Prior-guided attention fusion transformer for multi-lesion segmentation of diabetic retinopathy.

To solve the issue of diagnosis accuracy of diabetic retinopathy (DR) and reduce the workload of ophthalmologists, in this paper we propose a prior-guided attention fusion Transformer for multi-lesion segmentation of DR. An attention fusion module is proposed to improve the key generator to integrate self-attention and cross-attention and reduce the introduction of noise. The self-attention focuses on lesions themselves, capturing the correlation of lesions at a global scale, while the cross-attention, using pre-trained vessel masks as prior knowledge, utilizes the correlation between lesions and vessels to reduce the ambiguity of lesion detection caused by complex fundus structures. A shift block is introduced to expand association areas between lesions and vessels further and to enhance the sensitivity of the model to small-scale structures. To dynamically adjust the model's perception of features at different scales, we propose the scale-adaptive attention to adaptively learn fusion weights of feature maps at different scales in the decoder, capturing features and details more effectively. The experimental results on two public datasets (DDR and IDRiD) demonstrate that our model outperforms other state-of-the-art models for multi-lesion segmentation.

[Guasha-fangsha therapy combined with electroacupuncture in treatment of greater occipital neuralgia: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect of guasha-fangsha (scrapping and bleeding) therapy combined with electroacupuncture (EA) on greater occipital neuralgia. METHODS: Ninety patients with greater occipital neuralgia were randomly divided into an observation group (45 cases) and a control group (45 cases, 2 cases dropped out). In the control group, EA was delivered at Fengfu (GV 16) and bilateral Tianzhu (BL 10), Fengchi (GB 20), Wangu (GB 12), Yuzhen (BL 9) and Houxi (SI 3), with disperse-dense wave, at 2 Hz/100 Hz in frequency and 2 mA to 6 mA in intensity, for 30 min in each intervention, once every other days, 3 times a week. In the observation group, on the basis of the intervention as the control group, guasha-fangsha therapy was used along the distribution of the bladder meridian of foot-taiyang on the occipital region and that of the gallbladder meridian of foot-shaoyang on the lateral side of the head, once weekly. The duration of treatment was 3 weeks in the two groups. In the two groups, before treatment, after 1, 2 and 3 weeks of treatment and in follow-up visit after 3 weeks of treatment completion, the score of visual analogue scale (VAS) was observed; before and after treatment, as well as in follow-up visit after 3 weeks of treatment completion, the scores of self-rating anxiety scale (SAS), self-rating depression scale (SDS) and 36-item short-form health survey (SF-36) were observed; after treatment and in follow-up visit after 3 weeks of treatment completion, the clinical efficacy was evaluated. RESULTS: After one week of treatment, the VAS score in the observation group decreased when compared with that before treatment (P<0.05), while the scores in 2 and 3 weeks of treatment and in follow-up visit after 3 weeks of treatment completion were lower than those before treatment in the two groups (P<0.05) separately. At each time point after treatment, the VAS scores in the observation group were lower than those in the control group (P<0.05). After treatment and during the follow-up visit, the scores of SAS and SDS decreased when compared with those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05); the scores of each item in SF-36 were elevated in comparison with those before treatment in the two groups (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05). After treatment, the total effective rate of the observation group was 91.1% (41/45), higher than that (76.7%, 33/43) of the control group (P<0.05). In follow-up visit, the total effective rate of the observation group was 91.1% (41/45), which was higher than 72.1% (31/43) of the control group (P<0.05). CONCLUSION: Guasha-fangsha therapy combined with electroacupuncture can effectively relieve greater occipital neuralgia, alleviate pain severity, ameliorate anxiety and depression and improve the quality of life in the patients.

Multiliteracies meet new methods: The case for digital writing in English education case study in G-7 countries.

Recently, globe has tried to transform populace activities to digital platform, wherefrom all stakeholders can attain their basic information. However, education sector cannot be excluded from this debate. Since, the pandemic mostly most economies have utilized digital transformation in different aspects of life, but digital education becomes more prominent. Therefore, this empirical research focuses on digital writing specifically to English education in G-7 economies between the time frame spanning from January 2000 to April 2022. This study considers urbanization, income, renewable energy, information & communication technology, renewable energy, English education, and pandemic as the key environmental determinants. To address the challenges posed by panel data, this study utilized an advanced set of estimators such as AMG stands for Augmented Mean Group. The estimate of urbanization and income per capita is positively significant, confirming that urbanization and economic development cannot protect the green economy by minimizing environmental pollution. Likewise, the estimated coefficient of English Education and internet use is negative and significant, implying that English Education and ICT can protect the green economy by reducing emissions. Conversely, renewable energy consumption (REC) is an element that can increase economic activity and therefore decline the environmental damages to secure a green economy. Likewise, the growth in cases of Covid-19 also reduces the usage of resources like land, water, and forests and subsequently decreases carbon emissions, promoting the green economy. The results also indicate that interaction term of English Education and ICT have adverse impact on Carbon emission (CO2). The outcomes suggest that internet usage (ICT) in English Education (EE) can deal efficiently with environmental issues for the green economy; therefore, EE and ICT should be part of green policies across the international level.

