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BACKGROUND: Fifteen-and-a-Half Syndrome is an uncommon clinical presentation characterized by the coexistence of one-and-a-half syndrome and bilateral facial palsy. In this study, we provide a comprehensive description of symptom evolution and imaging changes in a patient with Fifteen-and-a-Half Syndrome. CASE PRESENTATION: A 54-year-old male presented with sudden onset of one-and-a-half syndrome, which gradually progressed to fifteen-and-a-half syndrome. The final diagnosis was confirmed to be pontine infarction which occurred at the midline of the pontine tegmentum. CONCLUSION: This case highlights the diverse and progressive early clinical manifestations associated with Fifteen-and-a-half Syndrome. Currently, all reported cases of this syndrome are linked to brainstem infarction; however, early differential diagnosis is crucial to ensure prompt initiation of appropriate treatment for affected patients.
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Brain Stem Infarctions , Facial Paralysis , Humans , Male , Middle Aged , Facial Paralysis/diagnosis , Facial Paralysis/diagnostic imaging , Facial Paralysis/etiology , Brain Stem Infarctions/diagnostic imaging , Brain Stem Infarctions/complications , Brain Stem Infarctions/diagnosis , Syndrome , Magnetic Resonance Imaging/methods , Pontine Tegmentum/diagnostic imagingABSTRACT
Directly capturing atmospheric CO2 and converting it into valuable fuel through photothermal synergy is an effective way to mitigate the greenhouse effect. This study developed a gas-solid interface photothermal catalytic system for atmospheric CO2 reduction, utilizing the innovative photothermal catalyst (Cu porphyrin) CuTCPP/MXene/TiO2. The catalyst demonstrated a photothermal catalytic performance of 124 µmol·g-1·h-1 for CO and 106 µmol·g-1·h-1 for CH4, significantly outperforming individual components. Density functional theory (DFT) results indicate that the enhanced catalytic performance is attributed to the internal electric field between the components, which significantly enhances carrier utilization. The introduction of CuTCPP reduces free energy of the photothermal catalytic reaction. Additionally, the local surface plasmon resonance (LSPR) effect and high-speed electron transfer properties of MXene further boost the catalytic reaction rate. This well-designed catalyst and catalytic system offer a simple method for capturing atmospheric CO2 and converting it in-situ through photothermal catalysis.
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The purpose of this research was to investigate the main active components, potential targets of action, and pharmacological mechanisms of Erhuang Quzhi Formula (EHQZF) against NAFLD using network pharmacology, molecular docking, and experimental validation. The main active chemical components of EHQZF and the potential targets for treating NAFLD were extracted and analyzed. The PPI network diagram of "Traditional Chinese Medicine-Active Ingredients-Core Targets" was constructed and the GO, KEGG, and molecular docking analysis were carried out. Identification of components in traditional Chinese medicine compounds was conducted by LC-MS. NAFLD models were established and relevant pathologic indicators and Western blot were analyzed in vivo and ex vivo. Totally 8 herbs attributed to the liver meridian and 20 corresponding targets of NAFLD were obtained from EHQZF. Flavonoids and phenolic acids as the main components of EHQZF treated NAFLD through the MAPK/AKT signaling pathway. Pathway enrichment analysis focused on the MAPK/AKT signaling pathway and apoptosis signaling pathway. Molecular docking showed that Quercetin and Luteolin had stable binding structures with AKT1, STAT3, and other targets. Experiments showed that EHQZF reduced lipid accumulation, regulated changes in adipose tissue, inhibited the MAPK/AKT signaling pathway and exert multiple components, several targets, and multiple pathway interactions to treat NAFLD.
