Microstructural abnormality of white matter tracts in rheumatoid arthritis

BACKGROUND

Structural and functional brain imaging studies have reported abnormalities of gray matter morphology and functional activities in patients with rheumatoid arthritis (RA). However, it is largely unknown whether patients with RA show alterations of white matter microstructural organization.

OBJECTIVES

To automatically identify alteration of white matter microstructure in patients with RA and further examine how this alteration associates with clinical characteristics.

METHODS

This single-institutional prospective study included 66 participants (33 patients with RA [52 ± 9 years, 29 women] and 33 sex/age-matched healthy controls [53 ± 12 years, 27 women]), who underwent diffusion MRI scan from January 2021 to December 2021. The white matter microstructure was assessed using fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. Voxelwise analyses were conducted on white matter skeleton using an automated, observer-independent tract-based spatial statistics analysis. The relationship between white matter microstructural alterations and clinical and neuropsychological variables was evaluated using correlation analysis.

RESULTS

Compared with healthy controls, patients with RA exhibited lower fractional anisotropy in several major white matter tracts (threshold-free cluster enhancement at P < 0.05 for multiple comparison correction, permutation test), involving the forceps minor, bilateral inferior fronto-occipital fasciculus, bilateral anterior thalamic radiation, and bilateral uncinate fasciculus. Lower fractional anisotropy values in the patients with RA were significantly associated with pain-related assessments, including tender joint count (r = -0.43, P = 0.015), Clinical Disease Activity Index score (r = -0.36, P = 0.049), pain severity rated through visual analogue scale (r = -0.45, P = 0.012), and Simplified Disease Activity Index score (r = -0.36, P = 0.045). No significant group difference was found in mean diffusivity, axial diffusivity, and radial diffusivity.

CONCLUSIONS

We report the first anatomical evidence for aberrant microstructure organization of several major white matter tracts and its associations with pain processing in patients with rheumatoid arthritis.

Charge Carrier Regulation for Efficient Blue Quantum-Dot Light-Emitting Diodes Via a High-Mobility Coplanar Cyclopentane[b]thiopyran Derivative

The performance of blue quantum dot light-emitting diodes (QLEDs) is limited by unbalanced charge injection, resulting from insufficient holes caused by low mobility or significant energy barriers. Here, we introduce an angular-shaped heteroarene based on cyclopentane[b]thiopyran (C8-SS) to modify the hole transport layer poly-N-vinylcarbazole (PVK), in blue QLEDs. C8-SS exhibits high hole mobility and conductivity due to the π···π and S···π interactions. Introducing C8-SS to PVK significantly enhanced hole mobility, increasing it by 2 orders of magnitude from 2.44 × 10-6 to 1.73 × 10-4 cm2 V-1 s-1. Benefiting from high mobility and conductivity, PVK:C8-SS-based QLEDs exhibit a low turn-on voltage (Von) of 3.2 V. More importantly, the optimized QLEDs achieve a high peak power efficiency (PE) of 7.13 lm/W, which is 2.65 times that of the control QLEDs. The as-proposed interface engineering provides a novel and effective strategy for achieving high-performance blue QLEDs in low-energy consumption lighting applications.

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

BACKGROUND

In the clinic, practitioners encounter many patients with an abnormal pattern of dense punctate magnetic resonance imaging (MRI) signal in the basal ganglia, a phenomenon known as "cheese sign". This sign is reported as common in cerebrovascular diseases, dementia, and old age. Recently, cheese sign has been speculated to consist of dense perivascular space (PVS). This study aimed to assess the lesion types of cheese sign and analyze the correlation between this sign and vascular disease risk factors.

METHODS

A total of 812 patients from Peking Union Medical College Hospital (PUMCH) dementia cohort were enrolled. We analyzed the relationship between cheese sign and vascular risk. For assessing cheese sign and defining its degree, the abnormal punctate signals were classified into basal ganglia hyperintensity (BGH), PVS, lacunae/infarctions and microbleeds, and counted separately. Each type of lesion was rated on a four-level scale, and then the sum was calculated; this total was defined as the cheese sign score. Fazekas and Age-Related White Matter Changes (ARWMC) scores were used to evaluate the paraventricular, deep, and subcortical gray/white matter hyperintensities.

RESULTS

A total of 118 patients (14.5%) in this dementia cohort were found to have cheese sign. Age (odds ratio [OR]: 1.090, 95% confidence interval [CI]: 1.064-1.120, P <0.001), hypertension (OR: 1.828, 95% CI: 1.123-2.983, P = 0.014), and stroke (OR: 1.901, 95% CI: 1.092-3.259, P = 0.025) were risk factors for cheese sign. There was no significant relationship between diabetes, hyperlipidemia, and cheese sign. The main components of cheese sign were BGH, PVS, and lacunae/infarction. The proportion of PVS increased with cheese sign severity.

CONCLUSIONS

The risk factors for cheese sign were hypertension, age, and stroke. Cheese sign consists of BGH, PVS, and lacunae/infarction.

Chitin microspheres: From fabrication to applications

Chitin microspheres (CMs) have attracted increasing attention due to their biocompatibility, uniform size and shape, large surface area, and porous structure. Considerable research efforts have been focused on developing CMs and promoting their applications in various areas. In this context, this review aims to describe the most recent progress in the fabrication and application of CMs. Different routes that can be used to prepare CMs, such as the drip method and the emulsion method, are emphatically introduced. Moreover, the applications of CMs as drug delivery systems, wound dressings, three-dimensional (3D) scaffolds, water purification, and functional supporting materials in the fields of biomedicine, tissue engineering, environmental protection, and energy storage are also highlighted. We hope this review can provide a comprehensive and useful database for further innovation of CMs.

The booster immunization using commercial vaccines effectively protect chickens against novel variants of infectious bursal disease virus (genotype A2dB1)

The novel variant IBDV (nVarIBDV, genotype A2dB1), characterized by bursal atrophy of fabricius and decreased lymphocytes, has been emerging on a large scale in Asia (including China) since late 2018. nVarIBDV is a new threat to the poultry industry, yet the currently licensed commercial vaccines, including the live viral vector vaccine, IBDV immune complex vaccine or VP2 subunit vaccine, are ineffective against nVarIBDV infection. In this study, specific-pathogen-free (SPF) chickens and broilers divided into 3 groups were vaccinated with the live viral vector vaccine, the VP2 subunit vaccine or the IBDV immune complex vaccine at 1 day-old, respectively. The SPF chickens received a secondary vaccination with the live B87 strain vaccine at 11-day-old. The bursa/body weight ratio, histopathology lesion of the bursa, and the differentiation between infected and vaccinated animals (DIVA) by qRT-PCR confirmed that the live viral vector vaccine or immune complex vaccine plus live B87 strain booster could provide at least 80% protection against the FJ2019-01 strain of nVarIBDV in SPF chickens. The broilers also received a secondary vaccination using a live W2512 G-61 strain vaccine at 14-day-old, and analyses showed that the VP2 subunit vaccine or immune complex vaccine plus the live W2512 G-61 strain booster also provided more than 80% protection against the FJ2019-01 strain of nVarIBDV. Unfortunately, the live viral vector vaccine plus live W2512 G-61 strain booster provided poor to moderate protection against FJ2019-01 in broilers. These findings suggest that combining commercial vaccines with rational booster immunization can effectively protect chickens against an nVarIBDV challenge.

Bioinspired Gradient Covalent Organic Framework Membranes for Ultrafast and Asymmetric Solvent Transport

Gradients play a pivotal role in membrane technologies, e.g., osmotic energy conversion, desalination, biomimetic actuation, selective separation, and more. In these applications, the compositional gradients are of great relevance for successful function implementation, ranging from solvent separation to smart devices; However, the construction of functional gradient in membranes is still challenging both in scale and directions. Inspired by the specific function-related, graded porous structures in glomerular filtration membranes, a general approach for constructing gradient covalent organic framework membranes (GCOMx) applying poly (ionic liquid)s (PILs) as template is reported here. With graded distribution of highly porous covalent organic framework (COF) crystals along the membrane, GCOMx exhibts an unprecedented asymmetric solvent transport when applying different membrane sides as the solvent feed surface during filtration, leading to a much-enhanced flux (10-18 times) of the "large-to-small" pore flow comparing to the reverse direction, verified by hydromechanical theoretical calculations. Upon systematic experiments, GCOMx achieves superior permeance in nonpolar (hexane ≈260.45 LMH bar-1) and polar (methanol ≈175.93 LMH bar-1) solvents, together with narrow molecular weight cut-off (MWCO, 472 g mol-1) and molecular weight retention onset (MWRO, <182 g mol-1). Interestingly, GCOMx shows significant filtration performance in simulated kidney dialysis, revealing great potential of GCOMx in bionic applications.

Exploring the role of exosomal MicroRNAs as potential biomarkers in preeclampsia

The complex pathogenesis of preeclampsia (PE), a significant contributor to maternal and neonatal mortality globally, is poorly understood despite substantial research. This review explores the involvement of exosomal microRNAs (exomiRs) in PE, focusing on their impact on the protein kinase B (AKT)/hypoxia-inducible factor 1-α (HIF1α)/vascular endothelial growth factor (VEGF) signaling pathway as well as endothelial cell proliferation and migration. Specifically, this article amalgamates existing evidence to reveal the pivotal role of exomiRs in regulating mesenchymal stem cell and trophoblast function, placental angiogenesis, the renin-angiotensin system, and nitric oxide production, which may contribute to PE etiology. This review emphasizes the limited knowledge regarding the role of exomiRs in PE while underscoring the potential of exomiRs as non-invasive biomarkers for PE diagnosis, prediction, and treatment. Further, it provides valuable insights into the mechanisms of PE, highlighting exomiRs as key players with clinical implications, warranting further exploration to enhance the current understanding and the development of novel therapeutic interventions.

