Serum analysis based on SERS combined with 2D convolutional neural network and Gramian angular field for breast cancer screening.

Breast cancer is a significant cause of death among women worldwide. It is crucial to quickly and accurately diagnose breast cancer in order to reduce mortality rates. While traditional diagnostic techniques for medical imaging and pathology samples have been commonly used in breast cancer screening, they still have certain limitations. Surface-enhanced Raman spectroscopy (SERS) is a fast, highly sensitive and user-friendly method that is often combined with deep learning techniques like convolutional neural networks. This combination helps identify unique molecular spectral features, also known as "fingerprint", in biological samples such as serum. Ultimately, this approach is able to accurately screen for cancer. The Gramian angular field (GAF) algorithm can convert one-dimensional (1D) time series into two-dimensional (2D) images. These images can be used for data visualization, pattern recognition and machine learning tasks. In this study, 640 serum SERS from breast cancer patients and healthy volunteers were converted into 2D spectral images by Gramian angular field (GAF) technique. These images were then used to train and test a two-dimensional convolutional neural network-GAF (2D-CNN-GAF) model for breast cancer classification. We compared the performance of the 2D-CNN-GAF model with other methods, including one-dimensional convolutional neural network (1D-CNN), support vector machine (SVM), K-nearest neighbor (KNN) and principal component analysis-linear discriminant analysis (PCA-LDA), using various evaluation metrics such as accuracy, precision, sensitivity, F1-score, receiver operating characteristic (ROC) curve and area under curve (AUC) value. The results showed that the 2D-CNN model outperformed the traditional models, achieving an AUC value of 0.9884, an accuracy of 98.13%, sensitivity of 98.65% and specificity of 97.67% for breast cancer classification. In this study, we used conventional nano-silver sol as the SERS-enhanced substrate and a portable laser Raman spectrometer to obtain the serum SERS data. The 2D-CNN-GAF model demonstrated accurate and automatic classification of breast cancer patients and healthy volunteers. The method does not require augmentation and preprocessing of spectral data, simplifying the processing steps of spectral data. This method has great potential for accurate breast cancer screening and also provides a useful reference in more types of cancer classification and automatic screening.

Congenital adrenal hyperplasia disorder due to 17 α-hydroxylase deficiency: a case report.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder with a related enzyme deficiency involved in the adrenal corticosteroid synthesis pathway due to genetic mutations. 17α-hydroxylase deficiency(17α-OHD) is a rare form of CAH. Herein, we reported clinical data on diagnosis and treatment regimens for a 17α-hydroxylase-deficient patient. A 24-year-old female patient was admitted to the hospital with limb numbness for 7 days and sudden limb weakness. Full laboratory and radio-imaging investigations showed hypokalemia and abdominal occupation. Abnormal rhythm of cortisol(Cor) and adrenocorticotrophic hormone (ACTH)was observed. The diagnosis was confirmed by molecular mutation detection, which showed a homozygous mutation of c.987del in the 17-hydroxylase/17,20-lyase deficiency (17OHD) lease-related CYP17A1 from both biological parents. The patient was treated with prednisone acetate and estradiol valerate. After one year of treatment with predisoone acetate and estradiol valerate, the patient had normal menstruation, increased blood potassium, estradiol and 24h-UFC, and decreased ACTH level. There is no significant change in large adrenal hyperplasia lesions although sexual characteristics and menstrual cycles have recovered. Through this case and literature review, it can be concluded that CAH with 17α-OHD can be diagnosed according to the genetic detection.

The influence of overnight orthokeratology and soft contact lens on the meibomian gland evaluated using an artificial intelligence analytic system.