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Liver fibrosis, one of the leading causes of morbidity and mortality worldwide, lacks effective therapy. The activation of hepatic stellate cells (HSCs) is the dominant event in hepatic fibrogenesis. Luteolin-7-diglucuronide (L7DG) is the major flavonoid extracted from Perilla frutescens and Verbena officinalis. Their beneficial effects in the treatment of liver diseases were well documented. In this study we investigated the anti-fibrotic activities of L7DG and the potential mechanisms. We established TGF-ß1-activated mouse primary hepatic stellate cells (pHSCs) and human HSC line LX-2 as in vitro liver fibrosis models. Co-treatment with L7DG (5, 20, 50 µM) dose-dependently decreased TGF-ß1-induced expression of fibrotic markers collagen 1, α-SMA and fibronectin. In liver fibrosis mouse models induced by CCl4 challenge alone or in combination with HFHC diet, administration of L7DG (40, 150 mg·kg-1·d-1, i.g., for 4 or 8 weeks) dose-dependently attenuated hepatic histopathological injury and collagen accumulation, decreased expression of fibrogenic genes. By conducting target prediction, molecular docking and enzyme activity detection, we identified L7DG as a potent inhibitor of protein tyrosine phosphatase 1B (PTP1B) with an IC50 value of 2.10 µM. Further studies revealed that L7DG inhibited PTP1B activity, up-regulated AMPK phosphorylation and subsequently inhibited HSC activation. This study demonstrates that the phytochemical L7DG may be a potential therapeutic candidate for the treatment of liver fibrosis.
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[This corrects the article DOI: 10.3389/fonc.2024.1347123.].
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OBJECTIVE: This study examines the therapeutic impact and prognosis of acoustic therapy in patients with chronic subjective tinnitus across different tinnitus frequencies. METHODS: A total of 135 patients with subjective tinnitus were selected and categorized based on their primary tone frequency into three groups: high frequency (43 patients, 4-8 kHz), mid frequency (40 patients, 1-3 kHz), and low frequency (42 patients, < 1 kHz). All patients received acoustic therapy customized to their specific frequency and loudness levels, along with tinnitus cognitive behavioral therapy. Changes in tinnitus loudness and efficacy rates before and after treatment in the different groups, as well as before and after tinnitus cognitive behavioral therapy were evaluated and assessed. RESULTS: The low frequency group showed a statistical improvement in tinnitus loudness compared to the mid and high frequency groups (P < 0.05). The efficacy rate was 93.55 % in the low frequency group, 82.88 % in the mid frequency group, and 58.82 % in the high frequency group. The efficacy rate in the low frequency group was significantly higher than in the high frequency group, but there was no statistical difference when compared to the mid frequency group. CONCLUSION: The frequency of tinnitus in patients with chronic subjective tinnitus might be a key factor affecting treatment effectiveness and could account for the differences in treatment outcomes among patients.
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Vessel density within tumor tissues strongly correlates with tumor proliferation and serves as a critical marker for tumor grading. Recognition of vessel density by pathologists is subject to a strong inter-rater bias, thus limiting its prognostic value. There are many challenges in the task of object detection in pathological images, including complex image backgrounds, dense distribution of small targets, and insignificant differences between the features of the target to be detected and the image background. To address these problems and thus help physicians quantify blood vessels in pathology images, we propose Pathological Images-YOLO (PI-YOLO), an enhanced detection network based on YOLOv7. PI-YOLO incorporates the BiFormer attention mechanism, enhancing global feature extraction and accelerating processing for regions with subtle differences. Additionally, it introduces the CARAFE upsampling module, which optimizes feature utilization and information retention for small targets. Furthermore, the GSConv module improves the ELAN module, reducing model parameters and enhancing inference speed while preserving detection accuracy. Experimental results show that our proposed PI-YOLO network has higher detection accuracy compared to Faster-RCNN, SSD, RetinaNet, YOLOv5 network, and the latest YOLOv7 network, with a mAP value of 87.48%, which is 2.83% higher than the original model. We also validated the performance of this network on the ICPR 2012 mitotic dataset with an F1 value of 0.8678, outperforming other methods, demonstrating the advantages of our network in the task of target detection in complex pathology images.
