of-the-art machine learning models were evaluated in terms of robustness to varying noise levels. The evaluation was performed on a dataset of ICP signals assembled from 700 h of monitoring from 64 neurosurgical patients. The groundtruth of the peak locations was established manually on a subset of 13, 611 pulses. Additional evaluation was performed using a simulated dataset of ICP with controlled temporal dynamics and noise. RESULTS: The quantitative analysis of peak detection algorithms applied to individual waveforms indicates that most techniques provide acceptable accuracy with a mean absolute error (MAE) ≤ 10 ms without noise. In the presence of a higher noise level, however, only kernel spectral regression and random forest remain below that error threshold while the performance of other techniques deteriorates. Our experiments also demonstrated that tracking methods such as Bayesian inference and long short-term memory (LSTM) can be applied continuously and provide additional robustness in situations where single pulse analysis methods fail, such as missing data. CONCLUSION: While machine learning-based peak detection methods require manually labeled data for training, these models outperform conventional signal processing ones based on handcrafted rules and should be considered for peak detection in modern frameworks. In particular, peak tracking methods that incorporate temporal information between successive periods of the signals have demonstrated in our experiments to provide more robustness to noise and temporary artifacts that commonly arise as part of the monitoring setup in the clinical setting.

Synchronous supraclavicular vascularized lymph node transfer and liposuction for gynecological cancer-related lower extremity lymphedema: a clinical comparative analysis of three different procedures.

OBJECTIVE: Gynecological cancer-related lower extremity lymphedema (GC-LEL), a chronic, progressive condition, lacks a standardized treatment. Currently, supraclavicular vascularized lymph node transfer (SC-VLNT) is a favored approach in the treatment of lymphedema, and there is a trend toward combination technology. This study conducts a comparative analysis of three techniques for treating GC-LEL with simultaneous SC-VLNT and liposuction. METHODS: A cohort of 35 patients with GC-LEL was examined, comprising 13 patients who underwent single lymph nodes flap with a skin paddle (SLNF+P), 12 who received single lymph nodes flap without a skin paddle (SLNF), and 10 who accepted dual lymph nodes flap without a skin paddle (DLNF). Patient demographics and outcomes were meticulously documented, covering intra- and postoperative variables. RESULTS: The median limb volume reduction were 56.4% (SLNF+P), 60.8% (SLNF), and 50.5% (DLNF) in stage II, and 54.0% (SLNF+P), 59.8% (SLNF), and 54.4% (DLNF) in stage III. DLNF group procedures entailed longer flap harvesting and transplantation times. The SLNF+P group, on average, had an 8-day postoperative hospitalization, longer than others. All patients noted subjective improvements in Lymphedema Quality of Life scores, with lymphoscintigraphy revealing enhanced lymphatic flow in 29 of the 35 cases. A notable decrease in cellulitis incidence was observed. Additionally, the occurrence of cellulitis decreased significantly, except for DLNF (Stage Ⅱ). The median follow-up time was 16 months (range, 12-36 months), with no reported severe postoperative complications. CONCLUSIONS: For advanced GC-LEL, SLNF combined with liposuction is a preferred treatment, offering fewer complications, shorter operative time, and hospitalization.

A ternary correlation multi-symptom network strategy based on in vivo chemical profile identification and metabolomics to explore the molecular basis of Ephedra herb against viral pneumonia.

Ephedra herb (EH), an important medicine prescribed in herbal formulas by Traditional Chinese Medicine practitioners, has been widely used in the treatment of viral pneumonia in China. However, the molecular basis of EH in viral pneumonia remains unclear. In this study, a ternary correlation multi-symptom network strategy was established based on in vivo chemical profile identification and metabolomics to explore the molecular basis of EH against viral pneumonia. Results showed that 143 compounds of EH and 70 prototype components were identified in vivo. EH could reduce alveolar-capillary barrier disruption in rats with viral pneumonia and significantly downregulate the expression of inflammatory factors and bronchoalveolar lavage fluid. Plasma metabolomics revealed that EH may be involved in the regulation of arachidonic acid, tryptophan, tyrosine, nicotinate, and nicotinamide metabolism. The multi-symptom network showed that 12 compounds have an integral function in the treatment of viral pneumonia by intervening in many pathways related to viruses, immunity and inflammation, and lung injury. Further verification demonstrated that sinapic acid and frambinone can regulate the expression of related genes. It has been shown to be a promising representative of the pharmacological constituents of ephedra.

