Exercise-Induced Reduction of IGF1R Sumoylation Attenuates Neuroinflammation in APP/PS1 Transgenic Mice.

INTRODUCTION: Alzheimer's Disease (AD), a progressive neurodegenerative disorder, is marked by cognitive deterioration and heightened neuroinflammation. The influence of Insulin-like Growth Factor 1 Receptor (IGF1R) and its post-translational modifications, especially sumoylation, is crucial in understanding the progression of AD and exploring novel therapeutic avenues. OBJECTIVES: This study investigates the impact of exercise on the sumoylation of IGF1R and its role in ameliorating AD symptoms in APP/PS1 mice, with a specific focus on neuroinflammation and innovative therapeutic strategies. METHODS: APP/PS1 mice were subjected to a regimen of moderate-intensity exercise. The investigation encompassed assessments of cognitive functions, alterations in hippocampal protein expressions, neuroinflammatory markers, and the effects of exercise on IGF1R and SUMO1 nuclear translocation. Additionally, the study evaluated the efficacy of KPT-330, a nuclear export inhibitor, as an alternative to exercise. RESULTS: Exercise notably enhanced cognitive functions in AD mice, possibly through modulations in hippocampal proteins, including Bcl-2 and BACE1. A decrease in neuroinflammatory markers such as IL-1ß, IL-6, and TNF-α was observed, indicative of reduced neuroinflammation. Exercise modulated the nuclear translocation of SUMO1 and IGF1R in the hippocampus, thereby facilitating neuronal regeneration. Mutant IGF1R (MT IGF1R), lacking SUMO1 modification sites, showed reduced SUMOylation, leading to diminished expression of pro-inflammatory cytokines and apoptosis. KPT-330 impeded the formation of the IGF1R/RanBP2/SUMO1 complex, thereby limiting IGF1R nuclear translocation, inflammation, and neuronal apoptosis, while enhancing cognitive functions and neuron proliferation. CONCLUSION: Moderate-intensity exercise effectively mitigates AD symptoms in mice, primarily by diminishing neuroinflammation, through the reduction of IGF1R Sumoylation. KPT-330, as a potential alternative to physical exercise, enhances the neuroprotective role of IGF1R by inhibiting SUMOylation through targeting XPO1, presenting a promising therapeutic strategy for AD.

The relationship between serum levels of epidermal growth factor and ß-human chorionic gonadotropin and the type and prognosis of ectopic pregnancy.

PURPOSE: This work aimed to explore the relationship between epidermal growth factor (EGF) and ß-human chorionic gonadotropin (ß-HCG) and ectopic pregnancy types and impact on prognosis. METHODS: Twenty women with normal pregnancies (NPs) were recruited as control group, and twenty women each with tubal pregnancy (TP) and cervical pregnancy (CP) were recruited. Blood samples were collected to detect EGF and ß-HCG. Data on length of hospital stay and incidence of complications were collected. The differences in serum EGF and ß-HCG levels were compared among groups and within various types of ectopic pregnancy using analysis of variance and Pearson correlation analysis. RESULTS: Serum EGF and ß-HCG were notably lower in TP and CP group vs. controls (P < 0.05). In subgroup analysis within the types of ectopic pregnancy, serum EGF levels were drastically higher in TP group vs. CP group (P < 0.05). Serum EGF levels were negatively correlated with pregnancy outcomes and incidence of complications (P < 0.05). In patients with TP and CP, serum EGF and ß-HCG recovery time and hospital stay differed drastically (P < 0.05). Serum EGF and ß-HCG levels showed optimal cutoff values identified at 2.65 µg/L and 11,745.35 IU/L, respectively. The corresponding area under the curve (AUC) values were 0.885 and 0.841. CONCLUSION: Elevated levels of EGF may be associated with the occurrence of ectopic pregnancy and may impact the type of ectopic pregnancy, pregnancy outcomes, and the incidence of complications. Further clinical research is warranted to investigate these findings.

Deep learning nomogram for preoperative distinction between Xanthogranulomatous cholecystitis and gallbladder carcinoma: A novel approach for surgical decision.