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Background: The purpose of this network meta-analysis (NMA) was to evaluate the efficacy of intravenous opioid µ-receptor analgesics in shortening the duration of mechanical ventilation (MV) in ICU patients. Methods: Randomized controlled trials comparing the efficacy of remifentanil, sufentanil, morphine, and fentanyl on the duration of MV in ICU patients were searched in Embase, Cochrane, Pubmed, and Web of Science electronic databases. The primary outcome was MV duration. The Bayesian random-effects framework was used to evaluate relative efficacy. Results: In total 20 studies were included in this NMA involving 3,442 patients. Remifentanil was not associated with a reduction in the duration of MV compared with fentanyl (mean difference (MD) -0.16; 95% credible interval (CrI): -4.75 ~ 5.63) and morphine (MD 3.84; 95% CrI: -0.29 ~ 10.68). The secondary outcomes showed that, compared with remifentanil, sufentanil can prolong the duration of extubation. No regimen significantly shortened the ICU length of stay and improved the ICU mortality, efficacy, safety, and drug-related adverse events. Conclusion: Among these analgesics, remifentanil did not appear to be associated with a reduction in MV duration. Clinicians should carefully titrate the analgesia of MV patients to prevent a potentially prolonged duration of MV due to excessive or inadequate analgesic therapy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, CRD42021232604.
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Glioblastoma (GBM) presents significant challenges due to its invasive nature and genetic heterogeneity. In this study, we investigated the impact of Small VCP/P97-Interacting Protein (SVIP) on GBM progression. Our results revealed elevated expression of Insulin-like Growth Factor Binding Protein 2 (IGFBP-2) and STIP1 homology and U-box containing protein 1 (STUB1), coupled with reduced SVIP levels in GBM samples. Notably, high IGFBP-2 expression correlated with poor prognosis. Mechanistically, SVIP competitively inhibited STUB1, selectively binding to VCP/p97, thereby reducing PTEN degradation. This SVIP-mediated regulation exerted influence on the PTEN/PI3K/AKT/mTOR pathway, leading to the suppression of GBM progression. Co-localization experiments demonstrated that SVIP hindered PTEN ubiquitination and degradation by outcompeting STUB1 for VCP/p97 binding. Moreover, SVIP overexpression resulted in reduced activation of AKT/mTOR signaling and facilitated autophagy. In vivo experiments using a GBM xenograft model substantiated the tumor-suppressive effects of SVIP, evident by suppressed tumor growth, decreased IGFBP-2 expression, and improved survival rates. Collectively, our findings underscore the functional significance of SVIP in GBM progression. By inhibiting STUB1 and stabilizing PTEN, SVIP modulates the expression of IGFBP-2 and attenuates the activation of the PI3K/AKT/mTOR pathway, thereby emerging as a promising therapeutic target for GBM treatment.
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Aqueous Mn-ion batteries (MIBs) exhibit a promising development potential due to their cost-effectiveness, high safety, and potential for high energy density. However, the development of MIBs is hindered by the lack of electrode materials capable of storing Mn2+ ions due to acidic manganese salt electrolytes and large ion radius. Herein, the tunnel-type structure of monoclinic VO2 nanorods to effectively store Mn2+ ions via a reversible (de)insertion chemistry for the first time is reported. Utilizing exhaustive in situ/ex situ multi-scale characterization techniques and theoretical calculations, the co-insertion process of Mn2+/proton is revealed, elucidating the capacity decay mechanism wherein high proton activity leads to irreversible dissolution loss of vanadium species. Further, the Grotthuss transfer mechanism of protons is broken via a hydrogen bond reconstruction strategy while achieving the modulation of the electric double-layer structure, which effectively suppresses the electrode interface proton activity. Consequently, the VO2 demonstrates excellent electrochemical performance at both ambient temperatures and -20 °C, especially maintaining a high capacity of 162 mAh g-1 at 5 A g-1 after a record-breaking 20 000 cycles. Notably, the all-vanadium symmetric pouch cells are successfully assembled for the first time based on the "rocking-chair" Mn2+/proton hybrid mechanism, demonstrating the practical application potential.
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Co-inhibition of histone deacetylase (HDAC) and cyclin-dependent kinase (CDK) synergizes to produce enhanced antitumor effects and potentially overcomes the drug resistance. In this work, we discovered a series of novel CDK9/HDACs dual inhibitors. Among them, compound 8e was identified to show potent CDK9 and HDAC1 inhibitory activities, with IC50 values at 88.4 and 168.9 nM, respectively, and exhibited antiproliferative capacities against hematological and solid tumor cells. Meanwhile, 8e showed high selectivity for CDK9 and HDAC1, remarkably induced MV-4-11 cell apoptosis and S cell cycle arrests. Furthermore, 8e possessed a significant antitumor potency with a T/C value of 29.98% in the MV-4-11 xenograft model. Interestingly, a potent FLT3/HDAC dual inhibitor 9e was also identified (FLT3/HDAC1/3 IC50 = 30.4/52.4/14.7 nM) and found to possess powerful apoptosis induction ability in MV-4-11 cell and potent antiproliferative capacities against FLT3 mutant-transformed BaF3 cells. Overall, our work provided valuable lead compounds for dual inhibitors with potent anticancer activity.
