Interplay between myotubularins and Ca2+ homeostasis.

The myotubularin family, encompassing myotubularin 1 (MTM1) and 14 myotubularin-related proteins (MTMRs), represents a conserved group of phosphatases featuring a protein tyrosine phosphatase domain. Nine members are characterized by an active phosphatase domain C(X)5R, dephosphorylating the D3 position of PtdIns(3)P and PtdIns(3,5)P2. Mutations in myotubularin genes result in human myopathies, and several neuropathies including X-linked myotubular myopathy and Charcot-Marie-Tooth type 4B. MTM1, MTMR6 and MTMR14 also contribute to Ca2+ signaling and Ca2+ homeostasis that play a key role in many MTM-dependent myopathies and neuropathies. Here we explore the evolving roles of MTM1/MTMRs, unveiling their influence on critical aspects of Ca2+ signaling pathways.

Humidity-tolerant and highly sensitive gas sensor for hydrogen sulfide based on WO3 nanocubes modified with CeO2.

The influence of ambient humidity on the gas-sensing characteristics of metal oxide semiconductors has been one of the greatest obstacles for gas-sensing applications. In this paper, the pure WO3 and CeO2-modified WO3 nanocubes were prepared by a simple hydrothermal method, and their gas-sensing characteristics in dry and humid atmospheres were investigated. The results show that CeO2/WO3 demonstrated excellent gas-sensing properties toward H2S with high sensitivity and high selectivity at 115 °C. Noteworthy, the humidity independence of the CeO2/WO3 increased compared to the WO3. The response retentions over the whole humidity range of the CeO2/WO3-6 and CeO2/WO3-15 sensors were 70.3, and 76%, respectively, which were much higher than the WO3 sensor (17.9%). The gas-sensing mechanism of CeO2-modified WO3 is discussed based on the gas sensitivity properties. The obtained results provide a promising route to enhance the anti-humidity properties of metal oxide semiconductor gas sensors.

A high-performance room-temperature NH3 gas sensor based on WO3/TiO2 nanocrystals decorated with Pt NPs.

In this work, a high-performance room-temperature ammonia (NH3) gas sensor based on Pt-modified WO3-TiO2 nanocrystals was synthesized via a two-step hydrothermal method. The structural properties were characterized by scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy. The 10 at% Pt@WO3-TiO2 nanocrystals present the highest NH3 sensing performance at room temperature. Compared with the nanocrystals without Pt modification, the sensitivity of the Pt@WO3-TiO2 sensor is tenfold higher, with the lowest concentration threshold reaching the 75 ppb level. The response is approximately 92.28 to 50 ppm, and response and recovery times are 23 s and 8 s, respectively. The improved sensing was attributed to a synergetic mechanism involving the space charge layer effect and Pt metal sensitization, enhancing the electron transfer efficiency, oxygen vacancy and specific surface area. This study is expected to guide the development of high-performance room-temperature ammonia sensors for clinical breath testing.

Vonoprazan 10 mg or 20 mg vs. lansoprazole 15 mg as maintenance therapy in Asian patients with healed erosive esophagitis: A randomized controlled trial.