The distinction between Xanthogranulomatous Cholecystitis (XGC) and Gallbladder Carcinoma (GBC) is challenging due to their similar imaging features. This study aimed to differentiate between XGC and GBC using a deep learning nomogram model built from contrast enhanced computed tomography (CT) scans. 297 patients were included with confirmed XGC (94) and GBC (203) as the training and internal validation cohort from 2017 to 2021. The deep learning model Resnet-18 with Fourier transformation named FCovResnet18, shows most impressive potential in distinguishing XGC from GBC using 3-phase merged images. The accuracy, precision and area under the curve (AUC) of the model were then calculated. An additional cohort of 74 patients consisting of 22 XGC and 52 GBC patients was enrolled from two subsidiary hospitals as the external validation cohort. The accuracy, precision and AUC achieve 0.98, 0.99, 1.00 in the internal validation cohort and 0.89, 0.92, 0.92 in external validation cohort. A nomogram model combining clinical characteristics and deep learning prediction score showed improved predicting value. Altogether, FCovResnet18 nomogram has demonstrated its ability to effectively differentiate XGC from GBC preoperatively, which significantly aid surgeons in making informed and accurate surgical decisions for XGC and GBC patients.

Graphene quantum dots promote migration and differentiation of periodontal ligament stem cells.

Graphene and its derivatives have attracted much attention as nanomaterials in bone tissue engineering because of their remarkable ability to induce cell osteogenic differentiation. However, graphene quantum dots (GQDs), as graphene derivatives, little is known about their osteodifferentiation- and osteoinduction-promoting capabilities, especially in the restoration of bone defect caused by periodontitis. Therefore, there is a growing need to investigate the effect of GQDs on periodontal ligament stem cells (PDLSCs). Here, we postulated that GQDs are a promising biocompatible nanomaterial that facilitated the migration and differentiation of PDLSCs, and use laboratory methods like CCK-8, transwell experiments, qRT-PCR, Alizarin red staining and immunofluorescence staining to evaluate. Our experiments confirmed that GQDs did not inhibit cell viability, with most cells remaining viable even at GQDs concentrations of up to 30 µg mL-1. Moreover, GQDs were found to significantly enhance PDLSC migration, with the peak effect observed at concentrations of 5 and 10 µg mL-1. Furthermore, GQDs accelerated osteoblastic differentiation in PDLSCs and induced the mineralization of calcium nodules. Additionally, GQDs were shown to promote fibroblast differentiation in PDLSCs compared to the control group. Thus, GQDs not only possessed low cytotoxicity and good biocompatibility, but also displayed the beneficial capability to migration and differentiation of PDLSCs, which indicated GQDs might be a potential nanomaterial for bone regeneration.

Direct detection system for independent triplet-sideband signals based on a single photodiode.

This paper proposes a novel, to the best of our knowledge, independent triplet-single-sideband (triplet-SSB) transmission system scheme aimed at increasing channel capacity and improving spectrum efficiency. The conventional independent multiband transmission systems are limited by their complexity and high computational requirements, which hinder the improvement of spectrum efficiency and channel capacity. To address these challenges, this scheme uses three independent signals, modulated by an in-phase/quadrature (I/Q) modulator, and transmits them over a 5-km standard single-mode fiber (SSMF). At the receiver end, a single photodiode (PD) is used for signal reception, and the signals are separated using digital signal processing (DSP) algorithms. Through simulation and verification, the feasibility and reliability of the system are demonstrated, with the bit error rates (BERs) of all three signals below the hard decision forward error correction (HD-FEC) threshold value of 3.8 × 10-3. This independent triplet-SSB transmission system scheme effectively improves spectrum efficiency and channel capacity, providing a valuable solution for meeting the growing demands of data transmission.

Direct detection system based on a single photodiode receiving the independent quadruple-SSB signal.

We propose and verify a direct detection (DD) system based on a single photodiode (PD) receiving the independent quadruple-single-sideband (quadruple-SSB) signal. At the transmitter side, an I/Q modulator is utilized to modulate the independent quadruple-SSB signal, the signal is received via one PD without optical bandpass filters (OBPFs). Then, the independent quadruple-SSB signal is separated into four sideband signals by subsequent digital signal processing (DSP). In the scheme of back-to-back (BTB), 1-km and 5-km standard single-mode fiber (SSMF) transmission, the four sideband signals are extensively studied and analyzed. The simulation results show that the bit error rate (BER) of 1Gbaud, 2Gbaud and 4Gbaud independent quadruple-SSB signal can reach the 7% hard-decision forward error correction (HD-FEC) threshold of 3.8 × 10-3 when the received optical power (ROP) is -21, -20 and -17.2 dBm in 5-km SSMF transmission. Meanwhile, as the frequency interval gets wider, the crosstalk in the sideband signal reception can be mitigated and the BER decreases. This scheme for the first time demonstrates that the independent quadruple-SSB signal can further expand the system transmission capacity and enhance the spectrum efficiency. Our simplified independent quadruple-SSB signal direct detection system has a simple structure and high spectral efficiency, which will have a promising future in high-speed optical communication.

