A Novel Deep Learning-based Artificial Intelligence System for Interpreting Urolithiasis in Computed Tomography.

BACKGROUND AND OBJECTIVE: Our aim was to develop an artificial intelligence (AI) system for detection of urolithiasis in computed tomography (CT) images using advanced deep learning capable of real-time calculation of stone parameters such as volume and density, which are essential for treatment decisions. The performance of the system was compared to that of urologists in emergency room (ER) scenarios. METHODS: Axial CT images for patients who underwent stone surgery between August 2022 and July 2023 comprised the data set, which was divided into 70% for training, 10% for internal validation, and 20% for testing. Two urologists and an AI specialist annotated stones using Labelimg for ground-truth data. The YOLOv4 architecture was used for training, with acceleration via an RTX 4900 graphics processing unit (GPU). External validation was performed using CT images for 100 patients with suspected urolithiasis. KEY FINDINGS AND LIMITATIONS: The AI system was trained on 39 433 CT images, of which 9.1% were positive. The system achieved accuracy of 95%, peaking with a 1:2 positive-to-negative sample ratio. In a validation set of 5736 images (482 positive), accuracy remained at 95%. Misses (2.6%) were mainly irregular stones. False positives (3.4%) were often due to artifacts or calcifications. External validation using 100 CT images from the ER revealed accuracy of 94%; cases that were missed were mostly ureterovesical junction stones, which were not included in the training set. The AI system surpassed human specialists in speed, analyzing 150 CT images in 13 s, versus 38.6 s for evaluation by urologists and 23 h for formal reading. The AI system calculated stone volume in 0.2 s, versus 77 s for calculation by urologists. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our AI system, which uses advanced deep learning, assists in diagnosing urolithiasis with 94% accuracy in real clinical settings and has potential for rapid diagnosis using standard consumer-grade GPUs. PATIENT SUMMARY: We developed a new AI (artificial intelligence) system that can quickly and accurately detect kidney stones in CT (computed tomography) scans. Testing showed that this system is highly effective, with accuracy of 94% for real cases in the emergency department. It is much faster than traditional methods and provides rapid and reliable results to help doctors in making better treatment decisions for their patients.

Silver Nanowire Network Hybridized with Silver Nanoparticle-Anchored Ruthenium Oxide Nanosheets for Foldable Transparent Conductive Electrodes.

Facile strategies in flexible transparent conductive electrode materials that can sustain their electrical conductivities under 1 mm-scale radius of curvature are required for wider applications such as foldable devices. We propose a rational design as well as a fabrication process for a silver nanowire-based transparent conductive electrode with low sheet resistance and high transmittance even after prolonged cyclic bending. The electrode is fabricated on a poly(ethylene terephthalate) film through the hybridization of silver nanowires with silver nanoparticles-anchored RuO2 nanosheets. This hybridization significantly improves the performance of the silver nanowire network under severe bending strain and creates an electrically percolative structure between silver nanowires and RuO2 nanosheets in the presence of anchored silver nanoparticles on the surface of RuO2 nanosheets. The resistance change of this hybrid transparent conductive electrode is 8.8% after 200,000 bending cycles at a curvature radius of 1 mm, making it feasible for use in foldable devices.

Low diffuse reflection of silver nanowire/ruthenium oxide nanosheet hybrid films for high-performance transparent flexible electrodes.

Transparent conducting electrodes (TCEs) based on silver nanowire (AgNW) networks possess high conductance, transmittance, and mechanical flexibility. However, due to the relatively high diffuse reflection of incident light on AgNWs, they cannot be practically implemented in displays requiring low pattern visibility. One promising strategy for solving this problem is to place an optical stack with high refractive index underneath the AgNW layer. In this work, AgNW-RuO2 nanosheet hybrid TCEs with low diffuse reflections are fabricated using metallic RuO2 nanosheets as undercoats. As predicted by theoretical simulations, RuO2 nanosheets with high refractive indices reduce the diffuse reflections of AgNWs by almost 8%. Moreover, after the partial etching of AgNWs, the difference in the diffuse reflections of their etched and non-etched regions becomes equal to about 0.003, leading to the formation of an invisible pattern. The film consisting of micro-sized RuO2 nanosheets is not damaged during etching, but instead forms a current path between different AgNWs broken by cyclic bending, resulting in a tenfold decrease in the resistance of the AgNW TCE after 170 000 cycles. Further, RuO2 nanosheets suppress the diffusion of humid air from the outside, thus improving the environmental stability of the AgNW-RuO2 nanosheet hybrid TCEs.

