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Background: The potential benefits or harms of intensive systolic blood pressure (BP) control on cognitive function and cerebral blood flow in individuals with low diastolic blood pressure (DBP) remain unclear. Methods: We conducted a post hoc analysis of the SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension) that randomly assigned hypertensive participants to an intensive ( Results: Participants in the intensive group had a lower incidence rate of probable dementia or mild cognitive impairment than those in the standard group, regardless of DBP quartiles. The hazard ratio of intensive versus standard target for probable dementia or mild cognitive impairment was 0.91 (95% CI, 0.73–1.12) in the lowest DBP quartile and 0.70 (95% CI, 0.48–1.02) in the highest DBP quartile, respectively, with an interaction P value of 0.24. Similar results were found for probable dementia (interaction P =0.06) and mild cognitive impairment (interaction P =0.80). The effect of intensive treatment on cerebral blood flow was not modified by baseline DBP either (interaction P =0.25). Even among participants within the lowest DBP quartile, intensive versus standard BP treatment resulted in an increasing trend of annualized change in cerebral blood flow (+0.26 [95% CI, −0.72 to 1.24] mL/[100 g·min]). Conclusions: Intensive BP control did not appear to have a detrimental effect on cognitive outcomes and cerebral perfusion in patients with low baseline DBP. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01206062

To elucidate the clinical profile of sporadic fatal insomnia (sFI), assess the similarities and differences between sFI and fatal familial insomnia (FFI), and evaluate the influence of ethnicity on the phenotype of sFI patients.The data of sFI and FFI patients was retrieved from our case series and through literature review. The clinical and diagnostic features of sFI and FFI were compared, as were the phenotypes of Asian and Caucasian sFI patients.We identified 44 sFI and 157 FFI cases. The prevalence of sleep-related, neuropsychiatric and autonomic symptoms among the sFI patients were 65.9%, 100.0% and 43.2% respectively. Compared to FFI, sFI exhibited longer disease duration and a higher proportion of neuropsychiatric symptoms, while FFI was characterized by a higher incidence of sleep-related and autonomic symptoms in the early stages of the disease or throughout its course. In addition, a higher proportion of the sFI patients showed hyperintensity on MRI and PSWCs on EEG compared to the FFI patients, especially those presenting with pathological changes associated with MM2-cortical type sCJD. The Asian sFI patients had a higher proportion of males and positivity for CSF 14-3-3 protein, and fewer sleep-related symptoms compared to Caucasian sFI patients. The age of onset and duration of sFI differed between ethnic groups, but failed to reach statistical significance.Despite its similarities to FFI, sFI is characterized by longer disease duration, higher proportion of neuropsychiatric symptoms and hyperintensity on MRI, along with differences in the clinical characteristics based on ethnicity.

Background and aimsCurrent practice onHelicobacter pyloriinfection mostly focuses on individual-based care in the community, but family-basedH. pylorimanagement has recently been suggested as a better strategy for infection control. However, the family-basedH. pyloriinfection status, risk factors and transmission pattern remain to be elucidated.MethodsFrom September 2021 to December 2021, 10 735 families (31 098 individuals) were enrolled from 29 of 31 provinces in mainland China to examine family-basedH. pyloriinfection, related factors and transmission pattern. All family members were required to answer questionnaires and test forH. pyloriinfection.ResultsAmong all participants, the average individual-basedH. pyloriinfection rate was 40.66%, with 43.45% for adults and 20.55% for children and adolescents. Family-based infection rates ranged from 50.27% to 85.06% among the 29 provinces, with an average rate of 71.21%. In 28.87% (3099/10 735) of enrolled families, there were no infections; the remaining 71.13% (7636/10 735) of families had 1–7 infected members, and in 19.70% (1504/7636), all members were infected. Among 7961 enrolled couples, 33.21% had no infection, but in 22.99%, both were infected. Childhood infection was significantly associated with parental infection. Independent risk factors for household infection were infected family members (eg, five infected members: OR 2.72, 95% CI 1.86 to 4.00), living in highly infected areas (eg, northwest China: OR 1.83, 95% CI 1.57 to 2.13), and large families in a household (eg, family of three: OR 1.97, 95% CI 1.76 to 2.21). However, family members with higher education and income levels (OR 0.85, 95% CI 0.79 to 0.91), using serving spoons or chopsticks, more generations in a household (eg, three generations: OR 0.79, 95% CI 0.68 to 0.92), and who were younger (OR 0.57, 95% CI 0.46 to 0.70) had lower infection rates (pConclusionFamilialH. pyloriinfection rate is high in general household in China. Exposure to infected family members is likely the major source of its spread. These results provide supporting evidence for the strategic changes fromH. pyloriindividual-based treatment to family-based management, and the notion has important clinical and public health implications for infection control and related disease prevention.

