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Genome-wide association studies (GWAS) have identified hundreds of genetic signals associated with autoimmune disease. The majority of these signals are located in non-coding regions and likely impact cis-regulatory elements (cRE). Because cRE function is dynamic across cell types and states, profiling the epigenetic status of cRE across physiological processes is necessary to characterize the molecular mechanisms by which autoimmune variants contribute to disease risk. We localized risk variants from 15 autoimmune GWAS to cRE active during TCR-CD28 co-stimulation of naïve human CD4+ T cells. To characterize how dynamic changes in gene expression correlate with cRE activity, we measured transcript levels, chromatin accessibility, and promoter–cRE contacts across three phases of naive CD4+ T cell activation using RNA-seq, ATAC-seq, and HiC. We identified ~1200 protein-coding genes physically connected to accessible disease-associated variants at 423 GWAS signals, at least one-third of which are dynamically regulated by activation. From these maps, we functionally validated a novel stretch of evolutionarily conserved intergenic enhancers whose activity is required for activation-induced IL2 gene expression in human and mouse, and is influenced by autoimmune-associated genetic variation. The set of genes implicated by this approach are enriched for genes controlling CD4+ T cell function and genes involved in human inborn errors of immunity, and we pharmacologically validated eight implicated genes as novel regulators of T cell activation. These studies directly show how autoimmune variants and the genes they regulate influence processes involved in CD4+ T cell proliferation and activation.

Abstract Autism Spectrum Disorder (ASD) is among the most prevalent neurodevelopmental disorders, yet the current diagnostic procedures rely on behavioral analyses and interviews, without objective screening methods to support the diagnostic process. This study seeks to address this gap by integrating upper limb kinematics and deep learning methods to identify potential biomarkers that could be validated in younger age groups in the future to enhance the identification of ASD. Forty-one school-age children, with and without an ASD diagnosis (mean age ± SE: TD group: 10.3 ± 0.8, 8 males and 7 females; ASD group: 10.3 ± 0.5, 21 males and 5 females), participated in the study. A single Inertial Measurement Unit (IMU) was affixed to the child’s wrist as they engaged in a continuous reaching and placing task. Deep learning techniques were employed to classify children with and without ASD. Our findings suggest differential movement kinematics in school-age children compared to healthy adults. Compared to TD children, children with ASD exhibited poor feedforward/feedback control of arm movements as seen by greater number of movement units, more movement overshooting, and prolonged time to peak velocity/acceleration. Unique movement strategies such as greater velocity and acceleration were also seen in the ASD group. More importantly, using Multilayer Perceptron (MLP) model, we demonstrated an accuracy of ~ 78.1% in classifying children with and without ASD. These findings underscore the potential use of studying upper limb movement kinematics during goal-directed arm movements and deep learning methods as valuable tools for classifying and, consequently, aiding in the diagnosis and early identification of ASD upon further validation of their specificity among younger children.

Although research suggests a relationship among personal characteristics, behaviors, and performance, there has been limited examination of these influences in the context of intelligence tests using eye movement techniques. Thus, this study explored the roles of personal characteristics (i.e., visual/verbal cognitive styles, self-efficacy) and reading behaviors in the reasoning performance of Raven's Advanced Progressive Matrices test based on social cognitive perspectives using eye movement techniques, in order to provide more authentic information about individuals' actual behaviors. A total of 53 undergraduate and graduate students participated. Thirty participants were classified as visual style and the others were classified as verbal style learners. Regarding the role of cognitive styles in reading behaviors and reasoning performance, the results indicated a marginal difference in dispersion reading behavior between participants with visual and verbal cognitive style, and a significant relationship between visual style and dispersion reading behavior. However, no difference was found in performance between these two styles. As for the role of self-efficacy, the results showed that it was positively related to horizontal reading and APM-short performance. Mediation analyses revealed that self-efficacy not only directly impacted reasoning performance, but also had an indirect effect on performance through horizontal and tilted reading. On the other hand, cognitive style had no direct or indirect effect on reasoning performance. Moreover, the results showed that horizontal, vertical and tilted reading significantly predicted reasoning performance. The findings suggest that educators could enhance learners' self-efficacy through goal setting, feedback, and strategy instruction, which would help facilitate their learning behaviors and performance.

