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1.
Chem Biol Drug Des ; 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34981654

RESUMO

mtbDHFR targeting inhibition has become a promising approach for tuberculosis treatment. In the current research, a multi-step virtual screening effort towards ZINC and MCE databases was devoted to discover novel mtbDHFR inhibitors. Based on binding affinity of small molecules through molecular docking study in AutoDock Vina, the number of compounds was reduced to 952688. Further, these compounds were employed by a step-by-step multiple docking programs of Schrödinger suite and filtered by pharmacokinetics and PAINS parameters. Finally, 9 ZINC compounds and 400 MCE compounds were obtained. These compounds of binding ability were tested with mtbDHFR by FluoPol-ABPP approach established in this work. Finally, AF-353 compound was found to have strong binding effect to mtbDHFR. AF-353 was further tested for mtb and hDHFR enzymatic activities, and it was proved to possess fifty-fold selectivity towards mtbDHFR over hDHFR. In silico MD simulation results supported this selectivity.

2.
J Intern Med ; 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982490

RESUMO

BACKGROUND: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are systemic inflammatory diseases that primarily affect elderly women. OBJECTIVES: To compare the risk of thromboembolic events and retinal vascular occlusions in GCA and/or PMR with that in osteoarthritis (OA), evaluating a veteran-based population. METHODS: A total of 1535 patients with GCA, 10,265 with PMR, and 1203 with overlapping disease, as well as 39,009 age- and sex-matched patients with OA were identified in this retrospective study. The incidence rate ratios (IRRs) of pulmonary embolism (PE), deep venous thrombosis (DVT), arterial thromboembolism, central retinal artery occlusion, and central retinal vein occlusion were calculated and examined over time. The cumulative incidence was plotted and hazard ratios (HRs) of thromboembolic events were calculated, adjusting for independent risk factors of thromboembolism. RESULTS: Patients with GCA and overlapping disease exhibited higher IRRs for all thromboembolic events compared to patients with OA. Patients with GCA had a higher risk of developing DVT and retinal vascular occlusions than those with overlapping disease (HR: 2.01, 95% confidence interval [CI]: 1.35-2.99, p < 0.001; HR: 2.37, 95% CI: 1.23-4.53, p = 0.009, respectively) or PMR alone (HR: 1.89, 95% CI: 1.50-2.41, p < 0.001; HR: 4.68, 95% CI: 3.10-7.07, p < 0.001, respectively). Patients with GCA had a higher risk of developing PE than those with PMR (HR: 1.55, 95% CI: 1.1-2.18, p = 0.01). CONCLUSION: The risk of thromboembolic events differs between GCA, PMR, and overlapping diseases. Our findings may help predict the risk of thromboembolic events based on disease phenotype.

3.
Reprod Domest Anim ; 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35014107

RESUMO

The reproductive function of animals is often affected by climatic conditions. High-temperature conditions can cause damage to oocyte maturation and embryonic development in a variety of ways. The purpose of this study was to prove that supplementation idebenone (IDB) to the maturation medium can improve the maturation and development of porcine oocytes after heat stress (HS). Porcine cumulus-oocyte complexes (COCs) were cultured in the maturation medium with different concentrations of IDB (0, 0.1, 1 and 10 µM) for 44 hr at either 38.5°C or under the HS conditions. The cumulus oophorus expansion, nuclear maturation and blastocyst rate after parthenogenetic activation (PA) were measured. We found that HS (in vitro maturation 20-24 hr, 42°C) exposure significantly reduced cumulus expansion index and maturation rate of oocytes and the blastocyst rate of PA embryos, while IDB supplementation significantly improved oocyte maturation and development to the blastocysts stage after PA. Moreover, the addition of IDB decreased the intracellular level of ROS and increased GSH content, hence enhancing the antioxidant capacity of oocytes under HS. Meanwhile, IDB treatment also obviously improved the mitochondrial membrane potential and ATP synthesis of oocytes under HS conditions. Furthermore, IDB treatment increased the expression of GDF9 and BMP15 in IVM oocytes which attribute to improve the quality and outcome of IVM oocytes and the development competence of PA embryos in pigs. In summary, we demonstrated that IDB supplementation into the maturation medium exerted protective effects and improved the ability of maturation and developmental competence of porcine oocytes exposed to HS.