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Purpose: To investigate the long-term patterns and risk factors of visual field defect (VFD) development in nonpathologic high myopia (HM) over an 8-year follow-up. Methods: This was an observational cohort study. The VFD classification adhered to the Glaucoma Suspects with High Myopia Study Group. Logistic regression models with generalized estimating equations were used to identify risk factors for VFD development. Results: A total of 330 eyes from 194 patients were included. Among them, 49.4% of eyes developed VFD, with enlarged blind spot and nonspecific defect ranked as the most common VFDs, followed by partial arcuate defect, vertical step, nasal step, paracentral defect, and combined defects. Longer axial length (odds ratio [OR] = 1.43 per 1-mm increase; 95% CI, 1.04-1.95; P = 0.026), thinner central corneal thickness (OR = 1.01 per 1-µm decrease; 95% CI, 1.003-1.02; P = 0.013), worse mean deviation of visual field (OR = 1.51 per 1-dB decrease; 95% CI, 1.14-2.00; P = 0.004), and the presence of peripapillary γ-zone (OR = 5.57; 95% CI, 3.06-10.15; P < 0.001) at baseline correlated with the development of any VFD. By incorporating these factors, the prediction models achieved area under the curves of 0.789 (95% CI, 0.726-0.853) and 0.828 (95% CI, 0.714-0.943) for discriminating the development of any VFD and moderate/severe VFD, respectively, with good calibration power. Conclusions: The development of VFD occurred frequently in individuals with nonpathologic HM and can be effectively predicted using relevant metrics. The findings will aid in expanding our knowledge of optic neuropathy in HM.
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Myopia, Degenerative , Visual Field Tests , Visual Fields , Humans , Visual Fields/physiology , Female , Male , Risk Factors , Middle Aged , Follow-Up Studies , Myopia, Degenerative/complications , Myopia, Degenerative/diagnosis , Adult , Incidence , Vision Disorders/physiopathology , Vision Disorders/diagnosis , Intraocular Pressure/physiology , AgedABSTRACT
The development of sustainable and effective electrochemical nitrogen fixation catalysts is crucial for the mitigation of the terrible energy consumption resulting from the Haber-Bosch process. Molybdenum disulfide (MoS2) exhibits promise toward nitrogen reduction reaction (NRR) on account of its similar structure to natural nitrogenases MoFe-co but still undergoes serious challenges with unsatisfactory catalytic performance resulted from limited active sites, conductivity, and selectivity. In this work, Fe/Co/B codoped MoS2 ultrathin nanosheets are synthesized and verified as excellent NRR catalysts with high activity, selectivity, and durability. The FeCoB-MoS2 demonstrates a high ammonia yield of 36.99 µg h-1 mgcat-1 at -0.15 V vs RHE and Faraday efficiency (FE) of 30.65% at -0.10 V vs RHE in 0.1 M HCl. The experimental results and the density functional theory (DFT) calculations emphasize that codoping of Fe, Co, and B into MoS2 synergistically enhances its conductivity and optimizes the electronic structure of the catalyst, which significantly improves the electrocatalytic ammonia synthesis performance. This work broadens the potential and enlightens the strategy for designing efficient electrocatalysts in the NRR field.
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The electronic and magnetic properties of the Au-doped diamond surface are investigated by first-principles calculation. After Au-doping, diamond shows surface p-type conductivity with an areal electron density of 6.34 × 1013 cm-2. Unlike the non-magnetic feature of intrinsic diamond, magnetism is induced for diamond (100), (110) and (111) surfaces as well as at different terminations (H, F, N and O). The magnetism originates from the s-p hybridization between the Au-6s state and the C-2p state, and the spin charge density and magnetic moments of Au-doped diamond originate mainly from the Au atoms and their surrounding C atoms. Further studies show that the magnetic properties still maintain under different doping concentrations (0.125-0.5 monolayer). Therefore, this study would provide great potential applications of diamond in novel magnetic semiconductors and transistors.
