Prognostic effect of obstructive sleep apnea in acute coronary syndrome patients with heart failure.

BACKGROUND AND OBJECTIVE: Acute coronary syndrome (ACS), heart failure (HF) and obstructive sleep apnea (OSA) often overlap and interact, the impact of OSA on ACS patients with HF remains unclear. The study sought to comprehensively evaluate the effects of the interaction between OSA and HF on long-term cardiovascular outcomes in ACS patients. METHODS: Between June 2015 and January 2020, patients hospitalized for ACS were prospectively enrolled and underwent portable sleep monitoring after clinically stabilization. OSA was defined as an apnea hypopnea index ≥15 events/h. HF was defined using medical records. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE), including death, myocardial infarction, stroke, ischemia-driven revascularization, and hospitalization for unstable angina. RESULTS: Among all 1927 included patients, 214 (11.1 %) had HF, and 1014 (52.6 %) had OSA. For 2.9 years (1.5, 3.6 years) follow-up, OSA was independently associated with the risk of MACCE in HF patients (adjusted hazard ratio [HR], 2.11; 95%CI, 1.16-3.84; P = 0.014), but not in those without HF (adjusted HR, 1.15; 95%CI, 0.92-1.45; P = 0.228). Further analysis showed OSA exerted more prognostic effect in HF patients with preserved eject fraction (adjusted HR, 2.45; 95 % CI, 1.11-5.41; P = 0.027) than those with reduced eject fraction (adjusted HR, 1.62; 95 % CI, 0.63-4.20; P = 0.319). CONCLUSIONS: In the settings of ACS, OSA was independently associated with poor prognosis in patients with concomitant HF especially those with persevered ejection fraction. Screening and treatment for OSA are highly recommended in ACS patients with HF. CLINICAL TRIAL REGISTRATION: URL: www.clinicaltrails.gov; Unique Identifier: NCT03362385.

Tumor oxygen microenvironment-tailored electron transfer-type photosensitizers for precise cancer therapy.

The oxygen level in a tumor typically exhibits complex characteristics, ranging from mild hypoxia to moderate and even severe hypoxia. This poses significant challenges for the efficacy of photodynamic therapy, where oxygen is an essential element. Herein, we propose a novel therapeutic strategy and develop a series of lipid droplet-targeting photosensitive dyes (Ser-TPAs), i.e., in situ synergistic activation of two different electron transfer-type reactions. Based on this strategy, Ser-TPAs can synergistically generate O2˙- and nitrogen radicals regardless of the oxygen content, which results in a sustained high concentration of strongly oxidizing substances in the lipid droplets of cancer cells. As such, Ser-TPAs exhibited inhibitory activity against tumor growth in vivo, resulting in a significant reduction in tumor volume (V experimental group : V control group ≈ 0.07). This strategy offers a conceptual framework for the design of innovative photosensitive dyes that are suitable for cancer therapy in complex oxygen environments.

Biochar regulates the functions of keystone taxa to reduce p-coumaric acid accumulation in soil.

Introduction: Applying biochar (BC) to reduce toxic substance accumulation in soil, either through direct adsorption or modulation of the microbial community, has received considerable attention. However, a knowledge gap exists regarding how BC regulates microbial community structure and functions to mitigate toxic substance accumulation. Methods: We previously identified p-coumaric acid (p-CA) as a representative autotoxin in tobacco rhizosphere soil. On this basis, this study simulated a soil environment with p-CA accumulation to investigate the impacts of BC on p-CA, soil physicochemical properties, and microbial community structure and function. Results: The results showed that p-CA could be directly adsorbed onto BC, which followed the pseudo-second-order kinetic model (R 2 = 0.996). A pot experiment revealed that BC significantly reduced soil p-CA, altered soil microbial composition, and enhanced bacterial community diversity. A weighted correlation network analysis showed a close association between taxon 1 in the microbial network and p-CA, suggesting a pivotal role for this taxon in reducing p-CA, with Devosia and Nocardioides identified as potential key contributors to this process. The prediction of possible keystone taxa functions showed that BC increased the relative abundances of aromatic compound degraders. Mantel tests indicated that soil organic matter exerted the greatest influence on keystone taxa functions and hub genera. Discussion: These findings suggest that BC may either directly chemisorb p-CA or indirectly facilitate p-CA degradation by regulating the functioning of keystone taxa. The results of this study provide a novel perspective for further investigation of the mechanisms through which BC reduces the accumulation of toxic substances in soil.

