Search

Background Previous studies have shown that polycystic ovary syndrome (PCOS) patients suffer from low-grade chronic inflammation. Furthermore, our previous studies have confirmed that IL-18 is highly expressed in the serum and endometria of PCOS patients. Nevertheless, the mechanisms underlying IL-18 elevation remain unclear. This study aims to explore the signaling pathways that lead to IL-18 upregulation in the endometria of PCOS patients. Methods Using the TF-Search tool, we predicted that C/EBP-β may be a transcription factor for IL-18 and that deacetylase SIRT1 could be involved in its regulation. Subsequently, we analyzed SIRT1 and C/EBP-β in the proliferative endometria of PCOS patients and healthy control using immunohistochemistry, real-time quantitative PCR and western blot; PCOS diagnosis was based on the 2003 Rotterdam ESHRE/ASRM criteria. We further verified the interaction between C/EBP-β and IL-18 using a double luciferase assay. Results SIRT1 and C/EBP-β gene and protein levels in the proliferative endometria of PCOS patients were significantly higher than the control group. Immunohistochemical experiments confirmed that SIRT1 was primarily expressed in the endometrial nucleus, while C/EBP-β was predominantly expressed in the endometrial nucleus and cytoplasm. Double luciferase assay verified the interaction between C/EBP-β and IL-18. Conclusion SIRT1 and C/EBP-β are probable IL-18 regulatory mechanism in the endometria of PCOS patients.

Pathologic findings showed that neutrophils played an important role in the pathogenesis of NMO. This study aims to investigate the CSF levels of neutrophil‐related chemokines in NMO. CXCL1, CXCL5, and CXCL7 were measured in 95 patients with NMO, 15 patients with MS, 18 patients with GFAP astrocytopathy, and 16 controls. The CSF level of CXCL1, CXCL5, and CXCL7 was significantly elevated in the NMO group but not correlated with the patient clinical severity. Besides, the CSF CXCL1, CXCL5, and CXCL7 could act as biomarkers to distinguish NMO from MS with good reliability, especially the CXCL7.

Background Number of small segments (NSS) and activity analysis is a mature method for electromyographic automatic interference pattern analysis (IPA), but there are few reports on the application of this technique. Our objective was to establish normal reference values of NSS-activity clouds. Methods The NSS and activity data of the sternocleidomastoid, deltoid, biceps brachii (long head), extensor digitorum communis, abductor digiti minimi, vastus medialis, tibialis anterior, and gastrocnemius (lateral head) muscles were obtained from 34 men and 25 women, aged 15-80 years, using concentric needle electrodes. A linear regression of log(NSS) vs log(activity) was performed and the slope, intercept and standard deviation were calculated for each muscle. These variables were transformed back to the original parameters to yield clouds. Results Normal NSS-activity clouds for the above eight muscles were obtained. Conclusions Normal reference values of NSS-activity may facilitate detection of early and mild neurogenic and myogenic abnormalities.

ObjectiveTo explore the outcomes of NMOSD attacks and investigate serum biomarkers for prognosis and severity.MethodPatients with NMOSD attacks were prospectively and observationally enrolled from January 2019 to December 2020 at four hospitals in Guangzhou, southern China. Data were collected at attack, discharge and 1/3/6 months after acute treatment. Serum cytokine/chemokine and neurofilament light chain (NfL) levels were examined at the onset stage.ResultsOne hundred patients with NMOSD attacks were included. The treatment comprised intravenous methylprednisolone pulse therapy alone (IVMP, 71%), IVMP combined with apheresis (8%), IVMP combined with intravenous immunoglobulin (18%) and other therapies (3%). EDSS scores decreased significantly from a medium of 4 (interquartile range 3.0–5.5) at attack to 3.5 (3.0–4.5) at discharge, 3.5 (2.0–4.0) at the 1-month visit and 3.0 (2.0–4.0) at the 3-month visit (p2 = 0.487).ConclusionsOutcomes of NMOSD attacks were generally moderate. A high level of serum Th2-related cytokines predicted remission at the 1-month visit, and serum NfL may serve as a biomarker of disease severity at attack.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT04101058, identifier NCT04101058.

Herbal weight loss drugs are becoming more widely used in the fight against obesity, but ineffective regulation of these products have resulted in harmful additives. These products may contain adulterants such as sibutramine hydrochloride that may result in serious adverse health events including death. This work established a color precipitation reaction-based rapid screening method for illegal adulteration of sibutramine hydrochloride in natural herbal medicines (NHM) and dietary supplements (DS). While a variety of chromatography- and electrophoresis-based systems have been reported to measure this analyte, they generally suffer from high costs, complicated sample preparation, and a costly analytical infrastructure. In contrast, we present a simple, handheld kit to assay for sibutramine. The performance metrics of this tool include an average detection time of approximately 3 minutes, which is markedly shorter than conventional methods (HPLC or HPLC-MS, etc.), a detection limit of 0.1 mg per aliquot, and an accuracy of 99.02% (n = 820). More strikingly, the sensitivity is 100% (n = 278), and the specificity is 98.52% (n = 542). The rapid test kit developed from this screening method was evaluated by FDA. In summary, this screening method is a rapid, simple, and low-cost tool for the detection of sibutramine in NHM and DS with superior selectivity and sensitivity. For these reasons, this method is especially suitable for underdeveloped settings because it can be employed onsite without any instrumentation. In addition, this approach could rapidly exclude most of the negative samples to boost efficiency in large-scale samples assay. If necessary, positive samples can undergo further alternate testing methods to confirm the positive results of sibutramine hydrochloride content.

BackgroundNeuromyelitis optica (NMO), multiple sclerosis (MS) and autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy are idiopathic inflammatory demyelinating diseases (IIDDs) that mainly present as encephalomyelitis. Heparan sulfate (HS) and hyaluronic acid (HA) are two components of glycocalyx, a carbohydrate-rich layer on the surface of blood vessels that mediates interaction with blood. Degradation of glycocalyx in NMO is poorly understood.PurposeTo detect the serum and cerebrospinal fluid (CSF) levels of shed HS and HA and to correlate these levels with disease severity to determine their diagnostic value.MethodsWe obtained serum and CSF samples from 24 NMO patients, 15 MS patients, 10 autoimmune GFAP astrocytopathy patients, and 18 controls without non-inflammatory neurological diseases. Soluble HS and HA, and IFNγ, IL17A, and matrix metalloproteinase (MMP) 1 were detected via ELISA.ResultsSerum and CSF levels of HS, HA and related cytokines but not of plasma MMP1 were significantly elevated in these diseases. Notably, HS and HA levels were positively correlated with Expanded Disability Status Scale scores.ConclusionsOur results indicate glycocalyx degradation and inflammation in NMO, MS and autoimmune GFAP astrocytopathy. Moreover, increased shedding of HS or HA may indicate a worse clinical situation. Furthermore, therapeutic strategies that protect glycocalyx may be effective in these diseases.