PURPOSE: To test the changes of meibomian gland (MG) morphology using an artificial intelligence (AI) analytic system in asymptomatic children wearing overnight orthokeratology (OOK) and soft contact lens (SCL). METHODS: A retrospective study was conducted including 89 participants treated with OOK and 70 participants with SCL. Tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), and meibography were obtained using Keratograph 5 M. MG tortuosity, height, width, density, and vagueness value were measured using an artificial intelligence (AI) analytic system. RESULTS: In an average of 20.80 ± 10.83 months follow-up, MG width of the upper eyelid significantly increased and MG vagueness value significantly decreased after OOK and SCL treatment (all P < 0.05). MG tortuosity of the upper eyelid significantly increased after OOK treatment (P < 0.05). TMH and NIBUT did not differ significantly pre- and post- OOK and SCL treatment (all P > 0.05). The results from the GEE model demonstrated that OOK treatment positively affected MG tortuosity of both upper and lower eyelids (P < 0.001; P = 0.041, respectively) and MG width of the upper eyelid (P = 0.038), while it negatively affected MG density of the upper eyelid (P = 0.036) and MG vagueness value of both upper and lower eyelids (P < 0.001; P < 0.001, respectively). SCL treatment positively affected MG width of both upper and lower eyelids (P < 0.001; P = 0.049, respectively) as well as MG height of the lower eyelid (P = 0.009) and tortuosity of the upper eyelid, (P = 0.034) while it negatively affected MG vagueness value of both upper and lower eyelids (P < 0.001; P < 0.001, respectively). However, no significant relationship was found between the treatment duration and TMH, NIBUT, MG morphological parameters in OOK group. SCL treatment duration negatively affected MG height of the lower eyelid (P = 0.002). CONCLUSIONS: OOK and SCL treatment in asymptomatic children can influence MG morphology. The AI analytic system may be an effective method to facilitate the quantitative detection of MG morphological changes.

Spectacle lenses with slightly aspherical lenslets for myopia control: clinical trial design and baseline data.

OBJECTIVES: Myopia is a major public health problem and it is essential to find safe and effective means to control its progression. The study design and baseline data are presented for a one-year prospective, double-masked, crossover, randomized clinical trial evaluating the efficacy of single vision spectacle lenses with concentric rings of slightly aspherical contiguous lenslets technology (SAL) on myopia control. METHODS: One hundred 8- to 13-year old Chinese children with a refractive error of -0.75 D to -4.75 D were assigned to two groups. In Group 1, SAL and single vision lenses were each worn for 6 months, and Group 2 wore the lenses in the reversed order. Primary outcomes are axial length and spherical equivalent of cycloplegic refractive error. Secondary outcomes included corneal thickness, anterior chamber depth, lens thickness, visual acuity, and lens adaptation. RESULTS: No significant differences in baseline parameters (cycloplegic spherical equivalent, axial length, age) were found between groups (0.49 < p < 0.94). All children adapted well to the test lenses and there was no significant difference in visual acuity between the SAL and single vision lenses (p = 0.27). CONCLUSIONS: The children in the two well balanced groups had comparable visual acuity and adapted well to the test lenses. These results imply that visual acuity can be well improved by SAL lenses. Clear visual acuity provides the assurance for good compliance in this longitudinal study.

Associations of the baseline level and change in glycosylated hemoglobin A1c with incident hypertension in non-diabetic individuals: a 3-year cohort study.

BACKGROUND: Diabetes mellitus increases the risk of developing hypertension. The relationship between glycosylated hemoglobin A1c (HbA1c) level and incident hypertension remains controversial. This study examined the associations of the baseline level and change in the HbA1c level over 3 years with incident hypertension in non-diabetic individuals. METHODS: This community-based cohort study was conducted with 2591 individuals aged 40-75 years without hypertension or diabetes at baseline, who participated in a longitudinal (REACTION) study program. Questionnaires were administered during interviews, and anthropometric and laboratory measurements were performed at baseline (2011) and follow-up (2014-2015). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of incident hypertension. RESULTS: Over a median follow-up period of 3.08 years (interquartile range 3.00, 3.25), 384 (14.82%) subjects developed hypertension. In the fully adjusted linear regression models, change in HbA1c remained significantly associated with changes in systolic blood pressure and diastolic blood pressure [ß-coefficient (95% CI), 4.421 (2.811-6.032), 1.681 (0.695-2.667)]. Logistic regression analyses showed that baseline HbA1c level was positively associated with incident hypertension in the unadjusted model; however, the association was no longer significant after further adjustment. Change in HbA1c was positively associated with the development of hypertension, both as a categorical variable stratified by tertiles [adjusted OR (95% CI) in the highest tertile was 1.690 (1.240-2.303) versus the lowest tertile)] and as a continuous variable [adjusted OR (95% CI), 1.242 (1.106-1.394)], independent of age, sex, body mass index, systolic blood pressure, fasting plasma glucose level, lipid profile, the HbA1c level at baseline and 3-year change in body mass index. CONCLUSIONS: A higher baseline HbA1c level was not an independent risk factor for incident hypertension, whereas the change in HbA1c was independently associated with a greater longitudinal increase in blood pressure and an increased risk of incident hypertension in non-diabetic individuals.