Metformin eliminates lymphedema in mice by alleviating inflammation and fibrosis: implications for human therapy.

BACKGROUND: Secondary lymphedema is a chronic, disabling disease impacting over 50% of patients with cancer and lacking effective pharmacological treatment even for early- to mid-disease stages. Metformin reportedly exerts anti-inflammatory and anti-fibrotic effects and is safe, with minimal side effects; We investigated the role of metformin in lymphedema mouse models and examined underlying molecular mechanisms. METHODS: Male C57BL/6 mice (6-8-week-old; n=15/group) received metformin (300 mg/kg/day) by gavage on day 3 after lymphedema surgery; saline and sham groups were administered the same volume of saline. Hindlimb circumference and tail volume were monitored every two days. On day 28, samples were collected for histological assessment, western blotting, and reverse transcription-quantitative PCR analysis of inflammation, fibrosis, and AMPK expression. AMPK activity was assayed in patients with secondary lymphedema (ISL II) and controls following strict inclusion criteria. RESULTS: Compared with the saline group, the metformin group exhibited hindlimb circumference and tail volume reduced by 469.70% and 305.18%, respectively. on day 28. Dermal thickness was reduced by 38.27% and 72.57% in the hindlimbs and tail, respectively. Metformin decreased CD4+ T cell infiltration by 19.73% and expression levels of interleukin (IL)-4, IL-13, IL-17, and transforming growth factor-ß1. Additionally, it lowered collagen I deposition by 33.18%. Compared with the saline group, the number of lymphatic vessels increased by 229.96% in the metformin group. Both the saline group mice and patients with lymphedema showed reduced AMPK activity, while metformin increased p-AMPK expression by 106.12%. CONCLUSION: Metformin alleviated inflammation and fibrosis and increased lymphangiogenesis in lymphedema mouse models by activating AMPK signaling.

Performance Optimization in Frequency Estimation of Noisy Signals: Ds-IpDTFT Estimator.

This research presents a comprehensive study of the dichotomous search iterative parabolic discrete time Fourier transform (Ds-IpDTFT) estimator, a novel approach for fine frequency estimation in noisy exponential signals. The proposed estimator leverages a dichotomous search process before iterative interpolation estimation, which significantly reduces computational complexity while maintaining high estimation accuracy. An in-depth exploration of the relationship between the optimal parameter p and the unknown parameter δ forms the backbone of the methodology. Through extensive simulations and real-world experiments, the Ds-IpDTFT estimator exhibits superior performance relative to other established estimators, demonstrating robustness in noisy conditions and stability across varying frequencies. This efficient and accurate estimation method is a significant contribution to the field of signal processing and offers promising potential for practical applications.

Immunogenicity and safety of quadrivalent influenza vaccine among young and older adults in Tianjin, China: implication of immunosenescence as a risk factor.

BACKGROUND: Older adults are more vulnerable to seasonal influenza than younger adults. The immune responses of older persons to the influenza vaccine are usually poorer than those of young individuals, which is hypothesized due to immunosenescence. We conducted a study to evaluate the immunogenicity and safety of a quadrivalent inactivated influenza vaccine (IIV4) in a total of 167 young (< 65 years, n = 79) and older (≥ 65 years, n = 88) adults from October 2021 to March 2022 in Tianjin, China. A single dose was administered to all participants. Blood samples were collected and strain-specific hemagglutination inhibition (HAI) antibody titers were measured before and 21 to 28 days after vaccination. Safety information was also collected for 28 days and 6 months after vaccination. Differences in immunogenicity and safety were compared between young and old age groups, and multivariate logistic regression was used to estimate the effect of age and other factors on HAI antibody responses. RESULTS: Overall, geometric mean titers (GMTs) against all four vaccine strains in older adults were lower than those in the young, whereas the seroconversion rates (SCRs) were similar. Multivariate logistic regression analysis showed that age, influenza vaccination history, and pre-vaccination HAI titers were independent factors affecting SCRs and seroprotection rates (SCRs). Older age had significant negative impact on SCRs against H1N1 (OR, 0.971; 95% CI: 0.944-0.999; P = 0.042) and B/Victoria (OR, 0.964; 95% CI: 0.937-0.992; P = 0.011). In addition, there was a significant negative correlation between chronological age (years) and post-vaccination HAI titers against H1N1 (rho = -0.2298, P < 0.0001), B/Victoria (rho = -0.2235, P = 0.0037), and B/Yamagata (rho = -0.3689, P < 0.0001). All adverse events were mild (grade 1 or grade 2) that occurred within 28 days after vaccination, and no serious adverse event was observed. CONCLUSIONS: IIV4 is immunogenic and well-tolerated in young and older adults living in Tianjin, China. Our findings also indicate that age is an independent factor associated with poorer humoral immune responses to IIV4.