Analysis of Clinicopathological Characteristics of Malignancy Patients with Membranous Nephropathy and Literature Review.

Purpose: In recent years, the incidence of malignancy patients with membranous nephropathy (MN) has gradually increased, but the clinical and pathological characteristics of these patients are still unclear. Our study aims at elucidating the clinical and pathological characteristics of malignancy patients with MN, especially the expression patterns of MN-specific antigens in both kidney and tumor tissue. Patients and Methods: A retrospective analysis was performed to summarize the clinical and pathological data of MN patients with malignancy at Beijing Anzhen Hospital from January 1, 2012, to December 31, 2022, followed by a thorough review of relevant literature published between May 1, 2000 to May 1, 2023 and case aggregation. Results: 19 patients in our center's MN cohort and 21 patients from literature review were diagnosed with malignancy either before or after being diagnosed with MN. Among them, 16 (40.0%) and 17 (42.5%) patients tested PLA2R-only and THSD7A-only positive in renal tissue, respectively. And 16 of 26 patients showed similar staining in tumor and kidney tissues. Compared to the idiopathic membranous nephropathy (IMN) patients at our center, patients with malignancy were older, had a lower estimated glomerular filtration rate, and had a lower rate of partial or complete response to treatment. Renal tissue from MN patients with concomitant malignancy was less frequently PLA2R-positive, more frequently THSD7A-positive, and more often glomerular IgG subclass IgG2 (P = 0.033) but less frequently IgG4 (P < 0.001). Conclusion: The clinical and pathological characteristics of MN patients with concomitant malignancy are different from those of IMN patients. Active screening for malignancy should be performed in non-PLA2R-positive elderly MN patients with a poor therapeutic response. Staining for MN target antigens in kidney and tumor tissues may be inconsistent, and the role of MN target antigens needs to be further explored.

Bi-Interlayer Strategy for Modulating NiCoP-Based Heterostructure toward High-Performance Aqueous Energy Storage Devices.

Nickel-cobalt (NiCo) phosphides (NCPs) possess high electrochemical activity, which makes them promising candidates for electrode materials in aqueous energy storage devices, such as supercapacitors and zinc (Zn) batteries. However, the actual specific capacitance and rate capability of NCPs require further improvement, which can be achieved through reasonable heterostructural design and loading conditions of active materials on substrates. Herein, novel hierarchical Bi-NCP heterogeneous structures with built-in electric fields consisting of bismuth (Bi) interlayers (electrodeposited on carbon cloth (CC)) are designed and fabricated to ensure the formation of uniform high-load layered active materials for efficient charge and ion transport. The resulting CC/Bi-NCP electrodes show a uniform, continuous, and high mass loading (>3.5 mg) with a superior capacitance reaching 1200 F g-1 at 1 A g-1 and 4129 mF cm-2 at 1 mA cm-2 combined with high-rate capability and durable cyclic stability. Moreover, assembled hybrid supercapacitors (HSCs), supercapatteries, and alkaline Zn-ion (AZBs) batteries constructed using these electrodes deliver high energy densities of 64.4, 81.8, and 319.1 Wh kg-1, respectively. Overall, the constructed NCPs with excellent aqueous energy storage performance have the potential for the development of novel transition metal-based heterostructure electrodes for advanced energy devices.

Ca2+-independent ZmCPK2 is inhibited by Ca2+-dependent ZmCPK17 during drought response in maize.