In this study, we propose a fire classification system using image clustering based on a federated learning (FL) structure. This system enables fire detection in various industries, including manufacturing. The accurate classification of fire, smoke, and normal conditions is an important element of fire prevention and response systems in industrial sites. The server in the proposed system extracts data features using a pretrained vision transformer model and clusters the data using the bisecting K-means algorithm to obtain weights. The clients utilize these weights to cluster local data with the K-means algorithm and measure the difference in data distribution using the Kullback–Leibler divergence. Experimental results show that the proposed model achieves nearly 99% accuracy on the server, and the clustering accuracy on the clients remains high. In addition, the normalized mutual information value remains above 0.6 and the silhouette score reaches 0.9 as the rounds progress, indicating improved clustering quality. This study shows that the accuracy of fire classification is enhanced by using FL and clustering techniques and has a high potential for real-time detection. [ABSTRACT FROM AUTHOR]

The canonical Wnt signaling pathway plays crucial roles in cell fate decisions as well as in pathogenesis of various diseases. Previously, we reported Caprin-2 as a new regulator of canonical Wnt signaling through a mechanism of facilitating LRP5/6 phosphorylation. Here, we resolved the crystal structure of the N-terminal homologous region 1 (HR1) domain of human Caprin-2. HR1 domain is so far only observed in Caprin-2 and its homologous protein Caprin-1, and the function of this domain remains largely mysterious. Here, the structure showed that HR1 domain of human Caprin-2 forms a homo-dimer and exhibits an overall structure roughly resembling the appearance of a pair of scissors. Moreover, we found that residues R200 and R201, which located at a basic cluster within the N-terminal "blades" region, are critical for Caprin-2's localization to the plasma membrane. In line with this, mutations targeting these two residues decrease Caprin-2's activity in the canonical Wnt signaling. Overall, we characterized a previously unknown "scissors"-like structure of the fulllength HR1 domain and revealed its function in mediating Caprin-2's localization to the plasma membrane. [ABSTRACT FROM AUTHOR]

Asian ginseng, the root of Panax ginseng C.A. Meyer, occupies a prominent position in the list of best-selling natural products in the world. There are two major types of ginseng roots: white ginseng and red ginseng, each with numerous preparations. White ginseng is prepared by air-drying fresh Asian ginseng roots after harvest. Red ginseng is prepared by steaming roots in controlled conditions using fresh or raw Asian ginseng. Red ginseng is commonly used in Asian countries due to its unique chemical profile, different therapeutic efficacy, and increased stability. Compared with the widespread research on white ginseng, the study of red ginseng is relatively limited. In this paper, after a botanical feature description, the structures of different types of constituents in red ginseng are systematically described, including naturally occurring compounds and those resulting from the steam processing. In red ginseng phytochemical studies, the number of published reports on ginsenosides is significantly higher than that for other constituents. Up to now, 57 ginsenosides have been isolated and characterized in red ginseng. The structural transformation pathways during steaming have been summarized. In comparison with white ginseng, red ginseng also contains other constituents, including polyacetylenes, Maillard reaction products, other types of glycosides, lignans, amino acids, fatty acids, and polysaccharides, which have also been presented. Appropriate analytical methods are necessary for differentiating between unprocessed white ginseng and processed red ginseng. Specific marker compounds and chemical profiles have been used to discriminate red ginseng from white ginseng and adulterated commercial products. Additionally, a brief phytochemical profile comparison has been made between white ginseng and black ginseng, and the latter is another type of processed ginseng prepared from white or red ginseng by steaming several times. In conclusion, to ensure the safe and effective use of red ginseng, phytochemical and analytical studies of its constituents are necessary and even crucial. [ABSTRACT FROM AUTHOR]

