MR Cranial Bone Imaging: Evaluation of Both Motion-Corrected and Automated Deep Learning Pseudo-CT Estimated MR Images.

BACKGROUND AND PURPOSE: CT imaging exposes patients to ionizing radiation. MR imaging is radiation free but previously has not been able to produce diagnostic-quality images of bone on a timeline suitable for clinical use. We developed automated motion correction and use deep learning to generate pseudo-CT images from MR images. We aim to evaluate whether motion-corrected pseudo-CT produces cranial images that have potential to be acceptable for clinical use. MATERIALS AND METHODS: Patients younger than age 18 who underwent CT imaging of the head for either trauma or evaluation of cranial suture patency were recruited. Subjects underwent a 5-minute golden-angle stack-of-stars radial volumetric interpolated breath-hold MR image. Motion correction was applied to the MR imaging followed by a deep learning-based method to generate pseudo-CT images. CT and pseudo-CT images were evaluated and, based on indication for imaging, either presence of skull fracture or cranial suture patency was first recorded while viewing the MR imaging-based pseudo-CT and then recorded while viewing the clinical CT. RESULTS: A total of 12 patients underwent CT and MR imaging to evaluate suture patency, and 60 patients underwent CT and MR imaging for evaluation of head trauma. For cranial suture patency, pseudo-CT had 100% specificity and 100% sensitivity for the identification of suture closure. For identification of skull fractures, pseudo-CT had 100% specificity and 90% sensitivity. CONCLUSIONS: Our early results show that automated motion-corrected and deep learning-generated pseudo-CT images of the pediatric skull have potential for clinical use and offer a high level of diagnostic accuracy when compared with standard CT scans.

Biliary atresia.

Biliary atresia (BA) is a progressive inflammatory fibrosclerosing disease of the biliary system and a major cause of neonatal cholestasis. It affects 1:5,000-20,000 live births, with the highest incidence in Asia. The pathogenesis is still unknown, but emerging research suggests a role for ciliary dysfunction, redox stress and hypoxia. The study of the underlying mechanisms can be conceptualized along the likely prenatal timing of an initial insult and the distinction between the injury and prenatal and postnatal responses to injury. Although still speculative, these emerging concepts, new diagnostic tools and early diagnosis might enable neoadjuvant therapy (possibly aimed at oxidative stress) before a Kasai portoenterostomy (KPE). This is particularly important, as timely KPE restores bile flow in only 50-75% of patients of whom many subsequently develop cholangitis, portal hypertension and progressive fibrosis; 60-75% of patients require liver transplantation by the age of 18 years. Early diagnosis, multidisciplinary management, centralization of surgery and optimized interventions for complications after KPE lead to better survival. Postoperative corticosteroid use has shown benefits, whereas the role of other adjuvant therapies remains to be evaluated. Continued research to better understand disease mechanisms is necessary to develop innovative treatments, including adjuvant therapies targeting the immune response, regenerative medicine approaches and new clinical tests to improve patient outcomes.

Kinetic model-informed deep learning for multiplexed PET image separation.

BACKGROUND: Multiplexed positron emission tomography (mPET) imaging can measure physiological and pathological information from different tracers simultaneously in a single scan. Separation of the multiplexed PET signals within a single PET scan is challenging due to the fact that each tracer gives rise to indistinguishable 511 keV photon pairs, and thus no unique energy information for differentiating the source of each photon pair. METHODS: Recently, many applications of deep learning for mPET image separation have been concentrated on pure data-driven methods, e.g., training a neural network to separate mPET images into single-tracer dynamic/static images. These methods use over-parameterized networks with only a very weak inductive prior. In this work, we improve the inductive prior of the deep network by incorporating a general kinetic model based on spectral analysis. The model is incorporated, along with deep networks, into an unrolled image-space version of an iterative fully 4D PET reconstruction algorithm. RESULTS: The performance of the proposed method was evaluated on a simulated brain image dataset for dual-tracer [ 18 F]FDG+[ 11 C]MET PET image separation. The results demonstrate that the proposed method can achieve separation performance comparable to that obtained with single-tracer imaging. In addition, the proposed method outperformed the model-based separation methods (the conventional voxel-wise multi-tracer compartment modeling method (v-MTCM) and the image-space dual-tracer version of the fully 4D PET image reconstruction algorithm (IS-F4D)), as well as a pure data-driven separation [using a convolutional encoder-decoder (CED)], with fewer training examples. CONCLUSIONS: This work proposes a kinetic model-informed unrolled deep learning method for mPET image separation. In simulation studies, the method proved able to outperform both the conventional v-MTCM method and a pure data-driven CED with less training data.

