Search

Sparse subspace clustering (SSC) is a representative data clustering paradigm that has been broadly applied in the unsupervised classification of hyperspectral images (HSIs). Existing SSC methods usually produce a subspace affinity matrix between representations of hyperspectral pixels first, followed by spectral clustering for the affinity matrix. To this end, the separated framework fails to exploit the dualities contained in both features and pixels or higher order entities at the same time, and thus, it is difficult to compute coclusters simultaneously. In addition, SSC methods often require expensive computational consumption and memory capacity to approximate the spectral decomposition of the affinity matrix, thus hindering the applicability of SSC methods for large HSIs. To overcome these limitations, we propose a novel graph convolutional sparse subspace coclustering (GCSSC) model with nonnegative orthogonal factorization for large HSIs in which affinity matrix learning and spectral coclustering are integrated into a unified optimizing model to obtain the optimal clustering results. Specifically, to form a more compact self-representation, the superpixel-based adaptive dictionary construction strategy is proposed instead of the global dictionary to precisely represent the pixels. To explore the spatial-contextual and spectral neighboring characteristics between dictionary atoms, graph convolution is incorporated into the dictionary atoms to aggregate the local neighborhood information, and the affinity matrix in the proposed coclustering framework is constructed under a joint sparsity constrained representation model. To reduce high computational consumption and memory capacity, a nonnegative orthogonal factorization constraint is proposed to offer an alternative spectral clustering for hyperspectral pixels and dictionary atoms simultaneously. The clustering performance of the proposed method is evaluated for three classical HSIs, and the experimental results illustrate that the proposed method is memory and computationally efficient and outperforms the state-of-the-art HSI clustering methods.

Objective To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors. Methods Seventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal–Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis. Results WTs demonstrated the highest Kep value (median 1.89, interquartile range [1.46–2.31] min−1) but lowest Ve value (0.20, [0.15–0.25]) compared with PAs (Kep, 0.34 [0.21–0.55] min−1; Ve, 0.36 [0.24–0.43]), OBTs (Kep, 1.22 [0.27–1.67] min−1; Ve, 0.28 [0.25–0.41]), and MTs (Kep, 0.71 [0.50–1.23] min−1; Ve, 0.35 [0.26–0.45]) (all p D value (1.10, [0.88–1.29] × 10−3 mm2/s) compared with PAs (1.81, [1.60–2.20] × 10−3 mm2/s) and OBTs (1.57, [1.32–1.89] × 10−3 mm2/s) (both p trans value (0.12, [0.07–0.18] min−1) compared with OBTs (0.28, [0.11–0.50] min−1) (p Kep and Ve, D, and Ktrans to distinguish WTs, MTs, and PAs sequentially were 1.06 min−1, 0.28, 1.46 × 10−3 mm2/s, and 0.21 min−1, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively). Conclusion The combined use of DKI and DCE-MRI may help differentiate parotid gland tumors. Key Points • The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors. • A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.

Treatments of atherogenesis, one of the most common cardiovascular diseases (CVD), are continuously being made thanks to innovation and an increasingly in-depth knowledge of percutaneous transluminal coronary angioplasty (PTCA), the most revolutionary medical procedure used for vascular restoration. Combined with an expanding balloon, vascular stents used at stricture sites enable the long-time restoration of vascular permeability. However, complication after stenting, in-stent restenosis (ISR), hinders the advancement of vascular stents and are associated with high medical costs for patients for decades years. Thus, the development of a high biocompatibility stent with improved safety and efficiency is urgently needed. This review provides an overview of current advances and potential technologies for the modification of stents for better treatment and prevention of ISR. In particular, the mechanisms of in-stent restenosis are investigated and summarized with the aim to comprehensively understanding the pathogenesis of stent complications. Then, according to different therapeutic functions, the current stent modification strategies are reviewed, including polymeric drug eluting stents, biological friendly stents, pro-healing stents, and gene stents. Finally, the review provides an outlook of the challenges in the design of stents with optimal properties. Therefore, this review is a valuable and practical guideline for the development of cardiovascular stents.

Since the meeting of China Securities Regulatory Commission in 2020 once again emphasized the issue of earnings quality of corporate governance, this paper intends to study this issue from different perspectives. This study takes the IT industry of China's A-share listed companies from 2015 to 2019 as the sample, and makes an empirical analysis with the fuzzy set/ Qualitative Comparative Analysis (fs/QCA). The results show that the companies with large scale and good corporate governance concept, poor financial structure but with the assistance of external experts, high salary and high proportion of independent directors have relatively high earnings quality. According to the above research results. According to the findings, we put forward the following suggestions. For enterprises, good corporate governance concept and the concept of integrity are very important, but there must be efficient operation of the board of directors in order to play the role of corporate governance. Therefore, the size of the board of directors should not be too large, but it can be adjusted flexibly depends on whether the required professionals are enough. In addition, enterprises with poor financial structure should rely on the assistance of professional managers, rather than using earnings manipulation to obtain short-term benefits. For the regulators of listed companies, the procedures of independent directors’ selection should be more strictly supervised, so as not to make the setting of independent directors become mere formality. For investors, we should always pay attention to the corporate governance, and announce the disclosure of real-time information about directors, supervisors and senior executives, to prevent losses caused by investment misjudgment.

Hybrid perovskites are emerging as a promising, high-performance luminescent material; however, the technological challenges associated with generating high-resolution, free-form perovskite structures remain unresolved, limiting innovation in optoelectronic devices. Here, we report nanoscale three-dimensional (3D) printing of colored perovskite pixels with programmed dimensions, placements, and emission characteristics. Notably, a meniscus comprising femtoliters of ink is used to guide a highly confined, out-of-plane crystallization process, which generates 3D red, green, and blue (RGB) perovskite nanopixels with ultrahigh integration density. We show that the 3D form of these nanopixels enhances their emission brightness without sacrificing their lateral resolution, thereby enabling the fabrication of high-resolution displays with improved brightness. Furthermore, 3D pixels can store and encode additional information into their vertical heights, providing multilevel security against counterfeiting. The proof-of-concept experiments demonstrate the potential of 3D printing to become a platform for the manufacture of smart, high-performance photonic devices without design restrictions.

Background Allergen immunotherapy (AIT) is the only causal therapy for IgE-mediated allergy. There is less evidence about the safety and efficacy of AIT especially subcutaneous immunotherapy (SCIT) in children under 5 years old. We aimed to investigate the side effects and associated risk factors of house dust mite (HDM) SCIT in preschool children with respiratory allergic diseases. Methods The preschool children who had HDM-related allergic rhinitis with/without asthma were enrolled and undergone standardized HDM SCIT in our department from June 2013 to December 2019. Local reactions (LRs) and systemic reactions (SRs) were recorded and categorized according to World Allergy Organization recommendations. Demographic data and other therapeutic-related parameters were also recorded to investigate potential risk factors for these side effects. Results A total of 91 children (60 boys, 65.93%; 31 girls, 34.07%; mean age 4.13 years old) were included in the study. Among the 91 patients, 3109 SCIT injections were recorded, 62/91 (68.13%) experienced 186 immediate LRs, 4 /91(4.40%) experienced 6 delayed LRs, 11/91 (12.09%) children experienced 44 immediate SRs, 21/44 (47.73%) were grade 1 SRs, 21/44 (47.73%) were grade 2, 2/44 (4.55%) were grade 3, no grade 4 or 5 SRs occurred. Furthermore, 1/91 (1.10%) experienced 1 delayed SRs, manifested by urticaria 2 days later after allergen injection. 9/91 (9.89%) experienced 2 or more times SRs. Multivariable logistic regression analysis showed BMI (OR 1.506; 95%CI 1.091 to 2.079; p p p > 0.05). Conclusions HDM subcutaneous immunotherapy is considered to be safe in preschool children with respiratory allergic diseases. Higher BMI and HDM sIgE level in children are risk factors for developing LRs. The incidence of SRs and the rate of severe SRs are low in preschool children.