Rhinogenic Headache: Standardization of Terminologies Used for Headaches Arising From Problems in the Nose and Nasal Cavity.

OBJECTIVE: The use of different expressions between physicians frequently results in confusion in the process of diagnosis and treatment of patients with headaches due to problems in the nose and nasal cavity. The aim of this study was to assess the terminologies that have been used most frequently to standardize these terminologies. METHODS: Terminologies that are most frequently used in general, including rhinogenic migraine, sinus headache, rhinogenic contact point headache, middle turbinate headache syndrome, and rhinogenic headache, were found by searching PubMed, Web of Science, and Google Scholar. These terminologies were objectively assessed on the basis of existing research and definitions and the range of diagnoses by organizations with public credibility. RESULTS: There were many terminologies in use for headache related to nose; however, these were not logical expressions and only partly explained the phenomenon. Among the terms, "rhinogenic headache" was most appropriate in expressing and describing the related symptoms. CONCLUSION: The results indicated that the term "rhinogenic headache" is most appropriate for describing pain in the nose and eyes in patients with deformation within the nose or the nasal cavity due to external injuries or underlying diseases related to nose as observed on computed tomography.

Correlation between dermal thickness and scar formation in female patients after thyroidectomy.

BACKGROUND: Minimizing scarring has long been a challenge in plastic surgery. Factors affecting scar formation are well known, but the effect of some patient-specific factors such as dermal thickness remains unverified. Management of factors predictive of scarring can improve postoperative patient satisfaction and scar treatment. METHODS: For 3 years, we used ultrasonography to measure dermal thickness in female patients who had undergone thyroidectomy for cancer at our hospital. We confirmed the influence of dermal thickness on hypertrophic scar formation and the Patient and Observer Scar Assessment Scale scar score 6 months after surgery. RESULTS: There was a positive correlation between dermal thickness and scar score (p<0.05), and dermal thickness appears to be a cause of hypertrophic scar formation (p<0.05). CONCLUSION: Thick dermis was found to cause poor scar formation and hypertrophic scarring. Prediction of factors that can influence scar formation can be used to educate patients before surgery and can help in scar management and improvement in patient satisfaction.

Novel Flexible Transparent Conductive Films with Enhanced Chemical and Electromechanical Sustainability: TiO2 Nanosheet-Ag Nanowire Hybrid.

Flexible transparent conductive films (TCFs) of TiO2 nanosheet (TiO2 NS) and silver nanowire (Ag NW) network hybrid were prepared through a simple and scalable solution-based process. The as-formed TiO2 NS-Ag NW hybrid TCF shows a high optical transmittance (TT: 97% (90.2% including plastic substrate)) and low sheet resistance (Rs: 40 Ω/sq). In addition, the TiO2 NS-Ag NW hybrid TCF exhibits a long-time chemical/aging and electromechanical stability. As for the chemical/aging stability, the hybrid TCF of Ag NW and TiO2 NS reveals a retained initial conductivity (ΔRs/Rs < 1%) under ambient oxidant gas over a month, superior to that of bare Ag NW (ΔRs/Rs > 4000%) or RuO2 NS-Ag NW hybrid (ΔRs/Rs > 200%). As corroborated by the density functional theory simulation, the superb chemical stability of TiO2 NS-Ag NW hybrid is attributable to the unique role of TiO2 NS as a barrier, which prevents Ag NW's chemical corrosion via the attenuated adsorption of sulfidation molecules (H2S) on TiO2 NS. With respect to the electromechanical stability, in contrast to Ag NWs (ΔR/R0 ∼ 152.9%), our hybrid TCF shows a limited increment of fractional resistivity (ΔR/R0 ∼ 14.4%) after 200 000 cycles of the 1R bending test (strain: 6.7%) owing to mechanically welded Ag NW networks by TiO2 NS. Overall, our unique hybrid of TiO2 NS and Ag NW exhibits excellent electrical/optical properties and reliable chemical/electromechanical stabilities.