Interfacial Passivation Engineering for Highly Efficient Quantum Dot Light-Emitting Diodes via Aromatic Amine-Functionalized Dipole Molecules

Blue quantum dot (QD) light-emitting diodes (QLEDs) exhibit unsatisfactory operational stability and electroluminescence (EL) properties due to severe nonradiative recombination induced by large numbers of dangling bond defects and charge imbalance in QD. Herein, dipolar aromatic amine-functionalized molecules with different molecular polarities are employed to regulate charge transport and passivate interfacial defects between QD and the electron transfer layer (ETL). The results show that the stronger the molecular polarity, especially with the -CF3 groups possessing a strong electron-withdrawing capacity, the more effective the defect passivation of S and Zn dangling bonds at the QD surface. Moreover, the dipole interlayer can effectively reduce electron injection into QD at high current density, enhancing charge balance and mitigating Joule heat. Finally, blue QLEDs exhibit a peak external quantum efficiency (EQE) of 21.02% with an operational lifetime (T50 at 100 cd m-2) exceeding 4000 h.

Preparation of Sol-Gel-Derived CaO-B2O3-SiO2 Glass/Al2O3 Composites with High Flexural Strength and Low Dielectric Constant for LTCC Application

Low-temperature co-fired ceramic (LTCC) substrate materials are widely applied in electronic components due to their excellent microwave dielectric properties. However, the absence of LTCC materials with a lower dielectric constant and higher mechanical strength restricts the creation of integrated and minified electronic devices. In this work, sol-gel-derived CaO-B2O3-SiO2 (CBS) glass/Al2O3 composites with high flexural strength and low dielectric constant were successfully prepared using the LTCC technique. Among the composites sintered at different temperatures, the composites sintered at 870 °C for 2 hours possess a dielectric constant of 6.3 (10 GHz), a dielectric loss of 0.2%, a flexural strength of 245 MPa, and a CTE of 5.3 × 10-6 K-1, demonstrating its great potential for applications in the electronic package field. By analyzing the CBS glass' physical characteristics, it was found that the sol-gel-derived glass has an extremely low dielectric constant of 3.6 and does not crystallize or react with Al2O3 at the sintering temperature, which is conducive to improving the flexural strength and reducing the dielectric constant of CBS glass/Al2O3 composites.

Association Between Wnt Target Genes and Cortical Volumes in Alzheimer's Disease

The disproportionate cortical atrophy is an established biomarker for the pathophysiological process of Alzheimer's disease (AD). However, the genetic basis underlying the cortical atrophy remains poorly defined. Herein, we aim to illustrate the effect of the Wnt target genes on the cortical volumes of AD patients. 82 sporadic AD patients were recruited. All the subjects had history survey, blood biochemical examination, cognitive assessment, MRI morphometry and whole exome sequencing. This report focused on 84 common variants (minor allele frequency > 0.01) of 32 Wnt target genes, including the APC, DAAM1, DACT1, DISC1, LATS2, TLR2, WDR61, and the AXIN, DVL, FZD, LRP, TCF/LEF, WNT family genes. The Wnt target genes showed asymmetric effects on the cortical volumes of AD patients. The right temporal/parietal/occipital cortices were more affected than left temporal/parietal/occipital cortices. Nevertheless, the reverse applied to the frontal cortex. The DACT1 affected the cortical thickness most, followed by the TCF3 and APC. The DACT1 rs698025-GG genotype displayed greater right temporal pole and left medial orbito-frontal gyrus than rs698025-GA genotype (2.4 ± 0.4 vs. 2.0 ± 0.6, P = 0.005; 5.2 ± 0.6 vs. 5.0 ± 0.6, P = 0.001). The brain region most influenced by the Wnt target genes was the right calcarine cortex. In conclusion, the common variants of the Wnt target genes exert asymmetric effects on the cortical volumes of AD patients. The Wnt signaling pathway may play a role in the cortical atrophy of AD patients.

Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience

OBJECTIVE

To compare outcomes of posterior fossa bony decompression alone (PFD) versus PFD with duraplasty (PFDD) versus PFDD with additional obex exploration (PFDDO) in patients with Chiari malformation type I (CMI) combining syringomyelia.

METHODS

Clinical records of adult patients who underwent decompressions from 2014 to 2022 were retrospectively analyzed. The decompression procedure was individualized based on the cerebrospinal fluid pulse in the surgical field. The Chicago Chiari Outcome Scale (CCOS) was used to assess the prognosis of the patients and a novel syringomyelia resolution scale, based on 3-dimensional volume, was introduced. The percentage change in the cervical syrinx volume was classified as follows by resolution: ≥ 70%, 30%-70%, and < 30%.

RESULTS

Seventy-eight individuals were enrolled, of which 22, 20, and 36 underwent PFD, PFDD, and PFDDO, respectively. The three decompression groups had no significant difference in the preoperative characteristics and postoperative prognosis. Multivariate analyses revealed that better CCOS was significantly correlated with younger age at surgery (p = 0.018), syrinx originated from lower cervical levels (p = 0.037), narrower preoperative cerebral aqueduct (p = 0.005), and better syrinx volume resolution (p = 0.004). Additionally, a better cervical syrinx volume resolution was significantly correlated with higher CCOS (p = 0.017), narrower cerebral aqueduct (p = 0.035), and better tonsillar descent resolution (p = 0.007).

CONCLUSION

Individualized functional decompression induced an equal effect on CCOS and syrinx volume resolution for all CMI patients with syringomyelia. Our syringomyelia resolution scale facilitates communication and prediction of CMI prognosis.

Health care utilisation and education outcomes of children with rare diseases: a born in Bradford cohort study

The purpose of this study is to describe the burden of health care utilisation and early education outcomes of children with and without rare diseases. Using the Born in Bradford birth cohort and its linked routine health care and education data, we looked at cumulative primary care episodes, hospital admissions and medication prescriptions. We assessed education outcomes using Early Years Foundation Stage Profile and the National Curriculum Tests-Key Stage 1 results. Among analytical sample of 13,858, 1711 or 12.3% children were identified with a rare disease by an average age of 14 years. Children with rare diseases were twice more likely to be admitted to hospital compared to children without. Average length of stay was around 5 days in those with rare diseases group compared to less than 1 day in those without. The average number of primary care episodes was 45.4 in children with rare diseases and 28.2 visits in those without. These children were over three times more likely to be on multiple medications. Children with rare diseases had 30% higher risk of being below academic expectations at Foundation Year and, depending on subject, between 50 and 60% higher risks at KS1 tests.  Conclusions: Children with rare diseases are significantly more likely to have increased primary care episodes and to have more regular medications. They are likely to have more hospital admissions with a longer stay also. Educationally, they are at higher risk of failing to achieve expected standards in early-year settings. What is Known: • Existing studies of rare diseases have used cross sectional data to describe secondary care data. Previous research has not explored the impact of rare diseases on academic outcomes in children. What is New: • Using Born in Bradford birth cohort and its linked primary and secondary care data, this study provides the most comprehensive estimate of prevalence of rare diseases in any study to date. Children with rare diseases were not only significantly more likely to have contact with primary care and to be admitted to hospitals; they were also more like to be on more regular medications and had higher risk of not achieving expected standards in early-year education outcomes. • Our study is unusual in being able to access linked health and education data and reinforces the importance of adopting a whole system approach to children's health and wellbeing that recognises the close links between health and education.

Pembrolizumab for the treatment of progressive multifocal leukoencephalopathy in China

The aim of this study is to analyze the clinical characteristics and outcomes of Chinese patients with progressive multifocal leukoencephalopathy (PML) who were treated with programmed cell death protein 1 (PD1) blockade therapies. We retrospectively analyzed patients who were admitted to our hospital between October 1, 2020, and October 1, 2022, diagnosed with PML and treated with PD1 blockade therapies. Four patients with PML who were treated with PD1 blockade therapies were identified. All patients were male, and their ages ranged from 19 to 54 years old. One patient (Case 2) exhibited mild pleocytosis, while three patients (Cases 2-4) had markedly reduced T lymphocyte cell counts prior to treatment. The time interval between symptom onset and treatment initiation ranged from six to 54 weeks. All patients received pembrolizumab treatment, with a total of two to four doses administered. Three patients who responded to pembrolizumab treatment showed clinical improvement starting around 8 weeks after the initiation of therapy. Although one patient did not show clinical improvement, they ultimately survived until the last follow-up. None of the patients in this study exhibited immune-related adverse events or immune reconstitution inflammatory syndrome. PD1 blockade appears to be a promising novel therapeutic option for PML; additional prospective studies are necessary to confirm its efficacy.