Increasing evidence indicates that immune system dysfunction affects anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis. This study aims to investigate the relationship between adhesion molecules and the pathophysiology in anti‐NMDAR encephalitis. Soluble forms of Intercellular adhesion molecule‐1 (sICAM‐1), vascular adhesion molecule‐1 (sVCAM‐1), and L‐selectin (sL‐selectin), were measured in the CSF and serum of 26 participants with anti‐NMDAR encephalitis, 11 patients with schizophrenia and 22 patients with noninflammatory disorders. CSF levels of sICAM‐1, sVCAM‐1 and sL‐selectin were significantly elevated in the anti‐NMDAR encephalitis group. sVCAM‐1 levels were positively associated with modified Rankin scale score in anti‐NMDAR encephalitis patients at the onset and 3‐month follow‐up.

BackgroundDisruption of the blood–brain barrier (BBB) is an important pathophysiological process of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A recent multi-center study showed that soluble (s) CD146 is a potential biomarker for monitoring early BBB damage and central nervous system inflammation, but little is known about sCD146 in anti-NMDAR encephalitis.MethodTwenty-three anti-NMDAR encephalitis patients and seventeen controls with non-inflammatory neurological diseases were recruited. sCD146 and inflammatory cytokines in cerebrospinal fluid (CSF) and serum were detected by ELISA. Modified Rankin scale (mRS) scores were used to assess the neurological status of each patient. A follow-up review was completed three months after discharge.ResultssCD146 levels in the CSF of patients with the acute stage anti-NMDAR encephalitis were significantly increased compared with controls and accompanied by increases in TNF-α, IL-6 and IL-10. CSF sCD146 was positively correlated with neuroinflammatory factors in the CSF and with mRS score. Three months after effective treatment, CSF sCD146 in patients was significantly decreased but remained significantly different compared with the controls.ConclusionOur data suggested that higher expression of CSF sCD146 correlated with more serious neurological damage. Therefore, levels of CSF sCD146 may represent a promising indicator for monitoring disease and optimizing clinical treatment decisions in the early stages of anti-NMDAR encephalitis.

Background: Neuromyelitis optica (NMO), multiple sclerosis (MS) and autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy are idiopathic inflammatory demyelinating diseases (IIDDs) that mainly present as encephalomyelitis. Heparan sulfate (HS) and hyaluronic acid (HA) are two components of glycocalyx, a carbohydrate-rich layer on the surface of blood vessels that mediates interaction with blood. Degradation of glycocalyx in IIDDs is poorly understood. Purpose: To detect the serum and cerebrospinal fluid (CSF) levels of shed HS and HA and to correlate these levels with disease severity to determine their diagnostic value. Methods: We obtained serum and CSF samples from 24 NMO patients, 15 MS patients, 10 autoimmune GFAP astrocytopathy patients, and 18 controls without non-inflammatory neurological diseases. Soluble HS and HA, and IFNγ, IL17A, and matrix metalloproteinase (MMP) 1 were detected via ELISA. Results: Serum and CSF levels of HS, HA and related cytokines but not of plasma MMP1 were significantly elevated in these diseases. Notably, HS and HA levels were positively correlated with Expanded Disability Status Scale scores. Conclusions: Our results indicate glycocalyx degradation and inflammation in NMO, MS and autoimmune GFAP astrocytopathy. Moreover, increased shedding of HS or HA may indicate a worse clinical situation. Furthermore, therapeutic strategies that protect glycocalyx may be effective in these diseases.

Objective: The prevalence of multiple sclerosis (MS) in China is low, although it has been increasing recently. Owing to the paucity of data on immunotherapy acceptance in the Chinese population, we conducted this study to analyze factors affecting the acceptance of immunotherapy and selection of disease-modifying therapies (DMTs) based on personal and clinical data of patients with MS.Methods: In this study, data were obtained from the Multiple Sclerosis Patient Survival Report 2018, which was the first national survey of patients with MS in China. There were 1,212 patients with MS from 31 provinces who were treated at 49 Chinese hospitals over a 4-month period from May 2018 to August 2018, and the patients were asked to complete online questionnaires to assess their understanding of the disease.Results: In general, highly educated patients with frequent relapses were more willing to receive treatment regardless of DMTs or other immunotherapy, and patients with more understanding of the disease opted to be treated. Younger patient population, patients with severe disease course, and those with more symptoms were likely to choose the treatment. Moreover, a higher proportion of women chose to be treated with DMTs than with other immunotherapies.Conclusions: Education status and patient awareness of the disease impact the treatment acceptance in Chinese patients with MS. Therefore, we call for improving the awareness of MS disease and social security to help patients to improve their quality of life.

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune neurological disorder. Osteopontin (OPN) is a secreted multifunctional phosphorylated glycoprotein that regulates various autoimmune and inflammatory diseases, but its diagnostic and prognostic values in anti-NMDAR encephalitis patients remain elusive. This retrospective study aimed to determine the levels of OPN and related cytokines in cerebrospinal fluid (CSF) of anti-NMDAR encephalitis patients and to assess their influence on disease severity so as to evaluate their efficacy as biomarkers for diagnosis and prognosis. CSF samples from 33 anti-NMDAR encephalitis, 13 viral encephalitis, and 21 controls were collected. All CSF were tested for levels of OPN and inflammation-associated cytokines [interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α] via ELISA. In addition, 15 anti-NMDAR encephalitis patients without follow-up relapse were re-examined for these four parameters 3 months later. The clinical status was evaluated by modified Rankin Scale (mRS) scores. Results showed that the CSF levels of these cytokines were increased in anti-NMDAR encephalitis patients compared to controls but not viral encephalitis patients. Their levels were decreased in remission compared with that in acute stage. Moreover, CSF OPN positively correlated with IL-6, white blood cell (WBC) counts, and C-reactive protein (CRP) levels in anti-NMDAR encephalitis patients. However, no associations were found between OPN or related cytokines and mRS scores in acute stage in anti-NMDAR encephalitis patients. Overall, CSF OPN and related cytokines were increased when anti-NMDAR encephalitis patients are in acute stage and decreased in remission, suggesting the underlying neuro-inflammatory process in this disease. However, they are not qualified with diagnostic or prognostic value.