Enhancing the sialylation of recombinant EPO produced in CHO cells via the inhibition of glycosphingolipid biosynthesis.

Sialylation regulates the in vivo half-life of recombinant therapeutic glycoproteins, affecting their therapeutic efficacy. Levels of the precursor molecule cytidine monophospho-N-acetylneuraminic acid (CMP-Neu5Ac) are considered a limiting factor in the sialylation of glycoproteins. Here, we show that by reducing the amount of intracellular CMP-Neu5Ac consumed for glycosphingolipid (GSL) biosynthesis, we can increase the sialylation of recombinant human erythropoietin (rhEPO) produced in CHO cells. Initially, we found that treating CHO cells with a potent inhibitor of GSL biosynthesis increases the sialylation of the rhEPO they produce. Then, we established a stable CHO cell line that produces rhEPO in the context of repression of the key GSL biosynthetic enzyme UDP-glucose ceramide glucosyltransferase (UGCG). These UGCG-depleted cells show reduced levels of gangliosides and significantly elevated levels of rhEPO sialylation. Upon further analysis of the resulting N-glycosylation pattern, we discovered that the enhanced rhEPO sialylation could be attributed to a decrease in neutral and mono-sialylated N-glycans and an increase in di-sialylated N-glycans. Our results suggest that the therapeutic efficacy of rhEPO produced in CHO cells can be improved by shunting intracellular CMP-Neu5Ac away from GSL biosynthesis and toward glycoprotein sialylation.

Strong enhancement of electrical conductivity in two-dimensional micrometer-sized RuO2 nanosheets for flexible transparent electrodes.

The enhancement in electrical transport properties of exfoliated individual RuO2 NSs was systemically investigated for their application in flexible electronics and optoelectronics. Decoration of Ag NPs on the surface of the RuO2 NSs provides donor electrons and dramatically increases the electrical conductivity of the monolayer RuO2 NSs by up to 3700%. The n-type doping behavior was confirmed via Hall measurement analysis of the doped RuO2 NSs. The layer number- and temperature-dependence of the conductivity were also investigated. Moreover, carrier concentration and mobility were obtained from Hall measurements, indicating that the undoped RuO2 NSs had ambipolar transport and semi-metallic characteristics. Moreover, the Ag-doped RuO2 NS multilayer films on polycarbonate substrates were demonstrated by the Langmuir-Blodgett assembly methods, showing one-third reduction in the sheet resistance and extraordinarily high bending stability that the change in the resistance was less than 1% over 50 000 cycles.

Silver nanowires decorated with silver nanoparticles for low-haze flexible transparent conductive films.

Silver nanowires have attracted much attention for use in flexible transparent conductive films (TCFs) due to their low sheet resistance and flexibility. However, the haze was too high for replacing indium-tin-oxide in high-quality display devices. Herein, we report flexible TCFs, which were prepared using a scalable bar-coating method, with a low sheet resistance (24.1 Ω/sq at 96.4% transmittance) and a haze (1.04%) that is comparable to that of indium-tin-oxide TCFs. To decrease the haze and maintain a low sheet resistance, small diameter silver nanowires (~20 nm) were functionalized with low-temperature surface-sintering silver nanoparticles (~5 nm) using bifunctional cysteamine. The silver nanowire-nanoparticle ink stability was excellent. The sheet resistance of the TCFs was decreased by 29.5% (from 34.2 to 24.1 Ω/sq) due to the functionalization at a low curing temperature of 85 °C. The TCFs were highly flexible and maintained their stability for more than 2 months and 10,000 bending cycles after coating with a protective layer.

Low-visibility patterning of transparent conductive silver-nanowire films.

A partial etching mechanism is proposed to meet the requirement for low-visibility patterning of silver nanowire (AgNW)-based transparent conductive electrodes (TCEs) by reducing the difference in optical properties between conductive and nonconductive regions of the pattern. Using the finite difference time domain (FDTD) method, etched geometries that provide the smallest difference in transmittance after etching are theoretically determined. A sodium hypochlorite-based etchant capable that allows the etched geometry to be varied by controlling the pH is used to create a low-visibility pattern with a transmittance and haze difference of 0.07 and 0.04%, respectively. To the best of our knowledge, this is the first time that a partial etching mechanism such as this has been studied in relation to AgNW-based TCEs.