Graphene quantum dots enhance the osteogenic differentiation of PDLSCs in the inflammatory microenvironment.

BACKGROUND AND OBJECTIVE: Graphene quantum dots (GQDs), a type of carbon-based nanomaterial, have remarkable biological, physical, and chemical properties. This study investigated the biological mechanisms of the proliferation and osteogenic differentiation of human periodontal ligament stem cells (PDLSCs) induced by GQDs in an inflammatory microenvironment. MATERIALS AND METHODS: PDLSCs were cultured in osteogenic-induced medium with various concentrations of GQDs in standard medium or medium mimicking a proinflammatory environment. The effects of GQDs on the proliferation and osteogenic differentiation activity of PDLSCs were tested by CCK-8 assay, Alizarin Red S staining, and qRT‒PCR. In addition, Wnt/ß-catenin signalling pathway-related gene expression was measured by qRT‒PCR. RESULTS: Compared with the control group, the mRNA expression levels of ALP, RUNX2, and OCN and the number of mineralized nodules were all increased in PDLSCs after treatment with GQDs. Moreover, during the osteogenic differentiation of PDLSCs, the expression levels of LRP6 and ß-catenin, which are Wnt/ß-catenin signalling pathway-related genes, were upregulated. CONCLUSION: In the inflammatory microenvironment, GQDs might promote the osteogenic differentiation ability of PDLSCs by activating the Wnt/ß-catenin signalling pathway.

Simplified independent triple-sideband signal generation and transmission scheme based on one I/Q modulator at 0.3-THz.

To meet the ultra-bandwidth high-capacity communication, improve spectral efficiency and reduce the complexity of system structure, we have proposed the independent triple-sideband signal transmission system based on photonics-aided terahertz-wave (THz-wave). In this paper, we demonstrate up to 16-Gbaud independent triple-sideband 16-ary quadrature amplitude modulation (16QAM) signal transmission over 20 km standard single mode fiber (SSMF) at 0.3 THz. At the transmitter, independent triple-sideband 16QAM signals are modulated by an in-phase/quadrature (I/Q) modulator. Carrying independent triple-sideband signals optical carrier coupled with another laser to generate independent triple-sideband terahertz optical signals with a carrier frequency interval of 0.3THz. While at the receiver side, enabled by a photodetector (PD) conversion, we successfully obtain independent triple-sideband terahertz signals with a frequency of 0.3THz. Then we employ a local oscillator (LO) to drive mixer to generate intermediate frequency (IF) signal, and only one ADC is used to sample independent triple-sideband signals, digital signal processing (DSP) is finally performed to obtain independent triple-sideband signals. In this scheme, independent triple-sideband 16QAM signals is delivered over 20 km SSMF under the bit error ratio (BER) of 7% hard-decision forward-error-correction (HD-FEC) threshold of 3.8 × 10-3. Our simulation results show that the independent triple-sideband signal can further improve THz system transmission capacity and spectral efficiency. Our simplified independent triple-sideband THz system has a simple structure, high spectral efficiency, and reduced bandwidth requirements for DAC and ADC, which is a promising solution for future high-speed optical communications.

Study on the process of cardiomyocyte apoptosis after pulsed field ablation.

