3D Multimodal Fusion Network with Disease-induced Joint Learning for Early Alzheimer's Disease Diagnosis.

Multimodal neuroimaging provides complementary information critical for accurate early diagnosis of Alzheimer's disease (AD). However, the inherent variability between multimodal neuroimages hinders the effective fusion of multimodal features. Moreover, achieving reliable and interpretable diagnoses in the field of multimodal fusion remains challenging. To address them, we propose a novel multimodal diagnosis network based on multi-fusion and disease-induced learning (MDL-Net) to enhance early AD diagnosis by efficiently fusing multimodal data. Specifically, MDL-Net proposes a multi-fusion joint learning (MJL) module, which effectively fuses multimodal features and enhances the feature representation from global, local, and latent learning perspectives. MJL consists of three modules, global-aware learning (GAL), local-aware learning (LAL), and outer latent-space learning (LSL) modules. GAL via a self-adaptive Transformer (SAT) learns the global relationships among the modalities. LAL constructs local-aware convolution to learn the local associations. LSL module introduces latent information through outer product operation to further enhance feature representation. MDL-Net integrates the disease-induced region-aware learning (DRL) module via gradient weight to enhance interpretability, which iteratively learns weight matrices to identify AD-related brain regions. We conduct the extensive experiments on public datasets and the results confirm the superiority of our proposed method. Our code will be available at: https://github.com/qzf0320/MDL-Net.

Clopidogrel versus ticagrelor in East Asian patients aged 75 years or older with acute coronary syndrome: observations from the GF-APT registry.

The benefits of potent antithrombotic therapy usually come at the expense of a higher risk of bleeding. The efficacy and safety of ticagrelor in elderly East Asian populations remains debated due to the concerns about the imbalance of ischemic and bleeding risks. This study aimed to compare the impact of clopidogrel with ticagrelor on clinical outcomes in East Asian patients aged ≥75 years with acute coronary syndrome (ACS) using data from an institutional registry. We assessed the treatment effect of ticagrelor versus clopidogrel based on propensity scores and multivariate Cox proportional hazards models. A total of 2775 ACS patients were included, of which 235 (8.5%) were treated with ticagrelor. The primary efficacy outcome occurred in 11.9% of patients treated with ticagrelor versus 8.8% treated with clopidogrel. There was no significant association between treatment with ticagrelor and a lower risk of the primary efficacy outcome (p = .156). However, the incidences of all-cause death (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.02 to 2.79) and major bleeding (adjusted HR 2.20, 95% CI 1.06 to 4.56) were significantly higher in patients treated with ticagrelor than clopidogrel. In elderly patients with ACS from East Asia, the efficacy of clopidogrel was comparable to ticagrelor, while ticagrelor is associated with an increased risk of mortality and major bleeding.

What is the context?Current guidelines recommend ticagrelor over clopidogrel for patients with acute coronary syndrome (ACS).There are no specific guidelines concerning the elderly, and data on optimal antiplatelet therapy in elderly are quite scarce.Further study was necessary to identify the efficacy and safety of ticagrelor and clopidogrel in elderly patients from East Asian populations which are reported to be at a higher risk of bleeding.What is new?The risk of major adverse cardiac events did not differ significantly between clopidogrel versus ticagrelor in patients aged ≥75 years from East Asia, while the use of ticagrelor might be associated with increased risk of mortality and major bleeding events.Analyses after propensity score matching showed consistent results on the safety and efficacy of clopidogrel versus ticagrelor.The benefit of potent P2Y₁₂ inhibitor ticagrelor over clopidogrel is questionable in elderly East Asian patients with ACS.What is the impact? This study provides more information on the use of potent antiplatelet therapy in older patients from Asia. The individual assessment of ischemic and bleeding risk is necessary to guide decision-making on DAPT rather than applying the recommendations of guidelines directly.

Novel class of aeschynite structure LaNbTiO6-based orange-red phosphors via a modified combustion approach.

A novel class of orange-red phosphors based on Eu(3+)-activated LaNbTiO(6) was successfully fabricated by a wet chemical method, called a modified combustion approach. XRD, TG-DTA, SEM, and EDS results show that the heat-treatment of the powders above 1000 degrees C is enough to obtain highly crystallized and phase-pure LaNbTiO(6) and Eu(3+)-doped samples, which is of prime importance in investigating the optical properties of the novel phosphors using LaNbTiO(6) as the host material. UV-vis diffuse reflectance spectroscopy reveals that the direct band gap of LaNbTiO(6) with large grains (above 200 nm) is calculated to be 3.27 eV, while the absorption edge of the small particles shows an obvious blue-shift. Two blue emission bands centered at 440 and 470 nm ascribed to the self-trapped exciton emission of the distorted NbO(6) and TiO(6) groups for the pure LaNbTiO(6) can be obtained. Photoluminescence spectra of the Eu(3+)-doped phosphor particles illuminated the simultaneous occurrence of several intense orange-red band emissions due to the characteristic transitions of (5)D(0,1) --> (7)F(J) (J = 0, 1, 2, 3, 4) of Eu(3+) under 395 nm excitation. The mechanism of these multiplets possibly arising from the odd-parity distortions of the Eu(3+) ion environment and the effect of crystallanity of the compounds on luminescence were discussed, respectively. The highly bright and color-uniform fluorescence images of the doped samples with short luminescence decay times (nanosecond magnitude) confirmed the potential applications of the phosphors in luminescence and display devices.

Combustion synthesis of novel Li 0.9 Y(0.9-x-y)Zr 0.1 O2:Eu x 3+, R y 3+(R = Ce,Bi) red luminescence nanocrystal and emission-mechanism research.

Novel Li(0.9)Y((0.9-x-y))Zr(0.1)O(2):Eu(x)(3+), R(y)(3+) (R = Ce,Bi) red nanocrystal phosphors were synthesized by the sol-combustion process at 800 degrees C. XRD and TEM were used to evaluate the crystallinity and the morphological characterization of the samples. The photoluminescence properties and lifetime of the obtained phosphor nanoparticles were measured using an Edinburgh FLS920 at room temperature. The result showed that the luminescence intensity of Li(0.9)Y((0.9-x-y))Zr(0.1)O(2):Eu(x)(3+) was increased by Bi(3+) and Ce(3+) by 900% and 600%, respectively. The emission mechanism and sensitization mechanism of Bi(3+) and Ce(3+) on Eu(3+) emission intensity were described and explained in detail in this work. The high bright and color-uniform fluorescence images of the doped samples with short luminescence decay times (nanosecond level) confirmed the potential applications of the phosphors in light-emitting diodes and display devices.