BACKGROUND: Erosive esophagitis (EE) is a gastroesophageal reflux disease characterized by mucosal breaks in the esophagus. Proton pump inhibitors are widely used as maintenance therapy for EE, but many patients still relapse. In this trial, we evaluated the noninferiority of vonoprazan vs. lansoprazole as maintenance therapy in patients with healed EE. METHODS: We performed a double-blind, double-dummy, multicenter, phase 3 clinical trial among non-Japanese Asian adults with endoscopically confirmed healed EE from April 2015 to February 2019. Patients from China, South Korea, and Malaysia were randomized to vonoprazan 10 mg or 20 mg once daily or lansoprazole 15 mg once daily for 24 weeks. The primary endpoint was endoscopically confirmed EE recurrence rate over 24 weeks with a noninferiority margin of 10% using a two-sided 95% confidence interval (CI). Treatment-emergent adverse events (TEAEs) were recorded. RESULTS: Among 703 patients, EE recurrence was observed in 24/181 (13.3%) and 21/171 (12.3%) patients receiving vonoprazan 10 mg or 20 mg, respectively, and 47/184 (25.5%) patients receiving lansoprazole (differences: -12.3% [95% CI, -20.3% to -4.3%] and -13.3% [95% CI, -21.3% to -5.3%], respectively), meeting the primary endpoint of noninferiority to lansoprazole in preventing EE recurrence at 24 weeks. Evidence of superiority (upper bound of 95% CI <0%) was also observed. At 12 weeks, endoscopically confirmed EE recurrence was observed in 5/18, 2/20, and 7/20 of patients receiving vonoprazan 10 mg, vonoprazan 20 mg, and lansoprazole, respectively. TEAEs were experienced by 66.8% (157/235), 69.0% (156/226), and 65.3% (158/242) of patients receiving vonoprazan 10 mg, vonoprazan 20 mg, and lansoprazole, respectively. The most common TEAE was upper respiratory tract infection in 12.8% (30/235) and 12.8% (29/226) patients in vonoprazan 10 mg and 20 mg groups, respectively and 8.7% (21/242) patients in lansoprazole group. CONCLUSION: Vonoprazan maintenance therapy was well-tolerated and noninferior to lansoprazole for preventing EE recurrence in Asian patients with healed EE. TRIAL REGISTRATION: https://clinicaltrials.gov; NCT02388737.

Self-assembling peptide hydrogel scaffold integrating stem cell-derived exosomes for infected bone defects.

Infected bone defect (IBD) is a great challenge in orthopedics, which involves in bone loss and infection. Here, a self-assembling hydrogel scaffold (named AMP-RAD/EXO), integrating antimicrobial peptides(AMPs), RADA16 and BMSCs exosomes with an innovative strategy, is developed and applied in IBD treatment for sustained antimicrobial ability, accelerating osteoblasts proliferation and promoting bone regeneration. AMPs present an excellent ability to inhibit infection, RADA16 is a self-assembling peptide hydrogel for AMPs delivery, and BMSCs exosomes can promote the bone regeneration. The prepared AMP-RAD/EXO exhibited a polyporous 3D structure for imbibition of BMSCs exosomes and migration of osteoblasts. In vitro studies indicate AMP-RAD/EXO can inhibit the growth of Staphylococcus aureus, accelerate the proliferation and migration of BMSCs. More importantly, in vivo results also prove that AMP-RAD/EXO exhibit an excellent effect on IBD treatment. Thus, the prepared AMP-RAD/EXO provides a multifunctional scaffold concept for bone tissue engineering technology.

Heterojunctions of Mercury Selenide Quantum Dots and Halide Perovskites with High Lattice Matching and Their Photodetection Properties.

Heterojunction semiconductors have been extensively applied in various optoelectronic devices due to their unique carrier transport characteristics. However, it is still a challenge to construct heterojunctions based on colloidal quantum dots (CQDs) due to stress and lattice mismatch. Herein, HgSe/CsPbBrxI3-x heterojunctions with type I band alignment are acquired that are derived from minor lattice mismatch (~1.5%) via tuning the ratio of Br and I in halide perovskite. Meanwhile, HgSe CQDs with oleylamine ligands can been exchanged with a halide perovskite precursor, acquiring a smooth and compact quantum dot film. The photoconductive detector based on HgSe/CsPbBrxI3-x heterojunction presents a distinct photoelectric response under an incident light of 630 nm. The work provides a promising strategy to construct CQD-based heterojunctions, simultaneously achieving inorganic ligand exchange, which paves the way to obtain high-performance photodetectors based on CQD heterojunction films.

MRI quantitative assessment of the effects of low-carbohydrate therapy on Hashimoto's thyroiditis.