Background: The development of pulsed field ablation (PFA) as a new technique for pulmonary vein isolation (PVI) has been advancing rapidly in recent years. My team's previous work has shown the safety and long-term efficacy of bipolar asymmetric pulses in animal experiments. However, in ongoing clinical trials, we have observed that atrial fibrillation (AF) recurs in some patients after surgery, but the rhythm returns to normal without surgical intervention after seven days, and there is no recurrence in the follow-up.Based on this observation, we have proposed the hypothesis that myocardial cell apoptosis may play a role in AF recurrence after PFA. Our team has designed animal experiments to verify this hypothesis and further investigate the process of PFA-induced cardiomyocyte apoptosis. Methods: Pulse field ablation was performed on 15 dogs and the animals were dissected at various time points after the operation (immediately, 3 days, 7 days, 30 days, and 150 days). To obtain ablation voltage maps, electroanatomic mapping was performed before and after ablation and before dissection. The ablation area was also subjected to HE and TUNEL staining to analyze apoptosis and pathological results. Results: The edge area of the ablation in the pulmonary vein (PV) demonstrated continuous dynamic changes from 0 to 2 h after the operation and a slight expansion of the ablation range was observed in the long-term follow-up. Myocardial intima hyperplasia was observed from 0 to 7 days. Local apoptosis was detected from 0 to 2 h and massive, concentrated apoptosis was observed at 3 days. No recurrence of apoptosis was seen at 7 days, 30 days, and 150 days. Conclusions: The results of this study showed that after pulse field ablation (PFA), the central ablation area of the canine heart experienced immediate cardiomyocyte death. Meanwhile, cardiomyocytes in the edge ablation area underwent apoptosis, which began from 0 to 2 h post-operation and ended between 3 and 7 days. This process occurred simultaneously with intimal thickening.In the long-term follow-up group, there was no recovery of isolation and no recurrence of cardiomyocyte apoptosis, and no change was observed in the endomyocardial intima.

MVI-TR: A Transformer-Based Deep Learning Model with Contrast-Enhanced CT for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma.

In this study, we considered preoperative prediction of microvascular invasion (MVI) status with deep learning (DL) models for patients with early-stage hepatocellular carcinoma (HCC) (tumor size ≤ 5 cm). Two types of DL models based only on venous phase (VP) of contrast-enhanced computed tomography (CECT) were constructed and validated. From our hospital (First Affiliated Hospital of Zhejiang University, Zhejiang, P.R. China), 559 patients, who had histopathological confirmed MVI status, participated in this study. All preoperative CECT were collected, and the patients were randomly divided into training and validation cohorts at a ratio of 4:1. We proposed a novel transformer-based end-to-end DL model, named MVI-TR, which is a supervised learning method. MVI-TR can capture features automatically from radiomics and perform MVI preoperative assessments. In addition, a popular self-supervised learning method, the contrastive learning model, and the widely used residual networks (ResNets family) were constructed for fair comparisons. With an accuracy of 99.1%, a precision of 99.3%, an area under the curve (AUC) of 0.98, a recalling rate of 98.8%, and an F1-score of 99.1% in the training cohort, MVI-TR achieved superior outcomes. Additionally, the validation cohort's MVI status prediction had the best accuracy (97.2%), precision (97.3%), AUC (0.935), recalling rate (93.1%), and F1-score (95.2%). MVI-TR outperformed other models for predicting MVI status, and showed great preoperative predictive value for early-stage HCC patients.

Predicting insomnia severity using structure-function coupling in female chronic insomnia patients.

Functional connectivity between brain regions is constrained by the underlying structural pathways. However, how this structure-function coupling is disrupted in female patients with insomnia disorder is unclear. This study examines if the whole-brain pattern of structure-function coupling could be used to predict unseen female patients' insomnia severity index. Resting-state functional MRI and diffusion-weighted imaging were performed in 82 female participants with chronic insomnia. Structure-function coupling was computed using the Spearman rank correlations between structural and functional connectivity profiles. Using relevance vector regression approach and 10-fold cross-validation, we predicted the individuals' insomnia severity index using the pattern of whole-brain structure-function coupling. Finally, we extracted the contribution of each regional coupling to the prediction model. The pattern of structure-function coupling could be used to significantly predict unseen individuals' insomnia severity index scores (r = 0.29, permutation P < 0.001; mean absolute error (MAE) = 4.59, permutation P < 0.001). Moreover, the brain regions with high functional hierarchy, including regions in the default mode network, mainly displayed negative contribution weights, while the regions with lower functional hierarchy, including occipital regions and the precentral gyrus, mainly displayed positive contribution weights. This is the first study to demonstrate an association between structure-function coupling and the insomnia severity index in females with insomnia disorder. Importantly, our data suggest that insomnia severity is associated with a reduction in structure-function coupling in higher-order brain regions and an increase in structure-function coupling in lower-order brain regions.

Catheter ablation of idiopathic left fascicular ventricular tachycardia: Implications of false tendons for mapping and ablation.