5.
Global Spine J ; 12(1): 130-141, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33272041

RESUMO

STUDY DESIGN: Meta-analysis. OBJECTIVES: To provide up-to-date evidence-based outcomes for the incidence and risk factors of adjacent vertebral fracture (AVF) after the vertebral augmentation. METHODS: The MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies assessing the risk factors of adjacent vertebral fracture after vertebral augmentation until June 2020. The AVF incidence and factors potentially affecting AVF were extracted and pooled. RESULTS: A total of 16 studies, encompassing 2549 patients were included in the meta-analysis. The pooled incidence of AVF was 14% after vertebral augmentation. Female, lower T-score, thoracolumbar junction fracture, intravertebral cleft, more injected cement volume, intradiscal cement leakage significantly increased the risk of AVF. Age, body mass index, steroid medication, Cobb angle change, postoperative Cobb angle showed no significant association with AVF. CONCLUSIONS: Identifying the risk factors of AVF can facilitate prevention strategy to avoid the AVF. Female, T-score, thoracolumbar junction fracture, intravertebral cleft, more cement volume, and intradiscal cement leakage increased the risk of AVF.

6.
Org Lett ; 24(1): 207-212, 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-34914391

RESUMO

An intramolecular C-C formation process based on catalytic asymmetric oxetane opening by carbon nucleophiles has been developed, which provides rapid access to a range of valuable enantioenriched 2,3-dihydrobenzo[b]oxepines. With the combination of Sc(OTf)3 and a Box ligand, good chemical efficiency and enantioselectivity were achieved under mild conditions. The products are also useful precursors to other valuable structures, such as the bicyclo[3.2.2]nonane derivatives.

8.
J Healthc Eng ; 2021: 5699025, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34873439

RESUMO

This study aimed to explore the expression level of miR-539 in the blood-brain barrier permeability induced by cerebrovascular occlusion and its mediated mechanism. Altogether, 48 patients with cerebral vascular occlusion lesions from March 2018 to June 2020 were collected. The expression level of miR-539 in the peripheral blood serum of the subjects was analyzed by qRT-PCR, and the participants were divided into two groups according to the results of head and neck ultrasound and CTA hemodynamics. The MCAO model of cerebral ischemia was established in rats, and the expression level of miR-539 was detected by qRT-PCR in brain tissues of different groups of rats. The effects of miR-539 on the permeability of blood-brain barrier were investigated by intraventricular injection of agomiR-539 and antagomir-539. The model of blood-brain barrier was established by culturing brain microvascular endothelial cells and pericytes in vitro, and the changes of miR-539 expression level and permeability after glucose and oxygen deprivation were detected. The expression level of SNAI2/MMP9 signaling pathway protein in cells was detected by Western blot. Compared with the healthy control group, the expression level of miR-539 in peripheral blood of patients with cerebrovascular occlusive disease decreased significantly, and the expression level of miR-539 in the MCAO rat model decreased and affected the permeability of blood-brain barrier. Glucose and oxygen deprivation treatment in brain microvascular endothelial cells can lead to downregulation of miR-539 expression and affect cell permeability. miR-539 in brain microvascular endothelial cells can target and bind to SNAI2 and participate in the regulation of endothelial cell permeability by affecting the SNAI2/MMP9 signaling pathway. The results of this study suggested that circulating miR-539 in peripheral blood may be a potential marker for predicting blood-brain barrier permeability after ischemic stroke. More detailed studies are needed to determine its diagnostic value.

9.
Exp Biol Med (Maywood) ; : 15353702211061881, 2021 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-34861122

RESUMO

Biomechanical properties of corneal scar are strongly correlated with many corneal diseases and some types of corneal surgery, however, there is no elasticity information available about corneal scar to date. Here, we proposed an acoustic radiation force optical coherence elastography system to evaluate corneal scar elasticity. Elasticity quantification was first conducted on ex vivo rabbit corneas, and the results validate the efficacy of our system. Then, experiments were performed on an ex vivo human scarred cornea, where the structural features, the elastic wave propagations, and the corresponding Young's modulus of both the scarred region and the normal region were achieved and based on this, 2D spatial distribution of Young's modulus of the scarred cornea was depicted. Up to our knowledge, we realized the first elasticity quantification of corneal scar, which may provide a potent tool to promote clinical research on the disorders and surgery of the cornea.