Codium fragile (CF) is a green seaweed that has been used in folk medicine to treat urinary tract disorders, intestinal bacteriosis, and dropsy. The CF is also used primarly as a seasoning to enhance the flavor of Kimchi, and in some areas it is consumed as a side dish. The CF has reported to have anti-coagulant, thrombolytic, anti-inflammatory, anti-oxidant activities. The purpose of this study was to analyze the immune-enhancing effect of aqueous extract of C. fragile (AECF) using RAW264.7 macrophages and splenocytes. The AECF induced the production of nitrite oxide and inducible nitric oxide synthase at 1 mg/mL without cytotoxicity, and also gradually increased the expression of pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6), determined by griess reagent, western blot, and Enzyme-linked immunosorbent assay. In addition, AECF significantly induced the expression of immune-related enzymes, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, and monocyte chemoattracted protein-1, which increase the production of immune cells, determined by mouse cytokine array, as determined by cytokine arrray. The AECF induced phosphorylation of mitogen-activated protein kinases and translocation of nuclear factor kappa B p65 subunit from cytosol to the nucleus. Our findings indicate that C. fragile may have potential as a functional ingredinet for developing immune-enhancing supplement that properly maintiain the body’s defense system.

AIMS Primary spontaneous pneumothorax (PSP) is a sudden pleural disease predominantly affecting healthy adolescents and young adults, making it a prevalent thoracic disorder within this demographic. This study evaluated the necessity of preoperative chest tube insertion for PSP patients and reassessed current clinical practices. METHODS We conducted a retrospective analysis of medical records for individuals aged 14–30 years diagnosed with PSP who underwent video-assisted thoracoscopic surgery (VATS) at Wonju Severance Christian Hospital from January 2016 to December 2022. Patients were categorized retrospectively into two groups based on their initial treatment: Those who had a chest tube inserted and those who did not. We collected and compared clinical data, including demographics, treatment specifics, and outcomes. RESULTS The study included 128 PSP cases. There was no difference in preoperative clinical data between the two groups, and there were no differences in operation time, number of wedge resections, and number of mechanical pleurodesis. However, the use of single-port surgery was significantly higher in the nonchest tube group (P = 0.001). The nonchest tube group had a significantly shorter hospital stay (P < 0.001), attributed to the absence of preoperative chest tube insertions. There were no significant differences in postoperative complications or recurrence rates between the groups. CONCLUSIONS In young PSP patients, proceeding directly to VATS without prior chest tube insertion in stable individuals does not lead to serious complications or negatively affect outcomes. This approach may offer an effective alternative for PSP management.

Rhodiola, belonging to the Crassulaceae family, is a perennial herbaceous plant genus. There are about 90 Rhodiola species worldwide, some of which have been reported to have medicinal properties. Rhodiola sachalinensis is a perennial medicinal herb within this genus and, in the present study, its chloroplast genome was sequenced, assembled, annotated and compared with 24 other Rhodiola species. The results obtained show that the chloroplast genome of R. sachalinensis is 151 595 bp long and has a CG content of 37.7%. The inverted repeats (IR) region of the Rhodiola chloroplast genome is the most conserved region, with the main differences being observed in the ycf1 and ndhF genes at the IRb‐small single copy boundary, and rps19 and trnH genes at the IRa‐large single copy boundary. Phylogenetic analysis showed that Rhodiola species form two major clades, and species with recorded medicinal properties, clustered together in one branch except for R. dumulosa. Within the genus, R. sachalinensis is most closely related to Rhodiola rosea, although comparative analyses showed that only R. sachalinensis and Rhodiola subopposita contained the psbZ gene, which encodes a highly conserved protein subunit of the Photosystem II core complex. Overall, the present study contributes to the understanding of the chloroplast genome of Rhodiola species, and provides a theoretical basis for the study of their genetic diversity and possible use as medicinal plants.

ABSTRACT: Notoginseng Radix et Rhizoma (Sanqi in Chinese) is a precious traditional Chinese herbal medicine. It has the effect of dispersing blood stasis and stopping bleeding, reducing swelling and fixing pain. However, it tends to contaminate with harmful fungi during storage, which may make it much less effective. In order to understand the fungal contamination of Notoginseng Radix et Rhizoma and master its composition of the exogenous fungi. The surface fungi of Notoginseng Radix et Rhizoma samples collected from six Chinese provinces and districts were investigated by using dilution plate method. Detection of aflatoxins by UPLC-MS/MS. The results showed that Penicillium citrinum was dominantly isolated from Notoginseng Radix et Rhizoma samples from No.1 to No.4. Aspergillus flavus, which produces aflatoxin, was dominantly isolated from Notoginseng Radix et Rhizoma samples from No.5 and No.6. In addition, kinds of mycotoxin were assayed which were produced by three of those identified A. flavus. All three fungi strains produced aflatoxin B1 (AFB1) and one strain HBSQ1-5 additionally produced other three kinds of mycotoxin, AFB2, AFG1 and AFG2. It is the results implied that it will be very important to take serious cautions when using Notoginseng Radix et Rhizoma. As well as, understanding the composition of the exogenous fungi of Notoginseng Radix et Rhizoma and the strains of toxin-producing fungi, which can play an important role in guiding the storage of Notoginseng Radix et Rhizoma..