Porous VN nanosheet arrays on MXene carbon fibers for flexible supercapacitors.

VN usually has poor rate performance and cycle stability. In this work, porous VN nanosheet arrays were prepared on carbon nanofibers embedded with Ti3C2Tx nanosheets by electrospinning and chemical vapor deposition. The 3D network accelerates the transfer of electrons and electrolyte ions, prevents the aggregation of VN and the self-stacking of MXene, and enhances cycle stability. The solid-state flexible device comprising Co3O4, MXCF@VN, and KOH/PVA exhibits exceptional energy densities of 83.95 W h kg-1 and robust cycling stability (82.8% retention after 20 000 cycles).

Open Versus Percutaneous Stabilization of Thoracolumbar Fractures: A Large Retrospective Analysis of Safety and Reoperation Rates.

BACKGROUND: Thoracolumbar fractures (TLF) requiring surgical intervention can be treated with either open or percutaneous stabilization, each with some distinct risks and benefits. There is insufficient evidence available to support one approach as superior. METHODS: Patients who underwent spinal fixation for TLF between 2008 and 2020 were reviewed. Patients with one or two levels of fracture treated with either open or percutaneous stabilization were included. Exclusion criteria were more than two levels of fracture, patients requiring corpectomy, stabilization constructs that crossed the cervicothoracic or lumbosacral junction, history of previous thoracolumbar fusion at the same level, spinal neoplasm, anterior or lateral fixation, and spinal infection. Demographic, operative, and clinical data were collected for all patients. RESULTS: 691 patients (377 open, 314 percutaneous) met the inclusion criteria. Patients in the percutaneous cohort sustained lower estimated blood loss (73 vs 334 ml; p< 0.001) and shorter length of surgery (114 vs. 151 minutes; p< 0.001). No differences were observed in the length of hospital stay or overall reoperation rates. Asymptomatic (7.0% vs 0.8%) and symptomatic (3.5% vs 0.5%) hardware removal was more common with the percutaneous cohort, while the incidence of revision surgery due to hardware failure requiring the extension of the construct (1.9% vs 5.8%) and infection (1.9% vs 6.4%) was greater in the open group. CONCLUSION: Percutaneous stabilization for TLF was associated with shorter operative time, less blood loss, lower infection rate, higher rates of elective hardware removal, and lower rates of hardware failure requiring extension of the construct compared to open stabilization.

Pleiotropic brain function of whirlin identified by a novel mutation.

Despite some evidence indicating diverse roles of whirlin in neurons, the functional corollary of whirlin gene function and behavior has not been investigated or broadly characterized. A single nucleotide variant was identified from our recessive ENU-mutagenesis screen at a donor-splice site in whirlin, a protein critical for proper sensorineural hearing function. The mutation (head-bob, hb) led to partial intron-retention causing a frameshift and introducing a premature termination codon. Mutant mice had a head-bobbing phenotype and significant hyperactivity across several phenotyping tests. Lack of complementation of head-bob with whirler mutant mice confirmed the head-bob mutation as functionally distinct with compound mutants having a mild-moderate hearing defect. Utilizing transgenics, we demonstrate rescue of the hyperactive phenotype and combined with the expression profiling data conclude whirlin plays an essential role in activity-related behaviors. These results highlight a pleiotropic role of whirlin within the brain and implicate alternative, central mediated pathways in its function.