The association of obesity with thyroid carcinoma risk.

BACKGROUND: The prevalence of obesity and an increased incidence of thyroid carcinoma (TC) threaten public health in parallel on a global scale. Sufficient evidence supports excess body fatness in thyroid carcinogenesis, and the role and anthropometric markers of obesity have been causally associated with the rising risk of TC. METHODS: A literature search was conducted in PubMed. Studies focused on the effect of obesity in TC. RESULTS: This review mainly discusses the global incidence and prevalence of obesity-related TC. We also review the role of obesity in TC and potential clinical strategies for obesity-related TC. CONCLUSIONS: Excess body fatness in early life and TC survival initiate adverse effects later in life.

Macular perfusion density evaluation in constant and intermittent exotropia by means of optical coherence tomography angiography.

BACKGROUND: To quantify and compare retinal microvascular features using optical coherence tomography angiography (OCTA) in constant (XT) and intermittent exotropia (IXT). METHODS: An observational cross-sectional study was conducted from September 2020 to November 2020 at the Affiliated Eye Hospital of Wenzhou Medical University. OCTA examination was performed to evaluate the macular perfusion density of the deep capillary plexus (DCP), superficial capillary plexus (SCP), and foveal avascular zone (FAZ) parameters in XT and IXT patients, and in age-matched controls. The study parameters were analyzed. RESULTS: A total of 76 participants, including 16 (21%) XT patients, 24 (32%) IXT patients, and 36 (47%) controls, were recruited. The exodeviation angle was 39.06 ± 10.38 prism degrees (PD) at near and 43.00 ± 9.74 PD at distance in the XT group, and 27.13 ± 18.28 PD at near and 31.04 ± 18.82 PD at distance in the IXT group. The macular perfusion density of the DCP in 6 × 6-mm scans and the SCP in 3 × 3-mm scans were lower in the deviating eyes than in the fixating eyes of XT patients (p < 0.001, p = 0.032, respectively). The macular perfusion density of the DCP in the deviating eyes of XT and IXT patients was significantly lower than that of the controls. There was no significant difference in the FAZ parameters among the groups. CONCLUSIONS: In XT patients, OCTA revealed lower macular perfusion density in deviating eyes than in fixating eyes and control eyes. IXT patients showed no difference between the two eyes, but the macular perfusion density of the DCP was lower than that of the controls.

Application of multi-active center organic quinone molecular functionalized graphene in fully pseudocapacitive asymmetric supercapacitors.

5, 7, 12, 14-pentacenetetrone (PT), polycyclic quinone derivatives, are rich in carbonyl, which were investigated as a novel organic electrode material for supercapacitors. PT with aπconjugated system, is a flat molecule, generating strongπ-πinteractions between molecules. PT molecules were uniformly fixed on conductive reduced graphene oxide (rGO) throughπ-πinteraction by one-step solvothermal method, forming a three-dimensional cross-linked PT@rGO hydrogel. This composite structure was conducive to reducing the charge transfer resistance and promoting the Faraday reaction of electrode, which achieved the superposition of electric double-layer capacitance and pseudocapacitance. Appropriate organic molecular loading can effectively improve electrochemical performance. The optimal PT@rGO electrode material displayed the specific capacitance of 433.2 F g-1at 5 mV s-1with an excellent rate capability in 1 mol l-1H2SO4electrolyte. Finally, the fully pseudocapacitive asymmetric supercapacitor has been assembled by using PT@rGO as positive electrode and benz[a]anthracene-7,12-quinone (BAQ) modified rGO(BAQ/rGO)as negative electrode, which exhibited the good energy storage performance in a cell voltage of 1.8 V.