10.
J Neuroeng Rehabil ; 18(1): 169, 2021 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-34863184

RESUMO

BACKGROUND: Automated and accurate assessment for postural abnormalities is necessary to monitor the clinical progress of Parkinson's disease (PD). The combination of depth camera and machine learning makes this purpose possible. METHODS: Kinect was used to collect the postural images from 70 PD patients. The collected images were processed to extract three-dimensional body joints, which were then converted to two-dimensional body joints to obtain eight quantified coronal and sagittal features (F1-F8) of the trunk. The decision tree classifier was carried out over a data set established by the collected features and the corresponding doctors' MDS-UPDRS-III 3.13 (the 13th item of the third part of Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale) scores. An objective function was implanted to further improve the human-machine consistency. RESULTS: The automated grading of postural abnormalities for PD patients was realized with only six selected features. The intraclass correlation coefficient (ICC) between the machine's and doctors' score was 0.940 (95%CI, 0.905-0.962), meaning the machine was highly consistent with the doctors' judgement. Besides, the decision tree classifier performed outstandingly, reaching 90.0% of accuracy, 95.7% of specificity and 89.1% of sensitivity in rating postural severity. CONCLUSIONS: We developed an intelligent evaluation system to provide accurate and automated assessment of trunk postural abnormalities in PD patients. This study demonstrates the practicability of our proposed method in the clinical scenario to help making the medical decision about PD.

11.
Food Sci Nutr ; 9(12): 6617-6626, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34925791

RESUMO

In this study, headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC/MS) was used to identify individual volatile compounds in five jujube varieties, and E-nose was used to identify their flavor. The results showed that a total of 45 volatile compounds were detected by GC-MS in the five varieties, and the proportion of acids was the highest (38.29%-54.95%), followed by that of aldehydes (22.94%-47.93%) and esters (6.33%-26.61%). Moreover, different varieties had obviously different volatile components. E-nose analysis showed that the R7 and R9 sensors were more sensitive to the aroma of jujube than other sensors. The strong response of R7 sensor was attributed to terpenes (or structurally similar substances) in jujube fruit, such as 1-penten-3-one, 2-octenal, (E)-2-heptanaldehyde, and (E)-2-hexenal and that of R9 sensor was attributed to the cyclic volatile components such as benzaldehyde, benzoic acid, and methyl benzoate. The multivariate data analysis (PCA, OPLS-DA, and HCA) of the results of GC/MS and E-nose showed that the five varieties could be divided into three groups: (1) Ziziphus jujuba Mill. cv. Huizao (HZ) and Z. jujuba cv. Junzao (JZ). Acids were the main volatile components for this group (accounting for 47.44% and 54.95%, respectively); (2) Z. jujuba cv. Hamidazao (HMDZ). This group had the most abundant volatile components (41), and the concentrations were also the highest (1285.43 µg/kg); (3) Winter jujube 1 (Z. jujuba cv. Dongzao, WJ1) and Winter jujube 2 (Z. jujuba cv. Dongzao, WJ2). The proportion of acids (38.38% and 38.29%) and aldehydes (40.35% and 38.19%) were similar in the two varieties. Therefore, the combination of headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry and E-nose could quickly and accurately identify the volatile components in jujube varieties from macro- and microperspectives. This study can provide guidance for the evaluation and distinguishing of jujube varieties and jujube cultivation and processing.