Stereoselective Bioconcentration and Neurotoxicity of Perfluoroethylcyclohexane Sulfonate in Marine Medaka.

Perfluoroethylcyclohexane sulfonate (PFECHS) is an emerging per- and polyfluoroalkyl substance used to replace perfluorooctane sulfonate (PFOS), mainly in aircraft hydraulic fluids. However, previous research indicates the potential neurotoxicity of this replacement chemical. In this study, marine medaka (Oryzias melastigma) was exposed to environmentally relevant concentrations of PFECHS (concentrations: 0, 0.08, 0.26, and 0.91 µg/L) from the embryonic stage for 90 days. After exposure, the brain and eyes of the medaka were collected to investigate the bioconcentration potential of PFECHS stereoisomers and their effects on the nervous systems. The determined bioconcentration factors (BCFs) of PFECHS ranged from 324 ± 97 to 435 ± 89 L/kg and from 454 ± 60 to 576 ± 86 L/kg in the brain and eyes of medaka, respectively. The BCFs of trans-PFECHS were higher than those of cis-PFECHS. PFECHS exposure significantly altered γ-aminobutyric acid (GABA) levels in the medaka brain and disrupted the GABAergic system, as revealed by proteomics, implying that PFECHS can disturb neural signal transduction like PFOS. PFECHS exposure resulted in significant alterations in multiple proteins associated with eye function in medaka. Abnormal locomotion was observed in PFECHS-exposed medaka larvae, which was rescued by adding exogenous GABA, suggesting the involvement of disrupted GABA signaling pathways in PFECHS neurotoxicity.

Effect of Insecticide Exposure Across Multiple Generations of the Earthworm Eisenia andrei.

The toxicity of neonicotinoids and many of their replacement insecticides to nontarget soil invertebrates such as earthworms has previously been established. However, the long-term effects of these substances on these organisms are largely unknown. In the field of soil ecotoxicology, lumbricid earthworms such as Eisenia andrei are used extensively due to the availability of standardized test methods and their adaptability to laboratory culture and testing. Multigenerational studies have gained popularity and attention in recent years, with a shift toward the use of long-term assays and lower concentrations of test chemicals. The use of exposure concentrations that include those measured in a monitoring program carried out by the Government of Ontario presents a realistic exposure scenario that may not show significant effects in contemporary, shorter term studies. We used current standardized test methods as a basis for the development of multigenerational studies on E. andrei. The effects of exposure to a single application of the insecticides thiamethoxam and cyantraniliprole on the survival and reproduction of E. andrei were observed over three (thiamethoxam) or two (cyantraniliprole) generations using consecutive reproduction tests. No significant impacts on adult survival were reported in any generation for either insecticide, whereas reproduction decreased between the first and second generations in the thiamethoxam test, with median effective concentration (EC50) values of 0.022 mg/kg dry weight reported for the first generation compared with 0.002 mg/kg dry weight in the second generation. For cyantraniliprole, an EC50 of 0.064 was determined for the first generation compared with 0.016 mg/kg dry weight in the second generation. A third generation was completed for the thiamethoxam test, and a significant decrease in reproduction was observed in all treatments and controls compared with previous generations. No significant difference between thiamethoxam treatments and the control treatment was reported for the third generation. Collectively, these data indicate that exposure of oligochaetes to these two insecticides at concentrations representative of field conditions may result in long-term stresses. Environ Toxicol Chem 2024;00:1-13. © 2024 The Author(s). Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report.