Pre-pregnancy body mass index and weight gain management are associated with pregnancy outcomes in expecting women. Poor gestational weight gain (GWG) management could increase the risk of adverse complications. These risks can be alleviated by lifestyle-based interventions if an undesired GWG trend is detected early on in the pregnancy. Current literature lacks analysis of gestational weight gain data and tracking the pregnancy over time. In this work, we collected longitudinal gestational weight gain data from women during their pregnancy and model their weight measurements to predict the end-of-pregnancy weight gain and classify it in accordance with the medically recommended guidelines. The measurement frequency of the weights is often very variable such that segments of data can be missing and the need to predict early utilising few data points complicates data modelling. We propose a Bayesian approach to forecast weight gain while effectively dealing with the limited data availability for early prediction. We validate on diverse populations from Europe and China. We show that utilising individual’s data only up to mid-way through the pregnancy, our approach produces mean absolute errors of 2.45 kgs and 2.82 kgs in forecasting end-of-pregnancy weight gain on these populations respectively, whereas the best of state-of-the-art yields 8.17 and 6.60 kgs on respective populations. The proposed method can serve as a tool to keep track of an individual’s pregnancy and achieve GWG goals, thus supporting the prevention of excessive or insufficient weight gain during pregnancy.

Background/Purpose: Multiple sclerosis is classified as a rare disease in Taiwan. This study evaluated the safety and effectiveness of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) from routine clinical practice in Taiwan. Methods: In this retrospective, multicentre, observational study, we collected clinical data of patients treated with fingolimod 0.5 mg/day in routine clinical practice between September 2012 and December 2015. Primary outcome was the overall safety of fingolimod; secondary outcome was the annualized relapse rate (ARR). Results: Overall, 62/69 (86.1%) patients were on fingolimod by the end of data collection period. Mean age (±standard deviation [SD]) at inclusion was 37.7 ± 10.10 years; mean duration of MS was 5.4 ± 4.52 years and mean duration of fingolimod exposure was 135.8 patient-years. The most common adverse events (AEs) were bradycardia (21.7%; first-dose related), upper respiratory tract infection, dizziness, and hypoaesthesia (numbness) (11.6% each), followed by urinary tract infection and back pain (7.2% each). Seven patients had liver enzyme-related AEs. Eight patients had absolute lymphocyte counts

Objective To assess interstitial lung disease (ILD) risk among patients newly diagnosed with systemic autoimmune rheumatic diseases (SARDs) including rheumatoid arthritis (RA), dermatomyositis (DMtis), polymyositis (PM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and primary Sjogren's syndrome (pSS). Method Using the 1997–2013 Taiwanese National Health Insurance Research Database, we identified 62,930 newly diagnosed SARD patients from 2001 to 2013. We selected 251,720 individuals without SARD diagnoses who were matched (1:4) with SARD patients by age, sex and year of index date. We compared the incidence rates (IRs) of ILD (consistent diagnosis with ICD-9 code 515, 516.3, 516.8, 516.9 or 517 after a ILD-related radiological or pathological procedure) between the specific SARD subgroups and the corresponding non-SARD comparison groups. Using multivariable Cox regression analyses, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of ILD in the various SARD groups compared with comparison groups after adjusting for age, sex and Charlson comorbidity index. Results The IR of ILD was greatest among patients with SSc (1,364 per 105 years), followed by DMtis (1,011 per 105 years), PM (831 per 105 years), pSS (196 per 105 years), RA (109 per 105 years) and SLE (120 per 105 years). Multivariable analyses showed that the risk of ILD was increased among patients with SSc (HR, 172.63), DMtis (HR, 119.61), PM (HR, 84.89), SLE (HR, 32.18), pSS (HR, 17.54), or RA (HR, 8.29). Conclusion This population-based, cohort study demonstrates that the risk of ILD is significantly increased in patients with newly diagnosed SARDs.

Background During COVID-19 pandemic, many allergic rhinitis (AR) patients stopped their treatment including pharmacotherapy and allergen immunotherapy. Objective This study aimed to investigate the anxiety and depression and general effect of COVID-19 pandemic on AR patients' psychological status in Wuhan, China. Methods In October 2019, 222 outpatients suffering from AR in our department and 133 healthy controls were enrolled. All participants were asked to finish the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) questionnaire. The demographic characteristics and the severity of AR symptoms were recorded. In April 2020, the AR patients and healthy controls were re-contacted to finish the questionnaires by telephone or online. The SAS and SDS scores in AR patients and healthy controls and the correlation with other variables were analyzed. Results For AR patients, the SAS and SDS scores were significantly higher than healthy controls. Meanwhile, the rates of anxiety and depression were 24.8% and 19.4% respectively. The education level and symptoms severity were correlated with SAS and SDS scores. Ninety-eight AR patients and 56 healthy controls finished the questionnaires after COVID-19 pandemic. The AR patients' SAS and SDS scores were lower than before COVID-19 pandemic and were correlated with AR symptom scores. The scores of healthy controls were not different with before COVID-19 pandemic. Conclusions The occurrence of anxiety and depression is common in AR patients. Severity of symptoms and low education level are the risk factors causing anxiety and depression. COVID-19 pandemic has no significant negative impact on the AR patients' psychological status.

Systemic lupus erythematosus (SLE) is an autoimmune disease that develops mainly in women of reproductive age. We aimed to explore the risk of pregnancy complications in Asian patients with SLE.From January 2005 to December 2014, we conducted a nationwide case-control study, using Taiwan's National Health Insurance Research Database. Obstetric complications and perinatal outcomes in SLE patients were compared with those without SLE.2059 SLE offspring and 8236 age-matched, maternal healthy controls were enrolled. We found increased obstetric and perinatal complications in SLE population compared with healthy controls. SLE patients exhibited increased risk of preeclampsia/eclampsia (8.98% vs.1.98%, odds ratio [OR]: 3.87, 95% confidence interval [95% CI]: 3.08-4.87, p0.0001). Their offspring tended to have lower Apgar scores (7) at both 1 min (10.7% vs. 2.58%, p0.0001) and 5 min (4.25% vs. 1.17%, p0.0001), as well as higher rates of intrauterine growth restriction (IUGR, 9.91% vs. 4.12%, OR: 2.24, 95% CI: 1.85-2.71, p0.0001), preterm birth (23.70% vs 7.56%, OR: 3.00, 95% CI: 2.61-3.45, p0.0001), and stillbirth (4.23% vs. 0.87%, OR: 3.59, 95% CI: 2.54-5.06, p0.0001). The risks of preterm birth and stillbirth were markedly increased in SLE patients with concomitant preeclampsia/eclampsia or IUGR. Preterm birth of SLE patients was 1~4 gestational weeks earlier than that of healthy controls and the peak occurrence of stillbirth in SLE population was at 20~30 gestational weeks.Asian SLE patients exhibited increased risks of maternal complications and adverse birth outcomes. Frequent antenatal visits before 20 gestational weeks are recommended in high-risk SLE patients.