12.
Ophthalmic Res ; 2021 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-34969027

RESUMO

Congenital ptosis, a birth defects presents at birth or by 1 year of age, is characterized by the drooping of the upper eyelid. either in isolation (non-syndromic) or with many different systemic disorders (syndromic). The estimated prevalence of ptosis (congenital & acquired) ranges from 0.79 to 1.99 per 10,000 people in different populations, and it is more prevalent in males. The underlying pathogenesis of congenital ptosis are myogenic and neurogenic, related to the development of muscles and nerves. Although most cases are sporadic, there are familial transmission characteristics, including autosomal dominant, recessive mode and X-linkage inheritance patterns. Moreover, some forms are due to chromosomal aberrations and mutations and deletions in mitochondrial DNA. Genes involved in simple congenital ptosis are ZFHX4 and COL25A1. The clinical aspects of various syndromes involving congenital ptosis are partly caused by single gene mutations. However, the pathogenesis of congenital ptosis is not fully understood. We review the reported epidemiology, genetics and clinical features of congenital ptosis and associated syndromes here.

13.
Artigo em Inglês | MEDLINE | ID: mdl-34948553

RESUMO

With the accelerated iteration of global electronic and electrical product updates, the demand for electronic and electrical products presents a new trend in which the life cycle of electronic and electrical products is shortened. Waste electrical and electronic equipment (WEEE) products pose a great threat to the global ecological environment, and solving this problem is urgent. Therefore, governments around the world have formulated funding policies for WEEE products, which has led to continuous improvements in such policies. Along these lines, we adopt the circular economy concept, extended producer responsibility theory and life cycle assessment method to comparatively analyse and compare the different fund operation modes in China, Germany, Japan and The Netherlands. In addition, based on the data related to fund policy implementation, we point out the problems in the development of the WEEE industry in China. The analysis results show that although China is the largest WEEE market, it is still in the initial stage and lags behind Western countries in efficiency and cost management. Then, taking as an example 'Go Green', an O2O classified recycling platform launched in 2005, this paper performs an extended analysis of the "Internet +" recycling model, which was proposed as a WEEE fund operation solution in China. Finally, we discuss the economic impact of this study on the future implementation and valuation of WEEE fund policy.


Assuntos
Resíduo Eletrônico , Administração Financeira , Gerenciamento de Resíduos , Resíduo Eletrônico/análise , Eletrônica , Políticas , Reciclagem
14.
Clin Otolaryngol ; 2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34847298

RESUMO

The Baha® Attract system can provide effective and stable hearing amplification for patients with microtia. Concurrent surgeries of auricle reconstruction and Baha® Attract implantation do not result in more soft tissue complications. The number of adverse events increased with the duration of implantation, even one year postoperatively. Benign skin evolutions, including skin thinning and erythema at the implant side, are commonly seen in Baha® Attract users. Implants are not necessarily removed when skin necrosis occurs in Baha® Attract users.

15.
Materials (Basel) ; 14(22)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34832356

RESUMO

Alkaline electrolyzed water, a kind of clean green water with excellent characteristics such as high activity, strong alkalinity, high ion penetrating ability, electrical charge, and good molecule adsorption, was significant to the resource utilization of industrial fly ash waste. This paper studies highly active potassium-based alkaline electrolyzed water's impact, compared with ordinary water, on the cement hydration process using microstructural methods such as a hydration heat test, differential thermal analysis, X-ray diffraction (XRD) pattern, and Scanning electron microscope (SEM) image analysis. Fly ash cement-based materials were first prepared with alkaline electrolyzed water as the mixing water. The alkaline electrolyzed water's influence on fly ash paste workability and the mechanical properties of fly ash mortar for varying fly ash proportions were ratified. Then alkaline electrolyzed water with the best pH value was selected to prepare fly ash concrete, and its durability was studied. The test results showed that it is feasible to increase the utilization rate of fly ash by using alkaline electrolyzed water. Furthermore, it promoted the process of cement hydration, increased the rate of the hydration reaction, and the promotion effect increased with the increase in pH value of the alkaline electrolyzed water, and also promoted the effective decomposition of the vitreous shell of fly ash to stimulate its early activity. Concurrent tests with ordinary water paste showed that the water requirement for normal consistency and setting time with alkaline electrolyzed water paste were significantly less. Alkaline electrolyzed water also solved the problem related to the low early strength of fly ash mortar. Furthermore, using alkaline electrolyzed water with an optimum pH value of 11.5 to prepare fly ash concrete effectively reduced concrete's carbonation depth and carbonation rate and lessened the chloride ion migration coefficient.