Objective: Hashimoto's thyroiditis is an inflammatory disease, and research suggests that a low-carbohydrate diet may have potential anti-inflammatory effects. This study aims to utilize Dixon-T2-weighted imaging (WI) sequence for a semi-quantitative assessment of the impact of a low-carbohydrate diet on the degree of thyroid inflammation in patients with Hashimoto's thyroiditis. Methods: Forty patients with Hashimoto's thyroiditis were recruited for this study and randomly divided into two groups: one with a normal diet and the other with a low-carbohydrate diet. Antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) were measured for all participants. Additionally, thyroid water content was semi-quantitatively measured using Dixon-T2WI. The same tests and measurements were repeated for all participants after 6 months. Results: After 6 months of a low-carbohydrate diet, patients with Hashimoto's thyroiditis showed a significant reduction in thyroid water content (94.84 ± 1.57% vs 93.07 ± 2.05%, P < 0.05). Concurrently, a decrease was observed in levels of TPOAb and TgAb (TPOAb: 211.30 (92.63-614.62) vs 89.45 (15.9-215.67); TgAb: 17.05 (1.47-81.64) vs 4.1 (0.51-19.42), P < 0.05). In contrast, there were no significant differences in thyroid water content or TPOAb and TgAb levels for patients with Hashimoto's thyroiditis following a normal diet after 6 months (P < 0.05). Conclusion: Dixon-T2WI can quantitatively assess the degree of thyroid inflammation in patients with Hashimoto's thyroiditis. Following a low-carbohydrate diet intervention, there is a significant reduction in thyroid water content and a decrease in levels of TPOAb and TgAb. These results suggest that a low-carbohydrate diet may help alleviate inflammation in patients with Hashimoto's thyroiditis.

Efficient markerless genetic manipulation of Pasteurella multocida using lacZ and pheSm as selection markers.

Pasteurella multocida is a zoonotic conditional pathogen that infects multiple livestock species, causing substantial economic losses in the animal husbandry industry. An efficient markerless method for gene manipulation may facilitate the investigations of P. multocida gene function and pathogenesis of P. multocida. Herein, a temperature-sensitive shuttle vector was constructed using lacZ as a selection marker, and markerless glgB, opa, and hyaE mutants of P. multocida were subsequently constructed through blue-white colony screening. The screening efficiency of markerless deletion strains was improved by the lacZ system, and the method could be used for multiple gene deletions. However, the fur mutant was unavailable via this method. Therefore, we constructed a pheSm screening system based on mutated phenylalanine tRNA synthetase as a counterselection marker to achieve fur deletion mutant. The transformed strain was sensitive to 20 mM p-chloro-phenylalanine, demonstrating the feasibility of pheSm as a counter-selective marker. The pheSm system was used for markerless deletions of glgB, opa, and hyaE as well as fur that could not be screened by the lacZ system. A comparison of screening efficiencies of the system showed that the pheSm counterselection system was more efficient than the lacZ system and broadly applicable for mutant screening. The methods developed herein may provide valuable tools for genetic manipulation of P. multocida.IMPORTANCEPasteurella multocida is a highly contagious zoonotic pathogen. An understanding of its underlying pathogenic mechanisms is of considerable importance and requires efficient species-specific genetic tools. Herein, we propose a screening system for P. multocida mutants using lacZ or pheSm screening markers. We evaluated the efficiencies of both systems, which were used to achieve markerless deletion of multiple genes. The results of this study support the use of lacZ or pheSm as counterselection markers to improve counterselection efficiency in P. multocida. This study provides an effective genetic tool for investigations of the virulence gene functions and pathogenic mechanisms of P. multocida.

Psychological factors may affect the quality of life in irritable bowel syndrome patients more than the gut itself? A multicenter cross-sectional study.