Effect of mild-thiol reducing agents and alpha2,3-sialyltransferase expression on secretion and sialylation of recombinant EPO in CHO cells.

We have previously reported that N-acetylcysteine (NAC) not only delayed apoptosis but also enhanced the production of recombinant erythropoietin (EPO) in Chinese hamster ovary (CHO) cell culture. To investigate the production enhancement mechanism, the effects of similar thiolreducing agents were studied. Intriguingly, all mild reducing agents examined including mercaptoethanesulfonic acid (MESNA), thiolactic acid (TLA), and thioglycolate (TG) were shown to block apoptosis and increase EPO production. A pulse-chase study of EPO secretion revealed that all four thiol-reducing agents increased the EPO secretion rate; among them TLA showed the highest rate. In terms of product quality, the sialic acid content of the glycoprotein is one of the most important factors. It was reported that a number of glycoproteins produced by CHO cells often have incomplete sialylation, particularly under high-producing conditions. Human alpha2,3-sialyltransferase (alpha2,3-ST) was introduced into EPO-producing CHO cells in order to compensate for the reduced sialylation during supplementation with NAC. When alpha2,3-ST was expressed in the presence of NAC, reduced sialylation was restored and an even more sialylated EPO was produced. Thus, our study is significant in that it offers increased EPO production while still allowing the prevention of decreased sialylation of EPO.

Globoside promotes activation of ERK by interaction with the epidermal growth factor receptor.

BACKGROUND: Globoside (Gb4), a globo-series glycosphingolipid (GSL), has been characterized as a stage-specific embryonic antigen (SSEA), and is highly expressed during embryogenesis as well as in cancer tissues. However, the functional role and molecular mechanism of Gb4 are so far unknown. METHODS: GSLs were preferentially inhibited by treatment with D-threo-1-ethylenedioxyphenyl-2-palmitoylamino-3-pyrrolidino-1-propanol (EtDO-P4), a nanomolar inhibitor of GSL synthesis, in two carcinoma cell lines, HCT116 and MCF7. The effect of EtDO-P4 was examined by MTT assay, FACS, wound assay, western blotting, and RTK array analysis. The functional role of Gb4 was determined by the exogenous addition of various GSLs, and an assay utilizing GSL-coated latex beads. RESULTS: Both cell lines contained higher levels of neutral GSLs than of sialic acid-containing GSLs. Gb4 was one of the major neutral GSLs. The depletion of total GSLs caused significant reduction of cell proliferation, but had less effect on cell apoptosis or motility. EtDO-P4 treatment also suppressed activation of the epidermal growth factor receptor (EGFR)-induced ERK pathway and various receptor tyrosine kinases (RTKs). The reduced activation of ERK was restored by the exogenous addition of Gb4, but not by the addition of gangliosides (GM1, GM2, GM3, and GD1a). The GSL-coated bead assay indicated that Gb4 forms a complex with EGFR, but not with other RTKs. Taken together, Gb4 promotes activation of EGFR-induced ERK signaling through direct interaction with EGFR. GENERAL SIGNIFICANCE: A globo-series GSL, Gb4, promotes EGFR-induced MAPK signaling, resulting in cancer cell proliferation. These findings suggest a possible application of Gb4 in cancer diagnostics and drug targeting.

Aldehyde-functionalized, water-soluble poly(para-phenylene): synthesis and streptavidin assay using FRET.

We have attempted to synthesize water-soluble poly(para-phenylene) derivative, poly{[2,5-bis(3-sulfonatobutoxy)-1,4-phenylene sodium salt]-alt-(1,4-phenylene)} (PPP-SO3). Aldehyde groups, versatile functional intermediate groups for immobilization of biomolecules, were introduced at both ends of PPP-SO3 chain to produce PPP-SO3-CHO. PPP-SO3-CHO showed good solubility in aqueous solution and blue emission color, which was expected as an energy donor in FRET mechanism. Biotin was attached to the polymer end groups via imine linkage to use as a ligand for streptavidin immobilization. The biotin coupled with polymer chain enables the polymer to bind with FITC-streptavidin leading to energy transfer from the blue-emitting polymer to green-emitting FITC via FRET.