INTRODUCTION: The anatomical substrate for idiopathic left ventricular tachycardia (ILVT) remains speculative. Purkinje networks surrounding false tendons (FTs) might be involved in the reentrant circuit of ILVT. The objective was to evaluate the anatomical and electrophysiological features of false tendons FTs in relation to ILVT. METHODS: Intracardiac echocardiography (ICE) was conducted on patients with ILVT. The relationship of the FTs with ILVT was determined using electro-anatomical mapping. RESULTS: Electrophysiological evaluation and radiofrequency ablation were conducted in 23 consecutive patients with ILVT. FTs were identified in 19/23 cases (82.6%) with P1 potentials during VT recorded at the FT in 14 of these patients (73.7%). Three FT types were identified. In type 1, the FT attached the septum to the base of the posteromedial papillary muscle (PPM) (4/19); type 2 FTs ran between the septum and the PPM apex (3/19), while in type 3, the connection occurred between the septum and apex (11/19) or between the septum and the LV free wall (1/19). The effective ILVT ablation sites were situated at the FT-PPM (3/19) and the FT-septum (16/19) attachment sites. CONCLUSIONS: This series demonstrates the association between Purkinje fibers and FTs during catheter ablation of ILVT and verifies that left ventricular FTs are an important substrate in this type of tachycardia.

Deep learning and radiomics based automatic diagnosis of hippocampal sclerosis.

Accurate and rapid segmentation of the hippocampus can help doctors perform intractable temporal lobe epilepsy (TLE) preoperative evaluations to identify good surgical candidates. This study aims to establish a radiomics system for the automatic diagnosis of hippocampal sclerosis with the help of machine learning. A total of 240 cases were analysed to develop a diagnostic model. First, an automatic hippocampal segmentation process was established that exploits a priori knowledge of the relatively fixed location of the hippocampus in brain partitions, as well as a deep-learning segmentation network based on an Attention U-net. Then, we extracted 527 radiomics features from each side of the segmented hippocampus. The iterative sparse representation based on feature selection and a support vector machine classifier were finally used to establish the diagnostic model of hippocampal sclerosis. The diagnostic model consists of two consecutive steps: distinguish hippocampal sclerosis (HS) from normal control (NC) and detect whether the HS is located on the left or right side. When the automatic diagnosis model identified HS and NC, the sensitivity and specificity reached 0.941 and 0.917 in the 10-fold cross-validation set and 0.920 and 0.909 in the independent testing set. When the diagnostic model detected HS lateralization, the sensitivity and specificity reached 0.923 and 0.920 in cross-validation and 0.909 and 0.929 in independent testing. Our results show that the developed radiomics model can help detect TLE patients with hippocampal sclerosis and has the potential to simplify preoperative evaluations and select surgical candidates.

Clinical characteristics and long-term outcomes of 12 children with vitamin D-dependent rickets type 1A: A retrospective study.

Purpose: Vitamin D-dependent rickets type 1A (VDDR1A) is a rare autosomal recessive disorder caused by deficiency of the CYP27B1 gene. This study aims to investigate the phenotypic and genotypic features of VDDR1A children in southern China and evaluate the long-term therapeutic effects. Methods: Twelve children from southern China with VDDR1A were enrolled in this study. Their clinical, radiological, biochemical, and molecular findings were analyzed retrospectively. The rickets severity score (RSS), biochemical parameters, and height standard deviation score (HtSDS) were used to evaluate clinical outcomes. Results: Six males and six females were included in this VDDR1A cohort. The age of onset was from 6 months to 1.8 years, and the age at diagnosis was 2.1 ± 0.8 years. The most common clinical symptoms at diagnosis were delayed walking (10/12) and severe growth retardation (9/12). HtSDS at diagnosis was negatively associated with age (p < 0.05). All patients presented with hypocalcemia, hypophosphatemia, increased serum alkaline phosphatase and parathyroid hormone, and high RSS at diagnosis. Two allelic variants of the CYP27B1 gene were identified in all patients, including nine different variants, four known and five novel, with c.1319_1325dupCCCACCC(p.Phe443Profs*24) being the most frequent. All patients were treated with calcitriol and calcium after diagnosis, and all patients but one were followed-up from 6 months to 15.6 years. HtSDS, RSS, and biochemical parameters were found to be improved during the first few years of the treatment. However, only five patients had good compliance. Although RSS and biochemical parameters were significantly improved, the HtSDS change was not significant from the time of diagnosis to the last visit, and seven patients remained of a short stature (HtSDS < -2). Conclusion: Our study extends the mutational spectrum of VDDR1A and finds a hotspot variant of the CYP27B1 gene in southern China. The results reconfirm the importance of early diagnosis and treatment compliance and reveal the challenge of height improvement in VDDR1A patients.