The effect of restrictive vs. liberal fluid protocols on ocular parameters in patients undergoing prone spine surgery: a randomized controlled trial.

BACKGROUND: Elevated intraocular pressure (IOP) and optic nerve edema occurring during prone surgeries may cause ocular and optic nerve ischaemia injury. We hypothesized that a liberal fluid protocol might further increase IOP and optic nerve sheath diameter (ONSD) than a restrictive fluid protocol for patients in the prone position. METHODS: A single-centre, prospective and randomized trial was conducted. Patients were randomly allocated into 2 groups: the liberal fluid infusion group, in which repeated bolus doses of Ringer's lactate solution were given to maintain pulse pressure variation (PPV) within 6~9%, and the restrictive fluid infusion group, where PPV was maintained within 13-16%. IOP and ONSD were measured in both eyes at 10min after the anaesthesia induction in the supine position, 10min after the prone position placement, and 1h and 2h since the prone position was placed, at the conclusion of surgery, and returned to the supine position. RESULTS: A total of 97 patients were recruited and completed the study. IOP increased significantly from 12±3mmHg in the supine position to 31±5 mmHg (p<0.001) at the end of surgery in the liberal fluid infusion group and from 12±2 to 28±4 mmHg (p<0.001) in the restrictive fluid infusion group. There was a statistically significant difference in the change of IOP over time between the two groups (p=0.019). ONSD increased significantly from 5.3±0.3mm in the supine position to 5.5±0.3mm (p<0.001) at the end of surgery in both groups (both p<0.001). There was no statistically significant difference in the change of ONSD over time between the two groups (p>0.05). CONCLUSIONS: Compared to the restrictive fluid protocol, the liberal fluid protocol increased IOP but not ONSD in patients undergoing prone spine surgery. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov ( https://clinicaltrials.gov ) prior to patient enrollment, ID: NCT03890510, on March 26, 2019. The principal investigator was Xiao-Yu Yang.

HyperTDP-Net: A Hyper-densely Connected Compression-and-Decomposition Network Based on Trident Dilated Perception for PET and MRI Image Fusion.

Objective. Since medical images generated by medical devices have low spatial resolution and quality, fusion approaches on medical images can generate a fused image containing a more comprehensive range of different modal features to help physicians accurately diagnose diseases. Conventional methods based on deep learning for medical image fusion usually extract only local features without considering their global features, which often leads to the problem of unclear detail information in the final fused image. Therefore, medical image fusion is a challenging task of great relevance.Approach.This paper proposes a novel end-to-end medical image fusion model for PET and MRI images to achieve information interaction between different pathways, termed as hyper-densely connected compression-and-decomposition network based on trident dilated perception for PET and MRI image fusion (HyperTDP-Net). In particular, in the compression network, a dual residual hyper densely module is constructed to take full advantage of middle layer information. Moreover, we establish the trident dilated perception module to precisely determine the location information of features, and improve the feature representation capability of the network. In addition, we abandon the ordinary mean square error as the content loss function and propose a new content-aware loss consisting of structural similarity loss and gradient loss, so that the fused image not only contains rich texture details but also maintains sufficient structural similarity with the source images.Main results. The experimental dataset used in this paper is derived from multimodal medical images published by Harvard Medical School. Extensive experiments illustrate that our model contains more edge information and texture detail information in the fusion result than the 12 state-of-the-art fusion models and ablation study results demonstrate the effectiveness of three technical innovations.Significance. As medical images continue to be used in clinical diagnosis, our method is expected to be a tool that can effectively improve the accuracy of physician diagnosis and automatic machine detection.