Ultrastructure of the larval rectum of the scorpionfly Panorpa liui (Mecoptera: Panorpidae).

The rectum is an important part of the alimentary canal responsible for ion and water reabsorption of insects. However, it has rarely been studied in the larvae of Panorpidae, the largest family in Mecoptera. Here, we investigated the ultrastructure of larval rectum of the scorpionfly Panorpa liui Hua, 1997 using light and transmission electron microscopy. The rectum comprises tracheal muscular layers, connective tissue, non-cellular basal lamina, junctional cells, rectal epithelium, cuticle with irregular outlines, and a central lumen. The rectal epithelium is infolded to form six longitudinal rectal folds, which are distinct from rectal pads or papillae. In each rectal fold, the apical and basal plasma membranes of epithelial cells are infolded and the lateral plasma membranes form septate and scalariform junctions. The well-developed rectal folds are postulated to be closely associated with reabsorption of ions and water in the larvae. The associations of rectal folds with larval behaviors are briefly discussed in Mecoptera.

Current development, optimisation strategies and future perspectives for lead-free dielectric ceramics in high field and high energy density capacitors.

To meet the United Nations' sustainable development goal of affordable and clean energy, there has been a growing need for low-cost, green, and safe energy storage technologies. High-field and energy-density capacitors have gained substantial attention from academics and industry, particularly for power electronics, where they will play a key role in optimising the performance of management systems in electric vehicles. The key figure of merit, energy density (Wrec), for high-field applications has dramatically increased year-on-year from 2020 to 2024, as evidenced by over 250 papers, demonstrating ever larger Wrec values. This review briefly introduces the background and principles of high energy density ceramics, but its focus is to provide constructive and comprehensive insight into the evaluation of Wrec, Emax, ΔP, and η, and more importantly, the normalised metrics, Wrec/Emax and Wrec/ΔP in lead-free dielectric ceramics. We also present several optimisation strategies for materials modification and process innovation that have been recently proposed before providing perspectives for the further development of high-field and high-energy density capacitors.

Fluorescence-plane polarization for the real-time monitoring of transferase migration in living cells.

Transferases are enzymes that exhibit multisite migration characteristics. Significantly, enzyme activity undergoes changes during this migration process, which inevitably impacts the physiological function of living organisms and can even lead to related malignant diseases. However, research in this field has been severely hindered by the lack of tools for the simultaneous and differential monitoring of site-specific transferase activity. Herein, we propose a novel strategy that integrates a fluorescence signal response with high sensitivity and an optical rotation signal response with superior spatial resolution. To validate the feasibility of this strategy, transferase γ-glutamyltransferase (GGT) was used as a model system to develop dual-mode chiral probes ACx-GGTB (AC17-GGTB and AC15-GGTB) using chiral amino acids as specific bifunctional recognition groups. The probes undergo structural changes under GGT, resulting in the release of bifunctional recognition groups (chiral amino acids) and simultaneously generate fluorescence signals and optical rotation signals. This dual-mode output exhibits high sensitivity and facilitates differentiation of sites. Furthermore, it enables simultaneous and differential detection of GGT activity at different sites during migration. We anticipate that probes developed based on this strategy will facilitate imaging-based monitoring of the activity for other transferases, thus providing an imaging platform suitable for the real-time tracking of transferase activity changes during migration.

Improved Liver Intravital Microscopic Imaging Using a Film-Assisted Stabilization Method.