Background: The 14-3-3 protein in cerebrospinal fluid (CSF) is a suitable biomarker for the diagnosis of Creutzfeldt-Jakob disease (CJD). However, it has also been detected in various non-prion-related rapidly progressive dementia (RPD), which affected its diagnostic performance and clinical utilization. Objective: To investigate the general disease distribution with positive 14-3-3 result and to evaluate the association between CSF 14-3-3 protein and the clinical features in patients with non-prion RPD. Methods: A total of 150 patients with non-prion RPD were enrolled. The clinical data were collected and CSF 14-3-3 test was performed for all patients. The distribution of various diseases with a positive 14-3-3 result was analyzed and the association of CSF 14-3-3 with clinical features was tested. Results: The CSF 14-3-3 protein was detected in 23.3% of non-prion RPD patients, and the most frequent diagnoses were autoimmune encephalitis (22.9%) and neurodegenerative disease (22.9%). CSF 14-3-3 protein was more common in older patients (p = 0.028) and those presenting myoclonus (p = 0.008). In subgroup analysis, the positive 14-3-3 test was more common in neurodegenerative disease with a long time from the symptom onset to CSF 14-3-3 test (p = 0.014). Conclusion: CSF 14-3-3 protein could be detected in a broad spectrum of non-prion RPD. In particular, patients with autoimmune encephalitis and rapidly progressive neurodegenerative diseases and those with myoclonus have a greater likelihood of a positive 14-3-3 result. These results could help clinicians interpret the results of CSF 14-3-3 protein more reasonably.

Gut microbiota alterations might affect the development of Alzheimer's disease (AD) through microbiota-derived metabolites. For example, microbiota-derived Indoles via tryptophan metabolism prevented Aβ accumulation and Tau hyperphosphorylation, restored synaptic plasticity, and then promoted the cognitive and behavioral ability of APP/PS1 mice. The imbalanced compositions of Indoles-producing bacteria with tryptophan deficiency were found in male APP/PS1 mice, but the molecular mechanisms remained unclear. Our current study revealed that Indoles (including indole, indole-3-acetic acid and indole-3-propionic acid) upregulated the production of aryl hydrocarbon receptor (AhR), inhibited the activation of the NF-κB signal pathway as well as the formation of the NLRP3 inflammasome, reduced the release of inflammatory cytokines, including TNF-α, IL-6, IL-1β and IL-18, alleviating the inflammatory response of APP/PS1 mice. These findings demonstrated the roles of Indoles-producing bacteria in activating the AhR pathway to regulate neuroinflammation of AD through gut microbiota-derived Indoles, which implied a novel way for AD treatment.