Imaging of Angiogenesis in White Matter Hyperintensities

Background White matter hyperintensities (WMHs) are areas of increased signal intensity on T2-weighted magnetic resonance imaging (MRI). WMH penumbra may be a potential target for early intervention in WMHs. We explored the relationship between angiogenesis and WMH penumbra in patients with WMHs. Methods and Results Twenty-one patients with confluent WMHs of Fazekas grade ≥2 were included. All the participants underwent 68Ga-NOTA-PRGD2 positron emission tomography/magnetic resonance imaging. WMH penumbra was analyzed with masks created for the WMH and 7 normal-appearing white matter layers; each layer was dilated away from the WMH by 2 mm. Angiogenesis array and ELISA were used to detect the serum levels of angiogenic factors, inflammatory factors, HIF-1 alpha, and S100B. Fourteen patients with increased 68Ga-NOTA-PRGD2 maximum standardized uptake (>0.17) were classified into group 2. Seven patients with maximum standardized uptake ≤0.17 were classified as group 1. WMH volume and serum levels of integrin αvβ3, vascular endothelial growth factor receptor 22, and interleukin-1β tended to be higher in group 2 than in group 1. In group 2, 68Ga-NOTA-PRGD2 uptake was significantly increased at the border between the WMH and normal-appearing white matter than in WMHs (P=0.004). The structure penumbra, defined by fractional anisotropy, was wider in group 2 (8 mm) than in group 1 (2 mm). The cerebral blood flow penumbra was 12 mm in both groups. Angiogenesis showed a correlation with reduced cerebral blood flow and microstructure integrity. Conclusions Our study provides evidence that angiogenesis occurs in the WMH penumbra. Further studies are warranted to verify the effect of angiogenesis on WMH growth.

Magnetically Responsive Superhydrophobic Surface with Reversibly Switchable Wettability: Fabrication, Deformation, and Switching Performance

Responsive surfaces with reversibly switchable wettability have attracted widespread attention due to their diverse range of potential applications in the past few years. As a representative example, the magnetically actuated dynamic regulation structured surfaces provide a convenient and unique approach to achieving remote control and instantaneous response. However, (quasi)quantitative design strategies and economical fabrication methods with high precision for magnetically responsive surfaces with both superhydrophobicity and superior wetting switchability still remain challenging. In this work, a manufacturing technique for high-aspect-ratio magnetically responsive superhydrophobic surfaces (MRSSs) via the integration of micromilling, replica molding, and coating modification is proposed. The geometrical parameters of magnetic micropillar arrays (MMAs) on the surface are specially designed on the basis of the Cassie-Wenzel (C-W) transition critical condition in order to guarantee the initial superhydrophobicity of the surface. Benefiting from the reconfigurable microstructures of MMAs in response to magnetic fields (i.e., shifting between upright and curved states), the wettability and adhesion of MRSSs can be reversibly switched. The smart wetting controllability presented on MRSSs is proven to be largely determined by the geometrical parameters and deformation capacity of the micropillars, while the visible wetting switching is mainly ascribed to the variation in wetting regimes of droplets. The modification of the superhydrophobic coatings on the micropillar top is also demonstrated to be capable of further enhancing the initial hydrophobicity and switchable wettability of surfaces, producing water droplets with a volume of 4-6 μL to exhibit the reversible switch from low adhesive superhydrophobicity to high adhesive hydrophilicity. In addition to providing an alternative fabrication strategy, this work also presents a set of design concepts for more applicable and sensitive MRSSs, offering a reference to both fundamental research and practical applications.

Reversibility of Impaired Large-Scale Functional Brain Networks in Cushing's Disease after Surgery Treatment: A Longitudinal Study

INTRODUCTION

Chronic exposure to excessive endogenous cortisol leads to brain changes in Cushing's disease (CD). However, it remains unclear how CD affects large-scale functional networks (FNs) and whether these effects are reversible after treatment. This study aimed to investigate functional network changes of CD patients and their reversibility in a longitudinal cohort.

METHODS

Active CD patients (N = 37) were treated by transsphenoidal pituitary surgery and reexamined 3 months later. FNs were computed from resting-state fMRI data of the CD patients and matched normal controls (NCs, N = 37). A pattern classifier was built on the FNs to distinguish active CD patients from controls and applied to FNs of the CD patients at the 3-month follow-up. Two subgroups of endocrine-remitted CD patients were identified according to their classification scores, referred to as image-based phenotypically (IBP) recovered and unrecovered CD patients, respectively. The informative FNs identified by the classification model were compared between NCs, active CD patients, and endocrine-remitted patients as well as between IBP recovered and unrecovered CD patients to explore their functional network reversibility.

RESULTS

All 37 CD patients reached endocrine remission after treatment. The classification model identified three informative FNs, including cerebellar network (CerebN), fronto-parietal network (FPN), and default mode network. Among them, CerebN and FPN partially recovered toward normal at 3 months after treatment. Moreover, the informative FNs were correlated with 24-h urinary-free cortisol and emotion scales in CD patients.

CONCLUSION

These findings suggest that CD patients have aberrant FNs that are partially reversible toward normal after treatment.

Optical Integration in Wearable, Implantable and Swallowable Healthcare Devices

Recent advances in materials and semiconductor technologies have led to extensive research on optical integration in wearable, implantable, and swallowable health devices. These optical systems utilize the properties of light─intensity, wavelength, polarization, and phase─to monitor and potentially intervene in various biological events. The potential of these devices is greatly enhanced through the use of multifunctional optical materials, adaptable integration processes, advanced optical sensing principles, and optimized artificial intelligence algorithms. This synergy creates many possibilities for clinical applications. This Perspective discusses key opportunities, challenges, and future directions, particularly with respect to sensing modalities, multifunctionality, and the integration of miniaturized optoelectronic devices. We present fundamental insights and illustrative examples of such devices in wearable, implantable, and swallowable forms. The constant pursuit of innovation and the dedicated approach to critical challenges are poised to influence diverse fields.

Multidelay MR Arterial Spin Labeling Perfusion Map for the Prediction of Cerebral Hyperperfusion After Carotid Endarterectomy

BACKGROUND

Multidelay arterial spin labeling (ASL) generates time-resolved perfusion maps, which may provide sufficient and accurate hemodynamic information in carotid stenosis.

PURPOSE

To use imaging markers derived from multidelay ASL magnetic resonance imaging (MRI) and to determine the optimal strategy for predicting cerebral hyperperfusion after carotid endarterectomy (CEA).

STUDY TYPE

Prospective observational cohort.

SUBJECTS

A total of 79 patients who underwent CEA for carotid stenosis.

FIELD STRENGTH/SEQUENCE

A 3.0 T/pseudo-continuous ASL with three postlabeling delays of 1.0, 1.57, and 2.46 seconds using fast-spin echo readout.

ASSESSMENT

Cerebral perfusion pressure, antegrade, and collateral flow were scored on a four-grade ordinal scale based on preoperative multidelay ASL perfusion maps. Simultaneously, quantitative hemodynamic parameters including cerebral blood flow (CBF), arterial transit time (ATT), relative CBF (rCBF) and relative ATT (rATT; ipsilateral/contralateral values) were calculated. On the CBF ratio map obtained through dividing postoperative by preoperative CBF map, regions of interest were placed covering ipsilateral middle cerebral artery territory. Three neuroradiologists conducted this procedure. Cerebral hyperperfusion was defined as a CBF ratio >2.

STATISTICAL TESTS

Weighted κ values, independent sample t test, chi-square test, Mann-Whitney U-test, multivariable logistic regression analysis, receiver-operating characteristic curve analysis, and Delong test. Significance level was P < 0.05.

RESULTS

Cerebral hyperperfusion was observed in 15 (19%) patients. Higher blood pressure (odd ratio [OR] = 1.08) and carotid near-occlusion (NO; OR = 7.31) were clinical risk factors for postoperative hyperperfusion. Poor ASL perfusion score (OR = 37.33), decreased CBF (OR = 0.74), prolonged ATT (OR = 1.02), lower rCBF (OR = 0.91), and higher rATT (OR = 1.12) were independent imaging predictors of hyperperfusion. ASL perfusion score exhibited the highest specificity (95.3%), while CBF exhibited the highest sensitivity (93.3%) for the prediction of hyperperfusion. When combined with ASL perfusion score, CBF and ATT, the predictive ability was significantly higher than using blood pressure and NO alone (AUC: 0.98 vs. 0.78).

DATA CONCLUSIONS

Multidelay ASL can accurately predict cerebral hyperperfusion after CEA with high sensitivity and specificity.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY: Stage 5.

Raw to charred: Changes of protein oxidation and in vitro digestion characteristics of grilled lamb

This study aimed to evaluate protein oxidation and in vitro digestion characteristics of lamb that was grilled from raw to charred (0-30 min). Results showed that protein oxidation was aggravated with the time of grilling, indicated by a significant linear increase in carbonyl groups and a linear decrease in sulfhydryl groups. Proteins had the highest simulated gastric and gastrointestinal digestibility at 10-15 min of grilling. Newly formed specific peptides were continuously released during the grilling process. The identified peptides were mainly derived from creatine kinase, phosphoglycerate kinase, actin and myosin light chain. Protein oxidation was closely related to digestive characteristics, and grilling for >15 min would aggravate protein oxidation and reduce its digestibility. Therefore, at 220 °C lamb should not be grilled for longer than 15 min.