The objective of this study was to explore the effect of Alpiniae oxyphyllae Fructus (AOF) on a rat model of chronic intermittent hypoxia (CIH)–induced enuresis. Findings of this study may help identify therapeutic targets in children with nocturnal enuresis (NE). Female rats were randomly divided into a control group (saline gavage, 4 weeks of normal air), CIH group (saline gavage, 4 weeks of CIH), and AOF group (AOF gavage, 4 weeks of CIH). The variables measured in this study included water intake, urine output, bladder leak point pressure (BLPP), malondialdehyde (MDA) levels, and superoxide dismutase (SOD) activity. The expression levels of the purinergic P2X3 receptor, muscarinic M3 receptor, and s3-adrenergic receptor (s3-AR) in the bladder were also measured. The bladder was subjected to haematoxylin and eosin (HE) and Weigert staining, and histological changes were observed under a light microscope to evaluate the morphological changes in the bladder in each group. Compared with the control group, urine output was increased, and the BLPP was decreased in the CIH group, but AOF administration decreased urine output and increased BLPP. In addition, the serum MDA level increased and the SOD activity decreased in the CIH group compared with the control group. Administration of AOF decreased the MDA level and increased the SOD activity. Additionally, compared with the control group, HE and Weigert staining in the CIH group showed that the bladder detrusor muscle bundles were disordered and loose, some muscle bundles were broken, the content of collagen fibres in the gap was reduced, and the gap was significantly widened. However, following the administration of AOF, the bladder detrusor muscle bundles were neatly arranged, and the content of collagen fibres in the gap was increased. Furthermore, compared with the control group, the purinergic P2X3 receptor and muscarinic M3 receptor were expressed at higher levels, and s3-AR was expressed at lower levels in the CIH group, but AOF administration decreased the expression of the purinergic P2X3 receptor and muscarinic M3 receptor and increased the expression of the s3-AR. AOF improves enuresis by inhibiting oxidative stress and regulating the expression of the purinergic P2X3 receptor, muscarinic M3 receptor, and s3 adrenergic receptor.

Optical image computing, such as spatial differentiation, logical transform, and addition-subtraction operation, is of great importance to signal enhancement, transform, and extraction, but such nonlinear methods are restrained in incoherent or scattering imaging. Here, the logical white-light image reconstruction, as an optical image computing method for incoherent and scattered images, is proposed by monitoring a seeded potential in variable detection planes. The weak white-light signals collectively seed a potential at the expense of scattering noise based on seeded modulation instability in a photorefractive crystal. Then the logical image operation is achieved by sensitively probing the seeded potential and recording the intensity distribution of the probe beam in different detection planes. The proposed method has a strong ability of ballistic signal recording, reproduction, and reversal. The numerical and experimental results show a new physical phenomena in which the indirect interaction between light waves through a seeded potential is presented in different forms. The nonlinear method is proved to effectively operate pure images, the images scattered by a rotating diffuser, and the images scattered by fogs whether under back lighting or under front lighting. Our work suggests an alternative method for all-optical image processing, recovery, and computing.

Silicon vacancy (SiV) centers in CVD-deposited nanodiamond particles or films always exhibit a photoluminescent (PL)-quenching behavior. Herein, in order to overcome this issue, air annealing of nanocrystalline diamond (NCD) films with uniform doping of Si atoms is employed to improve the PL emission efficiency of SiV centers. Without severe mass loss in diamond, SiV centers exhibit an increased PL emission intensity at 738 nm with an increased annealing temperature and time. In comparison to the untreated film, the maximum PL enhancement reaches about 200 and 1473 folds when the NCD films are annealed at 600 °C for 60 min and 700 °C for 20 min, respectively. Such giant increase in SiV PL emission is mainly attributed to the transition of diamond surface from hydrogen to oxygen termination together with the optimized crystalline quality of the annealed films, as confirmed by the HRTEM, Raman and XPS measurements. A schematic model based on the theory of surface band bending is proposed to elucidate the mechanism of the SiV PL enhancement in oxygen-terminated NCD films: a near-surface light trap layer formed in hydrogen-terminated NCD is converted during the oxidation process, leading to the additional collection of SiV PL emission from the inner layer.

Clustering for hyperspectral images (HSIs) is a very challenging task because HSIs usually have large spectral variability, high dimensionality, and complex structures. Recently, the sparse representation and dictionary-learning-based spectral clustering (SC) approaches have achieved great success in clustering HSIs. However, SC deals with hyperspectral clustering by one-way clustering, i.e., either dictionary atoms or sparse-representation-based clustering, and only clusters the columns information of adjacency matrix. To overcome these problems, we propose a novel coclustering based on bipartite graph partition (BGP) with joint sparsity for two disjoint sets: dictionary atoms and hyperspectral pixels. First, the structured dictionary constraint is incorporated into a unified joint sparsity constrained optimizing model to learn a structured sparse representation by incorporating spectral and contextual characteristics of HSIs where the joint sparsity coefficients provide related information between hyperspectral pixels and dictionary atoms. Then, a BGP-based classifier is proposed to simultaneously group hyperspectral pixels with the learned dictionary atoms by mapping the joint sparsity coefficients to a non-negative affinity matrix of graph, and simultaneously clusters rows and columns information of adjacency matrix. To solve the BGP problem, we use spectral graph partition algorithm, which uses the left and right singular vectors of an appropriately dictionary-signal adjacent matrix to yield good bipartitionings and the singular vectors solve a real relaxation of the NP-complete BGP problem. The proposed algorithm was tested on three widely used hyperspectral datasets, and experimental results demonstrate that the proposed algorithm outperforms other state-of-the-art methods.

This article experimentally investigates the cyclic behavior of ultra high performance concrete–filled steel tube beam-columns. A total of eight specimens were tested. The considered parameters were the axial load ratio and steel ratio. The results showed that all ultra high performance concrete–filled steel tube beam-columns had a very good cyclic behavior without significant pinching. Increasing the axial load ratio results in the decrease of strength and ductility, but it has no obvious influence on the initial flexural stiffness. Reducing the steel ratio results in the decrease of the strength, stiffness and ductility, and energy dissipation capacity.

Background. Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is associated with respiratory failure and death in patients with idiopathic inflammatory myositis (IIM) and interstitial lung disease (ILD). This study aimed to investigate clinical parameters associated with mortality in anti-MDA-5 antibody-positive patients. Methods. We retrospectively reviewed the clinical and laboratory data, and pulmonary function test results in 55 anti-MDA-5 antibody-positive patients. A comparison was made between the survivors and non-survivors at the 12-month follow-up. Results. A total of 13 patients (23.6%) died within 12 months. Non-survivors had higher GAP scores (gender, age, and physiology score for idiopathic pulmonary fibrosis) (1 vs. 6, p &lt, 0.01) and CA-153 (16.4 vs. 72.9, p &lt, 0.01). In addition, rapid progressive ILD, fever, peak ferritin, leukocyte count, lactate dehydrogenase, CT score, intravenous immunoglobulin, mycophenolic acid, CMV infections, pneumocystis pneumonia, and pneumothorax were significantly associated with increased risks of 1-year mortality, while forced vital capacity, forced expiratory volume in one second, and diffusion capacity for carbon monoxide were correlated with decreased risk of 1-year mortality. Conclusions. Our study results suggest that GAP scores and CA-153 could be prognostic factors for 1-year mortality in anti-MDA-5 antibody-positive patients. A prompt pulmonary function test and CA-153 are essential for these patients to guide further management.

To the Editor,Eutylone [1-(1,3-benzodioxol-5-yl)-2-(ethylamino) butan-1-one], also known as bk-EBDB or N-ethylbutylone, is a synthetic cathinone that first appeared in Poland in 2014 [1]. In the US...