Background and Aim: Both intestinal symptoms and comorbidities exist in irritable bowel syndrome (IBS) patients and influence their quality of life (QOL). More research is needed to determine how these variables impact the QOL of IBS patients. This study aimed to determine which specific factors had a higher influence on QOL and to further compare the effects of intestinal symptoms and comorbidities on QOL. Methods: IBS patients were recruited from six tertiary hospitals in different regions of China. QOL, gastrointestinal symptoms, and comorbidities were assessed by different scales. Correlation analysis, multiple linear regression, and mediation model were used for statistics. Results: Four hundred fifty-three IBS patients (39.7% women, mean age 45 years) were included and no significant differences in QOL were found across demographic characteristics. Abnormal defecation (r = -0.398), fatigue (r = -0.266), and weakness (r = -0.286) were found to show higher correlation with QOL. More than 40% of IBS patients were found to suffer from varying degrees of anxiety or depression, and anxiety (r = -0.564) and depression (r = -0.411) were significantly negatively correlated with QOL (P < 0.001). Psychological factors showed the strongest impact (ß' = -0.451) and play a strong mediating role in the impact of physiological symptoms on QOL. Anxiety was found to be the strongest factor (ß' = -0.421). Conclusion: Compared with other symptoms, psychological symptoms, particularly anxiety, are more common and have a more negative influence on QOL. The QOL of IBS patients is also significantly impacted by abnormal defecation, abdominal distension, and systemic extraintestinal somatic symptoms. In the treatment of IBS patients with unhealthy mental status, psychotherapy might be prioritized.

Global research trends in tongue cancer from 2000 to 2022: bibliometric and visualized analysis.

OBJECTIVES: This study conducts a systematic bibliometric analysis of tongue cancer publications to identify key topics, hotspots, and research distribution. METHODS: We analyzed tongue cancer publications in the Web of Science core collection database, assessing their quantity and quality. We investigated contributors, including countries, affiliations, journals, authors, and categories, within collaborative networks. Additionally, we synthesized key research findings using various analytical techniques, such as alluvial flow, burstness analysis, cluster analysis, co-occurrence network of associations, and network layer overlay. RESULTS: From 2000 to 2022, this bibliometric study covers 2205 articles and reviews across 617 journals, involving 72 countries, 2233 institutions, and 11,266 authors. It shows consistent growth, particularly in 2016. Key contributors include China (499 publications), Karolinska Institute (84 publications), Oral Oncology (144 publications), and Tuula Salo (47 publications). Other notable contributors are the USA (16,747 citations), the National Cancer Institute (NCI) (2597 citations), and the Memorial Sloan-Kettering Cancer Center (MSK) (2231 citations). Additionally, there are significant teams led by Tuula Salo and Dalianis. We have identified six primary clusters: #0 apoptosis, #1 depth of invasion, #2 radiotherapy, #3 hpv, #4 tongue cancer, #5 oral cancer. The top ten highly cited documents primarily pertain to epidemiology, prognostic indicators in early-stage oral tongue cancer, and HPV. Additionally, we observed 16 reference clusters, with depth of invasion (#3), young patients (#4), and tumor budding (#6) gaining prominence since 2012, indicating sustained research interests. CONCLUSIONS: This analysis emphasizes the increasing scholarly interest in tongue cancer research. The bibliometric evaluation highlights pivotal recent research themes such as HPV, depth of invasion, tumor budding, and surgical margins. CLINICAL RELEVANCE: The bibliometric analysis highlights the key topics and studies which have shaped the understanding and management of tongue cancer.

Black Arsenic Phosphorus Mid-Wave Infrared Barrier Detector with High Detectivity at Room Temperature.

The barrier structure is designed to enhance the operating temperature of the infrared detector, thereby improving the efficiency of collecting photogenerated carriers and reducing dark current generation, without suppressing the photocurrent. However, the development of barrier detectors using conventional materials is limited due to the strict requirements for lattice and band matching. In this study, a high-performance unipolar barrier detector is designed utilizing a black arsenic phosphorus/molybdenum disulfide/black phosphorus van der Waals heterojunction. The device exhibits a broad response bandwidth ranging from visible light to mid-wave infrared (520 nm to 4.6 µm), with a blackbody detectivity of 2.7 × 1010 cmHz-1/2 W-1 in the mid-wave infrared range at room temperature. Moreover, the optical absorption anisotropy of black arsenic phosphorus enables polarization resolution detection, achieving a polarization extinction ratio of 35.5 at 4.6 µm. Mid-wave infrared imaging of the device is successfully demonstrated at room temperature, highlighting the significant potential of barrier devices based on van der Waals heterojunctions in mid-wave infrared detection.