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Despite significant efforts to eliminate bacterial biofilm within root canals, achieving effective disinfection remains challenging due to the complex anatomy and limitations of disinfectants. In this study, a second near-infrared (NIR-II) semiconducting polymer with aggregation-induced emission (AIE) properties, named PIDT-TBT, is deliberately designed and synthesized. This proposes an AIE luminogen-based sterilization strategy in synergy with a low concentration of sodium hypochlorite (NaClO). Water-dispersible PIDT-TBT nanoparticles (NPs) are prepared, demonstrating good biocompatibility, as well as photothermal and photodynamic properties. Subsequent antibacterial tests show that PIDT-TBT NPs exhibit excellent bactericidal effects against three bacterial strains: Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis, upon 808 nm laser irradiation. In synergy with a low concentration of NaClO (0.5%) solution, PIDT-TBT NPs significantly improves the outcome of root canal treatment under 808 nm laser irradiation in a human extracted tooth root canal infection model. Additionally, it is found that PIDT-TBT NPs combine with a low concentration of NaClO solution could safely dissolve dentin debris and further increase the efficiency of root canal preparation by altering the elemental composition of the inner root canal wall.
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[This corrects the article DOI: 10.3389/fphar.2022.957433.].
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BACKGROUND: For medical artificial intelligence (AI) training and validation, human expert labels are considered the gold standard that represents the correct answers or desired outputs for a given data set. These labels serve as a reference or benchmark against which the model's predictions are compared. OBJECTIVE: This study aimed to assess the accuracy of a custom deep learning (DL) algorithm on classifying diabetic retinopathy (DR) and further demonstrate how label errors may contribute to this assessment in a nationwide DR-screening program. METHODS: Fundus photographs from the Lifeline Express, a nationwide DR-screening program, were analyzed to identify the presence of referable DR using both (1) manual grading by National Health Service England-certificated graders and (2) a DL-based DR-screening algorithm with validated good lab performance. To assess the accuracy of labels, a random sample of images with disagreement between the DL algorithm and the labels was adjudicated by ophthalmologists who were masked to the previous grading results. The error rates of labels in this sample were then used to correct the number of negative and positive cases in the entire data set, serving as postcorrection labels. The DL algorithm's performance was evaluated against both pre- and postcorrection labels. RESULTS: The analysis included 736,083 images from 237,824 participants. The DL algorithm exhibited a gap between the real-world performance and the lab-reported performance in this nationwide data set, with a sensitivity increase of 12.5% (from 79.6% to 92.5%, P<.001) and a specificity increase of 6.9% (from 91.6% to 98.5%, P<.001). In the random sample, 63.6% (560/880) of negative images and 5.2% (140/2710) of positive images were misclassified in the precorrection human labels. High myopia was the primary reason for misclassifying non-DR images as referable DR images, while laser spots were predominantly responsible for misclassified referable cases. The estimated label error rate for the entire data set was 1.2%. The label correction was estimated to bring about a 12.5% enhancement in the estimated sensitivity of the DL algorithm (P<.001). CONCLUSIONS: Label errors based on human image grading, although in a small percentage, can significantly affect the performance evaluation of DL algorithms in real-world DR screening.
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Deep Learning , Diabetic Retinopathy , Diabetic Retinopathy/diagnosis , Humans , Algorithms , Mass Screening/methods , Mass Screening/standards , Female , Male , Middle AgedABSTRACT
Background: There is now increasing evidence that type 2 diabetes mellitus (T2DM) is associated with Alzheimer's disease (AD). However, it is unclear whether the two are causally related. Objective: To reveal the causal association between T2DM and AD, we performed a bidirectional Mendelian randomization (MR) analysis. Methods: Genetic instrumental variables were systematically screened, and inverse-variance weighting, MR-Egger regression, weighted median, simple mode, and weighted mode were applied to assess the pathogenic associations between the two diseases, and sensitivity analyses were used to further validate the robustness of the results. Results: The results of forward MR analysis with T2DM as the exposure were [ORâ=â0.998, 95% CI (0.975â¼1.021), pâ=â0.857], and the results of reverse MR analysis with AD as the exposure were [ORâ=â0.966, 95% CI (0.934â¼0.999), pâ=â0.043]. The results showed no significant association between T2DM and AD at the gene level (pâ<â0.025). Sensitivity analyses were consistent with the results of the main analysis, confirming the robustness of the study. Conclusions: T2DM and AD may not be genetically causally associated.