Synthesis of a GS-16QAM signal for a simplified optical ISB system and direct detection with the K-means clustering algorithm.

An independent sideband (ISB) is a promising scheme for short-reach and metro applications because of its high spectral efficiency, low complexity, and tolerance to chromatic dispersion. Here, we develop a signal synthesis scheme to further reduce the complexity of ISB direct-detection (DD) systems. Two lower-order quadrature amplitude modulation (QAM) sideband signals are generated digitally, then the left sideband (LSB) and right sideband (RSB) are modulated with regular quadrature phase shift keying (QPSK) and geometrically shaped shifted QPSK (GS-S-QPSK), respectively. Then, the two independent sideband signals are received in a single photodiode to synthesize a GS-16QAM signal. The LSB and RSB signals can be separated and demodulated by a digital signal process (DSP) instead of using two optical bandpass filters. The proposed scheme significantly reduces the complexity of the ISB-DD receiver, thus saving system cost. Three different GS-S-QPSK signals are evaluated, with the square GS-S-QPSK achieving the best bit error rate (BER) with its optimal shaping factor. Considering signal-signal beating interference, a sub-blind K-means clustering algorithm is used to improve the BER performance, and the results indicate that it can achieve a large received optical power (ROP) gain at a threshold of 3.8 × 10-3.

Independent dual-single sideband lower-IF RF receiver based on a single photodetector.

The two sidebands of the independent dual-single-sideband (dual-SSB) signal can carry different information, which achieves higher spectral efficiency and system capacity. However, the receiver divides the signal into two channels, so a pair of optical bandpass filters (OBPFs) and photodetectors (PDs) are generally required to select and detect an independent dual-SSB signal. To reduce the complexity and cost of the receiver, we propose an independent dual-SSB lower intermediate frequency (IF) radio frequency (RF) signal detection scheme based on a single PD combined with conventional digital signal processing (DSP). A theoretical analysis is presented and validated by a simulation. The left sideband (LSB) and the right sideband (RSB) are quadrature phase-shift keying (QPSK) modulated. After 50-km standard single-mode fiber (SSMF) transmission, a 10-Gbps 16QAM signal is synthesized from 2 × 5-Gbps dual-SSB QPSK and the independent dual-SSB is extracted by DSP. The bit error rate (BER) of the dual-SSB (LSB and RSB) is below the hard-decision forward-error-correction (HD-FEC) threshold of 3.8 × 10-3.

Optical Polarization Division Multiplexing Transmission System Based on Simplified Twin-SSB Modulation.

Optical twin-single sideband (Twin-SSB) modulation, due to the left sideband (LSB) and right sideband (RSB) signal carrying individual data, has become an attractive technique in fiber transmission because it satisfies the demand of the explosive increase in data traffic. This paper focuses on reducing the complexity of Twin-SSB system and further enhancing the spectral efficiency by proposing a polarization division multiplexing (PDM) Twin-SSB modulation scheme. LSB and RSB signals are extracted using de-mapping algorithm instead of optical bandpass filters (OBPFs) to reduce system complexity. To further improve spectral efficiency, PDM is employed to meet the polarization multiplexing transmission and achieve a higher transmission capacity. Based on the PDM Twin-SSB system, the LSB is 3-arr phase-shift-keying (3PSK) modulated, while RSB is quadrature phase-shift keying (QPSK) modulated. We simulated that the bit error ratio (BER) performance of LSB and RSB of X-polarization (X-Pol) and Y-polarization (Y-Pol) at 8-Gbaud, 10-Gbaud, 12-Gbaud, 14-Gbaud, and 16-Gbaud in the case of back-to-back (BTB) and 2 km standard single-mode fiber (SSMF) transmission. The simulation results verify the effectiveness and practical feasibility of the proposed PDM Twin-SSB scheme for future short-distance transmission owing to low cost, simplified structure, low algorithm complexity, and high data transmission capacity.

Surgery for Epilepsy Involving Rolandic and Perirolandic Cortex: A Case Series Assessing Complications and Efficacy.