The design displacement, its corresponding acceleration performance, and the re-centering performance of bilinear hysteretic isolation systems are adopted as previously determined design objectives for equivalent linear analysis. To demonstrate the applicability and generalization of the analysis procedure, two sets of values for damping modification factors are employed in the analysis: those provided by ASCE/SEI 7-16, and those estimated for different ranges of the ratios of effective periods of seismic isolation systems to pulse periods of ground motions. To investigate a broad range of seismic responses of base-isolated structures, 15 pulse-like near-fault ground motions are used for numerical demonstration. The analysis procedure is numerically verified to be practically feasible. A numerical comparison also shows that the three design objectives previously determined in the analysis procedure are sufficiently conservative compared with analysis results from nonlinear dynamic response history, even when subjected to pulse-like near-fault ground motions. Regarding the approximation to maximum inelastic acceleration and displacement responses, it is particularly more conservative for the former when the design displacement is greater and when adopting values of the damping modification factors provided in ASCE/SEI 7-16. For the approximation to dynamic residual displacement responses, the influences of pulse-like near-fault ground motions and different design objectives on the re-centering performance of bilinear hysteretic isolation systems still need further study.

Background Mycophenolate mofetil (MMF) is extensively used for induction and maintenance therapy in patients with lupus nephritis (LN). Enteric-coated mycophenolate sodium (EC-MPS) was developed to reduce the adverse gastrointestinal effects of MMF. However, the therapeutic efficacy of MMF and EC-MPS in LN remains unclear. This study aimed to examine the treatment effects of EC-MPS in LN patients with prior MMF exposure. Methods In this medical records review study, we included 54 LN patients, of whom 34 converted from MMF to EC-MPS at equimolar doses in 2016-2018 (nonmedical switching group) and 20 received continuous MMF treatment. Patients achieving complete remission or partial remission before the conversion were categorized as responders, whereas those who had never achieved complete remission or partial remission were categorized as nonresponders. Results Baseline proteinuria was higher in the nonmedical switching group. Although elevation in proteinuria was observed after nonmedical switching, the serum creatinine concentration and estimated glomerular filtration rate both improved. Responders in the nonmedical switching group had lower proteinuria and higher complement 3 levels. In the subgroup analysis, albeit the modest increase in daily urine protein, anti-double-stranded DNA antibody levels, estimated glomerular filtration rate, and complements 3 and 4 seemed comparable after conversion. Conclusion Switching to EC-MPS demonstrated a similar short-term renal response to continuous MMF treatment in LN patients. Prospective randomized trials are required to verify our findings.

Macro photography allows direct visualization of the enlarged whole mouse brain by a combination of lightsheet illumination and expansion microscopy with single-cell resolution. Taking advantage of the long working distance of a camera lens, we imaged a 3.7 cm thick, transparent, fluorescently-labeled expanded brain. In order to improve 3D sectioning capability, we used lightsheet excitation confined as the depth of field of the camera lens. Using 4x sample expansion and 5x optical magnification, macro photography enables imaging of expanded whole mouse brain with an effective resolution of 300 nm, which provides the subcellular structural information at the organ level.

Introduction: Asymptomatic sensitization is defined as the presence of positive skin prick test (SPT) and/or positive serum allergen-specific IgE in the absence of clinical allergic symptoms. Currently, there is no convincing explanation why some people with positive allergen tests do not show symptoms. We aimed to investigate the house dust mite (HDM)-specific IgE and IgG4 repertoire in asymptomatic HDM-sensitized subjects and HDM-induced allergic rhinitis (AR) patients. Methods: A total of 48 subjects sensitized to HDM were included in this study: 27 had AR with/without asthma (symptomatic group), and 21 had no allergic symptoms (asymptomatic group). Six healthy individuals served as control group. Peripheral blood samples were collected for serum IgE and IgG4 assay and basophil activation tests (BATs). IgE and IgG4 assay included antibodies to Dermatophagoides (Der) p1, 2, 7, 10, 21, 23, and Der f1, 2. Results: AR patients had a larger wheal diameter of SPT (7.0 vs. 3.0 mm, p < 0.0001) and a higher specific IgE to Der p (15.50 vs. 0.70 KU/L, p < 0.0001) than asymptomatic subjects. They also showed more frequent sensitization to Der p1 and Der p2 (both p < 0.05). However, the total IgE and specific IgG4 did not differ significantly between the 2 groups. The basophil activation response after being stimulated with HDM was observed to be higher in AR patients (all p < 0.05). Conclusions: There are differences in SPT, serum-specific IgE to Der p, component allergen Der p1 and Der p2 level and BAT between AR patients and asymptomatic subjects sensitized to HDM. IgG4 alone cannot differentiate asymptomatic individuals from AR patients.

Objective: To compare the prognostic predictive performance of six lymph node (LN) staging schemes: American Joint Committee on Cancer (AJCC) N stage, number of retrieved lymph nodes (NRLN), number of positive lymph nodes (NPLN), number of negative lymph nodes (NNLN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) among node-positive endometrioid endometrial cancer (EEC) patients.Methods: A total of 3,533 patients diagnosed with node-positive EEC between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. We applied X-tile software to identify the optimal cutoff value for different staging schemes. Univariate and multivariate Cox regression models were used to assess the relationships between different LN schemes and survival outcomes [disease-specific survival (DSS) and overall survival (OS)]. Moreover, Akaike information criterion (AIC) and Harrell concordance index (C-index) were used to evaluate the predictive performance of each scheme in both continuous and categorical patterns.Results: N stage (N1/N2) was not an independent prognostic factor for node-positive EEC patients based on multivariate analysis (DSS: p = 0.235; OS: p = 0.145). Multivariate model incorporating LNR demonstrated the most superior goodness of fit regardless of continuous or categorical pattern. Regarding discrimination power of the models, LNR outperformed other models in categorical pattern (OS: C-index = 0.735; DSS: C-index = 0.737); however, LODDS obtained the highest C-index in continuous pattern (OS: 0.736; DSS: 0.739).Conclusions: N stage (N1/N2) was unable to differentiate the prognosis for node-positive EEC patients in our study. However, LNR and LODDS schemes seemed to have a better predictive performance for these patients than other number-based LN schemes whether in DSS or OS, which revealed that LNR and LODDS should be more helpful in prognosis assessment for node-positive EEC patients than AJCC N stage.

The risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-negative, antibody to hepatitis B core antigen (anti-HBc)-positive patients after glucocorticoid (GC) pulse therapy remains unclear. Aims: Our study aimed to examine the safety of GC pulse therapy in HBsAg-negative, anti-HBc-positive rheumatic patients. Methods: Medical records of HBsAg-negative, anti-HBc-positive patients receiving GC pulse therapy to treat rheumatic diseases were reviewed. The primary outcome was HBV-associated hepatitis occurring within the first year after GC pulse therapy, the secondary outcome was HBsAg seroreversion occurring during the follow-up period. Results: We identified 5222 HBsAg-negative, anti-HBc-positive patients with rheumatic diseases who had attended Taichung Veterans General Hospital from October 2006 to December 2018. A total of 689 patients had received GC pulse therapy, with 424 patients being analyzed. Hepatitis was noted in 28 patients (6.6%) within the first year after GC pulse therapy, but none had been diagnosed as HBV-associated hepatitis. Three patients (0.7%) later developed HBsAg seroreversion, with a median interval of 97 months from the first episode of GC pulse therapy. These cases concurrently had maintained high dose oral prednisolone (≥20 mg prednisolone daily for over 4 weeks). Conclusions: Amongst the HBsAg-negative, anti-HBc-positive rheumatic patients treated with GC pulse therapy, the risk of HBV-associated hepatitis within the first year was low. HBsAg seroreversion may have developed in the later stage, but only in those patients who had maintained high-dose oral steroid.