Data on recurrence are important to inform surveillance and improve long-term surgical outcomes for patients with hepatocellular carcinoma. We sought to identify risk factors and long-term prognosis among patients who experienced beyond-Milan recurrence after hepatectomy for early-stage hepatocellular carcinoma.Patients who underwent hepatectomy for Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma were identified from a multi-institutional database. Predictors of beyond-Milan recurrence and risk factors associated with post-recurrence survival among patients with beyond-Milan recurrence were assessed using univariate and multivariate Cox regression analyses.Among 753 patients (median follow-up, 51.8 months), 138 (18.3%) developed beyond-Milan recurrence. Regular surveillance (interval follow-up ≤3 months within 1 year and ≤6 months in subsequent years after surgery) was not carried out for 53 (38.4%) patients who developed beyond-Milan recurrence. On multivariate analysis, increased risk of beyond-Milan recurrence was independently associated with preoperative alpha-fetoprotein level400 ng/mL, tumor size5.0 cm, multifocal disease, microvascular invasion, and no/irregular recurrence surveillance. Median post-recurrence survival among patients with beyond-Milan recurrence was only 8.4 months (95% confidence interval: 7.0-9.8 months). Among patients who developed beyond-Milan recurrence, Child-Pugh grade B/C, early recurrence within 1 year after surgery, macrovascular invasion/distant metastasis, and noncurative treatment of recurrence were independent risk factors associated with worse post-recurrence survival.Nearly 1 in 5 patients developed beyond-Milan recurrence after hepatectomy for early-stage hepatocellular carcinoma. Patients with beyond-Milan recurrence had a median survival of less than 1 year after diagnosis of the recurrence. Regular surveillance is an important and actionable measure to decrease beyond-Milan recurrence and, in turn, improve long-term survival among patients treated with hepatectomy for hepatocellular carcinoma.

Background: Creutzfeldt-Jakob disease (CJD) can be difficult to distinguish clinically from some non-prion neurological diseases. Previous studies have reported markedly increased levels of α-synuclein in cerebrospinal fluid (CSF) of CJD patients, indicating that it is a potential diagnostic biomarker. Objective: The aim of this study was to assess the diagnostic power of CSF α-synuclein in discriminating CJD from non-prion disorders. Methods: The Ovid MEDLINE, Cochrane, and Embase databases were searched for articles published on or before February 25, 2022, using the search term (prion diseases OR Creutzfeldt-Jakob syndrome) AND (synuclein OR α-synuclein). The difference in CSF α-synuclein levels between CJD and non-prion diseases was calculated using random-effects models (I2 > 50%) or fixed-effects models (I2

The identification of patients at high risk of developing postoperative complications is important to improve surgical safety. We sought to develop an individualized tool to predict post-hepatectomy major complications in hepatitis B virus (HBV)-infected patients with hepatocellular carcinoma (HCC).A multicenter database of patients undergoing hepatectomy for HCC were analyzed; 2/3 and 1/3 of patients were assigned to the training and validation cohorts, respectively. Independent risks of postoperative 30-day major complications (Clavien-Dindo grades III-V) were identified and used to construct a web-based prediction model, which predictive accuracy was assessed using C-index and calibration curves, which was further validated by the validation cohort and compared with conventional scores.Among 2762 patients, 391 (14.2%) developed major complications after hepatectomy. Diabetes mellitus, concurrent hepatitis C virus infection, HCC beyond the Milan criteria, cirrhosis, preoperative HBV-DNA level, albumin-bilirubin (ALBI), and aspartate transaminase to platelet ratio index (APRI) were identified as independent predictors of developing major complications, which were used to construct the online calculator ( http://www.asapcalculate.top/Cal11_en.html ). This model demonstrated good calibration and discrimination, with the C-indexes of 0.752 and 0.743 in the training and validation cohorts, respectively, which were significantly higher than those conventional scores (the training and validation cohorts: 0.565 ~ 0.650 and 0.568 ~ 0.614, all P 0.001).A web-based prediction model was developed to predict the probability of post-hepatectomy major complications in an individual HBV-infected patient with HCC. It can be used easily in the real-world clinical setting to help management-related decision-making and early warning, especially in areas with endemic HBV infection.