Introduction Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an autoimmune-mediated disease that is common in young female patients with ovarian teratomas. With appropriate immunotherapy, most patients achieve a good prognosis. Nevertheless, some patients may be refractory to first- and second-line immunotherapy, thus alternative treatments are required for these patients. Case presentation: We present a case of anti-NMDA receptor encephalitis with ovarian teratoma. After the prompt removal of the teratoma and intense immunotherapy was administered, including an intravenous methylprednisolone pulse, intravenous immunoglobin, plasmapheresis, immunoadsorption, intravenous cyclophosphamide, and rituximab, the patient’s neurologic status did not improve. Bilateral salpingo-oophorectomy was then conducted, and intrathecal injection of methotrexate (MTX) and dexamethasone (DXM) was performed. The patient’s neurological symptoms improved dramatically, and she achieved a good prognosis after 23 months. Conclusions Intrathecal injection of MTX and DXM may be beneficial for treatment of refractory cases of anti-NMDA receptor encephalitis. Additional research is required to elucidate the mechanisms of intrathecal treatment with this therapy.

BACKGROUND AND PURPOSE Autoantibodies targeting the GluN1(NR1) subunit of the anti-N-methyl-D-aspartate receptor (NMDAR) cause encephalitis. Although it has been shown that anti-NMDAR encephalitis is associated with human leukocyte antigen (HLA) loci, susceptibility genes for the disease outside the HLA loci remain unidentified. In this study, we aimed to explore the association of anti-NMDAR encephalitis with non-HLA genes. METHODS Two Chinese anti-NMDAR encephalitis cohorts from Han populations were recruited for this study. The North Chinese case-control set consisted of 98 patients and 460 controls, while the South Chinese case-control set included 78 patients and 541 controls. All participants were genotyped for 28 single nucleotide polymorphisms that are associated with autoimmune disorders or infectious diseases. RESULTS In two independent case-control sets, we identified significant associations of anti-NMDAR encephalitis with IRF7 rs1131665 (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.99-5.63; P

Aim: Microglia, the resident immune cells in the brain can activated by inflammation in the central nervous system (CNS), then become significant sources of inflammatory mediators. However, little is known about that whether microglia activation in neuromyelitis optica (NMO). The aims of this pilot study were to investigate the levels of the biomarkers of microglia activation, YKL-40, sCD163 and sCD14 in patients with NMO，and the possible associations between those and Expanded Disability Status Scale EDSS scores. Methods: We found significantly higher CSF YKL-40, sCD163 and sCD14 levels in NMO patients. The level of neurological disability was assessed by the EDSS scores.Results: The levels of microglia biomarkers in NMO patients were positively correlated with Expanded Disability Status Scale (EDSS) scores, but not in MS and GFAP groups. Finally, we showed levels of CSF YKL-40, sCD163 and sCD14 were higher in NMO patients and positive relationship with disease severity of NMO. Conclusion: These finding suggesting that microglial activation, may be implicated in the pathogenesis of NMO.

Objectives Caregiver burden in neurologic Wilson disease (NWD) has received little attention. We investigated predictors of caregiver burden in Chinese NWD patients. Methods Participants in this retrospective study were NWD patients admitted to The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from 1 August to 31 December 2019. Sociodemographic information was recorded for caregivers and NWD patients. Caregiver burden was evaluated using the Caregiver Burden Inventory (CBI). Cognitive impairment, functional problems, depression and anxiety were evaluated by professional interviewers. Path analysis was used to evaluate predictors of CBI scores. Results Sixty NWD patients were enrolled (mean age: 21.35 ± 4.89 years; mean NWD duration: 7.85 ± 3.11 years). The mean CBI score was 52.00 ± 17.16. Care duration had a significant direct effect on CBI score after controlling for confounders (r = 0.493). Cognitive impairment (r = −0.426), functional problems (r = 0.581), depression (r = 0.349) and anxiety (r = 0.317) had significant indirect effects on CBI score. Conclusion Caregivers of NWD patients may experience a medium level of caregiver burden. NWD duration, cognitive impairment, functional problems, depression and anxiety in NWD patients may be useful predictors of caregiver burden.

Introduction Turns-amplitude, number of small segments (NSS)-activity, and envelope-activity clouds are three methods of electromyography (EMG) interference pattern analysis. Our objective was to evaluate the sensitivity and specificity of each individual cloud analysis and combined clouds analysis to compare with that of quantitative motor unit potential (QMUP) analysis. Methods A total of 379 muscles from 100 patients were analyzed by both QMUP and clouds analyses. Calculation of sensitivity and specificity was based on the clinical diagnosis as the "gold standard." Results For discrimination of abnormal vs normal and neuropathic vs non-neuropathic, combined clouds analysis had greater sensitivity than QMUP analysis and any single cloud analysis, but there were no differences in specificity. For discrimination of myopathic vs non-myopathic, combined clouds analysis and single cloud analysis had greater sensitivity than QMUP analysis, but there were no differences in specificity. Discussion Combined clouds analysis was superior to QMUP and each single cloud analysis for distinguishing normal, myopathic, and neuropathic muscles.

Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently discovered autoimmune syndrome associated with psychosis, dyskinesia, and seizures. However, the underlying mechanisms of this disease remain unclear, in part because of a lack of suitable animal models. Methods This study describes a novel female C57BL/6 mouse model of anti-NMDAR encephalitis that was induced by active immunization against NMDARs using an amino terminal domain (ATD) peptide from the GluN1 subunit (GluN1356–385). Results Twelve weeks after immunization, the immunized mice showed significant memory loss. Furthermore, antibodies from the cerebrospinal fluid of immunized mice decreased the surface NMDAR cluster density in hippocampal neurons which was similar to the effect induced by the anti-NMDAR encephalitis patients’ antibodies. Immunization also impaired long-term potentiation at Schaffer collateral–CA1 synapses and reduced NMDAR-induced calcium influx. Conclusion We established a novel anti-NMDAR encephalitis model using active immunization with peptide GluN1356–385 targeting the ATD of GluN1. This novel model may allow further research into the pathogenesis of anti-NMDAR encephalitis and aid in the development of new therapies for this disease.