Intravital microscopy (IVM) is a valuable method for biomedical characterization of dynamic processes, which has been applied to many fields such as neuroscience, oncology, and immunology. During IVM, vibration suppression is a major challenge due to the inevitable respiration and heartbeat from live animals. In this study, taking liver IVM as an example, we have unraveled the vibration inhibition effect of liquid bridges by studying the friction characteristics of a moist surface on the mouse liver. We confirmed the presence of liquid bridges on the liver through fluorescence imaging, which can provide microscale and nondestructive liquid connections between adjacent surfaces. Liquid bridges were constructed to sufficiently stabilize the liver after abdominal dissection by covering it with a polymer film, taking advantage of the high adhesion properties of liquid bridges. We further prototyped a microscope-integrated vibration-damping device with adjustable film tension to simplify the sample preparation procedure, which remarkably decreased the liver vibration. In practical application scenarios, we observed the process of liposome phagocytosis by liver Kupffer cells with significantly improved image and video quality. Collectively, our method not only provided a feasible solution to vibration suppression in the field of IVM, but also has the potential to be applied to vibration damping of precision instruments or other fields that require nondestructive ″soft″ vibration damping.

ß-glucan combined with Envafolimab and Endostar as immune rechallenge for metastatic non-small cell lung cancer.

BACKGROUND: Immune checkpoint inhibitor rechallenge has emerged as a prominent study area in non-small cell lung cancer (NSCLC). ß-glucan was reported to reverse resistance to anti-PD-1/PD-L1 inhibitors by regulating the tumor microenvironment. In this self-initiated clinical trial (ChiCTR2100054796), NSCLC participants who have previously failed anti-PD-1 therapy received ß-glucan (500 mg, bid, d1-21), Envafolimab (300 mg, d1) and Endostar (210 mg, civ72h) every 3 weeks until disease progression or unacceptable toxicity. The clinical efficacy and adverse events were observed, while serum samples were collected for proteomic analysis. RESULTS: Twenty Three patients were enrolled from January 2022 to March 2023 (median age, 65 years; male, n = 18 [78.3%]; squamous NSCLC, n = 9 [39.1%]; mutant type, n = 13 [56.5%]). The overall response rate (ORR) was 21.7% and disease control rate (DCR) was 73.9%. Median progression-free survival (mPFS) and median overall survival (mOS) was 4.3 months [95% CI: 2.0-6.6] and 9.8 months [95% CI: 7.2-12.4], respectively. The mPFS between PD-L1 positive and negative subgroup has significant difference (6.3 months vs. 2.3 months, p = 0.002). Treatment-related adverse events (TRAEs) occurred in 52.2% of patients. The most common TRAEs were hypothyroidism (26.1%) and fatigue (26.1%). 2 (8.7%) grade 3 adverse events were reported. No adverse reaction related deaths have been observed. Proteomic analysis revealed that the levels of CASP-8, ARG1, MMP12, CD28 and CXCL5 correlated with resistance to the treatment while the levels of CD40-L and EGF related to the favorable response. CONCLUSION: ß-glucan combined with Envafolimab and Endostar has considerable efficacy and safety for immune rechallenge in metastatic NSCLC patients who failed of anti-PD-1 treatment previously, especially for PD-L1 positive patients.

Low-dose computed tomography perceptual image quality assessment.

In computed tomography (CT) imaging, optimizing the balance between radiation dose and image quality is crucial due to the potentially harmful effects of radiation on patients. Although subjective assessments by radiologists are considered the gold standard in medical imaging, these evaluations can be time-consuming and costly. Thus, objective methods, such as the peak signal-to-noise ratio and structural similarity index measure, are often employed as alternatives. However, these metrics, initially developed for natural images, may not fully encapsulate the radiologists' assessment process. Consequently, interest in developing deep learning-based image quality assessment (IQA) methods that more closely align with radiologists' perceptions is growing. A significant barrier to this development has been the absence of open-source datasets and benchmark models specific to CT IQA. Addressing these challenges, we organized the Low-dose Computed Tomography Perceptual Image Quality Assessment Challenge in conjunction with the Medical Image Computing and Computer Assisted Intervention 2023. This event introduced the first open-source CT IQA dataset, consisting of 1,000 CT images of various quality, annotated with radiologists' assessment scores. As a benchmark, this challenge offers a comprehensive analysis of six submitted methods, providing valuable insight into their performance. This paper presents a summary of these methods and insights. This challenge underscores the potential for developing no-reference IQA methods that could exceed the capabilities of full-reference IQA methods, making a significant contribution to the research community with this novel dataset. The dataset is accessible at https://zenodo.org/records/7833096.