16.
Materials (Basel) ; 14(22)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34832357

RESUMO

The carburizing-quenching-tempering process is generally conducted on heavy-duty gear in order to obtain favorable comprehensive mechanical performance. Different mechanical properties could be produced by carbon partition and precipitation. In this study, the carburizing-quenching-tempering process was carried out on low-carbon alloy steel in order to investigate the influence of microstructure evolution and precipitate transition on mechanical behavior and wear resistance under different carburizing/tempering durations. Favorable comprehensive mechanical property and wear resistance could be obtained in favor of long durations of carburizing/tempering. A fatigue-wear model was proposed to describe fatigue crack evolution and damage mechanism on the basis of wear features.

17.
Phytomedicine ; : 153847, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34836744

RESUMO

BACKGROUND: N-methyl-d-aspartate receptors (NMDARs) have been demonstrated to play central roles in stroke pathology and recovery, including dual roles in promoting either neuronal survival or death with their different subtypes and locations. PURPOSE: We have previously demonstrated that pseudoginsenoside-F11 (PF11) can provide long-term neuroprotective effects on transient and permanent ischemic stroke-induced neuronal damage. However, it is still needed to clarify whether NMDAR-2A (NR2A)-mediated pro-survival signaling pathway is involved in the beneficial effect of PF11 on permanent ischemic stroke. MATERIAL AND METHODS: PF11 was administrated in permanent middle cerebral artery occlusion (pMCAO)-operated rats. The effect of PF11 on oxygen-glucose deprivation (OGD)-exposed primary cultured neurons were further evaluated. The regulatory effect of PF11 on NR2A expression and the activation of its downstream AKT-CREB pathway were detected by Western blotting and immunofluorescence in the presence or absence of a specific NR2A antagonist NVP-AAM077 (NVP) both in vivo and in vitro. RESULTS: PF11 dose- and time-dependently decreased calpain1 (CAPN1) activity and its specific breakdown product α-Fodrin expression, while the expression of Ca2+/calmodulin-dependent protein kinase II alpha (CaMKII-α) was significantly upregulated in the cortex and striatum of rats at 24 h after the onset of pMCAO operation. Moreover, PF11 prevented the downregulation of NR2A, p-AKT/AKT, and p-CREB/CREB in both in vivo and in vitro stroke models. Finally, the results indicated treatment with NVP can abolish the effects of PF11 on alleviating the ischemic injury and activating NR2A-mediated AKT-CREB signaling pathway. CONCLUSIONS: Our results demonstrate that PF11 can exert neuroprotective effects on ischemic stroke by inhibiting the activation of CAPN1 and subsequently enhancing the NR2A-medicated activation of AKT-CREB pathway, which provides a mechanistic link between the neuroprotective effect of PF11 against cerebral ischemia and NR2A-associated pro-survival signaling pathway.

18.
Stem Cell Rev Rep ; 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34787794

RESUMO

BACKGROUND: Tissue ischemia usually leads to necrosis and is a threatening condition associated with reconstructive surgery. Promoting the survival of ischemic tissue is critical for improving clinical outcomes. Although various solutions based on stem cells have been reported, there are still limitations to clinical translation. The aim of this study was to develop an effective method to promote the survival of ischemic tissue. METHODS: Adipose-derived CD34 + and CD34- cells were obtained by magnetic bead sorting from the stromal vascular faction (SVF). Adipose-derived stem cells (ADSCs) were collected by subculture. The angiogenic capacities of CD34 + cells, CD34- cells and ADSCs were evaluated in vitro by comparing mRNA and protein expression. Random axial flaps in nude mice were used to evaluate the efficacy of these cells in protecting tissue from necrosis. The effect of these cells in preventing inflammation was also evaluated. RESULTS: Our data suggest that CD34 + cells expressed higher levels of angiogenetic factors and lower levels of inflammatory factors than the other cell types. More vessel branches were formed when human umbilical vein endothelial cells (HUVECs) were treated with conditioned medium from CD34 + cells than conditioned medium from the other cell types. Compared to ADSCs, CD34 + cells showed significantly higher efficacy in promoting tissue survival. More CD31 + cells and higher levels of angiogenic factors were observed in tissues from the CD34 + group than in those from the other groups. Lower levels of the proinflammatory factors TNF-α and IL-1b and higher levels of anti-inflammatory factors were found in the CD34 + group than in the other groups. CONCLUSION: Adipose-derived CD34 + cells showed better efficacy in improving ischemic tissue survival than ADSCs by reducing tissue inflammation and promoting angiogenesis. CD34 + cells can be obtained easily and may be suitable for clinical applications.