Background Neuromyelitis optica (NMO), multiple sclerosis (MS) and autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy belong to autoimmune diseases incentral nervous system mainly manifestate encephalomyelitis. The glycocalyx (GLX), consists of several membrane-bound macromolecules, is located on the luminal side of the endothelium and mediates the blood and the vessel interaction. Until now, there is still lacking a holistic understanding of the GLX degradation in autoimmune encephalomyelitis. Aim This study aimed to detect the shedding levels of GLX components, heparan sulfate (HS) and hyaluronic acid (HA) in serum and cerebrospinal fluid (CSF), correlate them with the severity and assess the diagnostic value of them, and evaluate their correlations with pro-inflammatory cytokines. Methods Serum and CSF samples were obtained from 24 NMO patients, 15 MS patients, 10 autoimmune GFAP astrocytopathy patients, and 18 controls without non-inflammatory neurological diseases. Soluble HS, HA and IFN-γ, IL-17A, matrix metalloproteinase (MMP)-1 were detected by enzyme linked immunosorbent assay ELISA. Results Besides levels of serum and CSF levels of HS, HA and related cytokines were significantly elevated in these diseases. Notably, HS, HA in NMO, MS patients, and autoimmune GFAP astrocytopathy diseases were widely correlated with EDSS scores. Importantly, the ROC curve analysis suggested a potential diagnostic role of HS or HA . Conclusions The results here suggested the GLX degradation and inflammation in NMO, MS and autoimmune GFAP astrocytopathy. Moreover, increased shedding of HS or HA may indicate worse clinical situation. Importantly, CSF HS and HA may be informative diagnostic biomarkers for telling autoimmune encephalomyelitis from the non-inflammatory neurological controls. Furthermore, therapeutic strategy for protecting GLX may be effective to these diseases.

The current volume of freight traffic has increased significantly during the past decades, impacted by the fast development of the national transportation market. As a result, the phenomena of truck overloading and traffic congestion emerge, which have resulted in numerous bridge collapse events or damage due to truck overloading. Thus, it is an urgent task to evaluate bridge safety under actual traffic loads. This study evaluated probabilistic dynamic load effects on rigid-frame bridges under highway traffic monitoring loads. The site-specific traffic monitoring data of a highway in China were utilized to establish stochastic traffic models. The dynamic effect was considered in a vehicle-bridge coupled vibration model, and the probability estimation was conducted based on the first-passage criterion of the girder deflection. The prototype bridge is a continuous rigid-frame bridge with a midspan length of 200 m and a pier height of 182 m. It is demonstrated that the dynamic traffic load effect follows Gaussian distribution, which can be treated as a stationary random process. The mean value and standard deviation of the deflections are 0.071 m and 0.088 m, respectively. The dynamic reliability index for the first passage of girder deflection is 6.45 for the current traffic condition. However, the reliability index decreases to 5.60 in the bridge lifetime, accounting for an average traffic volume growth ratio of 3.6%.

Syndecan-1 (SDC-1) is a transmembrane member that has a profound influence on the resolution of inflammation. Soluble syndecan-1 (sSDC-1) levels have been shown to increase in many inflammatory diseases. However, it remains unknown whether sSDC-1 concentration is elevated in neuromyelitis optica (NMO) and multiple sclerosis (MS) patients. The aims of this pilot study were to investigate the relationship between sSDC-1 and disease severity in NMO and MS and whether sSDC-1 has potential as an effective marker for disease severity. We measured sSDC-1 concentrations by using an enzyme-linked immunosorbent assay (ELISA). NMO patients had significantly higher CSF sSDC-1 levels than MS patients or controls. We also found a positive correlation between the increased CSF sSDC-1 levels and increased severity in NMO disease, but not in MS. In NMO, CSF sSDC-1 concentrations were positively correlated with CSF interleukin (IL)-6, IL-8 and IL-17. Overall, we showed levels of CSF sSDC-1 were higher in NMO patients and had a positive relationship with disease severity of NMO but not with MS. CSF sSDC-1 may be an effective marker of NMO disease severity.

To compare the utility and limitation of magnetic resonance spectroscopy (MRS) and arterial spin labeling (ASL) in the differentiation between mitochondrial encephalomyopathy, lactic acidosis, plus stroke-like episodes (MELAS) and acute ischemic stroke (AIS), a retrospective review of 17 MELAS and 26 AIS patients were performed. In all patients both MRS and ASL scans were performed within 1 week after admission. Demographic, clinical, laboratory and MR imaging data were reviewed and compared between the two groups. Compared with AIS, MELAS patients had a younger age of onset, a longer disease duration, a higher occurrence of epilepsy attack, occipital and parietal lesions, and dilated cerebral arteries (P 0.05). In all MELAS patients lactate peak and hyperperfusion of the lesion was revealed. However in AIS lactate peak was observed in only 69.2% and hyperperfusion was observed in only 34.6% ischemic lesions (P 0.05). Choline/Creatine ratios and Lactate/Creatine ratios were higher in AIS, while in MELAS cerebral blood flow and lesion-normal perfusion ratio was much higher (P 0.05). No correlations was found between metabolite ratios and perfusion parameters in either group (P 0.05). Area under curve (AUC) of perfusion for the differentiation between MELAS and AIS was 0.958 (P 0.001). The cut-off value was 2.075, with a sensitivity of 88.2% and a specificity of 96.2%. AUC of Lactate/Creatine ratio was 0.469 (P = 0.737). Utility of MRS is limited in the differentiation between MELAS and AIS, while MR perfusion profiles are much more sensitive and specific.

Background Anti‑N‑methyl‑ d ‑aspartate receptor (NMDAR) encephalitis is a relatively common autoimmune neurological disease of the central nervous system (CNS). Neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B) are structural proteins of the central nervous system (CNS). In patients with CNS injury accompanied by nervous tissue and cellular damage, these structural proteins are released from cells; their extracellular concentrations, including those in cerebrospinal fluid (CSF) and blood, subsequently increase. Methods Thirty-six patients with anti-NMDAR encephalitis were prospectively recruited. The CSF NSE and S100B concentrations were measured in 19 and 17 patients, respectively. The CSF NSE and S100B concentrations were measured in 21 patients with noninflammatory neurological disease as controls. All measurements were performed using enzyme-linked immunosorbent assays. Results The CSF NSE and S100B concentrations were remarkably higher in the patients with anti-NMDAR encephalitis than in the controls. The early NSE or S100B concentrations in CSF were associated with the mRS. Conclusion CSF NSE and S100B concentration in patients with anti-NMDAR encephalitis is higher than in patients with non-inflammatory neurological disease. The early NSE or S100B concentrations in CSF were associated with the mRS and we can use it to determine the prognosis of the disease.

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder of the central nervous system whose pathogenesis involves interleukin (IL)-6 and IL-17A. We examined the correlations between CSF concentrations of the acute-phase protein pentraxin 3 (PTX3), the chronic inflammatory mediator CD40L, IL-6, and IL-17A in anti-NMDAR encephalitis, and the impact on clinical outcome. PTX3, CD40L, IL-6, and IL-17A were significantly higher in the CSF of patients with anti-NMDAR encephalitis than in controls. Within the former, PTX3 levels correlated positively with IL-6 and the mRS, and CD40L levels with IL-17A and the mRS. Higher PTX3 and CD40L levels may reflect the underlying neuroinflammation.