Coronary atherosclerotic plaque characterization with silicon-based photon-counting computed tomography (CT): A simulation-based feasibility study.

BACKGROUND: Recent photon-counting computed tomography (PCCT) development brings great opportunities for plaque characterization with much-improved spatial resolution and spectral imaging capability. While existing coronary plaque PCCT imaging results are based on CZT- or CdTe-materials detectors, deep-silicon photon-counting detectors offer unique performance characteristics and promise distinct imaging capabilities. PURPOSE: This study aims to numerically investigate the feasibility of characterizing plaques with a deep-silicon PCCT scanner and to demonstrate its potential performance advantages over traditional CT scanners using energy-integrating detectors (EID). METHODS: We conducted a systematic simulation study of a deep-silicon PCCT scanner using a newly developed digital plaque phantom with clinically relevant geometrical and chemical properties. Through qualitative and quantitative evaluations, this study investigates the effects of spatial resolution, noise, and motion artifacts on plaque imaging. RESULTS: Noise-free simulations indicated that PCCT imaging could delineate the boundary of necrotic cores with a much finer resolution than EID-CT imaging, achieving a structural similarity index metric (SSIM) score of 0.970 and reducing the root mean squared error (RMSE) by two-thirds. Measuring necrotic core area errors were reduced from 91.5% to 24%, and fibrous cap thickness errors were reduced from 349.8% to 33.3%. In the presence of noise, the optimal reconstruction was achieved using 0.25 mm voxels and a soft reconstruction kernel, yielding the highest contrast-to-noise ratio (CNR) of 3.48 for necrotic core detection and the best image quality metrics among all choices. However, the ultrahigh resolution of PCCT increased sensitivity to motion artifacts, which could be mitigated by keeping residual motion amplitude below 0.4 mm. CONCLUSIONS: The findings suggest that deep-silicon PCCT scanner can offer sufficient spatial resolution and tissue contrast for effective plaque characterization, potentially improving diagnostic accuracy in cardiovascular imaging, provided image noise and motion blur can be mitigated using advanced algorithms. This simulation study involves several simplifications, which may result in some idealized outcomes that do not directly translate to clinical practice. Further validation studies with physical scans are necessary and will be considered for future work.

Noise suppression in photon-counting computed tomography using unsupervised Poisson flow generative models.

Deep learning (DL) has proven to be important for computed tomography (CT) image denoising. However, such models are usually trained under supervision, requiring paired data that may be difficult to obtain in practice. Diffusion models offer unsupervised means of solving a wide range of inverse problems via posterior sampling. In particular, using the estimated unconditional score function of the prior distribution, obtained via unsupervised learning, one can sample from the desired posterior via hijacking and regularization. However, due to the iterative solvers used, the number of function evaluations (NFE) required may be orders of magnitudes larger than for single-step samplers. In this paper, we present a novel image denoising technique for photon-counting CT by extending the unsupervised approach to inverse problem solving to the case of Poisson flow generative models (PFGM)++. By hijacking and regularizing the sampling process we obtain a single-step sampler, that is NFE = 1. Our proposed method incorporates posterior sampling using diffusion models as a special case. We demonstrate that the added robustness afforded by the PFGM++ framework yields significant performance gains. Our results indicate competitive performance compared to popular supervised, including state-of-the-art diffusion-style models with NFE = 1 (consistency models), unsupervised, and non-DL-based image denoising techniques, on clinical low-dose CT data and clinical images from a prototype photon-counting CT system developed by GE HealthCare.

Outer casing structure design for the trisection turbine wheel burst of the air turbine starter.