Quantum Fluctuation of the Quantum Geometric Tensor and Its Manifestation as Intrinsic Hall Signatures in Time-Reversal Invariant Systems.

In time-reversal invariant systems, all charge Hall effects predicted so far are extrinsic effects due to the dependence on the relaxation time. We explore intrinsic Hall signatures by studying the quantum noise spectrum of the Hall current in time-reversal invariant systems, and discover intrinsic thermal Hall noises in both linear and nonlinear regimes. As the band geometric characteristics, quantum geometric tensor and Berry curvature play critical roles in various Hall effects; so do their quantum fluctuations. It is found that the thermal Hall noise in linear order of the electric field is purely intrinsic, and the second-order thermal Hall noise has both intrinsic and extrinsic contributions. In particular, the intrinsic part of the second-order thermal Hall noise is a manifestation of the quantum fluctuation of the quantum geometric tensor, which widely exists as long as Berry curvature is nonzero. These intrinsic thermal Hall noises provide direct measurable means to band geometric information, including Berry curvature related quantities and quantum fluctuation of quantum geometric tensor.

Hepatocyte-Specific Smad4 Deficiency Alleviates Liver Fibrosis via the p38/p65 Pathway.

Liver fibrosis is a wound-healing response caused by the abnormal accumulation of extracellular matrix, which is produced by activated hepatic stellate cells (HSCs). Most studies have focused on the activated HSCs themselves in liver fibrosis, and whether hepatocytes can modulate the process of fibrosis is still unclear. Sma mothers against decapentaplegic homologue 4 (Smad4) is a key intracellular transcription mediator of transforming growth factor-ß (TGF-ß) during the development and progression of liver fibrosis. However, the role of hepatocyte Smad4 in the development of fibrosis is poorly elucidated. Here, to explore the functional role of hepatocyte Smad4 and the molecular mechanism in liver fibrosis, a CCl4-induced liver fibrosis model was established in mice with hepatocyte-specific Smad4 deletion (Smad4Δhep). We found that hepatocyte-specific Smad4 deficiency reduced liver inflammation and fibrosis, alleviated epithelial-mesenchymal transition, and inhibited hepatocyte proliferation and migration. Molecularly, Smad4 deletion in hepatocytes suppressed the expression of inhibitor of differentiation 1 (ID1) and the secretion of connective tissue growth factor (CTGF) of hepatocytes, which subsequently activated the p38 and p65 signaling pathways of HSCs in an epidermal growth factor receptor-dependent manner. Taken together, our results clearly demonstrate that the Smad4 expression in hepatocytes plays an important role in promoting liver fibrosis and could therefore be a promising target for future anti-fibrotic therapy.

MyD88 in hepatic stellate cells promotes the development of alcoholic fatty liver via the AKT pathway.

Myeloid differentiation primary response gene 88 (MyD88), an adaptor protein in the Toll-like receptors (TLRs) signalling pathway, is expressed in various liver cells including hepatocytes, Kupffer cells and hepatic stellate cells (HSCs). And yet, the functional role of MyD88 in HSCs is poorly elucidated in alcoholic fatty liver (AFL). Here, to study the functional role of MyD88 in HSCs and the molecular mechanism related to the development of AFL, chronic-binge ethanol mouse models were established in mice with specific MyD88 knockout in quiescent (MyD88GFAP-KO) and activated HSCs (MyD88SMA-KO), respectively. Our results clearly showed an elevated expression of MyD88 in liver tissues of ethanol treated mouse model which harbours the wild type. Intriguingly, ethanol treatment profoundly inhibited inflammation in both MyD88GFAP-KO and MyD88SMA-KO mice, but the suppression of lipogenesis was only observed in MyD88GFAP-KO mice. Molecularly, our study indicated that MyD88 induced osteopontin (OPN) secretion in HSCs, which consequently resulted in activation of AKT signalling pathway and accumulation of fat in hepatocytes. Additionally, our data also suggested that OPN promoted inflammation by activating p-STAT1. Thus, targeting MyD88 may be a potentially represent a promising strategy for the prevention and treatment of AFL. KEY MESSAGES: The expression of MyD88 in HSCs was significantly increased in ethanol-induced liver tissues of wild-type mice. MyD88 deficiency in quiescent HSCs inhibited inflammation and lipogenesis under the ethanol feeding condition. MyD88 deficiency in activated HSCs only inhibited inflammation under the ethanol feeding condition. MyD88 promoted the OPN secretion of HSCs, which further activated the AKT signalling pathway of hepatocytes and upregulated lipogenic gene expression to promote fat accumulation. OPN also promotes inflammation by activating p-STAT1.