Research on the Algorithm of Position Correction for High-Speed Moving Express Packages Based on Traditional Vision and AI Vision.

The rapid development of the logistics industry poses significant challenges to the sorting work within this sector. The fast and precise identification of moving express parcels holds immense significance for the performance of logistics sorting systems. This paper proposes a motion express parcel positioning algorithm that combines traditional vision and AI-based vision. In the traditional vision aspect, we employ a brightness-based traditional visual parcel detection algorithm. In the AI vision aspect, we introduce a Convolutional Block Attention Module (CBAM) and Focal-EIoU to enhance YOLOv5, improving the model's recall rate and robustness. Additionally, we adopt an Optimal Transport Assignment (OTA) label assignment strategy to provide a training dataset based on global optimality for the model training phase. Our experimental results demonstrate that our modified AI model surpasses traditional algorithms in both parcel recognition accuracy and inference speed. The combined approach of traditional vision and AI vision in the motion express parcel positioning algorithm proves applicable for practical logistics sorting systems.

M6A modification regulates tumor suppressor DIRAS1 expression in cervical cancer cells.

DIRAS family GTPase 1 (DIRAS1) has been reported as a potential tumor suppressor in other human cancer. However, its expression pattern and role in cervical cancer remain unknown. Knockdown of DIRAS1 significantly promoted the proliferation, growth, migration, and invasion of C33A and SiHa cells cultured in vitro. Overexpression of DIRAS1 significantly inhibited the viability and motility of C33A and SiHa cells. Compared with normal cervical tissues, DIRAS1 mRNA levels were significantly lower in cervical cancer tissues. DIRAS1 protein expression was also significantly reduced in cervical cancer tissues compared with para-cancerous tissues. In addition, DIRAS1 expression level in tumor tissues was significantly negatively correlated with the pathological grades of cervical cancer patients. DNA methylation inhibitor (5-Azacytidine) and histone deacetylation inhibitor (SAHA) resulted in a significant increase in DIRAS1 mRNA levels in C33A and SiHa cells, but did not affect DIRAS1 protein levels. FTO inhibitor (FB23-2) significantly down-regulated intracellular DIRAS1 mRNA levels, but significantly up-regulated DIRAS1 protein levels. Moreover, the down-regulation of METTL3 and METTL14 expression significantly inhibited DIRAS1 protein expression, whereas the down-regulation of FTO and ALKBH5 expression significantly increased DIRAS1 protein expression. In conclusion, DIRAS1 exerts a significant anti-oncogenic function and its expression is significantly downregulated in cervical cancer cells. The m6A modification may be a key mechanism to regulate DIRAS1 mRNA stability and protein translation efficiency in cervical cancer.

Exploring Non-Toxic Lower Dimensional Perovskites for Next-Generation X-Ray Detectors.

Owing to their extraordinary photophysical properties, organometal halide perovskites are emerging as a new material class for X-ray detection. However, the existence of toxic lead makes their commercialization questionable and should readily be replaced. Accordingly, several lead alternatives have been introduced into the framework of conventional perovskites, resulting in various new perovskite dimensionalities. Among these, Pb-free lower dimensional perovskites (LPVKs) not only show promising X-ray detecting properties due to their higher ionic migration energy, wider and tunable energy bandgap, smaller dark currents, and structural versatility but also exhibit extended environmental stability. Herein, first, the structural organization of the PVKs (including LPVKs) is summarized. In the context of X-ray detectors (XDs), the outstanding properties of the LPVKs and active layer synthesis routes are elaborated afterward. Subsequently, their applications in direct XDs are extensively discussed and the device performance, in terms of the synthesis method, device architecture, active layer size, figure of merits, and device stability are tabulated. Finally, the review is concluded with an in-depth outlook, thoroughly exploring the present challenges to LPVKs XDs, proposing innovative solutions, and future directions. This review provides valuable insights into optimizing non-toxic Pb-free perovskite XDs, paving the way for future advancements in the field.