Hypertension is among the most important risk factors for cardiovascular disease, chronic kidney disease, and dementia. The artificial intelligence (AI) field is advancing quickly, and there has been little discussion on how AI could be leveraged for improving the diagnosis and management of hypertension. AI technologies, including machine learning tools, could alter the way we diagnose and manage hypertension, with potential impacts for improving individual and population health. The development of successful AI tools in public health and health care systems requires diverse types of expertise with collaborative relationships between clinicians, engineers, and data scientists. Unbiased data sources, management, and analyses remain a foundational challenge. From a diagnostic standpoint, machine learning tools may improve the measurement of blood pressure and be useful in the prediction of incident hypertension. To advance the management of hypertension, machine learning tools may be useful to find personalized treatments for patients using analytics to predict response to antihypertension medications and the risk for hypertension-related complications. However, there are real-world implementation challenges to using AI tools in hypertension. Herein, we summarize key findings from a diverse group of stakeholders who participated in a workshop held by the National Heart, Lung, and Blood Institute in March 2023. Workshop participants presented information on communication gaps between clinical medicine, data science, and engineering in health care; novel approaches to estimating BP, hypertension risk, and BP control; and real-world implementation challenges and issues.

Aggravating Pollution of Emerging Aryl Organophosphate Esters in Urban Estuarine Sediments of South China.

Emerging aryl organophosphate esters (aryl-OPEs) have been employed as substitutes for organohalogen flame retardants in recent years; however, their environmental occurrence and associated impacts in urban estuarine sediments have not been adequately investigated, impeding regulatory decision-making. Herein, field-based investigations and modeling based on surface sediment and sediment core analysis were employed to uncover the historical pollution and current environmental impacts of aryl-OPEs in the Pearl River Estuary, South China. Our results revealed a substantial increase in aryl-OPE emission, particularly emerging aryl-OPEs, through sediment transport to the estuary since the 2000s. The emerging aryl-OPEs comprised 83% of the total annual input in the past decade, with an average annual input of 155,000 g. Additionally, the emerging-to-traditional aryl-OPE concentration ratios increased with decreasing distance from the shore, peaking in the highly urbanized riverine outlets. These findings indicate that inventories of emerging aryl-OPEs are likely increasing in estuarine sediments and their emissions are surpassing those of traditional aryl-OPEs. Our risk-based priority screening approach indicates that some emerging aryl-OPEs, particularly bisphenol A bis(diphenyl phosphate), can pose a higher environmental risk than traditional aryl-OPEs in estuarine sediments. Overall, our study highlights the importance of recognizing the environmental impacts of emerging aryl-OPEs.

Stable and Tunable Quantum Conductance in Spider-Silk-like Synaptic Device for Neurocomputing.

The quantum conductance (QC) behaviors in synaptic devices with stable and tunable conductance states are essential for high-density storage and brain-like neurocomputing (NC). In this work, inspired by the discontinuous transport of fluid in spider silk, a synaptic device composed of a silicon oxide nanowire network embedded with silicon quantum dots (Si-QDs@SiOx) is designed. The tunable QC behaviors are achieved in both the SET and RESET processes, and the QC states exhibit stable retention time exceeding 104 s in the synaptic device and show stable reproducibility after an interval of two months. The synaptic plasticity, including long-term potentiation/depression and Pavlovian conditioning function, is simulated based on the tunable conductance. The mechanism of stable and tunable QC behaviors is analyzed and clarified by beading effect of spider silk in Si-QDs@SiOx nanowires structure. The digit recognition capability of the device is evaluated by simulation using an artificial neural network consisting of the Si-QDs@SiOx-based synaptic device. These results provide insights into the development of neurocomputing systems with high classification accuracy.

Characterization of Springtail (Arrhopalites caecus) for Use in Soil Ecotoxicity Testing.