Object: CD27 belongs to the tumor necrosis factor receptor family and is constitutively expressed on T cells. The concentration of cerebrospinal fluid (CSF) soluble (s)CD27 is elevated in patients with multiple sclerosis (MS). However, whether the level of CSF sCD27 is elevated in neuromyelitis optica spectrum disorder (NMOSD) remains unknown. The aim of this study was to measure the CSF concentration of sCD27 and to determine its relationship with NMOSD disease activity. Methods: CSF CXCL13 was measured by ELISA in neuromyelitis optica (NMO) (n = 31) and MS (n = 23) patients and in controls (CTLs) (n = 22). Results: The concentration of sCD27 was higher in the NMO group than in the MS (p = 0.082) and CTL (p = 0.002) groups, and there was a positive correlation with CSF IL-6 (p = 0.000) and a negative correlation with IL-10 (p = 0.073). In the NMO group, patients with higher sCD27 concentrations exhibited worse disease disability in their CSF (p = 0.006). Moreover, the sCD27 concentrations had a significantly positive correlation with the level of CSF total protein (p = 0.030). Furthermore, the patients positive for AQP4-IgG (n = 26) seemed to have higher levels of sCD27 in their CSF (p = 0.069) than those negative for AQP4-IgG (n = 5). Conclusions: We revealed that the level of CSF sCD27 was elevated in NMOSD and correlated with NMOSD disease activity.

BACKGROUND Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder of the central nervous system (CNS). Interleukin (IL)-6 and IL-17A may play important roles in the pathogenesis of this disease. High-mobility group box protein 1 (HMGB1), a small but highly conserved ubiquitous protein, is recognized to be a potent innate inflammatory mediator that can activate the nuclear factor light chain enhancer of activated B cells and release cytokines such as IL-6 and IL-17A when released extracellularly. However, whether cerebrospinal fluid (CSF) HMGB1 levels are altered in anti-NMDAR encephalitis is still unclear. OBJECTIVE The aim of this study was to determine whether a correlation exists between the CSF concentrations of HMGB1 and IL-6 and IL-17A in anti-NMDAR encephalitis patients. We also sought to assess whether HMGB1 influences the clinical outcomes in anti-NMDAR encephalitis patients. METHODS Thirty-three patients with anti-NMDAR antibodies and 38 controls were recruited. CSF HMGB1 was measured using an enzyme-linked immunosorbent assay. The main clinical outcomes were evaluated using the modified Rankin scale (mRS). The data were extracted using microarray analysis software. RESULTS AND CONCLUSION Our results showed significant increases in CSF HMGB1, IL-6, and IL-17A (P

An optimisation model for distribution network expansion is proposed to acquire the optimal economical scheme by planning the installation of distributed generations (DGs) as well as the investment on newly constructed lines. The scenario-based method is employed to deal with the uncertainties of DGs including wind generation and photovoltaic units together with energy storage devices. Especially, the model highlights the cyber security requirements as additional constrains by means of introducing a risk index to evaluate the vulnerability of cyber system, and the payoff of cyber system failure is estimated by the load losses after the load shedding operations for the sake of system security and reliability. An improved genetic algorithm is applied to solve the aforementioned optimisation model. Finally, case studies are carried out on the 16-bus system with typical substation automation architecture to verify the effectiveness of the proposed model and method.

Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy, a newly defined autoimmune encephalitis, is an antibody-mediated meningoencephalomyelitis. The pathogenesis of the disease is still unclear. Nod-like receptor protein 3 (NLRP3) inflammasome is a complex composed of a variety of proteins that recognizes a variety of ligands and ultimately leads to the development of inflammatory responses. This is important for infectious, inflammatory, and immune diseases. The aims of this study were to detect levels of cerebrospinal fluid (CSF) NLRP3 inflammasome and inflammatory factors in autoimmune GFAP astrocytopathy patients and to study the relationships between these profiles. Twenty autoimmune GFAP astrocytopathy patients, 17 viral meningoencephalitis (VM) patients, and 16 controls (CTLs) were recruited. The levels of NLRP3 inflammasomes, interleukin (IL)-1β, IL-6, and IL-17 were measured by enzyme-linked immunosorbent assay (ELISA). The Expanded Disability Status Scale (EDSS) score was used to assess the severity of clinical manifestations. The results showed that the levels of NLRP3 inflammasome and inflammatory cytokines (IL-1β, IL-6, IL-17) were significantly more elevated in CSF of patients with autoimmune GFAP astrocytopathy than that in CTLs. When compared with VM patients, significantly elevated NLRP3 inflammasome was found in GFAP astrocytopathy patients, while the levels of IL-1β, IL-6, and IL-17 were not different between the two groups. Significant positive correlations were found between NLRP3 inflammasome and inflammatory cytokines and they were all positively related to the severity of the disease. Moreover, we found that patients with positive anti-GFAP antibodies had higher levels of NLRP3 and inflammatory factors. And the severity of the disease was positively correlated with GFAP antibody titers. Taken together, the results suggested that NLRP3 inflammasome was involved in the pathogenesis of autoimmune GFAP astrocytopathy. It can be used to assess the severity of the disease or act as a new target for the therapy.