Objective: To systematically evaluate and synthesize quantitative evidence regarding the effects of pediatric massage in infants and children under five years. Review methods: We conducted searches in databases including MEDLINE, Embase, Health Technology Assessment Database, the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, Embase, the China National Knowledge Infrastructure, Wanfang Data, SinoMed, and CQVIP up to February 2024. Two reviewers independently screened articles, extracted data, and conducted quality appraisals on the included studies. We focused on systematic reviews with meta-analyses comparing pediatric tuina with a waitlist control, placebo, medication, massage combined with other interventions, and usual care. Outcomes analyzed included physical, psychological, developmental, and safety-related measures for children and their caregivers. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated using the GRADE approach. Pooled effect estimates and heterogeneity were extracted for each meta-analyzed outcome. Evidence evaluated as ‘high’ and ‘moderate’ quality by GRADEpro with low heterogeneity are presented in the result section. Results: Twenty-two systematic reviews with meta-analysis of 81 outcomes were included. Seven studies (31.8 %) were high quality, and the evidence of 6 (7.4 %) outcomes were evaluated as high quality. The meta-analysis results demonstrate significant benefits of pediatric massage for infants compared to routine care, with increased weight gain (MD 455.07 g; 95 % CI 86.33 to 823.8; I2 = 0 %) based on 2 studies with 157 cases, length growth (MD 1.58 cm; 95 % CI 1.42 to 1.74; I2 = 25 %) from 9 studies with 1294 cases, reduced fussing (MD -0.37 time; 95 % CI -0.53 to -0.21; I2 = 30 %) according to 3 studies with 271 cases, and lower post-intervention bilirubin levels (3 studies/345 cases; MD -31.75 mmol/L; 95 % CI -40.05 to -23.46; I2 = 0 %). Pediatric massage was associated with reduced diarrhea incidence compared to waitlist controls (2 RCTs/310 cases; RR 0.39; 95 % CI 0.2 to 0.76; I2 = 0 %) and improved psychomotor development indices (4 RCTs/466 cases; SMD -0.35; 95 % CI -0.54 to -0.15; I2 = 1.06 %). Additionally, pediatric massage significantly enhanced blood oxygen saturation variation post-procedure for pain management (5 RCTs/355 cases; MD 1.05; 95 % CI 0.51 to 1.58; I2 = 0 %). Conclusions: Pediatric massage significantly enhances mother-child attachment, promotes physical growth, reduces fussing, lowers bilirubin levels, improves motor and psychomotor development, as well as manages digestive conditions and pain in children under 5 years. Future research should improve study quality and comprehensively report adverse events.

Citri Reticulatae Pericarpium(CRP) and Polygalae Radix (PR) are traditional Chinese medicinal herbs and dietary supplements, and they are commonly included in most prescriptions. Fungal contamination in CRP and PR has long been a concern for the public. Thus, in this study, the fungal diversity and abundance in CRP and PR were investigated via high-throughput sequencing technology. Analysis was conducted to determine the differences in dominant fungal microbiomes between mouldy and nonmouldy samples, and the correlation between the total number of fungi and fungal diversity in medicinal herbs at different altitudes and latitudes with other research was explored. Results show the fungal contamination of all 12 samples. At the phylum level, Ascomycota prevailed the most in CRP and PR with relative abundances of 56.96%–99.26% and 23.28%–76.06%, respectively. The dominant genera in CRP comprised Xeromyces (2.57%–53.21%), Aspergillus (0.18%–23.04%), Cystofilobasidium (0.032%–28.03) and Xerochrysium (0.31%–34.41%). The dominant genera in PR included Wallemia (0.27%–56.20%), Aspergillus (2.03%–48.06%), Xeromyces (0.20%–48.28%) and Xerochrysium (0.093%–43.95%). Two potential toxigenic fungi were detected: Alternaria alternata and Aspergillus versicolor. In addition, combined with the results of previous studies, the findings reveal the possible relation of diversity and abundance of fungal species to altitude and latitude: As the altitude and latitude decrease, the diversity and abundance of fungal species may increase. In conclusion, for the first time, this study focused on altitude and latitude as indicators and integrated multiple research findings to explore the correlation between the total amount and diversity of fungal species in the two edible herbs. Results reveal the fungal contamination of the surfaces of CRP and PR and provide a theoretical basis for the prevention and control of their fungal contamination.