Calcium oscillations are induced by different stresses. Calcium-dependent protein kinases (CDPKs/CPKs) are one major group of the plant calcium decoders that are involved in various processes including drought response. Some CPKs are calcium-independent. Here, we identified ZmCPK2 as a negative regulator of drought resistance by screening an overexpression transgenic maize pool. We found that ZmCPK2 does not bind calcium, and its activity is mainly inhibited during short term abscisic acid (ABA) treatment, and dynamically changed in prolonged treatment. Interestingly, ZmCPK2 interacts with and is inhibited by calcium-dependent ZmCPK17, a positive regulator of drought resistance, which is activated by ABA. ZmCPK17 could prevent the nuclear localization of ZmCPK2 through phosphorylation of ZmCPK2T60. ZmCPK2 interacts with and phosphorylates and activates ZmYAB15, a negative transcriptional factor for drought resistance. Our results suggest that drought stress-induced Ca2+ can be decoded directly by ZmCPK17 that inhibits ZmCPK2, thereby promoting plant adaptation to water deficit.

Novel amorphous FeOOH-modified Co9S8 nanosheets with enhanced catalytic activity in oxygen evolution reaction.

Efficient oxygen evolution reaction (OER) is vital for water electrolysis and advanced hydrogen energy production. However, the sluggish kinetics of this reaction require significant overpotentials, leading to high energy consumption. Therefore, developing OER electrocatalysts with exceptional performance and long-term durability is crucial for enhancing the energy efficiency and cost-effectiveness of the hydrogen production process. In this research, novel FeOOH/Co9S8 catalysts were prepared through a two-step hydrothermal reaction followed by one-step electrodeposition on nickel foam for an alkaline OER. The as-obtained catalysts possessed abundant non-homogeneous interfaces between FeOOH and Co9S8 nanosheets, conducive to optimized coordination environments of Fe and Co sites by redistributing interfacial charges. This synergy strengthened the chemisorption of oxygenated intermediates, leading to accelerated reaction kinetics, abundant active sites, and enhanced OER performance. The optimized electrocatalyst FeOOH/Co9S8-15 achieved a current density of 10 mA cm-2 at an overpotential of 248 mV and good stability for over 140 h. This study presents a novel approach for producing compelling and durable alkaline dielectric OER electrocatalysts, which will be helpful in the future manufacturing of advanced energy devices.

Association of individual and combined exposures of 10 metals with periodontitis: Results from a large population-based study.

AIMS: To systematically investigate the association between individual and combined metal exposure and periodontitis. METHODS: Data encompassing complete periodontal examinations and metal detection in blood and urine samples were procured from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Three statistical methods, namely weighted logistic regression, Bayesian kernel machine regression (BKMR), and weighted quantile sum (WQS) regression, were used to evaluate the independent and combined associations between metals and periodontitis. RESULTS: Elevated concentrations of blood cadmium (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 1.15-2.61) and blood lead (OR: 1.17, 95 %CI: 1.02-1.34) exhibited a positive association with periodontitis, even after adjusting for potential confounding factors. The BKMR and WQS regression suggested that the co-exposure of metals was also positively associated with periodontitis. Moreover, estradiol and albumin were identified as potential mediators in the relationship between the WQS index of the 10 metals in blood and periodontitis explaining 25.36% and 2.02% of the relationship, respectively. Furthermore, generally consistent patterns of associations between metals and periodontitis and mediating roles of estrogen and albumin were observed after a series of sensitivity analyses. CONCLUSION: This study provides evidence of positive associations between elevated levels of cadmium, lead or metal mixture and periodontitis, which may be partially mediated by sex hormones and oxidative stress indicators.

Specific antigens in malignancy-associated membranous nephropathy.

Membranous nephropathy (MN) is a glomerular disease mediated by autoimmune complex deposition, with approximately 30% of cases attributed to secondary causes. Among them, malignant tumors are a significant cause of secondary MN. Recent advancements in the identification of MN-specific antigens, such as THSD7A and NELL-1, suggest a potential association with malignant tumors, yet definitive proof of this relationship remains elusive. Therefore, this article aims to review the distribution of MN-specific antigens in patients with MN caused by malignant tumors and the possible role of these antigens in the pathogenesis of the disease.

One step accurate phase demodulation from a closed fringe pattern with the convolutional neural network HRUnet.

Retrieving a phase map from a single closed fringe pattern is a challenging task in optical interferometry. In this paper, a convolutional neural network (CNN), HRUnet, is proposed to demodulate phase from a closed fringe pattern. The HRUnet, derived from the Unet model, adopts a high resolution network (HRnet) module to extract high resolution feature maps of the data and employs residual blocks to erase the gradient vanishing in the network. With the trained network, the unwrapped phase map can be directly obtained by feeding a scaled fringe pattern. The high accuracy of the phase map obtained from HRUnet is demonstrated by demodulation of both simulated data and actual fringe patterns. Compared results between HRUnet and two other CNNS are also provided, and the results proved that the performance of HRUnet in accuracy is superior to the two other counterparts.