Background Neurofilaments (Nf) are a series of highly specific scaffolding proteins of neurons. Neurofilament light chains (Nf‐L) and the heavy one (Nf‐H) are subunits of Nf, and they are recognized as potent productions of neural damage. The concentrations of Nf aggrandized significantly in neurological disease including neuromyelitis optica, multiple sclerosis, and Alzheimer's disease. However, whether Nf in cerebrospinal fluid (CSF) elevated in anti‐N‐methyl‐d‐aspartate receptor (NMDAR) encephalitis is unclear. Here, we aimed to detect whether CSF Nf is altered in NMDAR and whether changes in CSF Nf can serve as an objective and effective biomarker to evaluate disease severity and prognosis. Methods We collected 24 anti‐NMDAR encephalitis patients, 11 viral meningoencephalitis/encephalitis (VM) patients, and 21 controls in this study. CSF Nf‐L, Nf‐H, and cytokine levels (IL‐1β, IL‐6, and IL‐17A) were determined by enzyme‐linked immunosorbent assay (ELISA) and compared between groups. We evaluated patients’ clinical outcomes or prognosis according to modified Rankin scale (mRS) score. Results Compared with controls, both CSF Nf‐L and Nf‐H levels were significantly increased in anti‐NMDAR encephalitis patients. While compared with VM patients, only Nf‐L were increased in anti‐NMDAR encephalitis patients. Moreover, CSF Nf‐L were positively correlated with concentration of cytokines (IL‐1β, IL‐17A) and mRS scores in anti‐NMDAR encephalitis patients. After treatment, both CSF Nf‐L and Nf‐H levels decreased. Furthermore, the Nf‐L during follow‐up positively correlated with 3‐month mRS scores, and ΔNf‐L positively correlated with ΔmRS. Conclusions Briefly, CSF Nf‐L levels notably increased in anti‐NMDAR encephalitis patients in acute phase and positively correlated with disease severity. It could be considered as a useful indicator for clinical outcomes and prognosis.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is accepted as an autoimmune disorder of the central nervous system (CNS). NLR family pyrin domain containing 3 (NLRP3) inflammasome, a potent innate inflammatory mediator, can activate IL-1β and induce the migration of T helper cell into CNS. However, the possible role of NLRP3 inflammasome in the pathogenesis of anti-NMDAR encephalitis remains unclear. This study aims to determine the levels of NLRP3 and related cytokines (IL-1β, IL-6, and IL-17) in the cerebrospinal fluid (CSF) of anti-NMDAR encephalitis patients and to assess whether NLRP3 influences the clinical outcomes of this disease. Twenty-five patients with anti-NMDAR encephalitis, 12 viral meningoencephalitis patients and 26 controls with non-inflammatory neurological diseases were recruited. CSF NLRP3 inflammasome, IL-1β, IL-6, and IL-17 were measured by enzyme-linked immunosorbent assay. Thirteen out of 25 patients were re-examed for the concentrations of NLRP3 and cytokines 6 months later. Our results showed significant increases of CSF NLRP3 inflammasome, IL-1β, IL-6, and IL-17 in anti-NMDAR encephalitis patients. There were positive correlations between CSF NLRP3 inflammasome and cytokines in anti-NMDAR encephalitis patients. There was also a positive correlation between maximum modified Rankin Scale (mRS) scores and CSF NLRP3 inflammasome in anti-NMDAR encephalitis patients. During follow-up, the decrease of mRS was positively correlated with the decrease of CSF NLRP3 inflammasomes. These results suggested that the level of CSF NLRP3 inflammasome could represent the severity of anti-NMDAR encephalitis and the reduction of CSF NLRP3 inflammasome could act as an indicator for the prognosis of this disease.

Background CD138 (also known as syndecan-1) is an important component of endothelial cell glycocalyx, and it is reportedly involved in negative regulation of various inflammatory processes. The clinical implications of circulating and cerebrospinal fluid (CSF) soluble CD138 (sCD138) in patients with Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis remain unclear. Objective The aim of the current study was to investigate associations between serum and CSF sCD138 levels in anti-NMDAR encephalitis patients. Methods The participants enrolled in the study included 27 with anti-NMDAR encephalitis, 11 with viral meningoencephalitis, and 22 controls. At acute stage and 3 to 6-month follow-up time-points, sCD138, tumor necrosis factor-α, matrix metalloproteinase-2, and matrix metalloproteinase-9 in serum and CSF were measured in all participants via enzyme-linked immunosorbent assays. Results Serum and CSF levels of sCD138 were significantly increased in patients with anti-NMDAR encephalitis. Furthermore, after 3–6 months of follow-up CSF sCD138 levels were significantly decreased in anti-NMDAR encephalitis patients. Changes in sCD138 levels were significantly associated with amelioration of modified Rankin Scale scores in patients with anti-NMDAR encephalitis. Conclusion In anti-NMDAR encephalitis patients, high circulating, and CSF sCD138 is associated with inflammation and poor clinical prognosis. The present study suggests that sCD138 may be an informative biomarker of inflammation in anti-NMDAR encephalitis.

Background Neuromyelitis optica spectrum disorder (NMOSD) and MS are the most common autoimmune inflammatory demyelinating diseases of the CNS. However, the mechanisms of pathogenesis are still unclear. nucleotide-binding leucine-rich repeat (NLR) family pyrin domain containing 3 (NLRP3), an important protein of the innate immune system that is activated by mitochondrial DNA (mtDNA), has been reported to be associated with various autoimmune disorders. Objective To assess the levels of cerebrospinal fluid (CSF) NLRP3, mtDNA and inflammation-associated cytokines (IL-1β, IL-6 and IL-17) in patients with NMOSD and MS, and to examine the correlations between these factors. Methods 28 NMOSD patients, 15 MS patients, and 16 controls with non-inflammatory neurological diseases were recruited. NLRP3 inflammasome, IL-1β, IL-6 and IL-17 were measured by ELISA. CSF extracellular mtDNA was measured by qPCR. The severity of clinical presentation was evaluated by EDSS score. Results CSF levels of NLRP3, mtDNA, IL-1β, IL-6 and IL-17 were higher in NMOSD patients than in controls. Elevated CSF NLRP3, mtDNA and IL-6 were found in MS patients compared with controls. CSF NLRP3 and IL-6 levels were significantly higher in NMOSD patients than in MS patients. The EDSS scores of NMOSD patients during relapse were positively correlated with CSF NLRP3 and mtDNA. Conclusion Our findings suggest that CSF levels of the NLRP3 inflammasome may serve as a diagnostic biomarker for distinguishing NMOSD and MS. Pyroptosis mediated by the NLRP3 inflammasome following mitochondrial damage may play an important role in the pathogenesis of these neuroinflammatory disorders, especially NMOSD.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune inflammatory brain disease that can develop a variety of neuropsychiatric presentations. However, the underlying nature of its inflammatory neuronal injury remains unclear. Mitochondrial DNA (mtDNA) is recently regarded as a damage-associated molecular pattern molecule (DAMP) that can initiate an inflammatory response. In the presenting study, we aimed to evaluate the levels of cell-free mtDNA in cerebrospinal fluid (CSF) of patients with anti-NMDAR encephalitis and to determine a potential role of cell-free mtDNA in the prognosis of anti-NMDAR encephalitis. A total of 33 patients with NMDAR encephalitis and 17 patients with other non-inflammatory disorders as controls were included in this study. The CSF levels of cell-free mtDNA were measured by quantitative polymerase chain reaction (qPCR). Cytokines including interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNF-α) were measured by ELISA. The modified Rankin scale (mRS) score was evaluated for neurologic disabilities. Our data showed that the CSF levels of cell-free mtDNA and inflammation-associated cytokines were significantly higher in the patients with anti-NMDAR encephalitis compared with those in controls. Positive correlations were detected between the CSF levels of cell-free mtDNA and mRS scores of patients with anti-NMDAR encephalitis at both their admission and 6-month follow up. These findings suggest that the CSF level of cell-free mtDNA reflects the underlying neuroinflammatory process in patients with anti-NMDAR encephalitis and correlates with their clinical mRS scores. Therefore, cell-free mtDNA may be a potential prognostic biomarker for anti-NMDAR encephalitis.