ObjectivesTo evaluate the efficacy and safety of CHM in the prevention of COVID-19 infection and treatment for COVID-19 related symptoms.DesignProspective open-label randomized controlled trial.SettingParticipants’ home in Hong Kong.ParticipantsParticipants who had household close contact with COVID-19-infected family members.InterventionsClose contacts were stratified into 4 groups (cohort A, B, C, D) based on symptoms and infection status and were randomized in 4:1 ratio to receive CHM granules (9g/sachet, two times daily) or blank control for 7 days with 2 weeks of follow-up.Main outcome measuresThe primary outcome measure was the rate of positive nucleic acid tests. Secondary outcomes were the proportion of developed COVID-19 related symptoms and adverse events during the whole 3-week study period. Subgroup analysis was used to evaluate demographic factors associated with positive infection rates.ResultsA total of 2163 contacts were enrolled and randomly assigned to the CHM group (1720 contacts) and blank control (443 contacts) group. During the 21 days, the rate of PCR-positive cases in cohort A was markedly lower in the CHM group (3.6%) compared to the control group (7.0%) (P=0.036). Overall, the rate of infection in the CHM group was significantly lower than that in the control group (10.69% vs. 6.03%; RR 0.56, 95% CI 0.39-0.82) after 7-day treatment. No serious adverse events were reported during the medication period.ConclusionThe preliminary findings indicate that CHM may be effective and safe in preventing COVID-19. Future double-blind, randomized controlled trials and long-term follow-up are needed to fully evaluate the efficacy of CHM in a larger contact population.Clinical trial registrationClinicalTrials.gov, identifier NCT05269511

Traditional acute kidney injury (AKI) classifications, which are centered around semi-anatomical lines, can no longer capture the complexity of AKI. By employing strategies to identify predictive and prognostic enrichment targets, experts could gain a deeper comprehension of AKI’s pathophysiology, allowing for the development of treatment-specific targets and enhancing individualized care. Subphenotyping, which is enriched with AKI biomarkers, holds insights into distinct risk profiles and tailored treatment strategies that redefine AKI and contribute to improved clinical management. The utilization of biomarkers such as N-acetyl-D-glucosaminidase, tissue inhibitor of metalloprotease-2•insulin-like growth factor-binding protein 7, kidney injury molecule-1, and liver fatty acid-binding protein garnered significant attention as a means to predict subclinical AKI. Novel biomarkers offer promise in predicting persistent AKI, with urinary motif chemokine ligand 14 displaying significant sensitivity and specificity. Furthermore, they serve as predictive markers for weaning patients from acute dialysis and offer valuable insights into distinct AKI subgroups. The proposed management of AKI, which is encapsulated in a structured flowchart, bridges the gap between research and clinical practice. It streamlines the utilization of biomarkers and subphenotyping, promising a future in which AKI is swiftly identified and managed with unprecedented precision. Incorporating kidney biomarkers into strategies for early AKI detection and the initiation of AKI care bundles has proven to be more effective than using care bundles without these novel biomarkers. This comprehensive approach represents a significant stride toward precision medicine, enabling the identification of high-risk subphenotypes in patients with AKI.