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Background: Multiparametric magnetic resonance imaging (mpMRI) is a commonly used method to diagnose pelvic lymph node metastasis (PLNM) in prostate cancer (PCa) patients, but there are few comparative studies on mpMRI and 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) in locally advanced PCa (LAPC) patients. Therefore, we designed a retrospective study to compare the diagnostic value of 68Ga-PSMA PET/CT and mpMRI for PLNM of LAPC. Methods: A retrospective study was performed on 50 patients with LAPC who underwent radical prostatectomy (RP) in Tongji Hospital from 2021 to 2023. All patients underwent PET/CT and mpMRI examination, and were diagnosed as LAPC before surgery, followed by robot-assisted laparoscopic prostatectomy or laparoscopic RP and extended pelvic lymph node dissection (ePLND). Routine postoperative pathological examination was performed. According to the results, the sensitivity, specificity, positive predictive value, and negative predictive value of 68Ga-PSMA PET/CT and mpMRI for the diagnosis of PLNM of LAPC were compared. Results: Among the 50 patients, the mean age was 65.5±10.3 years, the preoperative total serum prostate-specific antigen (PSA) was 30.7±12.3 ng/mL, and the Gleason score was 7 [7, 8]. The difference in diagnostic efficacy between 68Ga-PSMA PET/CT and mpMRI in the preoperative diagnosis of PLNM of PCa was determined by postoperative pathological results. Based on the number of patients who developed PLNM, the sensitivity, specificity, positive predictive value, and negative predictive value of 68Ga-PSMA PET/CT were as follows: 93.75%, 100.00%, 100.00%, 97.14%, and 68.75%, 97.06%, 91.67%, 86.84% for mpMRI, respectively. Based on the number of pelvic metastatic lymph nodes, the sensitivity, specificity, positive predictive value, and negative predictive value of 68Ga-PSMA PET/CT were 95.24%, 100.00%, 100.00%, 99.48%, and 65.08%, 99.13%, 89.13%, 96.30% for mpMRI, respectively. It turned out that PET/CT was more sensitive than mpMRI in detecting PLNM of PCa, and the difference was statistically significant. Conclusions: 68Ga-PSMA PET/CT is more sensitive than mpMRI in the detection of PLNM in patients with LAPC. It is a promising method in the diagnosis and preoperative assessment of PLNM in LAPC.
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This paper aims to increase the Unmanned Aerial Vehicle's (UAV) capacity for target tracking. First, a control model based on fuzzy logic is created, which modifies the UAV's flight attitude in response to the target's motion status and changes in the surrounding environment. Then, an edge computing-based target tracking framework is created. By deploying edge devices around the UAV, the calculation of target recognition and position prediction is transferred from the central processing unit to the edge nodes. Finally, the latest Vision Transformer model is adopted for target recognition, the image is divided into uniform blocks, and then the attention mechanism is used to capture the relationship between different blocks to realize real-time image analysis. To anticipate the position, the particle filter algorithm is used with historical data and sensor inputs to produce a high-precision estimate of the target position. The experimental results in different scenes show that the average target capture time of the algorithm based on fuzzy logic control is shortened by 20% compared with the traditional proportional-integral-derivative (PID) method, from 5.2 s of the traditional PID to 4.2 s. The average tracking error is reduced by 15%, from 0.8 m of traditional PID to 0.68 m. Meanwhile, in the case of environmental change and target motion change, this algorithm shows better robustness, and the fluctuation range of tracking error is only half of that of traditional PID. This shows that the fuzzy logic control theory is successfully applied to the UAV target tracking field, which proves the effectiveness of this method in improving the target tracking performance.