2-Amino-3-chloro-1,4-naphthoquinone-covalent modification of graphene nanosheets for efficient electrochemical energy storage.

Green and renewable organic redox molecules are greatly advantageous over conventional inorganic intercalation electrode materials in terms of electrochemical reversibility and cycling stability. However, their electrical insulation prevents them from being used alone as electrode materials for supercapacitors. Herein, 2-amino-3-chloro-1,4-naphthoquinone (ACNQ) molecules were covalently grafted onto graphene nanosheets (GNS) via diazotization. The ACNQ-functionalized GNS (CNQ-GNS) electrode material exhibited a high specific capacitance of 364.2 ± 10 F g-1 at a current density of 1 A g-1, which is much larger than that of bare GNS (190 ± 6 F g-1). Moreover, the electrode exhibited an outstanding rate capability (capacitance retention of 76.8% at 100 A g-1). Finally, an asymmetric supercapacitor device was fabricated using graphene nanosheets as the positive electrode and the optimized CNQ-GNS as the negative electrode, which displayed a high energy density of 19.1 W h kg-1 at a power density of 0.8 kW kg-1 with a long cycling life span (nearly no loss after 10 000 cycles at 5 A g-1) in 1 M H2SO4 electrolyte. Briefly, the highly conductive GNS scaffold delivers a high electrical double-layer capacitance, while the organic functional groups covalently bonded on the GNS contribute additional faradaic pseudocapacitance, resulting in outstanding electrochemical energy storage.

Inferior Quadrant of Tear Film Is More Likely to Break and Breaks Early in Patients With Dry Eyes.

PURPOSE: To investigate the temporal and spatial distribution of tear film breakup time via a noninvasive topographer in normal subjects and patients with dry eye disease (DED). METHODS: A total of 77 subjects were separated into normal and DED groups based on their symptoms and tear film instabilities. In noninvasive evaluation with Oculus Keratograph, the precorneal tear film was recorded and reconstructed into a two-dimensional map that evolved with time. Whether or not each sector broke and the breakup time if it did were recorded. The map was further grouped into 4 quadrants to reveal the spatial variation. RESULTS: By the end of recording, the inferior quadrant in DED subjects had a higher number of broken sectors than other quadrants (P < 0.01). Over the recording period, the cumulative percentage of sectors that were broken rose much quicker in the inferior quadrants, and the inferior quadrant is the only quadrant that showed a significant difference between the normal and DED groups (P < 0.01). This difference peaked at 12 seconds and declined after 15 seconds. Receiver operating characteristic curve for each index always showed the largest differential value in the inferior quadrant. CONCLUSIONS: Tear film breakup is not homogenously distributed, with sectors in the inferior quadrant being more likely to break and to break earlier. Between normal and DED subjects, a significant difference of tear film instability is more likely to be found in the inferior quadrant.

Hierarchically porous and heteroatom self-doped graphitic biomass carbon for supercapacitors.