The aviation regulations mandate that high-energy rotor components must possesses adequate containment capabilities. Ensuring the containment of the turbine wheel of the air turbine starter is of paramount importance. In this paper, the design thickness of the containment ring was determined and the containment ring deformation was given. Based on the design thickness and deformation of the containment ring, an outer casing structure design method was proposed by using FEM. Then, two containment tests were conducted for different distances between the containment ring and outer casing to validate the outer casing structure design method. The errors of the containment ring deformation are smaller than 7.5%, and the experimental results of the containment process are in accordance with the simulation, validating correctness of the outer casing structure design method. The containment ring deformation rate with the design thickness T = 10 mm is 115%. A safety margin of 1.05 is designed by considering the uniformity of containment ring deformation and the containment ring assembly error. The results illustrate that the deformed containment ring does not damage the outer casing, when the inner diameter of the outer casing is designed as 1.2 times the outer diameter of the containment ring.

IQAGPT: computed tomography image quality assessment with vision-language and ChatGPT models.

Large language models (LLMs), such as ChatGPT, have demonstrated impressive capabilities in various tasks and attracted increasing interest as a natural language interface across many domains. Recently, large vision-language models (VLMs) that learn rich vision-language correlation from image-text pairs, like BLIP-2 and GPT-4, have been intensively investigated. However, despite these developments, the application of LLMs and VLMs in image quality assessment (IQA), particularly in medical imaging, remains unexplored. This is valuable for objective performance evaluation and potential supplement or even replacement of radiologists' opinions. To this end, this study introduces IQAGPT, an innovative computed tomography (CT) IQA system that integrates image-quality captioning VLM with ChatGPT to generate quality scores and textual reports. First, a CT-IQA dataset comprising 1,000 CT slices with diverse quality levels is professionally annotated and compiled for training and evaluation. To better leverage the capabilities of LLMs, the annotated quality scores are converted into semantically rich text descriptions using a prompt template. Second, the image-quality captioning VLM is fine-tuned on the CT-IQA dataset to generate quality descriptions. The captioning model fuses image and text features through cross-modal attention. Third, based on the quality descriptions, users verbally request ChatGPT to rate image-quality scores or produce radiological quality reports. Results demonstrate the feasibility of assessing image quality using LLMs. The proposed IQAGPT outperformed GPT-4 and CLIP-IQA, as well as multitask classification and regression models that solely rely on images.

The United States Department of Energy and National Institutes of Health Collaboration: Medical Care Advances by Discovery in Radiation Detection.

A National Institutes of Health (NIH) and U.S. Department of Energy (DOE) Office of Science virtual workshop on shared general topics was held in July of 2021 and reported on in this publication in January of 2023. Following the inaugural 2021 joint meeting representatives from the DOE Office of Science and NIH met to discuss organizing a second joint workshop that would concentrate on radiation detection to bring together teams from both agencies and their grantee populations to stimulate collaboration and efficiency. To meet this scientific mission within the NIH and DOE radiation detection space, the organizers assembled workshop sessions covering the state-of-the-art in cameras, detectors, and sensors for radiation external and internal (diagnostic and therapeutic) to human, data acquisition and electronics, image reconstruction and processing, and the application of artificial intelligence. NIH and DOE are committed to continuing the process of convening a joint workshop every 12-24 months. This Special Report recaps the findings of this second workshop. Beyond showing only the innovations and areas of success, important gaps in our knowledge were defined and presented. We summarize by defining four areas of greatest opportunity and need that emerged from the unique, dynamic dialogue the in-person workshop provided the attendees.

Water-soluble biodegradable polyesters with pH and ionic responsivity.

The synthesis of novel water-soluble polymers with biodegradability is an effective way to mitigate their negative environmental impacts. In this study, semi-aromatic copolyester poly(butylene succinate-co-butylene terephthalate) (PBST) with exceptional biodegradability is used as the resin matrix. Anionic sodium 1-3-isophthalate-5-sulfonate (SIPA) is introduced as a fourth monomer to prepare random poly(butylene succinate-co-butylene terephthalate-co-butylene 5-sodiosulfoisophthalate) (PBSTS) copolyesters by melt copolymerization. The incorporation of ionic groups enhances the hydrophilicity and water absorption of the copolyesters, resulting in water-soluble materials that exhibit ionic and temperature responsivity. Furthermore, the ionized biodegradable copolyesters demonstrate distinct pH-dependent degradation, which is accelerated at pH = 5.5 and 8.5 but inhibited at pH = 7.2. Degradation assessments in simulated body fluids reveal that the PBSTS copolyesters exhibit significant degradation in gastric fluids at pH = 1.5 with minimal degradation in intestinal fluids at pH = 6.8 and in body fluids at pH = 7.0. This unique degradation performance highlights the potential of these materials for addressing the challenges associated with selective drug delivery and localized controlled release in the human body.