Clinical and MRI features about two types of silent cerebral small-vessel disease in type-2 diabetes mellitus: a retrospective cross-sectional study in a tertiary hospital.

Background: The present study aimed to evaluate the frequency of silent cerebral small-vessel disease, especially lacunes and white matter hyperintensities, in patients with or without the impaired glucose tolerance (IGT) and type-2 diabetes mellitus, and to characterize the diabetes-correlated factors related to silent cerebral small-vessel disease. Methods: This is a retrospective cross-sectional study. Totally 698 patients were included in this study, from January 2014 to December 2019, among which 270 patients were included in the diabetes mellitus group, 106 patients were included in the IGT group, and 322 patients were included in the Control group. All patients underwent magnetic resonance imaging to investigate the silent cerebral small-vessel disease: the lacunes and the white matter hyperintensities. All the baseline information and diabetes-related factors, such as glycated hemoglobin level, insulin usage, etc., were collected. Then correlation analysis and regression analysis were used to explore the correlation between diabetes with related risk factors and silent cerebral small-vessel disease. Results: Lacunes and white matter hyperintensities were more common in the diabetes mellitus group than in the IGT group and the Control group, with an occurrence of lacunes of 83.3% vs. 70.8% vs. 70.4% (P=0.003), respectively, and an occurrence of white matter hyperintensities of 41.1% vs. 24.5% vs. 31.1% (P=0.003), respectively. The occurrence of lacunes was correlated with the duration of diabetes mellitus [odds ratio (OR) =1.483, 95% confidence interval (CI): 1.082-2.031, P=0.009] and the age (OR =1.141, 95% CI: 1.102-1.180, P<0.001), while white matter hyperintensities were independently correlated only with the age (OR =1.124, 95% CI: 1.094-1.155, P<0.001). Conclusions: Lacunes and white matter hyperintensities, are more common in the diabetes mellitus patients than in the IGT patients or in the other patients. The occurrence of lacunes was correlated with the duration of diabetes mellitus and the age, while the occurrence of white matter hyperintensities was independently correlated with the age.

An Efficient Frequency Estimator for a Complex Exponential Signal Based on Interpolation of Selectable DTFT Samples.

The frequency estimation of complex exponential carrier signals in noise is a critical problem in signal processing. To solve this problem, a new iterative frequency estimator is presented in this paper. By iteratively computing the interpolation of DTFT samples, the proposed algorithm obtains a fine frequency estimate. In addition, its mean square error (MSE) analysis is presented in this paper. By analyzing influences of the selectable parameters on the estimation accuracy of the model, a method for choosing appropriate parameters is discussed, helping to reduce the estimation error of the proposed estimator. Simulation results show that compared with other algorithms with a comparable estimation accuracy, the proposed iterative estimator can obtain a root mean square error (RMSE) that is closer to Cramér-Rao lower bound (CRLB).

Notoginsenoside Fc ameliorates renal tubular injury and mitochondrial damage in acetaminophen-induced acute kidney injury partly by regulating SIRT3/SOD2 pathway.

Introduction: Mitochondria dysfunction is one of the primary causes of tubular injury in acute kidney injury (AKI). Notoginsenoside Fc (Fc), a new saponin isolated from Panax notoginseng, exhibited numerous pharmacological actions. However, the beneficial effects of Fc on renal tubular impairment and mitochondrial dysfunction in AKI have not been fully studied. Methods: In this study, we established acetaminophen (APAP)-induced AKI model in mice to examine the therapeutic impacts of Fc on AKI. Results: Our results showed that Fc could decrease the levels of the serum creatinine (Scr), blood urea nitrogen (BUN) and Cystatin C in mice with AKI. Fc also ameliorated renal histopathology, renal tubular cells apoptosis and restored expression of apoptosis-related proteins such as Bax, Bcl-2 and caspase3 (C-caspase3). Additionally, Fc increased the protein expression of SIRT3 and SOD2 in kidneys from mice with AKI. In vitro studies further showed Fc reduced the apoptosis of HK-2 cells exposure to APAP, attenuated the loss of mitochondrial membrane potential and decreased the formation of mitochondrial superoxide. Fc also partly restored the protein expression of Bax, Bcl-2, C-Caspase3, SIRT3, and SOD2 in HK-2 cells exposure to APAP. Conclusion: In summary, Fc might reduce renal tubular injury and mitochondrial dysfunction in AKI partly through the regulation of SIRT3/SOD2 pathway.