The coherent Ising machine (CIM) implemented by degenerate optical parametric oscillator (DOPO) networks is a novel optical platform to accelerate computation of hard combinatorial optimization problems. Nevertheless, with the increase of the problem size, the probability of the machine being trapped by local minima increases exponentially. According to the quantum adiabatic theorem, a physical system will remain in its instantaneous ground state if the time-dependent Hamiltonian varies slowly enough. Here, we propose a method to help the machine partially avoid getting stuck in local minima by introducing quantum adiabatic evolution to the ground-state-search process of the CIM, which we call A-CIM. Numerical simulation results demonstrate that A-CIM can obtain improved solution accuracy in solving MAXCUT problems of vertices ranging from 10 to 2000 than CIM. The proposed machine that is based on quantum adiabatic theorem is expected to solve optimization problems more correctly.

Conventional in vitro methods for biological evaluation of intra-arterial devices such as stents fail to accurately predict cytotoxicity and remodeling events. An ex vivo flow-tunable vascular bioreactor system (VesselBRx), comprising intra- and extra-luminal monitoring capabilities, addresses these limitations. VesselBRx mimics the in vivo physiological, hyperplastic, and cytocompatibility events of absorbable magnesium (Mg)-based stents in ex vivo stent-treated porcine and human coronary arteries, with in-situ and real-time monitoring of local stent degradation effects. Unlike conventional, static cell culture, the VesselBRx perfusion system eliminates unphysiologically high intracellular Mg(2+) concentrations and localized O(2) consumption resulting from stent degradation. Whereas static stented arteries exhibited only 20.1% cell viability and upregulated apoptosis, necrosis, metallic ion, and hypoxia-related gene signatures, stented arteries in VesselBRx showed almost identical cell viability to in vivo rabbit models (~94.0%). Hyperplastic intimal remodeling developed in unstented arteries subjected to low shear stress, but was inhibited by Mg-based stents in VesselBRx, similarly to in vivo. VesselBRx represents a critical advance from the current static culture standard of testing absorbable vascular implants.

The first report of the red imported fire ant (RIFA), Solenopsis invicta Buren, in Taiwan was in the city of Taoyuan in 2003. The government has made great efforts to bring RIFA-infested areas under control. RIFA has gradually spread outward since its discovery, but it is still confined in northern Taiwan, in part due to the control efforts. RIFA is well established in densely populated environments (i.e., urban areas), causing damage to public utilities and significantly affects the inhabitants of Taiwan. Out of 10,127 human encounters with RIFA reported by the Plant Pest Information Management System in the Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, 3819 (37.71%) persons were stung, with 834 (21.8%) persons exhibiting wheal-and-flare reaction (swelling and redness of the skin). Among the victims, 288 (7.5%) sought medical care, and about 21 (0.6%) developed severe cellulitis and urticaria. Unexpectedly, 2.8% (106) of the victims exhibited anaphylactic shock, which was higher than previously reported cases (1%). The high anaphylactic shock percentage was probably because most victims were elderly farmers or because Asian people have higher sensitivity to the RIFA sting. RIFA is well adapted to the environmental conditions in Taiwan, which makes it extremely difficult (if not impossible) to eradicate. The management of RIFA in the future should focus on lowering the speed of spread to mitigate possible dangers to the inhabitants. Six major challenges of RIFA management in Taiwan are also discussed.

Headings Background : This is a case of a human disseminated nocardiosis caused by Nocardia vulneris which made the patient presenting with fever, cough, shortness of breath, muscle pain and multiple tubercle. Methods: Bacterial culture the blood, sputum, lung rinses and scalp pus samples of the patient, Nocardia vulneris was isolated and identified using the 16s ribosomal RNA gene sequence sequence data. and determine the sensitivity of the isolated bacteria to antibiotics and analysis of the strain's antibiotic treatment. Results: The isolated was identified as Nocardia brasiliensis, which was resistant to ciprofloxacin, but susceptible to amikacin, gentamicin, tobramycin, linezolid, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic, moxifloxacin, ceftriaxone, cefotaxim, imipenem. The patient recovered and his condition remained stable by combinations with linezolid, amikacin and trimethoprim-sulfamethoxazole. Conclusions: This is the first case report of disseminated nocardiosis caused by Nocardia vulneris, and the current case was treated successfully with linezolid, amikacin and trimethoprim-sulfamethoxazole. Clinicians should be aware of its diagnostic, and the MIC value of the drug sensitivity test should be concerned when there is a wide choice of medicines, for the disseminated cases which are diagnosed definitely should be treated with at least 12 months of antimicrobial therapy, bacteriological examination and antimicrobial susceptibility testing should be performed repeatedly.

Vascular stent is viewed as one of the greatest advancements in interventional cardiology. However, current approved stents suffer from in-stent restenosis associated with neointimal hyperplasia or stent thrombosis. To address this issue, we developed an endothelium-like (EL) dressing for vascular stents inspired by the importance and biological functions of native endothelium for cardiovascular system. Our EL dressing is based on a de novo designed hydrogel that is mechanically tough and could preserve integrity on stents during angioplasty. Due to its physiochemical similarities to subendothelial extracellular matrix, the EL dressing facilitated the adhesion and growth of endothelial cells. Besides, it is non-thrombotic and capable of inhibiting smooth muscle cells thanks to the capacity to catalyze nitric oxide generation. Transcriptome analysis further unraveled the EL dressing could modulate the inflammatory response and induce the relaxation of smooth muscle cells, while potentially promoting angiogenesis by stimulating the expression of angiogenic factors. In vivo study demonstrated vascular stents encapsulated by it promoted rapid restoration of native endothelium and persistently suppressed in-stent restenosis in both leporine and swine models. We expect such EL dressing will open a new avenue to the surface engineering of vascular implants for better clinical outcomes.

Hearing loss is one of the most prevalent sensory disabilities worldwide with huge social and economic burdens. The leading cause of sensorineural hearing loss (SNHL) in children is congenital cytomegalovirus (CMV) infection. Though the implementation of universal screening and early intervention such as antiviral or anti-inflammatory ameliorate the severity of CMV-associated diseases, direct and targeted therapeutics is still seriously lacking. The major hurdle for it is that the mechanism of CMV induced SNHL has not yet been well understood. In this review, we focus on the impact of CMV infection on the key players in inner ear development including the Wnt and Notch signaling pathways. Investigations on these interactions may gain new insights into viral pathogenesis and reveal novel targets for therapy.

Background: Antinuclear antibody pattern recognition is vital for autoimmune disease diagnosis but labor-intensive for manual interpretation. To develop an automated pattern recognition system, we established machine learning models based on the International Consensus on Antinuclear Antibody Patterns (ICAP) at a competent level, mixed patterns recognition, and evaluated their consistency with human reading. Methods: 51,694 human epithelial cells (HEp-2) cell images with patterns assigned by experienced medical technologists collected in a medical center were used to train six machine learning algorithms and were compared by their performance. Next, we choose the best performing model to test the consistency with five experienced readers and two beginners. Results: The mean F1 score in each classification of the best performing model was 0.86 evaluated by Testing Data 1. For the inter-observer agreement test on Testing Data 2, the average agreement was 0.849 (κ) among five experienced readers, 0.844 between the best performing model and experienced readers, 0.528 between experienced readers and beginners. The results indicate that the proposed model outperformed beginners and achieved an excellent agreement with experienced readers. Conclusions: This study demonstrated that the developed model could reach an excellent agreement with experienced human readers using machine learning methods.

Agricultural terraces are important for agricultural production and soil-and-water conservation. They comprise treads and risers that require manual construction and maintenance. If managed imprope...