Springtails (subclass: Collembola) represent one of the most extensively studied invertebrate groups in soil ecotoxicology. This is because of their ease of laboratory culture, significant ecological role, and sensitivity to environmental contaminants. Folsomia candida (family: Isotomidae) is a globally widespread parthenogenetic species that is prevalent in laboratory toxicity testing with springtails. Conversely, Arrhopalites caecus (family: Arrhopalitidae), a parthenogenic globular springtail species, remains untested in soil ecotoxicology. This species is found in diverse habitats, including cave systems and forest leaf litter, and has a global distribution. The sensitivity of A. caecus to environmental contaminants, such as neonicotinoid insecticides, as well as its life history and optimal culturing conditions, are largely unknown. The present study describes the establishment of a pure A. caecus laboratory culture and characterization of its life cycle and culturing conditions. We assessed the sensitivity of A. caecus to various insecticides, including exposures to the neonicotinoid thiamethoxam in soil and through a novel feeding assay as well as to clothianidin and cyantraniliprole in spiked soil exposures. In 7- and 14-day exposures to thiamethoxam in agricultural soil, the 50% lethal concentration (LC50) values were determined to be 0.129 mg/kg dry weight and 0.010 mg/kg dry weight, respectively. The 14-day LC50 for exposure to thiamethoxam via spiked food was determined to be 0.307 mg/kg dry weight. In addition, the 28-day 50% effect concentration for inhibition of juvenile production from cyantraniliprole exposure in the same soil type was 0.055 mg/kg dry weight. Challenges encountered in using this species included susceptibility to mite infestation and low adult survival rates in the 28-day cyantraniliprole test. Environ Toxicol Chem 2024;00:1-16. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Microplastics in Hong Kong's marine waters: Impact of rainfall and Pearl River discharge.

This study provided a systematic investigation of microplastics in Hong Kong's surface marine waters during the pandemic from 2019 to 2021. Microplastics (2.07 ± 4.00 particles/m3) exhibited significant temporal variations with higher abundance in the wet season, without a consistent trend after the mandatory mask-wearing requirement was announced. The impact of pandemic restrictions on microplastic distribution was found to be relatively minor. However, significant correlations between microplastic abundances and rainfall highlighted the substantial contribution of local emissions through surface runoff. Notably, sites in closer proximity to the Pearl River Delta exhibited higher microplastic abundances, indicating their association with emission sources. The influence of rainfall and adverse weather on marine microplastic loads demonstrated different sensitivities among various locations but can generally last for one month. These results revealed the impact of seasonal rainfall on coastal microplastics and emphasized the need for efforts to reduce microplastic discharge from land-based sources.

Intimate Partner Violence and HIV Outcomes Among Women Living with HIV in Durban, South Africa.

We examined the impact of past-year intimate partner violence (IPV) on HIV outcomes among women living with HIV (WLHIV) in Durban, South Africa. We assessed past-year IPV using the WHO Violence Against Women Questionnaire. We conducted logistic regression to assess associations between demographic variables and IPV at baseline, and between IPV at baseline and longitudinal HIV outcomes. Among 235 WLHIV, 17% reported past-year emotional, physical, or sexual IPV. At baseline, HIV-disclosure to partner was associated with 4.35-fold odds of past-year IPV (95% CI 1.17-16.10) after controlling for children, education, and harmful alcohol use. In the prospective analysis, IPV was associated with not achieving the co-primary outcome of retention in care and viral suppression in univariate (OR = 2.32, 95% CI 1.04-5.18), but not in the multivariate model. In the context of rapid treatment scale-up, the high burden of IPV among WLHIV needs to be prioritized, with an emphasis on disclosure support.

Indiana's Public Health Investment Holds Insights For Other States.

Indiana has a business-friendly environment, but historical underinvestment in public health has yielded poor health outcomes. In 2023, when trust in governmental public health was strained nationwide, Indiana increased public health spending by 1,500 percent. In this article, we explain how Indiana achieved this unprecedented legislative victory for public health, describing the context, approach, and lessons learned. Specifically, an Indiana University report linking economic vitality and overall health sparked the creation of a governor's commission charged with exploring ways to address Indiana's shortcomings. Working with the Indiana Department of Health, the commission developed multisectoral coalitions and business and government partnerships, and it maintained consistent and coordinated communication with policy makers. Lessons learned included the value of uncoupling public health from partisan narratives, appointing diverse commission membership with strategically selected cochairs, involving local leaders, and ensuring local decision-making control. We believe that Indiana's approach holds insights for other states interested in strengthening public health funding in the current era.