Characteristics and Risk Factors of Functional Dyspepsia Fulfilling the Rome IV Criteria Overlapping With Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, and Functional Constipation in South China.

Background/Aims: Functional dyspepsia (FD) overlapping with other gastrointestinal disorders are quite common. The characteristics of FD overlap in Chinese population with latest Rome IV criteria were unclear. This large-scale outpatient-based study assessed the characteristics of FD overlap in South China. Methods: Consecutive FD patients visited the Gastroenterology Clinic at 2 tertiary medical centers in Hangzhou, China who fulfilled the Rome IV criteria were enrolled. Complete questionnaires related to the gastrointestinal symptoms (Rome IV criteria), Reflux Disease Questionnaire, anxiety and depression, quality of sleep and life, and demographic information were collected. Results: Among the total of 3281 FD patients, 50.69% overlapped with gastroesophageal reflux disease, 21.46% overlapped with irritable bowel syndrome, 6.03% overlapped with functional constipation. FD overlap had higher proportion of single/divorced/widowed rate, high education level, being employed, drinking, night shift, unhealthy dietary habit than FD only (P < 0.05). They had higher frequency of consultation and economic burden, as well as lower scores in quality of life (P < 0.001). Multivariate logistic regression showed that increasing age, female, low body mass index, history of gastroenteritis, anxiety, depression, and poor sleep quality were independent risk factors for FD overlap. Conclusions: FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice.

High-performance narrowband thermal emitter based on aperiodic Tamm plasmon structures assisted by inverse design.

Controlling the bandwidth and directionality of thermal emission is important for a broad range of applications, from imaging and sensing to energy harvesting. Here, we propose a new, to the best of our knowledge, type of long-wavelength infrared narrowband thermal emitter that is basically composed of aperiodic Tamm plasmon polariton structures. Compared to the thermal emitter based on periodic structures, more parameters need to be considered. An inverse design algorithm instead of traditional forward methodologies is employed to do the geometric parameter optimization. Both theoretical and experimental results show that the thermal emitter exhibits a narrowband thermal emission peak at the wavelength of 8.6 µm in the normal direction. The angular response of emission properties of the thermal emitter is dependent on the emission angle. We believe that our proposed thermal emitter provides an alternative for low-cost, high-effective narrowband mid-infrared light sources and would have a great potential in many applications.

Multifunctional Multigate One-Transistor with Thin Advanced Materials, Logic-in-Memory, and Artificial Synaptic Behaviors.

The high device density and fabrication complexity have hampered the development of the electronics. The advanced designs, which could implement the functions of the circuits with higher device density but less fabrication complexity, are hence required. Meanwhile, the MoS2-based devices have recently attracted considerable attention owing to their advantages such as the ultrathin thickness. However, the MoS2-based multifunctional multigate one-transistor (MGT) designs with logic-in-memory and artificial synaptic functions have rarely been reported. Here, an MGT structure based on the MoS2 channel is proposed, with both the logic-in-memory and artificial synaptic behaviors and with more controllable processes than the manual transfer. The proposed MoS2-based MGT functions could be attributed to the semijunction mechanism and enhanced effect of the additional terminals with improved controllability. This study is the first to demonstrate that the neuromorphic computing, logic gate, and memory functions can all be achieved in a MoS2 MGT device without using any additional layers or plasticity to a transistor. The reported results provide a new strategy for developing brain-like systems and next-generation electronics using multifunctional designs and ultrathin materials.

Image generation technology for functional occlusal pits and fissures based on a conditional generative adversarial network.