Several studies have demonstrated the efficacy of house dust mite (HDM) immunotherapy in allergic rhinitis (AR). We aimed to compare the efficacy and safety of 2 commercial HDM extracts in a Chinese AR population.This was an open-label study. HDM-associated AR patients were randomized into Dermatophagoides pteronyssinus (Dp) extracts (Alutard SQ; ALK, Hørsholm, Denmark) and Dp/Dermatophagoides farinae (Df) extracts (NovoHelisen Depot [NHD]; Allergopharma, Reinbek, Germany) groups. All patients received subcutaneous injections for 1 year, and were followed every 3 months during that 1-year period. Symptom score, medication score, and adverse reactions were recorded. The primary endpoint was the total combined symptom and medication score (CSMS) during the efficacy evaluation period. Blood samples were taken for specific immunoglobulin E (IgE), IgG4, and IgE-blocking factor tests at baseline and after the 1-year treatment.A total of 230 AR patients were randomized; 29 patients dropped out. Analysis of the primary endpoint demonstrated significant reductions in CSMS of 1.8 vs 3.1 (p0.001) in the Alutard group and 1.8 vs 3.3 (p0.001) in the NHD group compared with baseline. The 2 groups presented equal effectiveness with regard to CSMS, symptom score, and medication score (p0.05). The treatment was well tolerated in both groups; 17 (14.8%) patients experienced systemic reactions (SRs) in the Alutard group and 13 (11.3%) in the NHD group. The rates of SRs showed no difference in the 2 groups (p0.05), and no anaphylaxis occurred. IgG4 and IgE-blocking factor to Dp and Df were increased significantly in both groups after the 1-year treatment.Our study confirmed the equal efficacy and safety profile of both commercial extracts in HDM-associated AR patients.

Alternaria is a major outdoor allergen. Immunotherapy with Alternaria extracts has been documented to be effective in the sensitized patients. However, Alternaria extracts are notoriously difficult to standardize. Our aim is to screen the B cell mimotopes of Alternaria and to evaluate the therapeutic effects of B cell mimotope peptides on a BALB/c mouse model of Alternaria allergy. After a human sera pool from Alternaria monosensitized patients was established, B cell mimotopes were screened by a phage-displayed random heptamer peptide library that was identified via mixed Alternaria-specific IgE in the sera pool. B cell mimotopes with phage as a carrier were used to perform immunotherapy in an Alternaria allergy mouse model. Serological Ab levels, lung histology, and cytokine profiles were compared in the mimotope immunotherapy group, natural extract immunotherapy group, irrelevant phage control group, Alternaria-sensitized model group, and saline-blank group. Two mimotopes (MISTSRK and QKRNTIT) presented high binding ability with the sera of the Alternaria-allergic patients and mice and, therefore, were selected for immunotherapy in the mouse model. Compared with irrelevant phage control, model, and natural extract immunotherapy group, mimotope immunotherapy group significantly reduced serum IgE levels, inflammatory cells infiltration in the lung tissue, and IL-4 levels in bronchoalveolar lavage fluid, whereas serum IgG1 and IFN-γ levels in bronchoalveolar lavage fluid were increased. Our results indicate that B cell mimotopes of Alternaria alleviates allergic response in a mouse model and have potential as novel therapeutic agents for IgE-mediated Alternaria-allergic diseases.

Diamond-like carbon (DLC) films were deposited by electron cyclotron resonance plasma-chemical vapor deposition (ECR-CVD) at different substrate bias potential (Us = −200 and −800 V). The mechanical properties and microstructure uniformity of the DLC films deposited at different positions (the distance between substrate and ECR plasma source, Decr-s) were studied. The results showed that the ionization of acetylene (C2H2) at different positions decreased with the increase of Decr-s at substrate bias potential Us = −200 V. The plasma distribution was non-uniform, so the mechanical properties and structure of the DLC films varied a lot with the change of deposition position. At substrate bias potential Us = −800 V, an additional self-sustained discharge around the substrate could be generated during ECR plasma discharge, then the ionization of C2H2 and the plasma distribution uniformity at different positions were found to be improved. The uniformity of mechanical properties and structure of DLC films could be improved due to enhanced ionization of C2H2 in front of the substrate at high values of the negative substrate bias (Us = −800 V).

Lupus nephritis (LN) is the leading cause of mortality in lupus patients. This study aimed to investigate the treatment outcome and renal histological risk factors of LN in a tertiary referral center. Between 2006 and 2017, a retrospective observational study enrolled 148 biopsy-proven LN patients. After propensity score matching, 75 cases were included for further analysis. The classification and scoring of LN were assessed according to the International Society of Nephrology/Renal Pathology Society. Treatment response was evaluated by daily urine protein and urinalysis at two years after commencing induction treatment and the development of end-stage renal disease (ESRD). In total, 50.7% patients achieved complete remission (CR) or partial remission (PR), while 49.3% patients were categorized as nonresponders. Therapeutic responses in terms of CR/PR rates were associated with Systemic Lupus Erythematosus Disease Activity Index scores (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.12–1.60, p = 0.001). Moreover, higher baseline creatinine levels (hazard ratio (HR): 2.10, 95% CI: 1.29–3.40, p = 0.003), higher renal activity index (HR: 1.30, 95% CI: 1.07–1.58, p = 0.008) and chronicity index (HR: 1.40, 95% CI: 1.06–1.85, p = 0.017) predicted ESRD. Among pathological scores, cellular crescents (HR: 4.42, 95% CI: 1.01–19.38, p = 0.049) and fibrous crescents (HR: 5.93, 95% CI: 1.41–24.92, p = 0.015) were independent risk factors for ESRD. In conclusion, higher lupus activity was a good prognostic marker for renal remission. Renal histology was predictive of ESRD. Large-scale prospective studies are required to verify the efficacy of mycophenolate in combination with azathioprine or cyclosporine in LN patients.

Optimal target-sputtering mode for Aluminum Nitride thin film deposition by high power pulse magnetron sputtering (HPPMS)

Clustering for hyperspectral images (HSIs) is a very challenging task because HSIs usually have large spectral variability, high dimensionality, and complex structures. The main issue of this study is to develop an improved sparse subspace clustering (SSC) method for HSIs. As an extension of spectral clustering, SSC algorithm has achieved great success; however, the direct self-representation dictionary which is created by raw samples has poor representation power and also the widely used dictionary learning (DL) such as K-Singular Value Decomposition (K-SVD) faces with the problems of high computational complexity. In this study, the authors propose a novel HSI clustering method based on sparse DL and anchored regression. The proposed method follows three stages: (i) sparse DL; (ii) anchored subspace construction and regression; and (iii) representation-based spectral clustering. Specifically, we adopt a fast sparse DL method under a double sparsity constrained optimising model to capture the intrinsic HSIs. To establish a compact subspace for collaborative representation, we present an anchored subspace construction method by using atoms clustering and grouping methods. Owing to the anchored subspace, we can fast compute the representation coefficients with a predefined projection matrix. Experimental results demonstrate that the proposed method achieves the best performance for the HSIs clustering.