A swallowable X-ray dosimeter for the real-time monitoring of radiotherapy

Monitoring X-ray radiation in the gastrointestinal tract can enhance the precision of radiotherapy in patients with gastrointestinal cancer. Here we report the design and performance, in the gastrointestinal tract of rabbits, of a swallowable X-ray dosimeter for the simultaneous real-time monitoring of absolute absorbed radiation dose and of changes in pH and temperature. The dosimeter consists of a biocompatible optoelectronic capsule containing an optical fibre, lanthanide-doped persistent nanoscintillators, a pH-sensitive polyaniline film and a miniaturized system for the wireless readout of luminescence. The persistent luminescence of the nanoscintillators after irradiation can be used to continuously monitor pH without the need for external excitation. By using a neural-network-based regression model, we estimated the radiation dose from radioluminescence and afterglow intensity and temperature, and show that the dosimeter was approximately five times more accurate than standard methods for dose determination. Swallowable dosimeters may help to improve radiotherapy and to understand how radiotherapy affects tumour pH and temperature.

High-Performance Nonfused Electron Acceptor with Precisely Controlled Side Chain Fluorination

Modification of the molecular packing of nonfullerene acceptors through fluorination represents one of the most promising strategies to achieve highly efficient organic solar cells (OSCs). In this work, three nonfused electron acceptors, namely, DTCBT-Fx (x = 0, 5, 9) with precisely controlled amounts of fluorine atoms in the side chains are designed and synthesized, and the effect of side chain fluorination is systematically studied. The results demonstrate that the light absorption, energy levels, molecular ordering, and film morphology could be effectively tuned by precisely controlling the side chain fluorination. DTCBT-F5 with an appropriate fluorine functionalization exhibits suitable miscibility with the donor polymer (PM6), leading to diminished charge recombination and improved charge carrier mobility. Consequently, a promising power conversion efficiency of 12.7% was obtained for DTCBT-F5-based solar cells, which outperforms those OSCs based on DTCBT-F0 (11.4%) and DTCBT-F9 (11.6%), respectively. This work demonstrates that precise control of the fluorine functionalization in side chains of nonfused electron acceptors is an effective strategy for realizing highly efficient OSCs.

Correlation analysis of bone metabolism indices and glycosylated hemoglobin in middle-aged and older adult patients with type 2 diabetes mellitus

This study aimed to evaluate the association between bone metabolism indices and glycated hemoglobin (HbA1c) levels in middle-aged and older adult patients with type 2 diabetes mellitus (T2DM). We retrospectively analyzed 372 T2DM patients aged > 45 years who had attended the Endocrinology Department at our hospital (males, n = 192; postmenopausal females, n = 180). We collected data concerning patient characteristics, HbA1c levels, and bone metabolism indices (25-hydroxyvitamin D [25(OH)D], β-isomerized C-terminal telopeptides, N-terminal osteocalcin [N-MID], procollagen type 1 N-terminal propeptide [P1NP], bone-specific alkaline phosphatase [BAP], calcium [Ca], and phosphorus [P]). Study patients were divided into 3 groups according to their HbA1c levels: Group A, HbA1c < 7.5%; Group B, HbA1c 7.5 to 8.9%; and Group C, HbA1c ≥ 9.0%. Pearson correlation was used to determine the correlation between HbA1c levels and the bone metabolism indices. Multiple linear regression analysis was performed to identify factors influencing HbA1c in T2DM patients. Among the 3 groups, no differences were observed in 25(OH)D, β-CTx, Ca, or P indices among the 3 groups, whereas a statistically significant difference in N-MID was observed. Pearson correlation analysis showed an inverse correlation between HbA1c levels and N-MID and no correlation with other bone metabolism indices. Multiple linear regression analysis showed that N-MID was a factor influencing HbA1c levels after adjusting for age and body mass index (BMI). Serum N-MID levels negatively correlated with HbA1c levels in middle-aged and older adult men with T2DM. Therefore, high serum N-MID levels may contribute to blood glucose control in T2DM patients.

Insights into the Diffusion Behaviors of Water over Hydrophilic/Hydrophobic Catalysts During the Conversion of Syngas to High-Quality Gasoline

Although considerable efforts towards directly converting syngas to liquid fuels through Fischer-Tropsch synthesis have been made, developing catalysts with low CO2 selectivity for the synthesis of high-quality gasoline remains a big challenge. Herein, we designed a bifunctional catalyst composed of hydrophobic FeNa@Si-c and HZSM-5 zeolite, which exhibited a low CO2 selectivity of 14.3 % at 49.8 % CO conversion, with a high selectivity of 62.5 % for gasoline in total products. Molecular dynamic simulations and model experiments revealed that the diffusion of water molecules through hydrophilic catalyst was bidirectional, while the diffusion through hydrophobic catalyst was unidirectional, which were crucial to tune the water-gas shift reaction and control CO2 formation. This work provides a new fundamental understanding about the function of hydrophobic modification of catalysts in syngas conversion.

Three-Dimensional Fast Spin Echo Pituitary MRI in Treatment-Naïve Cushing's Disease: Reduced Impact of Reader Experience and Increased Diagnostic Accuracy

BACKGROUND

In patients with Cushing's disease, the preoperative identification of pituitary adenomas is crucial to treatment. However, increasing diagnostic accuracy remains an unresolved issue.

PURPOSE

To evaluate the diagnostic accuracy and the impact of readers' experience regarding high-resolution contrast-enhanced magnetic resonance imaging (hrMRI) for identifying pituitary adenomas in comparison with conventional contrast-enhanced MRI (cMRI) and dynamic contrast-enhanced MRI (dMRI).

STUDY TYPE

Retrospective.

POPULATION

Sixty-five patients (median age, 39 years; interquartile range [IQR], 28-53 years; 60% females) with treatment-naïve Cushing's disease.

FIELD STRENGTH/SEQUENCE

3-T, seven fast spin echo sequences.

ASSESSMENT

The diagnostic accuracies of identifying pituitary adenomas on cMRI, dMRI, combined cMRI and dMRI (cdMRI), and hrMRI were independently evaluated by six readers with three experience levels (high: >20 years, modest: 10-20 years, low: <10 years; two readers for each experience level). Readers were asked to localize the lesion, and measure its diameter on the sequence where identified. The reference standard was postoperative histopathology. The impact of readers' experience and interobserver agreement were assessed. Image quality was assessed using a 5-point Likert scale, including overall image quality, sharpness, and structural conspicuity.

STATISTICAL TESTS

McNemar's test, Cochran's test, Wilcoxon signed-rank test, Mann-Whitney U test, and κ statistics for interobserver agreement. A P-value <0.05 was considered statistically significant.

RESULTS

For identifying pituitary adenomas (median diameter, 5 mm; IQR, 4-5 mm), hrMRI had significantly higher sensitivity (87.7%-93.8%) than cMRI, dMRI, and cdMRI (52.3%-75.4%) for readers with different experience levels. The interobserver agreement was moderate (κ = 0.461-0.523). The sensitivity for hrMRI was comparable between readers with different experience levels (P = 0.371). All image quality scores on hrMRI were significantly higher than cMRI and dMRI (5.0 vs. 4.0).

DATA CONCLUSION

For identifying pituitary adenomas in patients with treatment-naïve Cushing's disease, hrMRI may show high diagnostic accuracy and seems not to be affected by readers' experience.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY: Stage 2.

High-resolution contrast-enhanced MRI with three-dimensional fast spin echo improved the diagnostic performance for identifying pituitary microadenomas in Cushing's syndrome

OBJECTIVES

To assess the diagnostic performance of high-resolution contrast-enhanced MRI (hrMRI) with three-dimensional (3D) fast spin echo (FSE) sequence by comparison with conventional contrast-enhanced MRI (cMRI) and dynamic contrast-enhanced MRI (dMRI) with 2D FSE sequence for identifying pituitary microadenomas.

METHODS

This single-institutional retrospective study included 69 consecutive patients with Cushing's syndrome who underwent preoperative pituitary MRI, including cMRI, dMRI, and hrMRI, between January 2016 to December 2020. Reference standards were established by using all available imaging, clinical, surgical, and pathological resources. The diagnostic performance of cMRI, dMRI, and hrMRI for identifying pituitary microadenomas was independently evaluated by two experienced neuroradiologists. The area under the receiver operating characteristics curves (AUCs) were compared between protocols for each reader by using the DeLong test to assess the diagnostic performance for identifying pituitary microadenomas. The inter-observer agreement was assessed by using the κ analysis.

RESULTS

The diagnostic performance of hrMRI (AUC, 0.95-0.97) was higher than cMRI (AUC, 0.74-0.75; p ≤ .002) and dMRI (AUC, 0.59-0.68; p ≤ .001) for identifying pituitary microadenomas. The sensitivity and specificity of hrMRI were 90-93% and 100%, respectively. There were 78% (18/23) to 82% (14/17) of the patients, who were misdiagnosed on cMRI and dMRI and correctly diagnosed on hrMRI. The inter-observer agreement for identifying pituitary microadenomas was moderate on cMRI (κ = 0.50), moderate on dMRI (κ = 0.57), and almost perfect on hrMRI (κ = 0.91), respectively.

CONCLUSIONS

The hrMRI showed higher diagnostic performance than cMRI and dMRI for identifying pituitary microadenomas in patients with Cushing's syndrome.

KEY POINTS

• The diagnostic performance of hrMRI was higher than cMRI and dMRI for identifying pituitary microadenomas in Cushing's syndrome. • About 80% of patients, who were misdiagnosed on cMRI and dMRI, were correctly diagnosed on hrMRI. • The inter-observer agreement for identifying pituitary microadenomas was almost perfect on hrMRI.