The occlusal surfaces of natural teeth have complex features of functional pits and fissures. These morphological features directly affect the occlusal state of the upper and lower teeth. An image generation technology for functional occlusal pits and fissures is proposed to address the lack of local detailed crown surface features in existing dental restoration methods. First, tooth depth image datasets were constructed using an orthogonal projection method. Second, the optimization and improvement of the model parameters were guided by introducing the jaw position spatial constraint, the L1 loss and the perceptual loss functions. Finally, two image quality evaluation metrics were applied to evaluate the quality of the generated images, and deform the dental crown by using the generated occlusal pits and fissures as constraints to compare with expert data. The results showed that the images generated using the network constructed in this study had high quality, and the detailed pit and fissure features on the crown were effectively restored, with a standard deviation of 0.1802mm compared to the expert-designed tooth crown models.

Deep multi-task learning for nephropathy diagnosis on immunofluorescence images.

BACKGROUND AND OBJECTIVE: As an advanced technique, immunofluorescence (IF) is one of the most widely-used medical image for nephropathy diagnosis, due to its ease of acquisition with low cost. In practice, the clinically collected IF images are commonly corrupted by blurs at different degrees, mainly because of the inaccurate focus at the acquisition stage. Although deep neural network (DNN) methods achieve the great success in nephropathy diagnosis, their performance dramatically drops over the blurred IF images. This significantly limits the potential of leveraging the advanced DNN techniques in real-world nephropathy diagnosis scenarios. METHODS: This paper first establishes two IF databases with synthetic blurs (IFVB) and real-world blurs (Real-IF) for nephropathy diagnosis, respectively, including 1,659 patients and 6,521 IF images with various degrees of blurs. According to the analysis on these two databases, we propose a deep hierarchical multi-task learning based nephropathy diagnosis (DeepMT-ND) method to bridge the gap between the low-level vision and high-level medical tasks. Specifically, DeepMT-ND simultaneously handles the main task of automatic nephropathy diagnosis, as well as the auxiliary tasks of image quality assessment (IQA) and de-blurring. RESULTS: Extensive experiments show the superiority of our DeepMT-ND in terms of diagnosis accuracy and generalization ability. For instance, our method performs better than nephrologists with at least 15.4% and 6.5% accuracy improvements in IFVB and Real-IF, respectively. Meanwhile, our method also achieves comparable performance in two auxiliary tasks of IQA and de-blurring on blurred IF images. CONCLUSIONS: In this paper, we propose a new DeepMT-ND method for nephropathy diagnosis on blurred IF images. The proposed hierarchical multi-task learning framework provides the new scope to narrow the gap between the low-level vision and high-level medical tasks, and will contribute to nephropathy diagnosis in clinical scenarios. The diagnosis accuracy and generalization ability of DeepMT-ND are experimentally verified to be effective over both synthetic and real-world databases.

Relationship between vancomycin-induced nephrotoxicity and vancomycin trough concentration in older adults: A retrospective observational study.

OBJECTIVES: The objective of the study is to investigate the risk factors of vancomycin-induced renal toxicity in older adults, especially in those with chronic kidney disease (CKD) Stages 3-5. METHODS: In this retrospective observational study, serum vancomycin trough concentrations (VTCs) in patients aged g65 years treated with vancomycin were analyzed, and independent risk factors of vancomycin-induced nephrotoxicity (VIN) were determined by logistic regression analysis. RESULTS: In total, 321 patients were included in this study. Serum VTC was an independent risk factor for vancomycin-induced renal toxicity in total cohort (odds ratio [OR], 1.07; P = 0.004) as well as in the cohort with CKD Stages 3-5 (OR, 1.09; P = 0.010). A daily dose of vancomycin and Charlson comorbidity index was an independent risk factor for vancomycin-induced renal toxicity in total cohort (OR, 3.63; P = 0.006) and in the cohort with CKD Stage 3-5 (OR, 1.83; P = 0.002), respectively. In older adults with CKD Stages 3a and 3b-5, the VTCs associated with higher risk for vancomycin-induced renal toxicity were 21.5 mg/L and 16.5 mg/L, respectively. CONCLUSIONS: In older adults, serum VTC is an independent risk factor for VIN. VTCs over 21.5 mg/L and 16.5 mg/L are associated with increased risk of VIN in this population with CKD Stage 3a and 3b-5, respectively.