Objective: To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan. Method: All refractory RA patients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected. Results: A total of 114 RA patients were recruited. Despite the majority of them (93%) had previous biologic failure, 43.75% of the patients were able to reach ACR50 after one year. Serious adverse events commonly found were bacterial pneumonia (4.24/100 patient-years) followed by cellulitis (2.12/100 patient-years). Twenty-three patients had old or latent TB infections, 11 patients had chronic hepatitis B. During the 3 years follow-up, none of them had reactivation of TB, or hepatitis B with concomitant use of isoniazid prophylaxis or pre-emptive antiviral treatment. Conclusion: In this 3-year real-world study on RA patients of Taiwan, we found a good long-term effectiveness and similar safety profiles for the TCZ treatment. With prophylactic strategy for latent TB and pre-emptive antiviral treatment for HBV carriers, the risk of reactivation of latent TB and HBV may be reassured. Keywords: Hepatitis B, Rheumatoid arthritis, Safety and effectiveness, Tocilizumab, Tuberculosis

Background By combining regional homogeneity (ReHo) and functional connectivity (FC) analyses, this study aimed to explore brain functional alterations in Attenuated Psychosis Syndrome (APS), which could provide complementary information for the neurophysiological indicators for schizophrenia (SZ) associated brain dysfunction. Methods Twenty-one APS subjects and twenty healthy controls were enrolled in the data acquisition of demographics and clinical characteristics as well as structural and resting-state functional magnetic resonance imaging (rs-fMRI). ReHo analysis was conducted to determine the peak coordinate of the abnormal regional brain activity. Then, identified brain regions were considered as seed regions and were used to calculate FC between reginal brain voxels and whole brain voxels. Finally, potential correlations between imaging indices and clinical data were also explored. Results Four APS and two HC subjects were excluded because the largest dynamic translation or rotation had exceeded 2 mm / 2°. Compared with healthy controls (HCs), APS subjects exhibited higher ReHo values in the right middle temporal gyrus (MTG) and lower ReHo values in the left middle frontal gyrus (MFG), left superior frontal gyrus (SFG), left postcentral gyrus (PoCG), and left superior frontal gyrus, medial (SFGmed). Considered these areas as seed regions, the APS subjects showed abnormal enhancement in functional brain connections, predominantly in the frontal and temporal lobes. Conclusions We concluded that the APS subjects had spatially regional dysfunction and remoted synchronous dysfunction in the frontal and temporal lobes of the brain, and changes in ReHo and FC patterns may reveal the mechanism of brain dysfunctions and may serve as an imaging biomarker for the diagnosis and evaluation of SZ.

To evaluate the ability of quantitative dynamic contrast-enhanced (DCE)-MRI and readout segmentation of long variable echo-trains diffusion-weighted imaging (RESOLVE-DWI) in differentiating parotid tumors (PTs) with different histological types. In this retrospective study, 123 patients with 145 histologically proven PTs who underwent both RESOLVE-DWI and DCE-MRI were enrolled including 51 pleomorphic adenomas (PAs), 52 Warthin’s tumors (WTs), 27 other benign neoplasms (OBNs), and 15 malignant tumors (MTs). Quantitative parameters of DCE-MRI (Ktrans, Kep, and Ve) and the apparent diffusion coefficient (ADC) of lesions were calculated and analyzed. Kruskal–Wallis tests with Dunn-Bonferroni correction, logistic regression analyses, and receiver operating characteristic curve were used for statistical analyses. PAs exhibited a lowest Ktrans among these four PTs. WTs demonstrated the highest Kep and lowest Ve values. WTs and MTs showed lower ADCmin values than PAs and OBNs. The combination of Kep and Ve provided 98.1% sensitivity, 85% specificity, and 98.7% accuracy for differentiating WTs from the other three PTs. The ADCmin cutoff value of ≤ 0.826 yielded 80.0% sensitivity, 92.3% specificity, and 90.3% accuracy for the differentiation of MTs from PAs and OBNs. Ktrans with a cutoff value of ≤ 0.185 achieved a sensitivity, specificity, and accuracy of 84.3, 70.4, and 79.5%, respectively, for discriminating PAs from OBNs. The combination of quantitative DCE-MRI and RESOLVE-DWI is beneficial for characterizing four histological types of PTs.

The implications of boosting Omalizumab treatment (OT) in patients with severe allergic asthma (SAA) remain unclear. The study aimed to explore and compare the 12-month effectiveness between continuous, at least 10-month OT (continuation group) and four-month boost of Omalizumab (boost group) in adult patients with SAA. In this retrospective cohort study, clinical data were collected for further analysis. Of all participants (n = 124), a significant reduction in annual exacerbations (baseline = 0.8 ± 1.5, follow-up = 0.5 ± 1.0, p = 0.047 *) and improvement in small airway ventilation as evaluated by forced expiratory flow at 25–75% (baseline = 55.1 ± 11.1%, follow-up = 59.4 ± 8.4%, p &lt, 0.001 *) were found in the continuation group (n = 110). By contrast, the boost group (n = 14) had significantly increased annual exacerbations (baseline = 0.7 ± 1.4, follow-up = 2.9 ± 3.6, p = 0.031 *) and impaired small airway function (baseline = 55.3 ± 12.9, follow-up = 52.1 ± 12.5, p = 0.026 *). Furthermore, the continuation group rather than the boost group had significant decreases in the frequency of oral corticosteroid (OCS) use as controllers (baseline = 32.7%, follow-up = 20.0%, p = 0.047 *, baseline = 50.0%, follow-up = 21.4%, p = 0.237, respectively) and OCS maintenance dose (mg/month) (baseline = 85.9 ± 180.8, follow-up = 45.8 ± 106.6, p = 0.020 *, baseline = 171.4 ± 221.5, follow-up = 50.0 ± 104.3, p = 0.064, respectively), and increases in asthma control test scores (baseline = 16.0 ± 3.0, follow-up = 19.8 ± 4.4, p &lt, 0.001 *, baseline = 14.6 ± 3.8, follow-up = 19.7 ± 4.7, p = 0.050, respectively). Continuous OT would be beneficial for adult patients with SAA, while boost of Omalizumab would worsen their long-term outcomes.

Introduction: Seizure is a common poisoning-related neurological presentation in the emergency department (ED). Although brain computed tomography (CT) is recommended in patients presenting with first seizures, its role in patients with a suspected drug/substance-induced seizure (DSS) remains inconclusive. This study evaluated whether brain CT examination changes the management and outcome of DSS patients. Methods: We retrospectively reviewed adult patients presenting to the ED with a DSS in Linkou and Taipei Chang Gung Memorial Hospital, Taiwan, from January 2008 to December 2015. We also analyzed whether the brain CT examinations found meaningful acute abnormalities and their impact on subsequent management. We compared the differences between DSS patients undergoing CT scans or not to identify factors that affect the decision to arrange brain CT. Results: The study enrolled 97 patients (69 males). The most common cause of DSS was alcohol withdrawal (58.76%), followed by carbon monoxide (12.37%) and stimulants (8.25%). Eight (8.25%) patients developed status epilepticus, 15 (15.46%) were intubated, and 37 (37.76%) were admitted, including 12 (12.26%) to the intensive care unit. Brain CT was performed in 64 (66.0%) patients and four had abnormal reports that led to further imaging studies. The abnormal findings ultimately had no significant clinical impact. Patients who underwent CT scans had a worse Glasgow Coma Scale score (p = 0.024) and higher rate of status epilepticus (p = 0.031). Conclusion: Brain CT does not provide substantial information for the care of DSS patients. Multi-center prospective studies are needed to obtain stronger evidence.

Background/Aims: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale. Methods: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level. Result: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients. Conclusion: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.