Developing 15-minute cities, where people can access to living essentials within a 15-minute trip, has become a global effort. In addition to practical exercise, researchers have paid attention to the evaluation of 15-minute cities using home-based accessibility approaches. However, existing approaches do not account for human mobility, an important indicator of how people access and interact with urban amenities. In this study, we propose a novel network-based framework that assesses a 15-minute city considering human mobility patterns. We assume that there exists an optimal mobility network, which would maximize human mobility under the constraints of the current distribution of amenities. Locations where the provision of urban amenities does not match local needs are first identified based on the comparison between optimal mobility patterns and their actual counterparts. Built environment, demographic, and network structure factors that contribute to identified mismatch issues are then examined. The empirical study of Nanjing, China, suggests that the proposed framework could enable a dynamic evaluation of 15-minute cities and could provide important insights on policies and intervention strategies of planning and developing 15-minute cities.

The inefficient tumor penetration of therapeutic antibodies has hampered their effective use in treating solid tumors. Here, we report the identification of a fully human single-domain antibody (UdAb), designated as n501, targeting the oncofetal antigen 5T4. The high-resolution crystal structure indicates that n501 adopts a compact structure very similar to that of camelid nanobodies, and binds tightly to all eight leucine-rich repeats of 5T4. Furthermore, the UdAb n501 exhibits exceptionally high stability, with no apparent activity changes over 4 weeks of storage at various temperatures. Importantly, the UdAb-based antibody-drug conjugate (n501-SN38) showed much deeper tumor penetration, significantly higher tumor uptake, and faster accumulation at tumor sites than conventional IgG1-based antibody-drug conjugate (m603-SN38), resulting in improved tumor inhibition. These results highlight the potential of UdAb-based antibody-drug conjugates as a potential class of antitumor therapeutics with characteristics of high stability and strong tumor penetration for the effective treatment of solid tumors.

The fungal microbiota may be involved in the regulation of cognition and behavior, while the role of probiotic fungi against cognitive impairment is unclear. Here, we explored the idea that probiotic

Membrane separation provides effective methods for solving the global water crisis. Contemporary membrane systems depend on interfacial interactions between liquid and solid membrane matrixes. However, it may lead to a limiting permeate flux due to the large flow resistance at hydrophobic liquid-solid interfaces. Herein, the liquid-liquid interface with improved interface energy is reversibly introduced in membrane systems to boost wetting and reduce transport resistance. A series of interfaces were systematically explored to reveal mechanisms of wetting and boosted flow performances, which are further supported by simulations. Findings of this study highlight that interfacial liquids with lower surface energies, lower viscosities, and higher solubilities can effectively improve water flow without sacrificing rejection performance, achieving by transforming a solid-liquid interface into liquid-liquid interface interaction. It provides a concept to design advanced membrane systems for water purification (

The global carbon neutrality strategy brings a wave of rechargeable lithium‐ion batteries technique development and induces an ever-growing consumption and demand for lithium (Li). Among all the Li exploitation, extracting Li from spent LIBs would be a strategic and perspective approach, especially with the low energy consumption and eco-friendly membrane separation method. However, current membrane separation systems mainly focus on monotonous membrane design and structure optimization, and rarely further consider the coordination of inherent structure and applied external field, resulting in limited ion transport. Here, we propose a heterogeneous nanofluidic membrane as a platform for coupling multi-external fields (i.e., light-induced heat, electrical, and concentration gradient fields) to construct the multi-field-coupled synergistic ion transport system (MSITS) for Li-ion extraction from spent LIBs. The Li flux of the MSITS reaches 367.4 mmol m−2 h−1, even higher than the sum flux of those applied individual fields, reflecting synergistic enhancement for ion transport of the multi-field-coupled effect. Benefiting from the adaptation of membrane structure and multi-external fields, the proposed system exhibits ultrahigh selectivity with a Li+/Co2+ factor of 216,412, outperforming previous reports. MSITS based on nanofluidic membrane proves to be a promising ion transport strategy, as it could accelerate ion transmembrane transport and alleviate the ion concentration polarization effect. This work demonstrated a collaborative system equipped with an optimized membrane for high-efficient Li extraction, providing an expanded strategy to investigate the other membrane-based applications of their common similarities in core concepts.