High-sensitivity strain sensor based on an asymmetric tapered air microbubble Fabry-Pérot interferometer with an ultrathin wall.

A Fabry-Pérot interferometer (FPI) with an asymmetric tapered structure and air microbubble with an ultrathin wall is designed for high-sensitivity strain measurement. The sensor contains an air microbubble formed by two single-mode fibers (SMF) prepared by fusion splicer arc discharge, and a taper is applied to one side of the air microbubble with a wall thickness of 3.6 µm. In this unique asymmetric structure, the microbubble is more easily deformed under stress, and the strain sensitivity of the sensor is up to 15.89 pm/µÉ› as evidenced by experiments.The temperature sensitivity and cross-sensitivity of the sensor are 1.09 pm/°C and 0.069 µÉ›/°C in the temperature range of 25-200°C, respectively, thus reducing the measurement error arising from temperature variations. The sensor has notable virtues such as high strain sensitivity, low-temperature sensitivity, low-temperature cross-sensitivity, simple and safe process preparation, and low cost. Experiments confirm that the sensor has good stability and repeatability, and it has high commercial potential, especially strain measurements in complex environments.

Ultra-high sensitivity weak magnetic field detecting magnetic fluid surface plasmon resonance sensor based on a single-hole fiber.

An ultra-high sensitivity weak magnetic field detecting magnetic fluid surface plasmon resonance (SPR) sensor based on a single-hole fiber (SHF) is proposed for detecting weak magnetic fields. The sensor is constructed with a single-hole fiber in which an exclusive air hole in the cladding is embedded with a metal wire and filled with a magnetic fluid (MF) to enhance the magnetic field sensitivity. The effects of the structural parameters, embedded metals, and refractive index difference between the core and cladding on the magnetic field sensitivity and peak loss are investigated and optimized. The sensitivity, resolution, figure of merit (FOM), and other characteristics of the sensor are analyzed systematically. The numerical results reveal a maximum magnetic field sensitivity of 451,000 pm/mT and FOM of 15.03 mT-1. The ultra-high magnetic field sensitivity renders the sensor capable of detecting weak magnetic fields at the pT level for the first time, in addition to a detection range from 3.5 mT to 17 mT. The SHF-SPR magnetic field sensor featuring high accuracy, simple structure, and ease of filling has immense potential in applications such as mineral resource exploration as well as geological and environmental assessment.

Current approaches for diagnosis of subclinical pulmonary tuberculosis, clinical implications and future perspectives: a scoping review.

INTRODUCTION: Subclinical tuberculosis (TB) is the presence of TB disease among people who are either asymptomatic or have minimal symptoms. AREAS COVERED: Currently, there are no accurate diagnostic tools and clear treatment approaches for subclinical TB. In this study, a comprehensive literature search was conducted across major databases. This review aimed to uncover the latest advancements in diagnostic approaches, explore their clinical implications, and outline potential future perspectives. While innovative technologies are in development to enable sputum-free TB tests, there remains a critical need for precise diagnostic tools tailored to the unique characteristics of subclinical TB. Given the complexity of subclinical TB, a multidisciplinary approach involving clinicians, microbiologists, epidemiologists, and public health experts is essential. Further research is needed to establish standardized diagnostic criteria and treatment guidelines specifically tailored for subclinical TB, acknowledging the unique challenges posed by this elusive stage of the disease. EXPERT OPINION: Efforts are needed for the detection, diagnosis, and treatment of subclinical TB. In this review, we describe the importance of subclinical TB, both from a clinical and public health perspective and highlight the diagnostic and treatment gaps of this stage.