Background Methods Results Conclusions Whether structured exercise therapy improves chemotherapy delivery, tolerability, and tumor response is unclear.This was a secondary analysis of a phase 2 trial investigating exercise therapy (n = 72) versus usual care (n = 72) in patients with primary breast cancer. Exercise therapy comprised individualized treadmill walking three times weekly for 20–50 minutes per session at 55%–100% of pretreatment exercise capacity. Chemotherapy delivery was assessed according to the relative dose intensity (RDI), tolerability was assessed according to patient‐reported outcomes and blood laboratory values, and response was assessed based on the pathologic complete response rate in patients who received neoadjuvant chemotherapy.In the exercise therapy group, 51 patients (71%) reached 100% RDI (median, 100%; interquartile range, 100%–100%) compared with 41 patients (57%) in the usual care group (median, 100%; interquartile range, 95%–100%; p = .08). Tolerability was similar in both groups; the rates of grade 3 or higher neutropenia and anemia were 22% versus 39% and 7% versus 10% in the exercise and usual care groups, respectively. In patients who received anthracyclines (n = 104), 41 (77%) had 100% chemotherapy RDI in the exercise therapy group versus 29 (57%) in the usual care group (p = .026). In the neoadjuvant chemotherapy subgroup (n = 51 tumors), the postneoadjuvant therapy (yp) pathologic complete response (ypT0ypN0) rate was 27% (95% confidence interval, 12%–50%) in the exercise therapy group compared with 28% (95% confidence interval, 13%–47%) in the usual care group (p > .9).In patients with primary breast cancer, exercise therapy was associated with improved delivery of anthracycline‐based chemotherapy. Although exercise therapy was not significantly associated with tumor response, effects varied by tumor subtype (trial registration: Clinicaltrials.gov identifier NCT01943695). [ABSTRACT FROM AUTHOR]

Aims: We compared the efficacy, fidelity, acceptability, and feasibility of a creative movement (CM) intervention for children with autism spectrum disorder (ASD), delivered face-to-face (F2F) or through telehealth (TH). Methods: Fifteen children with ASD received the CM intervention F2F or through TH. Motor assessments were used to evaluate effects of F2F and TH interventions on children's motor skills, while video coding was used to assess affect, socially directed verbalization, interpersonal synchrony, and motor coordination during training. Stakeholder feedback and training fidelity data on the intervention were also collected. Results: Children in both subgroups showed similar baseline performance and training-related improvements in motor skills, positive/interested affect, socially directed verbalization, interpersonal synchrony, and dual/multilimb coordination. Parents in the TH subgroup considered the intervention feasible and acceptable; however, they reported greater effort to supervise and redirect their child's attention compared to the F2F subgroup. Trainers for the TH subgroup reported more communication difficulties, technological issues, and longer session lengths, but found greater parental involvement compared to the F2F subgroup. Conclusions: CM interventions are consistent, acceptable, feasible, and effective in improving social, behavioral-affective, and motor skills of children with ASD, regardless of the method of delivery. Clinicians should make efforts to reduce communication/technological issues and parental burden when delivering CM interventions through TH. ClinicalTrials.Gov Study ID-NCT04258254.

Detection of photons with energy below the bandgap or Schottky barrier height of silicon has been limited in the past. Here, we reveal an approach that harnesses hot carriers through diffusion over a very thin metal to achieve silicon-based mid-infrared detection. With strong localized surface plasmon resonance (LSPR) effect to enhance infrared absorption and diffusion across 10 nm metal in Schottky structure, the hot carriers can be effectively collected. Such mechanism leads to responsivity from 0.098 mA/W to 0.237 mA/W for the wavelengths between 2700 nm and 5300 nm, all corresponding to photon energy below Schottky barrier height. Our investigation further shows that inverted pyramidal structures could enhance LSPR and so the responsivity. In addition, this approach enables us to monitor high frequency optical signals up to 2.1 MHz. By harnessing hot carriers and enhancing LSPR, we have not only overcome previous limitations in silicon-based mid-infrared detection but also opened up new possibilities for advanced photonics and optoelectronics applications.

In this study, we propose a fire classification system using image clustering based on a federated learning (FL) structure. This system enables fire detection in various industries, including manufacturing. The accurate classification of fire, smoke, and normal conditions is an important element of fire prevention and response systems in industrial sites. The server in the proposed system extracts data features using a pretrained vision transformer model and clusters the data using the bisecting K-means algorithm to obtain weights. The clients utilize these weights to cluster local data with the K-means algorithm and measure the difference in data distribution using the Kullback–Leibler divergence. Experimental results show that the proposed model achieves nearly 99% accuracy on the server, and the clustering accuracy on the clients remains high. In addition, the normalized mutual information value remains above 0.6 and the silhouette score reaches 0.9 as the rounds progress, indicating improved clustering quality. This study shows that the accuracy of fire classification is enhanced by using FL and clustering techniques and has a high potential for real-time detection.