In recent years, the incidence of lung cancer is increasing. Lung cancer has become one of the most malignant tumors with the highest incidence in the world, which seriously affects people’s health. The most important cause of death of lung cancer is metastasis. Therefore, it is crucial to understand the mechanism of lung cancer progression and metastasis. This review article discusses the physiological functions, pathological states and disorders of the lung and intestine based on the concepts of traditional Chinese medicine (TCM), and analyzes the etiology and mechanisms of lung cancer formation from the perspective of TCM. From the theory of “the exterior and interior of the lung and gastrointestinal tract”, the theory of “the lung-intestinal axis” and the progression and metastasis of lung cancer, we proposed e “lung-gut co-treatment” therapy for lung cancer. This study provides ideas for studying the mechanism of lung cancer and the comprehensive alternative treatment for lung cancer patients.

Purpose We aimed to investigate the predictive validity of monocyte to high-density lipoprotein cholesterol ratio (MHR) for coronary artery lesions (CALs) and intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD). Methods MHR values of a total of 207 KD patients were calculated and analyzed with regard to their clinical characteristics and outcomes. We compared the differences in clinical data and laboratory parameters between CAL + group and CAL- group as well as between IVIG-resistant group and IVIG-responsive group. Spearman correlation analysis was applied to evaluate the correlation between C-reactive protein (CRP) and MHR. Multivariate logistic regression was used to identify risk factors of CALs and IVIG resistance. Receiver operating characteristic (ROC) curve analysis was chosen to determine the optimal cutoff value of MHR and its validity in predicting CALs and IVIG resistance. Results The MHR level was significantly higher in CAL + group, with cut-off value of 1.30 g/L, yielding sensitivity of 0.753 and specificity of 0.805, as well as in IVIG-resistant group, with cut-off value of 1.03 g/L, yielding sensitivity of 0.97 and specificity of 0.485. Multivariate logistic regression showed that MHR was an independent risk factor for CALs but not for IVIG resistance. According to the Spearman correlation analysis, CRP was positively correlated with the MHR. Conclusions As a practical, cost-effective inflammatory biomarker, MHR has a significantly predictive value in KD children complicated with CALs and IVIG-resistance. Paying more attention to the changes of MHR in KD children may contribute to better understanding of KD development and prognosis in clinical practice.

Background Epilepsy is a neurological disorder caused by abnormal brain discharges. In recent years, genome-wide expression studies (GES) have been conducted using human patient samples and experimental models of epilepsy. Numerous molecular targets for epileptogenesis and treatment have been identified. However, there is still an urgent need to identify new biomarkers for epilepsy. Methods We performed a meta-analysis and convergence analysis of GES available from human samples and mouse and rat models to identify differentially expressed genes. Functional and pathway enrichment analysis of differentially expressed genes was performed using Sangerbox 3.0. Protein–protein interaction networks were mapped using STRING and subsequently visualized using Cytoscape. Disease gene–drug interactions were explored using the Comparative Toxicology Database and the Drug Gene Interaction Database. Results The ten most highly differentially expressed genes were, LRRTM1, STX1A, SNAP25, SYNPR, STXBP1, NRXN1, CPLX1, SYT4, SYT13 and GABRG2, which were supported by multi-lineage genomic evidence. A functional enrichment analysis identified several important classifications, including regulation of neuronal differentiation and regulation of vesicle-mediated transport. Potential druggable genes were also identified (e.g., LRRTM1, GABRG2, CYP4X1, CHGB and TMEM130). Conclusions We performed a meta-analysis and convergence analysis of GES from human samples and multiple animal models of epileptogenesis by integrating the results of several studies. We identified the top ten candidate genes and pathways for epileptogenesis. Among them, LRRTM1 and GABRG2 have been validated to have high druggable value. The other eight genes require further study to explore their potential as therapeutic targets in medial temporal lobe epilepsy with hippocampal sclerosis.