The progress, prospects, and challenges of the use of non-coding RNA for diabetic wounds.

Chronic diabetic wounds affect the quality of life of patients, resulting in significant social and economic burdens on both individuals and the health care system. Although treatment methods for chronic diabetic wounds have been explored, there remains a lack of effective treatment strategies; therefore, alternative strategies must be explored. Recently, the abnormal expression of non-coding RNA in diabetic wounds has received widespread attention since it is an important factor in the development of diabetic wounds. This article reviews the regulatory role of three common non-coding RNAs (microRNA [miRNA], long non-coding RNA [lncRNA], and circular RNA [circRNA]) in diabetic wounds and discusses the diagnosis, treatment potential, and challenges of non-coding RNA in diabetic wounds. This article provides insights into new strategies for diabetic wound diagnosis and treatment at the genetic and molecular levels.

Large-Area Flexible Printed Thin-Film Transistors with Semiconducting Single-Walled Carbon Nanotubes for NO2 Sensors.

Development of large-area, low-cost, low-voltage, low-power consumption, flexible high-performance printed carbon nanotube thin-film transistors (TFTs) is helpful to promote their future applications in sensors and biosensors, wearable electronics, and the Internet of things. In this work, low-voltage, flexible printed carbon nanotube TFTs with a large-area and low-cost fabrication process were successfully constructed using ultrathin (∼3.6 nm) AlOx thin films formed by plasma oxidation of aluminum as dielectrics and screen-printed silver electrodes as contact electrodes. The as-prepared bottom-gate/bottom-contact carbon nanotube TFTs exhibit a low leakage current (∼10-10 A), a high charge carrier mobility (up to 9.9 cm2 V-1 s-1), high on/off ratios (higher than 105), and small subthreshold swings (80-120 mV/dec) at low operation voltages (from -1.5 to 1 V). At the same time, printed carbon nanotube TFTs showed a high response (ΔR/R = 99.6%) to NO2 gas even at 16 ppm with a faster response and recovery speed (∼8 s, exposure to 0.5 ppm NO2), a lower detection limit (0.069 ppm NO2), and a low power consumption (0.86 µW, exposure to 16 ppm NO2) at a gate voltage of 0.2 V at room temperature. Moreover, the printed carbon nanotube devices exhibited excellent mechanical flexibility and bias stress stability after 12,000 bending cycles at a radius of 5 mm and a bias stress test for 7200 s at a gate voltage of ±1 V, which originated from the ultrathin and compact AlOx dielectric and the super adhesion force between screen-printed silver electrodes and polyethylene terephthalate substrates.

Radiation-Hard and Repairable Complementary Metal-Oxide-Semiconductor Circuits Integrating n-type Indium Oxide and p-type Carbon Nanotube Field-Effect Transistors.

Special radiation-hard and ultralow-power complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) are used in the fields of deep space, nuclear energy, and medical X-ray imaging. In this work, we first constructed radiation-hard, repairable, and sub-1 V-driven printed hybrid CMOS field-effect transistors (FETs) and ICs, which integrate printed carbon nanotube (CNT) (band gap ∼ 0.65 eV) p-type FETs and indium oxide (In2O3) (band gap ∼3.64 eV) n-type FETs on glass substrates using a printed PS-PMMA/[EMIM][TFSI] mixture as the gate dielectric layer. The PS-PMMA/[EMIM][TFSI] mixture gate dielectric layer not only lowered the supply voltage (VDD) by providing ultrahigh gate efficiency but also improved the anti-irradiation ability of the hybrid CMOS FETs and ICs. Specifically, the hybrid CMOS inverters exhibited rail-to-rail output with a high voltage gain and high noise margins at a low VDD that could be scaled down to 0.4 V. Furthermore, the hybrid CMOS FETs and ICs showed excellent radiation hardness, that is, withstanding a 3 Mrad (Si) total irradiation dose (TID) at a dose rate of 560 rad s-1 (Si), which is an exceptional result for CMOS transistors and ICs. Furthermore, the radiation-damaged CMOS FETs could be fully recovered by removing and reprinting the PS-PMMA/[EMIM][TFSI] mixture gate dielectric layer, indicating the ability to repair irradiation damage. This work provides an in-space IC fabrication technology.