Coal mass is deformed and fractured under stress to generate electrical potential (EP) signals. The mechanical properties of coal change with the adsorption of gas. To investigate the EP response characteristics of gas-bearing coal during deformation and fracture, a test system to monitor multi-parameters of gas-bearing coal under load was designed. The results showed that abundant EP signals were generated during the loading process and the EP response corresponded well with the stress change and crack expansion, and validated this with the results from acoustic emission (AE) and high-speed photography. The higher stress level and the greater the sudden stress change led to the greater EP abnormal response. With the increase of gas pressure, the confining action and erosion effect are promoted, causing the damage evolution impacted and failure characteristics changes. As a result, the EP response is similar while the characteristics were promoted. The EP response was generated due to the charge separation caused by the friction effect etc. during the damage and deformation of the coal. Furthermore, the main factors of the EP response were different under diverse loading stages. The presence of gas promoted the EP effect. When the failure of the coal occurred, EP value rapidly rose to a maximum, which could be considered as an anomalous characteristic for monitoring the stability and revealing failure of gas-bearing coal. The research results are beneficial for further investigating the damage-evolution process of gas-bearing coal.

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are inflammatory demyelinating diseases of the central nervous system. In this study, the important role of fibrinogen in demyelination diseases was investigated. Plasma prothrombin time (PT), activated partial thrombin time (APTT), thrombin time (TT), fibrinogen, were measured among 189 patients with MS/NMO and 80 non-inflammatory neurological disease subjects as a control group. The Expanded Disability Status Scale (EDSS) was used to measure neurological impairment and disability of MS/NMO group. Fibrinogen levels were elevated in NMO and MS groups comparing with control ones, which was statistically associated with the severity of disease. Our results may lead to a better understanding of the etiopathogenesis of MS/NMO and contribute to prospects for preventions and treatments.

Objective: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis predominantly affects children and young women; the disease can have a multistage presentation and exhibit a wide variety of neuropsychiatric features. This study aimed to investigate the profile of YKL-40 (Chitinase 3-like 1) in anti-NMDAR encephalitis patients and evaluate its association with modified Rankin Scale (mRS) scores and expression of inflammatory cytokines. Methods: A total of 66 patients were enrolled in this study, 33 with anti-NMDAR encephalitis, 13 with viral meningitis and 20 with non-inflammatory neurological disease. Patients were evaluated to determine mRS scores at disease onset and at the 3-month follow-up; cerebrospinal fluid (CSF) samples were collected in the meantime. CSF levels of YKL-40 and cytokines (TNF-α, IL-6, IL-10) were measured by enzyme-linked immunosorbent assay. Results: CSF levels of YKL-40 and inflammatory cytokines (TNF-α, IL-6, IL-10) were all more highly elevated in patients with anti-NMDAR encephalitis at the acute stage of disease compared with the controls. Levels of CSF YKL-40 were correlated with levels of IL-6 both at disease onset and at the 3-month follow-up. Changes in YKL-40 levels were significantly correlated with improved mRS scores in patients with anti-NMDAR encephalitis. Conclusion: Our study suggests that CSF levels of YKL-40 in patients with anti-NMDAR encephalitis were increased and correlated with clinical mRS scores. This may be reflective of the underlying neuroinflammatory process. YKL-40 demonstrates potential as a possible biomarker for the prognosis of anti-NMDAR encephalitis.

A novel optimization model for distribution network expansion considering the construction of distributed generation (DG) and energy storage system (ESS) simultaneously is proposed in this paper. This proposed model consists of the upper-level sub-problem involving the long-term investment decisions and the lower-level sub-problem involving the short-term operation strategies. Several typical day scenarios are designed to deal with the uncertainties of load demand and DGs including wind generation together with photovoltaic unit. A bilevel programming method combing the improved genetic algorithm (IGA) with the mixed integer linear programming (MILP) is applied in the solution of the proposed optimization model. Finally, case studies are carried out on the 16-bus system as benchmark to achieve a variety of planning scheme options.

Background Axonal injury is the correlate of disease progression in NMO and MS. Neurofilament (Nf) belongs to neuron specific intermediate filaments located in axons. Nf protein subunits are potential biomarkers in cerebrospinal fluid (CSF) for acute axonal injury. However, whether CSF NfH and NfL levels are elevated in NMO patients has remained unclear. Methods Nf light subunit (NfL) and Nf heavy subunit NfH in cerebrospinal fluid were measured by enzyme-linked immunosorbent assay (ELISA) in NMO ( n = 32), MS ( n = 25), and other non-inflammatory neurological disease patients (OND, n = 18). Results CSF pNf-H levels were increased in the NMO patients compared with OND patients ( p = 0.001). CSF NfL levels in the NMO patients were also higher compared with MS patients ( p = 0.001), and OND patients ( p = 0.000001). When comparing NfL levels between MS and OND patients, there also significant differences ( p = 0.0003). NMO and MS patients revealed a trend to an increased disability with increased CSF NfL during relapse (NMO: p = 0.006; MS: p = 0.017). There is positive relationship between CSF pNf-H and disability of MS patients ( p = 0.041). Conclusions CSF levels of NfL are increased in NMO patients and reflect the disease severity in NMO.

Interleukin (IL)-22 secreting CD4(+) T (Th22) cells and IL-22 are involved in the pathogenesis of autoimmune disease, but their role in neuromyelitis optica (NMO) and multiple sclerosis (MS) is unclear. We measured the proportion of Th22, Th17, CD4(+)IL-22(+)IL-17A(+) T cells and serum IL-22 in NMO and MS patients. The proportion of Th22 cells, Th17 cells and serum IL-22 were increased in patients with NMO and MS. Our findings suggest that increased Th22 cells may play an important role in the pathogenesis of NMO and MS.

Background: Neuromyelitis optica (NMO) and multiple sclerosis (MS) are two autoimmune inflammatory demyelinating diseases in the central nervous system. Interleukin (IL)-6 and IL-17 may play important roles in the pathogenesis of these diseases. High-mobility group box protein 1 (HMGB1) can activate the nuclear factor light chain enhancer of activated B cells and release cytokines such as IL-6 and IL-17. However, whether cerebrospinal fluid (CSF) HMGB1 levels were altered in NMO and MS patients is still unclear. Objectives: It was our aim to measure the CSF HMGB1 concentration in NMO patients and explore their relationship with IL-6, IL-17 and disease activity. Methods: CSF HMGB1 was measured by enzyme-linked immunosorbent assay in NMO (n = 22) and MS (n = 18) patients as well as in controls (n = 14). Results: CSF HMGB1 was notably higher in the NMO group compared with controls (p = 0.007). CSF HMGB1 positively correlated with IL-6 and IL-17 in NMO patients (IL-6, p = 0.034; IL-17, p < 0.001). Conclusions: In conclusion, our study suggests that CSF levels of HMGB1 are increased in patients with NMO and reflect the neuroinflammatory process.