As a promising clean energy source, membrane-based osmotic energy harvesting has been widely investigated and developed through optimizing the membrane structure in recent years. For chasing higher energy conversion performance, various external stimuli have been introduced into the osmotic energy harvesting systems as assistant factors. Light as a renewable and well-tunable energy form has drawn great attention. Normally, it needs massive photoresponsive materials for improving the energy conversion performance and this hinders its wide applications. Herein, we fabricate a cellulose nanofiber (CNF) membrane with an ultrathin layer of low-dimensional carbon materials (LDCMs) for photothermal-enhanced osmotic energy conversion. The ultralow loading carbon quantum dot, carbon nanotube, and graphene oxide (LDCM/CNF = 1:200 wt) are used for light-to-heat conversion to build the heat gradient across the membrane. The output power density of the osmotic energy generator has increased from ∼3.55 to ∼7.67 W/m

The synergic coordination of trz, en, and PW9 resulted in a {Ni30} cluster substituted POM, [Ni(trz)3]2@[Ni30(H2O)16]POM, that was discovered as the SBU of four frameworks which served as heterogeneous catalysts for HERs.

A novel stator–rotator type luminophor: [(2,4,6-trifluoroanilinium)-(18-crown-6)][BF4], experiences a reversible first-order phase transition around Tp = 364 K, possessing evident Cp and permittivity changes, and long luminescence lifetime.

Host–guest inclusion compound-based ferroelectrics [Hcta-(18-crown-6)]+[BF4]− (1) and [Hcta-(18-crown-6)]+[ClO4]− (2) with a high Curie temperature (Tc = 403/394 K) and large spontaneous polarization (Ps = 5.7/4.7 μC cm−2) are reported.

Objective: To isolate a prevalent G9P[8] group A rotavirus (RVA) strain (N4006) in China and investigate its genomic and evolutionary characteristics, with the goal of facilitating the development of a new rotavirus vaccine. Methods: An RVA strain of the G9P[8] genotype from a diarrhea sample was passaged in MA104 cells. The strain was evaluated by SEM, polyacrylamide gel electrophoresis, and indirect immunofluorescence assay. The complete genome of the strain was obtained by RT-PCR and sequencing. The genomic and evolutionary characteristics of the strain were evaluated by nucleic acid sequence analysis with MEGA ver. 5.0.5 and DNASTAR software. The neutralizing epitopes of VP7 and VP4 (VP5* and VP8*) were analyzed using BioEdit ver. 7.0.9.0 and PyMOL ver. 2.5.2. Results: The N4006 strain (G9P[8] genotype) was adapted in MA104 cells with a high titer (105.5 PFU/mL). Whole-genome sequence analysis showed N4006 to be a reassortant rotavirus of Wa-like G9P[8] RVA and the NSP4 gene of DS-1-like G2P[4] RVA, with the genotype constellation G9-P[8]-I1-R1-C1-M1-A1-N1-T1-E2-H1 (G9P[8]-E2). Phylogenetic analysis indicated that N4006 had a common ancestor with Japanese G9P[8]-E2 rotavirus strains. Neutralizing epitope analysis showed that VP7, VP5*, and VP8* of N4006 had low homology with vaccine strains of the same genotype and marked differences with vaccine strains of other genotypes. Conclusion: The G9P[8] genotype rotavirus with the G9-P[8]-I1-R1-C1-M1-A1-N1-T1-E2-H1 (G9P[8]-E2) constellation predominates in China and may originate from reassortment between Japanese G9P[8] with Japanese DS-1-like G2P[4] rotaviruses. The antigenic variation of N4006 with the vaccine strain necessitates evaluation of the effect of the rotavirus vaccine on G9P[8]-E2 genotype rotavirus.