Highly durable and sustainable copper-iron-tin-sulphide (Cu2FeSnS4) anode for Li-ion batteries: effect of operating temperatures

Operating temperatures considerably influence the energy storage mechanism of the anode of Li-ion batteries (LiBs). This effect must be comprehensively studied to facilitate the effective integration of LiBs in practical applications and battery management. In this study, we fabricated a novel anode material, i.e., copper-iron-tin-sulphide (Cu2FeSnS4, CFTS), and investigated the corresponding LiB performance at operating temperatures ranging from 10 °C to 55 °C. The CFTS anode exhibited a discharge capacity of 283.1 mA h g-1 at room temperature (25 °C), which stabilized to 174.0 mA h g-1 in repeated cycles tested at a current density of 0.1 A g-1. The discharge capacity at higher operating temperatures, such as 40 °C and 55 °C, is found to be 209.3 and 230.0 mA h g-1 respectively. In contrast, the discharge capacity decreased to 36.2 mA h g-1 when the temperature decreased to 10 °C. Electrothermal impedance spectroscopy was performed to determine the rate of chemical reactions, mobility of active species, and change in internal resistance at different operating temperatures. In terms of the cycle life, CFTS exhibited outstanding cycling stability for more than 500 charge/discharge cycles, with a 146% capacity retention and more than 80% coulombic efficiency. The electrochemical investigation revealed that the charge storage in the CFTS anode is attributable to capacitive-type and diffusion-controlled mechanisms.

Correlation analysis of quantitative MRI measurements of thigh muscles with histopathology in patients with idiopathic inflammatory myopathy

OBJECTIVES

To validate the correlation between histopathological findings and quantitative magnetic resonance imaging (qMRI) fat fraction (FF) and water T2 mapping in patients with idiopathic inflammatory myopathy (IIM).

METHODS

The study included 13 patients with histopathologically confirmed IIM who underwent dedicated thigh qMRI scanning within 1 month before open muscle biopsy. For the biopsied muscles, FF derived from the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) and T2 time from T2 mapping with chemical shift selective fat saturation were measured using a machine learning software. Individual histochemical and immunohistochemical slides were evaluated using a 5-point Likert score. Inter-reader agreement and the correlation between qMRI markers and histopathological scores were analyzed.

RESULTS

Readers showed good to perfect agreement in qMRI measurements and most histopathological scores. FF of the biopsied muscles was positively correlated with the amount of fat in histopathological slides (p = 0.031). Prolonged T2 time was associated with the degree of variation in myofiber size, inflammatory cell infiltration, and amount of connective tissues (p ≤ 0.008 for all).

CONCLUSIONS

Using the machine learning-based muscle segmentation method, a positive correlation was confirmed between qMRI biomarkers and histopathological findings of patients with IIM. This finding provides a basis for using qMRI as a non-invasive tool in the diagnostic workflow of IIM.

RELEVANCE STATEMENT

By using ML-based muscle segmentation, a correlation between qMRI biomarkers and histopathology was found in patients with IIM: qMRI is a potential non-invasive tool in this clinical setting.

KEY POINTS

• Quantitative magnetic resonance imaging measurements using machine learning-based muscle segmentation have good consistency and reproductivity. • Fat fraction of idiopathic inflammatory myopathy (IIM) correlated with the amount of fat at histopathology. • Prolonged T2 time was associated with muscle inflammation in IIM.

Nano-chitin reinforced agarose hydrogels: Effects of nano-chitin addition and acidic gas-phase coagulation

Hydrogels based on natural polymers such as agarose usually show low applicability due to their weak mechanical properties. In this work, we developed a dual cross-linked agarose hydrogel by adding different amounts of TEMPO-oxidized nano-chitin (0-0.2 %) to agarose hydrogel matrices and then physically cross-linked under acidic gas-phase coagulation. The prepared hydrogels were characterized by FTIR, XRD, TGA, and SEM. The effects of nano-chitin addition and acidic gas-phase coagulation on the properties of agarose hydrogels, such as gel strength, swelling degree, rheological properties, and methylene blue (MB) adsorption capacity, were also studied. Structural characterizations confirmed that nano-chitin was successfully introduced into agarose hydrogels. The gel strength, storage modulus, and MB adsorption capacity of agarose hydrogels gradually increased with the increasing nano-chitin addition, whereas the swelling degree decreased. After acidic gas-phase coagulation, agarose/nano-chitin nanocomposite hydrogels exhibited improved gel strength and storage modulus, while the swelling degree and MB adsorption capacity were slightly reduced. The combination of oxidized nano-chitin and acidic gas-phase coagulation is expected to be an effective way to improve the properties of natural polymer hydrogels.

A pathogenic and recombinant infectious bronchitis virus variant (CK/CH/GX/202109) with multiorgan tropism

Despite vaccine use, novel strains and variants of infectious bronchitis virus (IBV) have emerged continuously, leading to economic losses to the poultry industry worldwide. This study aimed to characterize the IBV isolate CK/CH/GX/202109 from three yellow broilers in Guangxi, China. Recombination was shown to have occurred in regions of the 1ab gene. Compared to the whole genome of ck/CH/LGX/130530, which is genotypically related to tl/CH/LDT3-03, the 202109 strain had 21 mutations. The pathological assessment showed that this variant caused 30% and 40% mortality in 1-day-old chicks infected with oral and ocular inoculum, respectively. Nephritis, enlarged proventriculus, inflammation of the gizzard, and atrophy of the bursa of Fabricius were also observed at both 7 and 14 days post-infection (dpi). Viral loads in the trachea, proventriculus, gizzard, kidney, bursa, and cloacal swabs were higher at 7 dpi than at 14 dpi. Clinicopathological and immunohistochemical analyses revealed that this virus exhibited multiple organ tropisms capable of infecting the trachea, proventriculus, gizzard, kidney, bursa, ileum, jejunum, and rectum. Almost none of the 1-day-old infected chicks seroconverted until 14 dpi. While the virus was found in the ileum, jejunum, and rectum in the 28-day-old ocular group, the majority of 28-day-old infected chickens seroconverted at 10 dpi. These study findings demonstrate that recombination events and mutations during the evolution of IBV may greatly alter tissue tropism and emphasize the need for the continued surveillance of novel strains and variants in order to control this infection.

Development of a One-Step Real-Time TaqMan Reverse Transcription Polymerase Chain Reaction (RT-PCR) Assay for the Detection of the Novel Variant Infectious Bursal Disease Virus (nVarIBDV) Circulating in China

The novel variant IBDV (nVarIBDV, especially genotype A2dB1) mainly affects broilers in China. It causes an infection characterized by the atrophy of the bursa, a decrease in the level of lymphocytes, proliferation of fibrous tissue around the follicle, and severe atrophy of the follicle in the bursa. Poultry vaccinated with live IBDV vaccines do not have the challenge present with bursa atrophy, which is misdiagnosed for nVarIBDV because of the lack of other gross clinical symptoms. The present study sought to explore the potential and reliability of the real-time TaqMan analysis method for the detection and discrimination of the nVarIBDV genotype from that of the non-nVarIBDV, especially in live vaccine strains. This method will help monitor vaccinated poultry to control and manage infection with the nVarIBDV IBDVs. The nucleotide polymorphism in the 5'-UTR region and the vp5/vp2 overlapping region of the segment A sequences of IBDV were used to establish a one-step real-time TaqMan reverse transcription polymerase chain reaction (RT-PCR) method in this study. The results showed that the method accurately distinguished the nVarIBDV and non-nVarIBDV strains (especially live vaccine strains), and there were no cross-reactions with the infectious bronchitis virus (IBV), Newcastle disease virus (NDV), avian influenza virus (AIV), infectious laryngotracheitis virus (ILTV), fowlpox virus (FPV), Mycoplasma gallisepticum (M. gallisepticum), Mycoplasma synoviae (M. synoviae), and IBDV-negative field samples. The method showed a linear dynamic range between 10² and 10⁷ DNA copies/reaction, with an average R² of 0.99 and an efficiency of 93% for nVarIBDV and an average R² of 1.00 and an efficiency of 94% for non-nVarIBDV. The method was also used for the detection of 84 clinical bursae of chickens vaccinated with the live vaccine. The results showed that this method accurately distinguished the nVarIBDV and non-nVarIBDV strains (vaccine strains), compared with a strategy based on the sequence analysis of HVRs at the vp2 gene or the reverse transcription PCR (RT-PCR) for the vp5 gene. These findings showed that this one-step real-time TaqMan RT-PCR method provides a rapid, sensitive, specific, and simple approach for detection of infections caused by nVarIBDV and is a useful clinical diagnostic tool for identifying and distinguishing nVarIBDV from non-nVarIBDV, especially live vaccine strains.