19.
J Gastrointest Oncol ; 12(5): 2361-2376, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34790398

RESUMO

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer with a high mortality rate. However, spliceosomal genes are still lacking in the diagnosis and prognosis of HCC. Methods: Identification of differentially expressed genes (DEGs) was performed using the limma package in R software. Modules highly related to HCC were obtained by weighted gene co-expression network analysis (WGCNA), and the module genes were analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. The biomarker for diagnosing HCC was determined by receiver operating characteristic (ROC) curve analysis, and the effect of the biomarker in the diagnosis of HCC was evaluated by performing five-fold cross-validation with logistic regression. HCC specimens from preoperatively treated patients were tested for biomarker by real-time quantitative polymerase chain reaction (RT-qPCR). Kaplan-Meier analysis was used to assess the relationship between biomarker and patient survival. The role of biomarker was evaluated using ESTIMATE analysis in the tumor microenvironment. Results: In this study, 389 DEGs were screened out from three Gene Expression Omnibus (GEO) datasets. We also found that the turquoise module of 123 genes from The Cancer Genome Atlas (TCGA) data was the key module with the highest correlation with HCC traits. Then, 123 genes were analyzed using the KEGG enrichment pathway, and eight genes were found to be most significantly related to the spliceosome pathway. We selected 8 genes and 389 DEGs shared genes, and finally got the only gene, heterogeneous nuclear ribonucleoprotein (hnRNPU). The high expression of hnRNPU was associated with poor prognosis of HCC, and hnRNPU was a biomarker for diagnosing HCC. In the tissues of patients with excellent HCC treatment hnRNPU messenger RNA (mRNA) was lower than in the tissues of patients with poor HCC treatment. High expression of hnRNPU was significantly increased in HCC patients with low stromal (P<0.05), low immune (P<0.05), and low estimation scores (P<0.05), and with high tumor purity (P<0.05) and high malignant progression (P<0.05) of the HCC. Conclusions: The hnRNPU gene identified in this study may become a new biomarker for the diagnosis and prognosis of HCC.

20.
Front Med (Lausanne) ; 8: 754202, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733869

RESUMO

Background: Today's machine-learning based dermatologic research has largely focused on pigmented/non-pigmented lesions concerning skin cancers. However, studies on machine-learning-aided diagnosis of depigmented non-melanocytic lesions, which are more difficult to diagnose by unaided eye, are very few. Objective: We aim to assess the performance of deep learning methods for diagnosing vitiligo by deploying Convolutional Neural Networks (CNNs) and comparing their diagnosis accuracy with that of human raters with different levels of experience. Methods: A Chinese in-house dataset (2,876 images) and a world-wide public dataset (1,341 images) containing vitiligo and other depigmented/hypopigmented lesions were constructed. Three CNN models were trained on close-up images in both datasets. The results by the CNNs were compared with those by 14 human raters from four groups: expert raters (>10 years of experience), intermediate raters (5-10 years), dermatology residents, and general practitioners. F1 score, the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity metrics were used to compare the performance of the CNNs with that of the raters. Results: For the in-house dataset, CNNs achieved a comparable F1 score (mean [standard deviation]) with expert raters (0.8864 [0.005] vs. 0.8933 [0.044]) and outperformed intermediate raters (0.7603 [0.029]), dermatology residents (0.6161 [0.068]) and general practitioners (0.4964 [0.139]). For the public dataset, CNNs achieved a higher F1 score (0.9684 [0.005]) compared to the diagnosis of expert raters (0.9221 [0.031]). Conclusion: Properly designed and trained CNNs are able to diagnose vitiligo without the aid of Wood's lamp images and outperform human raters in an experimental setting.

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