Introduction Creutzfeldt-Jakob disease (CJD) is a fatal and irreversible neurodegenerative disease. Identification of inexpensive and easy-to-implement biomarkers of CJD which could predict disease severity and patient survival is important for improving disease management. The aim of this study was to assess the predictive value of peripheral neutrophil to lymphocyte ratio (NLR), high-density lipoprotein (HDL), monocyte to HDL ratio (MHR) and neutrophil to HDL ratio (NHR) for CJD. Methods Patients with definite or probable CJD admitted to the Neurology Department of Xuanwu Hospital from 2014 to 2021 were enrolled and followed up until April 2022. Clinical information including sex, age, Barth Index, survival time and results of auxiliary examination were collected, and NLR, HDL, NHR and MHR were measured for all enrolled patients. The associations between NLR, HDL, NHR and MHR, and disease severity (evaluated by Barth Index), survival time and auxiliary examinations were evaluated. Results A total of 88 CJD patients were enrolled and all were deceased. NLR (r = -0.341, p = 0.001), NHR (r = -0.346, p = 0.001) and MHR (r = -0.327, p = 0.002) were significantly associated with disease severity. Higher NHR (HR = 2.344, 95% CI = 1.277–4.303 p = 0.006) and lower HDL (HR = 0.567, 95% CI = 0.346–0.930, p = 0.025) were associated with shorter survival time in the CJD patients. Conclusions Peripheral inflammatory biomarkers, especially NHR, were associated with disease severity and survival duration. These findings provide new insights into the mechanisms and treatment strategies of CJD.

Aiming to solve the problem of low-light-level (LLL) images with dim overall brightness, uneven gray distribution, and low contrast, in this paper, we propose an effective LLL image enhancement method based on the guided filter and multi-scale fusion for contrast enhancement and detail preservation. First, a base image and detail image(s) are obtained by using the guided filter. After this procedure, the base image is processed by a maximum entropy-based Gamma correction to stretch the gray level distribution. Unlike the existing methods, we enhance the detail image(s) based on the guided filter kernel, which reflects the image area information. Finally, a new method is proposed to generate a sequence of artificial images to adjust the brightness of the output, which has a better performance in image detail preservation compared with other single-input algorithms. Experiments show that the proposed method can provide a more significant performance in enhancing contrast, preserving details, and maintaining the natural feeling of the image than the state of the art.

Background Behavioral variant frontotemporal dementia (bvFTD) is predominantly considered a dysfunction in cortico-cortical transmission, with limited direct investigation of cortical-subcortical transmission. Thus, we aimed to characterize the metabolic connectivity between areas of the limbic cortico-striato-thalamic-cortical (CSTC) circuit in presymptomatic and symptomatic bvFTD patients. Methods Thirty-three bvFTD patients and 33 unrelated healthy controls were recruited for this study. Additionally, six asymptomatic carriers of the MAPT P301L mutation were compared with 12 non-carriers who were all from the same family of bvFTD. Each participant underwent neuropsychological assessment, genetic testing, and a hybrid PET/MRI scan. Seed-based metabolic connectivity based on [18F]-fluorodeoxyglucose PET between the main components within the limbic CSTC circuit was explored according to the Oxford-GSK-Imanova Striatal Connectivity Atlas. Results BvFTD patients exhibited reduced metabolic connectivity between the relays in the limbic CSTC circuit, which included the frontal region (ventromedial prefrontal cortex, orbitofrontal cortex, rectus gyrus, and anterior cingulate cortex), the limbic striatum, and thalamus compared to controls. In the bvFTD patients, the involvement of the limbic CSTC circuit was associated with the severity of behavior disruption, as measured by the frontal behavior inventory, the disinhibition subscale, and the apathy subscale. Notably, asymptomatic MAPT carriers had weakened frontostriatal connectivity but enhanced striatothalamus and thalamofrontal connectivity within the limbic CSTC circuit compared with noncarriers. Conclusion These findings suggested that aberrant metabolic connectivity within the limbic CSTC circuit is present in symptomatic and even asymptomatic stages of bvFTD. Thus, metabolic connectivity patterns could be used as a potential biomarker to detect the presymptomatic stage and track disease progression.