The utilization of metal/semiconductor Schottky devices for plasmonic harvesting of hot carriers holds immense potential in the field of sub-bandgap photodetection. In this work, we explore a surface passivation scheme using air plasma exposure to modify the Si (100) surface and subsequently the crystal orientation of the deposited Ag film for photon detection in the mid-infrared (MIR) regime. This tailoring was achieved by varying the plasma exposure duration (0, 150, 300, 450, and 600 s). As a result, we could tune the crystal orientation of Ag from the (200) to the (210) crystal plane, with the Ag (111) orientation present in all devices. Furthermore, the photo-response behavior under MIR exposure at λ = 4.2 µm was studied both experimentally and using COMSOL simulations. It was observed that both photoelectric (PE) and photothermal (PT) effects contributed to the photo-response behavior of all devices. The Ag/Si device exposed to air plasma for 300 s exhibited the maximum PE-driven response (2.73 µA/W), while the device exposed to air plasma for 600 s showed a significant PT-driven response (13.01 µA/W). In addition, this strategy helped reduce the reverse leakage current by up to 99.5%. This study demonstrates that MIR detection at longer wavelengths can be optimized by tailoring the crystal orientation of the metal film.

Ductus arteriosus closure may be delayed in preterm infants, and prostaglandin, a vasodilator, can affect ductal patency. Furosemide can increase renal prostaglandin synthesis, so its net effect on patent ductus arteriosus (PDA) is uncertain. Our goal is to explore the relationship between furosemide and spontaneous ductal closure in very-low-birth-weight preterm infants. Our treatment for PDA involves fluid restriction initially and furosemide administration for hemodynamically significant PDA until closure is confirmed by the echocardiogram. We enrolled 105 infants from 1 January 2019 to 30 June 2022 and evaluated the impact of furosemide on ductal closure, including exposure duration and cumulative dose. There is no correlation between furosemide exposure and spontaneous ductal closure (p = 0.384). Furosemide exposure does not delay the postmenstrual age at which spontaneous ductal closure occurs (p = 0.558). The time for spontaneous ductal closure is positively associated with furosemide prescription days (coefficient value = 0.547, p = 0.026) and negatively with gestational age (coefficient value = −0.384, p = 0.062). The prescription of furosemide does not impact the probability or time duration of ductus arteriosus spontaneous closure. The cumulative dose of furosemide has minimal impact on ductal closure. The correlation between furosemide exposure duration and ductal patency duration is likely due to our treatment protocol, with gestational age being a significant factor.

In recent years, the utilization of minimally invasive surfactant therapy (MIST) and Non-invasive ventilation (NIV) as the primary respiratory assistance has become increasingly prevalent among preterm infants with neonatal respiratory distress syndrome (RDS). This study aims to compare the outcomes between MIST administered with nasal continuous positive airway pressure (NCPAP) versus nasal intermittent positive pressure ventilation (NIPPV), with the objective of exploring the respiratory therapeutic benefits of these two approaches. This retrospective study collected data from the neonatal intensive care unit of Kaohsiung Medical University Hospital spanning from January 2016 to June 2021. Infants were divided into two groups based on the type of NIV utilized. The NCPAP group comprised 32 infants, while the NIPPV group comprised 22 infants. Statistical analysis revealed significant differences: the NIPPV group had a smaller gestational age, lower birth weight, higher proportion of female infants, and earlier initiation of MIST. Additionally, the NIPPV group exhibited higher incidence rates of retinopathy of prematurity, longer respiratory support duration, prolonged hospitalization, and mortality. However, upon adjustment, these differences were not statistically significant. Analysis of venous blood gas and respiratory parameter changes indicated that both the NCPAP and NIPPV groups experienced improvements in oxygenation and ventilation following MIST.