The command platform of production and rush-repairs for distribution Network is a supporting platform, based on information technology, for the business applications of the command center. This article briefly described the basic functions and structural features of the platform, and discussed in detail the integration of business information, the contents and solutions needed to be focused on during inter-system data exchange, and the implementation techniques of the command platform. The benefits of the platform in the improvement of the distribution network production and rush-repairs are finally summed up. The entire above are provided as references.

We designed and implemented a just-in-time physical activity intervention system, WalkMore, which uses rich context extracted from smartphone and smart watch to encourage opportunistic walking without significantly altering users' daily schedules. This system incorporated several existing psychological theories such as Behavior Change Theory, Habit Formation Theory and Goal Setting Theory. We also conducted a 4-week user study to evaluate the acceptability and usability of WalkMore. In addition, the results of the study show that WalkMore is effective in encouraging people to walk more and engage other physical activities. Compared with reminders sent randomly in time, context-aware reminders are more acceptable to participants and more effective in increasing participants' self-awareness of possible walking opportunities.

This study aimed to assess the effect of pregnancy on the course of neuromyelitis optica spectrum disorder (NMOSD), and the effect of this disease on pregnancy outcomes.Consecutive patients with NMOSD were recruited between September 2015 and April 2016 at an outpatient clinic from four referral institutes in South China. Demographic, clinical, and pregnancy data were retrieved by questionnaires to analyze the association between NMOSD and pregnancy, as well as the potential risk factors for relapse.Among 249 patients with NMOSD, 55 had pregnancy-related attacks. The annual relapse rate in the first (3.20±6.82) and second (3.25±3.32) 3-month postpartum periods was marginally higher than that before pregnancy (1.44±0.92, p=0.682) and during pregnancy (1.23±1.32, p=0.758). The Kurtzke Expanded Disability Status Scale score increased from 1.55±0.38 before pregnancy to 2.88±2.14 at postpartum (p0.001). NMOSD significantly increased the premature birth rate in patients after disease onset (8.33%) compared with before disease onset (1.95%, p=0.025). Multivariate analysis showed that negative anti-aquaporin-4 IgG, concomitance with autoimmune diseases/antibodies, and no treatment in remission were risk factors of recurrence.Our study shows a significant association between pregnancy and NMOSD in the Chinese population. Larger scale prospective studies are warranted in the future.

Monitoring a person's dietary behavior has many health applications (e.g. weight management). Existing approaches for automatic eating detection using wearable sensors often require custom hardware that may not be practical as their usability and energy efficiency have not been validated. In this paper, we propose to use off-the-shelf Bluetooth headsets to unobtrusively monitor and detect users' eating episodes by analyzing the chewing sound. The challenges of using commodity acoustic hardware include the limited sampling rate that reduces feature fidelity and the impact of environment noise in real-world settings. Our experimental results show that the traditional kernel-based approach using Support Vector Machine (SVM) could achieve 94-95% classification accuracy in lab settings, though the detection performance quickly degraded to 65-76% for in-the-field testing. We then propose a novel Deep Learning based classification technique that drastically improved detection accuracy to 77-94% despite the existence of ambient noise. To the best of our knowledge, this is the first study to use Bluetooth headsets to detect eating episodes and to use Deep Learning to significantly increase classification performance in this context. We believe that the adoption of readily available and low-cost consumer devices provides a foundation for practical deployment of automated dietary monitoring applications.

In this work we study the feasibility and usability of an assistive food journaling system that sends users just-in-time reminders when unique hand gestures during food consumption are detected using a smartwatch. Our study shows that participants were able to sustain food logging throughout a 2-week period with the help of our eating detection system, as the number of reminders correlate well with the number of food logs. Despite the fact that participants were required to wear the watch on their dominant hand, it was still quite usable and did not interfere with their normal activities. Participant feedback provided additional insights to inform future work to increase detection accuracy, reduce detection delay, and allow for more dietary logging features in the app.

It is believed that auto-inflammatory activity, including cellular and humoral immunity responses, especially T cell-B cell collaboration, is one of the most important components of the pathogenesis of inflammatory demyelinating disease. CD40L is critical for T cell-B cell collaboration. Actually, serum CD40L levels have been shown to increase in MS. In the present study, serum CD40L levels were measured by an enzyme-linked immunosorbent assay (ELISA) in NMO (n=27) and MS (n=19) patients and controls (n=14). We revealed elevation of CD40L in NMO patients, and discovered a correlation between CD40L and humoral immunity in inflammatory demyelinating disease.

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a recently described paraneoplastic syndrome with prominent neuropsychiatric symptoms. Many of these cases are associated with neoplasma especially teratoma. In addition, a few of cases with anti-NMDAR antibodies triggered by viral infection have been reported, but never by parasitic infection. Here, we report a novel case of NMDA receptor encephalitis in a 51-year-old male related to the development of anti-NMDAR antibodies triggered by Angiostrongylus cantonensis infection.

Neuromyelitis optica (NMO) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). The pathogenesis of NMO remains unclear. IL-32 is emerging as a critical molecule in the pathophysiology of immune-mediated chronic inflammatory diseases. Whether IL-32 levels are elevated in NMO patients is unclear. We aimed to determine whether IL-32 levels are elevated in NMO patients and explore its relationship with IL-6, IL-17, and Expanded Disability Status Scale (EDSS) scores.Plasma IL-32α, IL-6 and IL-17A were measured by enzyme-linked immunosorbent assay in NMO (n = 26), MS (n = 23) and 22 healthy controls.We found IL-32α levels were higher in NMO patients compared with MS (p = 0.020) and healthy controls (p = 0.00001). IL-32α levels were increased in MS patients compared with controls (p = 0.009). IL-32α positively correlated with IL-6 and IL-17A levels and EDSS scores in NMO patients.In summary, plasma IL-32α levels are associated with inflammatory responses in NMO patients.

Background: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are immune-mediated inflammatory diseases of the central nervous system. In the acute phase of these diseases, secondary ischemia due to inflammation-induced endothelial dysfunction may be an important pathological change. Pentraxin 3 (PTX3) is a pro-inflammatory protein and a novel biomarker of inflammatory vascular diseases. Objective: We aimed to determine whether PTX3 levels are elevated in MS and NMO patients. Methods: The concentrations of plasma PTX3 were measured using an enzyme-linked immunosorbent assay in 22 MS patients, 26 NMO patients, 15 acute cerebral infarction (CI) patients, 11 mild headache patients, and 14 volunteer controls. Results: During relapse, plasma PTX3 levels were higher in MS patients than in headache patients ( p=0.003) and controls ( pConclusion: Plasma PTX3 level is associated with inflammatory responses in MS and NMO.