Here we report a simple, low-cost and environment friendly method, in which Black locust seed dregs and potassium ferrate (K2FeO4) are used as starting raw materials and activation agent. The hierarchically porous carbons (BDPC) with high special surface area and abundant mesopores (SBET = 2010.1 m2 g-1 and Vmeso = 1.457 cm3 g-1) are obtained through hydrothermal treatment and chemical activation. The BDPC electrode exhibits excellent electrochemical performances by virtue of unique architecture and heteroatoms pseudocapacitance contribution. In the three-electrode system, the optimized carbon material (BDPC-2) achieves a high specific capacitance of 333 F g-1 at 1 A g-1 and displays the high rate capability (81.1% capacitance retention at 100 A g-1) in 6 M KOH electrolyte. The symmetric supercapacitor based BDPC-2 exhibits energy density as high as 26.2 Wh kg-1 (at a power density of 0.79 kW kg-1) and excellent long-term cycling stability (only 8% decrease after 10,000 cycles) in 6 M KOH.

Measurement of the limbus-insertion distance in adult strabismus patients with anterior segment optical coherence tomography.

PURPOSE: To determine the ability of the anterior segment optical coherence tomography (AS-OCT) in measuring the distance from the corneoscleral limbus to the insertion site of the horizontal extraocular muscles in adult patients with strabismus. METHODS: A total of 16 strabismus patients were recruited for this study. The limbus-insertion distances of the horizontal rectus muscles were measured with AS-OCT preoperatively and calipers intraoperatively. The intraclass correlation coefficient (ICC), Pearson's correlation coefficients, and Bland-Altman plots were used to evaluate the degree of agreement between the two methods of measurements. RESULTS: Measurements of the limbus-insertion distances were taken on 37 muscles of the 16 patients: 18 medial rectus (MR) and 19 lateral rectus (LR). The mean limbus-insertion distance of MR and LR measured intraoperatively were 5.32 ± 0.44 mm (range, 4.5-6.1 mm) and 6.58 ± 0.53 mm (range, 5.5-7.5 mm). Comparable results measured with the AS-OCT were 5.72 ± 0.60 mm (range, 4.62-6.82 mm) and 6.80 ± 0.61 mm (range, 5.8-7.86 mm). For MR group and LR group, the values of limbus-insertion distance showed high Pearson's correlation coefficients (0.729 and 0.786, respectively). With the ICC analysis excellent agreement was observed for the measurements of LR group (ICC = 0.75). Fair to good agreement was observed for the MR group (ICC = 0.61). Bland-Altman plots also showed good agreement between the two methods of measurements. CONCLUSIONS: AS-OCT can image the structure of horizontal rectus muscles well and provide good reliability and accuracy in measurement of the limbus-insertion distance.

Cycloplegic and noncycloplegic refractions of Chinese neonatal infants.

PURPOSE: To examine Chinese neonatal infants with both cycloplegic and noncycloplegic retinoscopy and to compare the distribution of refractive errors for the two techniques. METHODS: Cycloplegic retinoscopy was performed by two experienced pediatric ophthalmologists on 81 neonatal infants randomly selected from a group of 185 neonates who had undergone noncycloplegic retinoscopy. All infants were between 1 day and 6 days of age and were born without incident at full term. RESULTS: The mean cycloplegic spherical equivalent (CSE) was highly hyperopic (+3.55 diopters [D] ± 2.39 D). The mean noncycloplegic spherical equivalent (nCSE) was +0.58 D ± 2.32 D. The high reliability of the refractive measurements was demonstrated by high correlations between examiners (CSE: OD, r = 0.96; OS, r = 0.97; nCSE: OD, r = 0.94; OS, r = 0.93 OS) and between eyes (CSE: examiner 1, r = 0.94; examiner 2, r = 0.95; nCSE: examiner 1, r = 0.95; examiner 2, r = 0.97). The correlation between CSE and nCSE was much lower (examiner 1: OD, r = 0.76; OS, r = 0.73; examiner 2: OD, r = 0.72; OS, r = 0.70). Prevalence of astigmatism was very low (1.6% ≥ 1.0 D). CONCLUSIONS: The level of hyperopia was very high in these infants, and the offsetting tonic accommodation demonstrated by the difference between CSE and nCSE was much higher than in any previous report. Low amounts of infantile hyperopia and high astigmatism are associated with future myopia in the West. The Chinese neonates in this study had high amounts of hyperopia and little astigmatism, yet they are at high risk to become myopic.