Ambipolar Deep-Subthreshold Printed-Carbon-Nanotube Transistors for Ultralow-Voltage and Ultralow-Power Electronics.

The development of ultralow-power and easy-to-fabricate electronics with potential for large-scale circuit integration (i.e., complementary or complementary-like) is an outstanding challenge for emerging off-the-grid applications, e.g., remote sensing, "place-and-forget", and the Internet of Things. Herein we address this challenge through the development of ambipolar transistors relying on solution-processed polymer-sorted semiconducting carbon nanotube networks (sc-SWCNTNs) operating in the deep-subthreshold regime. Application of self-assembled monolayers at the active channel interface enables the fine-tuning of sc-SWCNTN transistors toward well-balanced ambipolar deep-subthreshold characteristics. The significance of these features is assessed by exploring the applicability of such transistors to complementary-like integrated circuits, with respect to which the impact of the subthreshold slope and flatband voltage on voltage and power requirements is studied experimentally and theoretically. As demonstrated with inverter and NAND gates, the ambipolar deep-subthreshold sc-SWCNTN approach enables digital circuits with complementary-like operation and characteristics including wide noise margins and ultralow operational voltages (≤0.5 V), while exhibiting record-low power consumption (≤1 pW/µm). Among thin-film transistor technologies with minimal material complexity, our approach achieves the lowest energy and power dissipation figures reported to date, which are compatible with and highly attractive for emerging off-the-grid applications.

Identification of the Novel Effector RsIA_NP8 in Rhizoctonia solani AG1 IA That Induces Cell Death and Triggers Defense Responses in Non-Host Plants.

Rhizoctonia solani AG1 IA is a necrotrophic fungus that causes rice sheath blight, one of the most significant rice diseases in the world. However, little is known about the pathogenic mechanisms and functions of effectors in R. solani AG1 IA. We performed functional studies on effectors in R. solani AG1 IA and found that, of 11 putative effectors tested, only RsIA_NP8 caused necrosis in the leaves of Nicotiana benthamiana. The predicted signal peptide of this protein was required to induce cell death, whereas predicted N-glycosylation sites were not required. RsIA_NP8 was upregulated during early infection, and the encoded protein was secreted. Furthermore, the ability of RsIA_NP8 to trigger cell death in N. benthamiana depended on suppressor of G2 allele of Skp1 (SGT1) and heat shock protein 90 (HSP90), but not on Mla12 resistance (RAR1) and somatic embryogenesis receptor-like kinase (SERK3). A natural variation that prevents the triggering of cell death in N. benthamiana was found in RsIA_NP8 in 25 R. solani AG1 IA strains. It is important to note that RsIA_NP8 induced the immune response in N. benthamiana leaves. Collectively, these results show that RsIA_NP8 is a possible effector that plays a key role in R. solani AG1 IA-host interactions.

Relationship Between Type 2 Diabetes and White Matter Hyperintensity: A Systematic Review.

White matter (WM) disease is recognized as an important cause of cognitive decline and dementia. White matter lesions (WMLs) appear as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging (MRI) scans of the brain. Previous studies have shown that type 2 diabetes (T2DM) is associated with WMH. In this review, we reviewed the literature on the relationship between T2DM and WMH in PubMed and Cochrane over the past five years and explored the possible links among the presence of T2DM, the course or complications of diabetes, and WMH. We found that: (1) Both from a macro- and micro-scopic point of view, most studies support the relationship of a larger WMH and a decrease in the integrity of WMH in T2DM; (2) From the relationship between brain structural changes and cognition in T2DM, the poor performance in memory, attention, and executive function tests associated with abnormal brain structure is consistent; (3) Diabetic microangiopathy or peripheral neuropathy may be associated with WMH, suggesting that the brain may be a target organ for T2DM microangiopathy; (4) Laboratory markers such as insulin resistance and fasting insulin levels were significantly associated with WMH. High HbA1c and high glucose variability were associated with WMH but not glycemic control.