Background: Although surgery remains the primary treatment for gastric cancer (GC), the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance. HER2 overexpression occurs in approximately 15%-20% of advanced GC cases, directly affecting treatment-related decisions. Spectral-computed tomography (sCT) enables the quantification of material compositions, and sCT iodine concentration parameters have been demonstrated to be useful for the diagnosis of GC and prediction of its invasion depth, angiogenesis, and response to systemic chemotherapy. No existing report describes the prediction of GC HER2 status through histogram analysis based on sCT iodine maps (IMs)., Aim: To investigate whether whole-volume histogram analysis of sCT IMs enables the prediction of the GC HER2 status., Methods: This study was performed with data from 101 patients with pathologically confirmed GC who underwent preoperative sCT examinations. Nineteen parameters were extracted via sCT IM histogram analysis: The minimum, maximum, mean, standard deviation, variance, coefficient of variation, skewness, kurtosis, entropy, percentiles (1 st , 5 th , 10 th , 25 th , 50 th , 75 th , 90 th , 95 th , and 99 th ), and lesion volume. Spearman correlations of the parameters with the HER2 status and clinicopathological parameters were assessed. Receiver operating characteristic curves were used to evaluate the parameters' diagnostic performance., Results: Values for the histogram parameters of the maximum, mean, standard deviation, variance, entropy, and percentiles were significantly lower in the HER2+ group than in the HER2- group (all P < 0.05). The GC differentiation and Lauren classification correlated significantly with the HER2 status of tumor tissue ( P = 0.001 and 0.023, respectively). The 99 th percentile had the largest area under the curve for GC HER2 status identification (0.740), with 76.2%, sensitivity, 65.0% specificity, and 67.3% accuracy. All sCT IM histogram parameters correlated positively with the GC HER2 status ( r = 0.237-0.337, P = 0.001-0.017)., Conclusion: Whole-lesion histogram parameters derived from sCT IM analysis, and especially the 99 th percentile, can serve as imaging biomarkers of HER2 overexpression in GC., Competing Interests: Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To evaluate the comparative efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on glycaemic control, body weight, and lipid profile in adults with type 2 diabetes., Design: Systematic review and network meta-analysis., Data Sources: PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase from database inception to 19 August 2023., Eligibility Criteria for Selecting Studies: Eligible randomised controlled trials enrolled adults with type 2 diabetes who received GLP-1RA treatments and compared effects with placebo or any GLP-1RA drug, with a follow-up duration of at least 12 weeks. Trials with a crossover design, non-inferiority studies comparing GLP-1RA and other drug classes without a placebo group, using withdrawn drugs, and non-English studies were deemed ineligible., Results: 76 eligible trials involving 15 GLP-1RA drugs and 39 246 participants were included in this network meta-analysis; all subsequent estimates refer to the comparison with placebo. All 15 GLP-1RAs effectively lowered haemoglobin A 1c and fasting plasma glucose concentrations. Tirzepatide induced the largest reduction of haemoglobin A 1c concentrations (mean difference -2.10% (95% confidence interval -2.47% to -1.74%), surface under the cumulative ranking curve 94.2%; high confidence of evidence), and fasting plasma glucose concentrations (-3.12 mmol/L (-3.59 to -2.66), 97.2%; high confidence), and proved the most effective GLP-1RA drug for glycaemic control. Furthermore, GLP-1RAs were shown to have strong benefits to weight management for patients with type 2 diabetes. CagriSema (semaglutide with cagrilintide) resulted in the highest weight loss (mean difference -14.03 kg (95% confidence interval -17.05 to -11.00); high confidence of evidence), followed by tirzepatide (-8.47 kg (-9.68 to -7.26); high confidence). Semaglutide was effective in lowering the concentration of low density lipoprotein (-0.16 mmol/L (-0.30 to -0.02)) and total cholesterol (-0.48 mmol/L (-0.84 to -0.11)). Moreover, this study also raises awareness of gastrointestinal adverse events induced by GLP-1RAs, and concerns about safety are especially warranted for high dose administration., Conclusions: GLP-1RAs are efficacious in treating adults with type 2 diabetes. Compared with the placebo, tirzepatide was the most effective GLP-1RA drug for glycaemic control by reducing haemoglobin A 1c and fasting plasma glucose concentrations. GLP-1RAs also significantly improved weight management for type 2 diabetes, with CagriSema performing the best for weight loss. The results prompt safety concerns for GLP-1RAs, especially with high dose administration, regarding gastrointestinal adverse events., Systematic Review Registration: PROSPERO CRD42022342845., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from the National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, and Beijing University of Chinese Medicine High-level Talent Start-up Research Project; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)