BACKGROUND: Surgical removal of lesions around the rolandic cortex remains a challenge for neurosurgeons owing to the high risk of neurological deficits. Evaluating the risk factors associated with motor deficits after surgery in this region may help reduce the occurrence of motor deficits. OBJECTIVE: To report our surgical experience in treating epileptic lesions involving the rolandic and perirolandic cortices. METHODS: We performed a single-center retrospective review of patients undergoing epilepsy surgeries with lesions located in the rolandic and perirolandic cortices. Patients with detailed follow-up information were included. The lesion locations, resected regions, and invasive exploration techniques were studied to assess their relationship with postoperative motor deficits. RESULTS: Forty-one patients were included. Twenty-three patients suffered from a transient motor deficit, and 2 had permanent disabilities after surgery. Six patients with lesions at the posterior bank of the precentral sulcus underwent resection, and 5 experienced short-term motor deficits. Two patients with lesions adjacent to the anterior part of the precentral gyrus, in whom the adjacent precentral gyrus was removed, experienced permanent motor deficits. Lesions located at the bottom of the central sulcus and invading the anterior bank of the central sulcus were observed in 3 patients. The patients did not experience permanent motor deficits after surgery. CONCLUSION: The anterior bank of the central sulcus is indispensable for motor function, and destruction of this region would inevitably cause motor deficits. The anterior bank of the precentral gyrus can also be removed without motor impairment if there is a preexisting epileptogenic lesion.

Comparison of Lamotrigine and Oxcarbazepine Monotherapy Among Chinese Adult Patients With Newly-Diagnosed Focal-Onset Epilepsy: A Prospective Observational Study.

Objective: We performed a prospective cohort study to compare the efficacy, safety, effect on mood, and quality of life between lamotrigine (LTG) and oxcarbazepine (OXC) monotherapy among Chinese adult patients with newly-diagnosed focal-onset epilepsy (FOE) with or without secondarily generalized tonic-clonic seizures. Methods: We enrolled 106 adult patients with new-onset FOE, of whom 56 were in the OXC group and 50 in the LTG group. Their clinical characteristics were detailly recorded especially basic seizure frequency, seizure types, and drug-related adverse events. Efficacy was evaluated as seizure-free (no seizure for 6 months), effective (seizure reduction by more than 50%), and ineffective (seizure reduction by less than 50%). Both intention-to-treat and per-protocol analyses were performed. We also assessed their mood state with the Zung Self-rating Scale for anxiety (Z-SAS) and Zung Self-rating Scale for Depression (Z-SDS) and quality of life (QOL) with Quality of Life in Epilepsy (QOLIE-31) at their baseline visit, 3-month visits, and 6-month visit. Intra-group comparisons in each group and inter-group comparisons between the two groups were made. Correlation analysis and multiple regression analysis were also conducted. Results: Except for gender, the two groups were well matched in any other characteristics such as primary seizure frequency and seizure types. In terms of efficacy, 33 patients in the OXC group were evaluated as seizure-free and 15 as effective, while in the LTG group, 31 were seizure-free, and nine were effective. No significant differences could be observed in efficacy between the two groups (P = 0.429). Through multiple logistic regression analysis, we found that OXC monotherapy was more likely to predict a seizure-free state (OR = 1.76) than LTG, but the difference didn't reach statistical significance (P = 0.322) after correcting for other clinical variables. Both groups had adverse events such as fatigue, drowsiness, dizziness, rash, and gastrointestinal discomfort, most of which were mild and transient. In the OXC group, the scores of SAS (P = 0.067) and SDS (P = 0.004) reduced at the 6-month visit, while the score of QOLIE-31 significantly increased (P = 0.001). In the LTG group, a significant decrease in SAS and SDS scores and an increase in QOLIE-31 scores could be witnessed (All P < 0.001). The inter-group comparison showed that improvement of SAS and SDS in the LTG group was more evident than that in the OXC group, which was of statistical significance. Correlational analysis indicated that the improvement of mood and life quality scales in both groups was independent of baseline seizure frequency and treatment efficacy. Multiple linear regression analysis indicated that LTG monotherapy was the only independent factor that could predict a better SAS (P = 0.01) and SDS (P = 0.019) outcome. Conclusions: OXC and LTG are effective as monotherapy and can be considered first-line selection among adult patients with new-onset FOE. Most adverse events are mild, transient, and tolerable. The two drugs improve the mood state of patients, though LTG is superior to OXC in this respect. OXC and LTG have great power in enhancing patients' quality of life. The positive effect on the psychosocial well-being of epilepsy patients may be one of the intrinsic pharmacological properties of LTG and OXC.