Nanovesicles loaded with a TGF-β receptor 1 inhibitor overcome immune resistance to potentiate cancer immunotherapy

The immune-excluded tumors (IETs) show limited response to current immunotherapy due to intrinsic and adaptive immune resistance. In this study, it is identified that inhibition of transforming growth factor-β (TGF-β) receptor 1 can relieve tumor fibrosis, thus facilitating the recruitment of tumor-infiltrating T lymphocytes. Subsequently, a nanovesicle is constructed for tumor-specific co-delivery of a TGF-β inhibitor (LY2157299, LY) and the photosensitizer pyropheophorbide a (PPa). The LY-loaded nanovesicles suppress tumor fibrosis to promote intratumoral infiltration of T lymphocytes. Furthermore, PPa chelated with gadolinium ion is capable of fluorescence, photoacoustic and magnetic resonance triple-modal imaging-guided photodynamic therapy, to induce immunogenic death of tumor cells and elicit antitumor immunity in preclinical cancer models in female mice. These nanovesicles are further armored with a lipophilic prodrug of the bromodomain-containing protein 4 inhibitor (i.e., JQ1) to abolish programmed death ligand 1 expression of tumor cells and overcome adaptive immune resistance. This study may pave the way for nanomedicine-based immunotherapy of the IETs.

Defect passivation and electron band energy regulation of a ZnO electron transport layer through synergetic bifunctional surface engineering for efficient quantum dot light-emitting diodes

Zinc oxide nanoparticles (ZnO NPs) have been actively pursued as the most effective electron transport layer for quantum-dot light-emitting diodes (QLEDs) in light of their unique optical and electronic properties and low-temperature processing. However, the high electron mobility and smooth energy level alignment at QDs/ZnO/cathode interfaces cause electron over-injection, which aggravates non-radiative Auger recombination. Meanwhile, the abundant defects hydroxyl group (-OH) and oxygen vacancies (O_V) in ZnO NPs act as trap states inducing exciton quenching, which synergistically reduces the effective radiation recombination for degrading the device performance. Here, we develop a bifunctional surface engineering strategy to synthesize ZnO NPs with low defect density and high environmental stability by using ethylenediaminetetraacetic acid dipotassium salt (EDTAK) as an additive. The additive effectively passivates surface defects in ZnO NPs and induces chemical doping simultaneously. Bifunctional engineering alleviates electron excess injection by elevating the conduction band level of ZnO to promote charge balance. As a result, state-of-the-art blue QLEDs with an EQE of 16.31% and a T₅₀@100 cd m^-2 of 1685 h are achieved, providing a novel and effective strategy to fabricate blue QLEDs with high efficiency and a long operating lifetime.

The role of miR-21 as a predictive biomarker and a potential target to improve the effects of chemoradiotherapy against head and neck squamous cell carcinoma

This study aimed to clarify whether circulating miR-21 represents a predictive biomarker in patients with head and neck squamous cell carcinoma (HNSCC) undergoing chemoradiotherapy, and to investigate the effect of miR-21 inhibitor for chemoradiation in human SCC cells. Plasma samples were obtained from 22 patients with HNSCC and 25 non-cancer volunteers. Plasma miR-21 expression was measured using real-time quantitative reverse transcription polymerase chain reaction. The effects of miR-21 inhibitor in human SCC cells were investigated by performing 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, flow cytometry and western blot analysis. As a result, plasma miR-21 expression was higher in HNSCC patients than in control patients (P < 0.001). Seven patients with recurrence showed significantly higher plasma miR-21 than the 15 patients without recurrence. And high miR-21 expression group showed poor overall survival. Moreover, miR-21 inhibition significantly enhanced cisplatin- or radiation-induced apoptosis. Western blot analysis suggested the programmed cell death 4 protein as a potential target of miR-21 in relation to apoptosis. In conclusion, this study provides new insights into the role of miR-21 as a predictive biomarker for HNSCC treated with chemoradiotherapy and suggests a potential target to improve the effects of chemoradiotherapy against HNSCC.

Rheumatoid meningitis: a rare neurological complication of rheumatoid arthritis

Objective

To describe the clinical and neuroimaging characteristics of rheumatoid meningitis (RM) in Chinese patients.

Methods

The patients admitted to our hospital with the diagnosis of RM in the past 8 years were retrospectively analyzed.

Results

Six patients with RM were identified among 933 patients admitted with rheumatoid arthritis (RA). The symptoms of meningitis occurred after onset of arthritis in five patients and before onset in one. Headache (n=6), hyperacute focal neurological deficits (n=4) and seizures (n=3) were the most prevalent symptoms. The nadir modified Rankin Scale score was ≥3 in five patients. Rheumatoid factor was elevated in all patients, and interleukin-6 levels in cerebrospinal fluid were dramatically elevated in three of four tested patients. Magnetic resonance imaging of the brain revealed that the meninges were affected in all patients and the cerebral parenchyma was affected in one patient. The lesions were generally located in the frontoparietal region and showed restricted diffusion along the adjacent subarachnoid space. RM occurred during disease-modifying therapy in four patients. In the acute episode, three patients improved on tocilizumab and the other three improved on pulse corticosteroids. For maintenance therapy, two patients received combined therapy of tocilizumab and other immunosuppressive agents, one received adalimumab and methotrexate, and two received low-dose oral corticosteroids with an immunosuppressive agent. Five patients had a good outcome, and one died of Pneumocystis jirovecii pneumonia after stabilization of his neurologic conditions. No relapse of RM occurred on immunotherapy during follow-up.

Conclusions

Chinese patients with RM share some remarkable clinical and neuroimaging features and respond well to appropriate immunotherapy. Tocilizumab could be a treatment option for this severe complication of RA.

X-ray-to-visible light-field detection through pixelated colour conversion

Light-field detection measures both the intensity of light rays and their precise direction in free space. However, current light-field detection techniques either require complex microlens arrays or are limited to the ultraviolet-visible light wavelength ranges^1-4. Here we present a robust, scalable method based on lithographically patterned perovskite nanocrystal arrays that can be used to determine radiation vectors from X-rays to visible light (0.002-550 nm). With these multicolour nanocrystal arrays, light rays from specific directions can be converted into pixelated colour outputs with an angular resolution of 0.0018°. We find that three-dimensional light-field detection and spatial positioning of light sources are possible by modifying nanocrystal arrays with specific orientations. We also demonstrate three-dimensional object imaging and visible light and X-ray phase-contrast imaging by combining pixelated nanocrystal arrays with a colour charge-coupled device. The ability to detect light direction beyond optical wavelengths through colour-contrast encoding could enable new applications, for example, in three-dimensional phase-contrast imaging, robotics, virtual reality, tomographic biological imaging and satellite autonomous navigation.

Antihyperlipidemic effect of Vaccinium dunalianum buds based on biological activity screening and LC-MS

ETHNOPHARMACOLOGICAL RELEVANCE

The buds of Vaccinium dunalianum Wight are used as folk medicine in the Yi settlement of the Yunnan Province, China. It has long been used as herbal tea in the local area owing to its effects of lowering blood lipids and body weight. However, there are only a few studies on its antihyperlipidemic effects, effective substances and mechanisms, especially its effectiveness in diet-induced hyperlipidemia.

AIM OF THE STUDY

This study aimed to elucidate the therapeutic effects, pharmacodynamic material bases, and mechanisms of V. dunalianum buds on diet-induced hyperlipidemia.

MATERIALS AND METHODS

A high-fat diet-induced hyperlipidemic Sprague-Dawley (SD) rat model was established. Rats were gavaged with different doses of aqueous extract of V. dunalianum(VDW) for 8 weeks and their sera and organ samples were collected. The antihyperlipidemic effect of VDW on SD rats was evaluated based on the biochemical indices and histopathological outcomes. Liquid chromatography-mass spectrometry(LC-MS) was used to determine the main components in VDW, which were separated and purified using sequential chromatographic methods. Their chemical structures were determined using high-resolution electrospray ionization mass spectroscopy and nuclear magnetic resonance spectroscopy. 6'-O-caffeoyl-arbutin, as the principal component of VDW, was also evaluated for its antihyperlipidemic activity using an approach similar to that used for VDW. Lastly, the potential targets of VDW and 6'-O-caffeoyl-arbutin in lowering blood lipids were screened out using network pharmacology, and the selected targets were docked with arbutin derivatives. The expression of target proteins was determined using western blotting to illustrate the antihyperlipidemic mechanisms of VDW and 6'-O-caffeoyl-arbutin.

RESULTS

VDW reduced triglyceride, total cholesterol, low-density lipoprotein, alanine transaminase, and aspartate transaminase levels in the serum of modeled rats, and increased high-density lipoprotein levels. There was an improvement in steatoses, and lipid droplet accumulation decreased in vivo after VDW intervention. LC-MS revealed that VDW mainly contained arbutin and chlorogenic acid derivatives. Sixteen compounds were isolated and identified. 6'-O-caffeoyl-arbutin was the main compound of VDW (>21.67%) that showed obvious antihyperlipidemic effect with low hepatic damage at different doses. PTGS2, ADH1C, and MAOB were screened out using network pharmacology and they showed strong correlations with arbutin derivative through molecular docking. Results from WB showed that VDW and 6'-O-caffeoyl-arbutin could reduce blood lipid levels by reducing the protein expression of PTGS2, ADH1C, and MAOB.

CONCLUSIONS

6'-O-caffeoyl-arbutin was the main component of V. dunalianum buds. VDW and 6'-O-caffeoyl-arbutin could regulate blood lipid levels in the high-fat diet-induced rat model of hyperlipidemia without damaging their vital organs. Furthermore, they could regulate the expression of PTGS2, ADH1C, and MAOB proteins and play a role in lowering blood lipids. The findings of this study lay a foundation for the further development of V. dunalianum and 6'-O-caffeoyl-arbutin as health supplements or drugs for the management of hyperlipidemia.