Background Post-inflammatory hyperpigmentation (PIH) reflects a dynamic process from primary injury and cutaneous inflammation to subsequent melanogenesis and hyperpigmentation, of which pathogenesis remains unclear, hindering the development of targeted therapies. Aims To observe the dynamic development of PIH; determine the starting point and peak point of the inflammatory phase and pigmentary phase; clarify the timing of anti-inflammatory and anti-pigmentary treatment. Methods Thirty healthy volunteers with Fitzpatrick skin types III-IV were enrolled and underwent suction blisters. The non-invasive evaluation of inflammation and hyperpigmentation on suction-blister sites were performed via spectrophotometry (CM2600d and SIAscope) and RCM for the following 24 weeks. Results We successfully observed suction blister-induced PIH lasting over 24 weeks. The inflammatory phase started soon after the procedure and lasted for 8-12 weeks, manifested by significantly elevated a* values and erythema index detected by spectrophotometry, as well as inflammatory infiltration and angiogenesis shown in RCM images. Meanwhile, melanogenesis was accelerated after week 3 and reached peek on week 8, manifested by significantly accumulated melanin granules and bright pigment rings in different depths under RCM, which was in parallel with elevated melanin index. The darkening skin tone in PIH actually presented a mixture of inflammatory erythema, angiogenesis and hyperpigmentation. The inflammation and pigmentation phases of PIH were not sequential but partially overlap. Conclusion The duration of suction blister induced-PIH is more than 24 weeks. The inflammatory phase partially overlaps with the pigmentary phase, and those drugs with anti-inflammatory and anti-pigmentary dual effects are potential choices.

Introduction: The purpose of this study was to verify whether the prevalence of intracranial aneurysm (IA) in patients with acoustic neuroma is greater than that in age- and sex-matched controls and to evaluate the independent risk factors related to the occurrence of IA. Methods: We retrospectively analyzed 231 patients diagnosed with acoustic neuroma at our institute between 2015 and 2019 and 489 controls from the medical examination center. Cerebrovascular angiography was acquired from all subjects to assess the presence of IA or not. The prevalence of IA and risk factors associated with a higher IA occurrence were compared, respectively. Results: Cerebral aneurysms were detected in 23 patients (10.0%) and 11 controls (2.2%). The prevalence of IA was significantly different between patients with acoustic neuroma and controls (p < 0.001), and the difference was mainly reflected in the age of 50 and above. In the subgroup analysis, there were distinct differences in several clinical features including age, hypertension, and tumor volume, and cystic change between patients coexisted with IA or not. However, age was a unique independent risk factor for coexistence of IA in patients with acoustic neuroma after multivariate logistic regression (OR 1.050, 95% CI 1.008–1.093, p = 0.019). Conclusions: Our results demonstrate that patients with acoustic neuroma have a higher prevalence of IA than the general population. Older age is correlated with greater occurrence of IA in these patients.

Background: Drugs that affect the renin-angiotensin system, such as angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors are not typically recommended for pregnant women because of their potential fetal toxicity. Case study: A 32-year-old pregnant woman with nephrotic syndrome lasting more than 5 years became pregnant for the first time. She had been taking losartan tablets before and during pregnancy. Ultrasound at 24+2 weeks of pregnancy showed oligohydramnios, and the maximum vertical depth of amniotic fluid volume was 1.4 cm. Follow-up ultrasound examinations every 2 weeks showed persistent oligohydramnios [amniotic fluid volume: 1.1–3.4 cm, amniotic fluid index 1.9–6.9 cm]. B-ultrasound at 30+2 weeks showed slightly enhanced fetal renal cortex echo. The patient was treated at 32+2 weeks of pregnancy at our hospital. Diagnoses: Nephrotic syndrome and oligohydramnios. Interventions: Losartan was discontinued and replaced by nifedipine controlled-release tablets to lower blood pressure. The amount of amniotic fluid gradually increased to normal levels within 8 days. The patient was discharged at 33+2 weeks of pregnancy for follow-up. At 34+4 weeks, blood pressure had increased to 177/113 mm Hg and the patient was re-hospitalized with nephrotic syndrome complicated by preeclampsia. Due to progression of severe preeclampsia, elective cesarean section was performed at 35+3 weeks. After delivery, losartan and nifedipine were prescribed to continue lowering blood pressure. The patient was discharged 4 days after surgery. Outcomes: Losartan use was terminated at 32+2 weeks of pregnancy. Amniotic fluid returned to normal after 8 days and the baby was delivered after 22 days. At last follow-up, the infant was 24 months old and healthy. Conclusion: Although ARBs are effective for treating hypertension, they should be replaced by other classes of anti-hypertensive drugs in pregnant women. Pregnant women who elect to continue using ARBs should be informed about risks, they should be carefully monitored during pregnancy, and their pregnancy should be allowed to proceed as long as clinically feasible in order to optimize maternal and infant outcomes.

Clustering of hyperspectral images (HSIs) is a challenging task, due to high dimensional, unbalance data distribution and complex spectral-spatial structures. Existing methods mainly use either data spectral attribute only or spatial similarity only without gathering them appropriately. In this paper, under an extended linear discriminant analysis (LDA) framework, a new method, locally constrained collaborative representation based Fisher's LDA for clustering (LCR-FLDA), is proposed for the clustering of HSIs. We propose a New Fisher's LDA (FLDA) model by optimizing the integration of K-means-Laplacian and N-cut clustering to fully utilize the spectral-spatial discriminative representation information both in data and feature domain. Then, using locally constrained collaboration representation method to build a similarity matrix in FLDA to incorporate both local relationship structure and attribute information. Experimental results were conducted to illustrate the effectiveness of the proposed method.

Childhood trauma is a central risk factor for schizophrenia. We explored the correlation between early traumatic experiences and the functional connectivity of resting-state networks. This fMRI study included 28 first-episode schizophrenia patients and 27 healthy controls. In first-episode schizophrenia patients, higher levels of childhood trauma associated with abnormal connections of resting-state networks, and these anomalies distributed among task-positive networks (i.e., ventral attention network, dorsal-ventral attention network and frontal-parietal network), and sensory networks (i.e., visual network and auditory network). These findings mentioned that childhood traumatic experiences may impact resting-state network connectivity in adulthood, mainly involving systems related to attention and execution control.

Significance: Due to patients’ respiratory movement or involuntary body movements during breast cancer radiotherapy, the mismatched adjacent fields in surface exposure regions could result in insufficient dosage or overdose in these regions, which would lead to tissue injury, excessive skin burns, and potential death. Cherenkov luminescence imaging (CLI) could be used to effectively detect the matching information of adjacent radiation fields without extra radiation or invasive imaging. Aim: Our objective was to provide a biological experimental basis for monitoring matching of adjacent radiation fields between photon and electron fields due to introduced shifts during radiotherapy by CLI technique. Approach: A medical accelerator was used to generate photon and electron fields. An industrial camera system was adopted to image the excited CLI signal during irradiation of chicken tissue with yellow (group A and group C experiments) or black color (group B experiment). The following introduced shifts were tested: 10, 5, 2, and 0 mm toward superior or inferior direction. A model was introduced to deal with matching error analysis of adjacent radiation fields due to introduced shifts with adapted plans used to treat neoplasms of the right breast with supraclavicular nodes or internal mammary lymph node. Results: The matching values between photon and electron fields were consistent with the tested introduced shifts during yellow chicken irradiation. In group A, average discrepancies were 0.59 ± 0.35 mm and 0.68 ± 0.37 mm for photon fields and electron fields in anterior/posterior (AP) direction, with 87% and 75% of measurement within 1 mm, respectively. In group C, average discrepancies were 0.80 ± 0.65 mm and 1.07 ± 0.57 mm for oblique photon field with gantry angles of 330 deg and 150 deg, with 66% and 65% of measurement within 1 mm, respectively. The average discrepancies were 0.44 ± 0.30 mm for electron field in the AP direction, with 94% of measurement within 1 mm. The matching error introduced by the proposed method was less than 1.5 mm for AP fields and 2 mm for oblique incidence fields. However, the field matching could not be monitored with black chicken tissue irradiation due to a weak CLI signal that could hardly be extracted from background noise in group B. Conclusions: CLI is demonstrated for the quantitative monitoring of the field match line on light biological tissue phantoms and has potential for monitoring of field matching in surface tissue during breast cancer radiotherapy.