Managing tobacco black shank disease using biochar: direct toxicity and indirect ecological mechanisms.

Black shank disease in tobacco, caused by Phytophthora nicotianae, can lead to yield losses of 30%-50% upon outbreak. Recently, biochar derived from agricultural waste has shown significant potential in controlling soil-borne diseases, though its mechanisms remain unclear. Over a 3-year observation period, we found that the incidence of black shank was significantly lower in plots amended with biochar compared with normal cultivation plots. To investigate the underlying mechanisms, we studied both the direct and indirect effects of biochar on black shank. Direct antifungal assays indicated that biochar reduced the total number of sporangia by 53.91%. Further pot experiments revealed a 62.34% reduction in the P. nicotianae population in the soil following biochar application. Additionally, biochar application led to notable changes in soil physicochemical properties and microbial community composition. Microbial species analysis showed that biochar promoted the aggregation of beneficial microbes such as Sphingomonas, Flavisolibacter, and Mucoromycota. Functional predictions using the PICRUSt 2 software revealed that biochar enhances bacterial functions related to antimicrobial substance synthesis (Tetracycline biosynthesis), detoxification metabolism (D-arginine and D-ornithine metabolism, arginine and proline metabolism), and lipid and fatty acid metabolism (Lipopolysaccharide biosynthesis, fatty acid biosynthesis), while fungal functions showed no significant changes. This suggests that rhizosphere bacteria play a more prominent role in the suppression of black shank by biochar, a finding supported by partial least squares path modeling analysis. Therefore, we hypothesize that biochar not only directly inhibits P. nicotianae growth but also regulates the composition of the rhizosphere microbial community, inducing the production of antimicrobial substances by rhizosphere bacteria, effectively preventing P. nicotianae invasion.IMPORTANCEBlack shank, a global soil-borne fungal disease in tobacco, currently lacks effective control methods. Notably, biochar derived from agricultural waste has shown significant potential in controlling soil-borne diseases. Over a 3-year observation period, we found that plots amended with biochar had a significantly lower incidence of black shank compared with normal cultivation plots. However, the mechanisms of disease suppression remained unclear. Through in vitro antifungal assays and pot experiments, we discovered that tobacco-derived biochar can directly inhibit the growth of the pathogen. Additionally, biochar regulates the composition of the rhizosphere microbial community, inducing rhizosphere bacteria to produce antimicrobial substances, effectively preventing pathogen invasion. This discovery reveals both the direct and indirect mechanisms by which biochar suppresses black shank in tobacco. It provides a scientific basis for developing green control technologies for black shank and offers theoretical support for the application of biochar in managing soil-borne diseases in tobacco cultivation areas.

Unraveling Cross-Organ Impacts of Airborne Pollutants: A Multiomics Study on Respiratory Exposure and Gastrointestinal Health.

Poor air quality is increasingly linked to gastrointestinal diseases, suggesting a potential correlation with human intestine health. However, this relationship remains largely unexplored due to limited research. This study used a controlled mouse model exposed to cooking oil fumes (COFs) and metagenomics, transcriptomics, and metabolomics to elucidate interactions between intestine microbiota and host metabolism under environmental stress. Our findings reveal that short-term COF inhalation induces pulmonary inflammation within 3 days and leads to gastrointestinal disturbances, elucidating a pathway connecting respiratory exposure to intestinal dysfunction. The exposure intensity significantly correlates with changes in intestinal tissue integrity, microbial composition, and metabolic function. Extended exposure of 7 days disrupts intestine microbiota and alters tryptophan metabolism, with further changes observed after 14 days, highlighting an adaptive response. These results highlight the vulnerability of intestinal health to airborne pollutants and suggest a pathway through which inhaled pollutants may affect distant organ systems.