Sesquiterpenoids from the fruits of Alpinia oxyphylla Miq. and their neuroprotective effect

The purpose of this study was to identify sesquiterpenoids from Alpinia oxyphylla Miq. fruits under the guidance of LC-MS, and to evaluate their neuroprotective effects on the H₂O₂-induced SH-SY5Y cells. A total of 35 sesquiterpenoids, including 10 previously unreported ones, were isolated from A. oxyphylla fruits. The neuroprotective effect studies showed that compounds 2, 3, 12, 13, 20, 22, 25, 26, and 35 can improve the viability rates of the H₂O₂-induced SH-SY5Y cells whose viability rates were ≥ 80% and were higher than that of the positive control. Furthermore, thorough activity studies showed that compounds 3, 13, 22, and 35 can inhibit the production of ROS (reactive oxygen species), and that compounds 13, 22, and 35 can reduce both MDA (Malondialdehyde) and NO levels in the damaged cells in displaying a neuroprotective effect. This study confirmed that the fruits of A. oxyphylla contained abundant sesquiterpenoids with potential neuroprotective effect.

Use of IDEAL-IQ in Quantifying Femoral Bone Marrow Involvement in Gaucher Disease

OBJECTIVE

To quantitatively measure femoral bone marrow involvement in patients with Gaucher disease (GD) by using fat fraction (FF) derived from the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) technique.

METHODS

Bilateral femora of 23 patients with type 1 GD receiving low-dose imiglucerase treatment were prospectively scanned using structural magnetic resonance imaging sequences and an IDEAL-IQ sequence. Femoral bone marrow involvement was evaluated by both semiquantification (bone marrow burden [BMB] score based on magnetic resonance imaging structural images) and quantification (FF derived from IDEAL-IQ) methods. These patients were further divided into subgroups according to whether they underwent splenectomy or had bone complications. The interreader agreement of measurements and the correlation between FF and clinical status were statistically analyzed.

RESULTS

In patients with GD, both BMB and FF evaluation of femora showed good interreader concordance (intraclass correlation coefficient = 0.98 and 0.99, respectively), and FF highly correlated with BMB score (P < 0.001). The longer the duration of disease, the lower the FF (P = 0.026). Femoral FF was lower in subgroups with splenectomy or bone complications than those without splenectomy or bone complications (0.47 ± 0.08 vs 0.60 ± 0.15, 0.51 ± 0.10 vs 0.61 ± 0.17, respectively, both P < 0.05).

CONCLUSION

Femoral FF derived from IDEAL-IQ could be used to quantify femoral bone marrow involvement in patients with GD, and low bone marrow FF may predict worse outcomes of GD patients in this small-scale study.

Differentiation of Alzheimer’s Disease from Frontotemporal Dementia and Mild Cognitive Impairment Based on Arterial Spin Labeling Magnetic Resonance Imaging: A Pilot Cross-Sectional Study from PUMCH Dementia Cohort

Background: Arterial spin labeling (ASL) is helpful in early diagnosis and differential diagnosis of Alzheimer’s disease (AD), with advantages including no exposure to radioactivity, no injection of a contrast agent, more accessible, and relatively less expensive. Objective: To establish the perfusion pattern of different dementia in Chinese population and evaluate the effectiveness of ASL in differentiating AD from cognitive unimpaired (CU), mild cognitive impairment (MCI), and frontotemporal dementia (FTD). Methods: Four groups of participants were enrolled, including AD, FTD, MCI, and CU based on clinical diagnosis from PUMCH dementia cohort. ASL image was collected using 3D spiral fast spin echo–based pseudo-continuous ASL pulse sequence with background suppression and a high resolution T1-weighted scan covering the whole brain. Data processing was performed using Dr. Brain Platform to get cerebral blood flow (ml/100g/min) in every region of interest cortices. Results: Participants included 66 AD, 26 FTD, 21 MCI, and 21 CU. Statistically, widespread hypoperfusion neocortices, most significantly in temporal-parietal-occipital cortices, but not hippocampus and subcortical nucleus were found in AD. Hypoperfusion in parietal lobe was most significantly associated with cognitive decline in AD. Hypoperfusion in parietal lobe was found in MCI and extended to adjacent temporal, occipital and posterior cingulate cortices in AD. Significant reduced perfusion in frontal and temporal cortices, including subcortical nucleus and anterior cingulate cortex were found in FTD. Hypoperfusion regions were relatively symmetrical in AD and left predominant especially in FTD. Conclusion: Specific patterns of ASL hypoperfusion were helpful in differentiating AD from CU, MCI, and FTD.

Assessment of idiopathic inflammatory myopathy using a deep learning method for muscle T2 mapping segmentation

OBJECTIVE

To investigate the utility of an automatic deep learning (DL) method for segmentation of T2 maps in patients with idiopathic inflammatory myopathy (IIM) against healthy controls, and also the association of quantitative T2 values in patients with laboratory and pulmonary findings.

METHODS

Structural MRI and T2 mapping of bilateral thigh muscles from patients with IIM and healthy volunteers were segmented using dedicated software based on a pre-trained convolutional neural network. Incremental and federated learning were implemented for continuous adaptation and improvement. Muscle T2 values derived from DL segmentation were compared between patients and healthy controls, and T2 values of patients were further analyzed with serum muscle enzymes, and interstitial lung disease (ILD) which was diagnosed and graded based on chest HRCT.

RESULTS

Overall, 64 patients (27 patients with dermatomyositis, 29 with polymyositis, and 8 with antisynthetase syndrome (ASS)) and 10 healthy controls were included. By using DL-based muscle segmentation, T2 values generated from T2 maps accurately differentiated patients from those of controls (p < 0.001) with a cutoff value of 36.4 ms (sensitivity 96.9%, and specificity 100%). In patients with IIM, muscle T2 values positively correlated with all the serum muscle enzymes (all p < 0.05). ILD score of patients with ASS was markedly higher than that of those without ASS (p = 0.011), while dissociation between the severity of muscular involvement and ILD was observed (p = 0.080).

CONCLUSION

Automatic DL could be used to segment thigh muscles and help quantitatively assess muscular inflammation of IIM through T2 mapping.

KEY POINTS

• Muscle T2 mapping automatically segmented by deep learning can differentiate IIM from healthy controls. • T2 value, an indicator of active muscle inflammation, positively correlates with serum muscle enzymes. • T2 mapping can detect muscle disease in patients with normal muscle enzyme levels.

Correlation between 18F-FDG PET/MR parameters with the expression level of epidermal growth factor receptor and the diagnostic value of PET/MR in head and neck squamous cell carcinoma

Objective

To investigate the correlation between parameters of PET/MR and the expression level of epidermal growth factor receptor (EGFR) in head and neck squamous cell carcinoma (HNSCC) and to evaluate diagnostic efficacy of independent and combined PET/MR parameters for the expression level of EGFR.

Materials and methods

21 patients who had undergone PET/MR and been proven HNSCC pathologically were included in this retrospective study. The PET/MR sequences included 18-flurodeoxyglucose (¹⁸F-FDG) PET, T1, T2-weighted imaging, DWI, ADC and DCE. Parameters including ADC_mean from DWI, Ktrans, Ve, Kep from DCE, and SUV_mean, SUV_max from PET were obtained. Immunohistochemical method was used to detect the expression level of EGFR. The associations between parameters of PET/MR and EGFR expression level were analyzed by Spearman's analysis. Logistic regression was utilized to establish the diagnostic model of EGFR expression level with PET/MR parameters. The efficacy of the independent and combined diagnostic model for EGFR expression level in HNSCC was analyzed by ROC curve. P value ≤ 0.05 was considered statistically significant.

Results

(1) Expression level of EGFR was correlated to SUV_mean with correlation coefficient of 0.47 (p = 0.05). (2) There was significant difference of SUV_mean between the EGFR high- and low-expression groups (p = 0.02). (3) Combination of PET/MR improved the diagnostic efficacy for expression level of EGFR, with AUC = 0.93.

Conclusion

There were different degrees of correlation between PET/MR parameters and EGFR expression level in HNSCC. Combination of PET/MR might improve diagnostic efficacy of EGFR expression level.

Effect of MnO2 Crystal Type on the Oxidation of Furfural to Furoic Acid

The base-free oxidation of furfural by non-noble metal systems has been challenging. Although MnO2 emerges as a potential catalyst application in base-free conditions, its catalytic efficiency still needs to be improved. The crystalline form of MnO2 is an important factor affecting the oxidation ability of furfural. For this reason, four crystalline forms of MnO2 (α, β, γ, and δ-MnO2) were selected. Their oxidation performance and surface functional groups were analyzed and compared in detail. Only δ-MnO2 exhibited excellent activity, achieving 99.04% furfural conversion and 100% Propo.FA (Only furoic acid was detected by HPLC in the product) under base-free conditions, while the furfural conversion of α, β, and γ-MnO2 was below 10%. Characterization by XPS, IR, O2-TPD and other means revealed that δ-MnO2 has the most abundant active oxygen species and surface hydroxyl groups, which are responsible for the best performance of δ-MnO2. This work achieves the green and efficient oxidation of furfural to furoic acid over non-noble metal catalysts.

InP/ZnS quantum dot photoluminescence modulation via in situ H2S interface engineering

InP quantum dots (QDs) are attracting significant interest as a potentially less toxic alternative to Cd-based QDs in many research areas. Although InP-based core/shell QDs with excellent photoluminescence properties have been reported so far, sophisticated interface treatment to eliminate defects is often necessary. Herein, using aminophosphine as a seeding source of phosphorus, we find that H₂S can be efficiently generated from the reaction between a thiol and an alkylamine at high temperatures. Apart from general comprehension that H₂S acts as a S precursor, it is revealed that with core etching by H₂S, the interface between InP and ZnS can be reconstructed with S^2- incorporation. Such a transition layer can reduce inherent defects at the interface, resulting in significant photoluminescence (PL) enhancement. Meanwhile, the size of the InP core could be further controlled by H₂S etching, which offers a feasible process to obtain wide band gap InP-based QDs with blue emission.

Evolution of Local Structural Motifs in Colloidal Quantum Dot Semiconductor Nanocrystals Leading to Nanofaceting

Colloidal nanocrystals (NCs) have shown remarkable promise for optoelectronics, energy harvesting, photonics, and biomedical imaging. In addition to optimizing quantum confinement, the current challenge is to obtain a better understanding of the critical processing steps and their influence on the evolution of structural motifs. Computational simulations and electron microscopy presented in this work show that nanofaceting can occur during nanocrystal synthesis from a Pb-poor environment in a polar solvent. This could explain the curved interfaces and the olivelike-shaped NCs observed experimentally when these conditions are employed. Furthermore, the wettability of the PbS NCs solid film can be further modified via stoichiometry control, which impacts the interface band bending and, therefore, processes such as multiple junction deposition and interparticle epitaxial growth. Our results suggest that nanofaceting in NCs can become an inherent advantage when used to modulate band structures beyond what is traditionally possible in bulk crystals.

Study of the microstructure of brain white matter in medial temporal lobe epilepsy based on diffusion tensor imaging

OBJECTIVES

To compare the white matter (WM) asymmetry in left and right medial temporal lobe epilepsy (mTLE) with and without hippocampal sclerosis (HS+, HS-) and assess the correlation of preoperative asymmetry and the dynamics of WM fibers with surgical outcomes.

MATERIALS AND METHODS

Preoperative MRI scans were collected from 58 mTLE patients (40 HS+, 18 HS-); 15 (11 HS+, 4 HS-) then underwent postoperative MRI scans. DTI parameters, including the fractional anisotropy (FA), mean diffusion coefficient (MD), axial diffusion coefficient (AD), and radial diffusion coefficient (RD), were extracted from 20 paired WM tracts by PANDA based on the JHU WM tractography atlas. The bilateral cerebral parameters and the pre- to postoperative changes in the DTI parameters of specific fiber tracts were compared. The asymmetry indexes (AIs) of paired fibers were also analyzed.

RESULTS

There were fewer asymmetrical WM fibers in HS- patients than in HS+ patients. The pattern of WM asymmetry differed between left and right mTLE patients. Differences in the FA AI of the inferior fronto-occipital fasciculus and inferior longitudinal fasciculus (ILF) were found in left HS+ patients with different surgical outcomes. All mTLE patients exhibited decreases in FA and increases in MD and RD in specific ipsilateral WM fibers. In International League Against Epilepsy (ILAE) grade 1 patients, the MD values in the ipsilateral CGH increased over time, whereas the RD values in the ipsilateral ILF and the AD values in the ipsilateral ILF and UNC decreased. In ILAE grade 2-5 patients, the FA values in the ipsilateral cingulate gyrus part of the cingulum (CGC) increased over time.

CONCLUSION

The WM tract asymmetry was more extensive in HS+ patients than in HS- patients. The preoperative WM fiber AIs in left HS+ patients may be useful for surgical prognosis. Additionally, pre- to postoperative changes in WM fibers may help predict surgical outcomes.

Brief Report: Sex Differences in the Association Between Cerebrovascular Function and Cognitive Health in People Living With HIV in Urban China

BACKGROUND

Cardiometabolic and cerebrovascular disease are strong independent contributors to cognitive impairment in people living with HIV. Data suggest that cardiovascular risk may play a greater role in cognitive health in women than in men with HIV.

METHODS

We performed a cross-sectional study of 104 participants with virologically suppressed HIV from 2 clinics in urban China. Participants underwent neuropsychological testing from which we calculated T scores globally and in 5 cognitive domains. We assessed cerebral vasoreactivity of the middle cerebral arteries in response to breath holding. We constructed linear regression models to determine associations between cerebrovascular and cognitive function overall and stratified by sex.

RESULTS

Women were younger than men (48 versus 51 years, P = 0.053), had fewer years of education (9 years versus 12 years, P = 0.004), and fewer cardiometabolic risk factors (0 versus 1 factor, P = 0.008). In a model with all participants, cerebrovascular function was significantly associated with global cognition (2.74 higher T score per 1-point higher cerebral vasoreactivity [SE 1.30], P = 0.037). Cerebrovascular function remained significantly associated with global cognition among women (4.15 higher T score [SE 1.78], P = 0.028) but not men (1.70 higher T score [SE 1.74], P = 0.33). The relationships between cerebrovascular function and specific cognitive domains followed a similar pattern, with significant associations present among women but not men.

CONCLUSIONS

Women with well-controlled HIV may be more vulnerable to the effect of cerebrovascular injury on cognitive health than men. Studies evaluating strategies to protect against cognitive impairment in people living with HIV should include adequate representation of women and stratification of analyses by sex.

Energy-guided synapse coupling between neurons under noise

From a physical viewpoint, any external stimuli including noise disturbance can inject energy into the media, and the electric response is regulated by the equivalent electric stimulus. For example, mode transition in electric activities in neurons occurs and kinds of spatial patterns are formed during the wave propagation. In this paper, a feasible criterion is suggested to explain and control the growth of electric synapse and memristive synapse between Hindmarsh-Rose neurons in the presence of noise. It is claimed that synaptic coupling can be enhanced adaptively due to energy diversity, and the coupling intensity is increased to a saturation value until two neurons reach certain energy balance. Two identical neurons can reach perfect synchronization when electric synapse coupling is further increased. This scheme is also considered in a chain neural network and uniform noise is applied on all neurons. However, reaching synchronization becomes difficult for neurons in presenting spiking, bursting, and chaotic and periodic patterns, even when the local energy balance is corrupted to continue further growth of the coupling intensity. In the presence of noise, energy diversity becomes uncertain because of spatial diversity in excitability, and development of regular patterns is blocked. The similar scheme is used to control the growth of memristive synapse for neurons, and the synchronization stability and pattern formation are controlled by the energy diversity among neurons effectively. These results provide possible guidance for knowing the biophysical mechanism for synapse growth and energy flow can be applied to control the synchronous patterns between neurons.

Acid-Ionizable Iron Nanoadjuvant Augments STING Activation for Personalized Vaccination Immunotherapy of Cancer

The critical challenge for cancer vaccine-induced T-cell immunity is the sustained activation of antigen cross-presentation in antigen-presenting cells (APCs) with innate immune stimulation. In this study, it is first discovered that the clinically used magnetic contrast agents, iron oxide nanoparticles (IONPs), markedly augment the type-I interferon (IFN-I) production profile of the stimulator of interferon genes (STING) agonist MSA-2 and achieve a 16-fold dosage-sparing effect in the human STING haplotype. Acid-ionizable copolymers are coassembled with IONPs and MSA-2 into iron nanoadjuvants to concentrate STING activation in the draining lymph nodes. The top candidate iron nanoadjuvant (PEIM) efficiently delivers the model antigen ovalbumin (OVA) to CD169+ APCs and facilitates antigen cross-presentation to elicit a 55-fold greater frequency of antigen-specific CD8⁺ cytotoxic T-lymphocyte response than soluble antigen. PEIM@OVA nanovaccine immunization induces potent and durable antitumor immunity to prevent tumor lung metastasis and eliminate established tumors. Moreover, PEIM nanoadjuvant is applicable to deliver autologous tumor antigen and synergizes with immune checkpoint blockade therapy for prevention of postoperative tumor recurrence and distant metastasis in B16-OVA melanoma and MC38 colorectal tumor models. The acid-ionizable iron nanoadjuvant offers a generalizable and readily translatable strategy to augment STING cascade activation and antigen cross-presentation for personalized cancer vaccination immunotherapy.

Leveraging Macromolecular Isomerism for Phase Complexity in Janus Nanograins

It remains intriguing whether macromolecular isomerism, along with competing molecular interactions, could be leveraged to create unconventional phase structures and generate considerable phase complexity in soft matter. Herein, we report the synthesis, assembly, and phase behaviors of a series of precisely defined regioisomeric Janus nanograins with distinct core symmetry. They are named B₂DB₂ where B stands for iso-butyl-functionalized polyhedral oligomeric silsesquioxanes (POSS) and D stands for dihydroxyl-functionalized POSS. While BPOSS prefers crystallization with a flat interface, DPOSS prefers to phase-separate from BPOSS. In solution, they form 2D crystals owing to strong BPOSS crystallization. In bulk, the subtle competition between crystallization and phase separation is strongly influenced by the core symmetry, leading to distinct phase structures and transition behaviors. The phase complexity was understood based on their symmetry, molecular packing, and free energy profiles. The results demonstrate that regioisomerism could indeed generate profound phase complexity.