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Objective To obtain guiding recommendations for the development of fertility preservation in female patients of reproductive age,so as to promote the scientific,standardized and orderly implementation of fertility preservation work.Methods A previous questionnaire survey was used to determine the preliminary recommendations,a modified Delphi method was used to invite 18 domestic experts of fertility preservation to conduct two rounds of expert consultation.Then we adjusted and summarized recommendations according to the results of the consultation.Results Finally,14 guiding recommendations for the development of fertility preservation in female patients of reproductive age were obtained according to the results of the Delphi consultation,including 5 recommendations at technical level,5 recommendations at political level and 4 recommendations at educational level.At technical level,it was proposed to establish a standardized operation process;at political level,it was proposed to improve the relevant legislation of fertility preservation in China to protect the safety and interests of patients;at educational level,it was suggested to take various forms to promote the mass dissemination of fertility preservation knowledge.Conclusion Guiding recommendations for fertility preservation in female patients of reproductive age can provide detailed and comprehensive guidance for promoting fertility preservation in female patients of reproductive age in Shanghai,and provide reference for carrying out fertility preservation in other regions.
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Dry eye(DE)is a multifactorial chronic ocular surface disease.Patients often report pain,with inflamma-tion being one of the primary causes of ocular surface pain in DE.Anti-inflammation is the most critical tool in the treat-ment of DE.The latest inflammatory diagnosis and treatment specifications for DE are detailed in the Diagnosis,Manage-ment and Treatment of Inflammation in Dry Eye:Recommendations of the European Expert Working Group on the Man-agement of Infllammation in Dry Eye.This article provides a comprehensive interpretation of the consensus,aiming to im-prove the diagnosis and treatment levels of DE among medical practitioners and better serve ophthalmic patients.
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Objective To study the brain functional connectivity(FC)changes in patients with normal tension glau-coma(NTG)and healthy volunteers using FC technique of resting-state functional magnetic resonance imaging(rs-fMRI)based on V1 region seed point(ROI),so as to explore the pathogenesis and early diagnosis of NTG.Methods Fourteen NTG patients(NTG group)who met the inclusion criteria and 14 healthy controls(HCs group)were enrolled.The clinical data of all subjects were collected,and rs-fMRI was performed in both groups.The magnetic resonance data was pre-pro-cessed by software,and bilateral A1 regions were taken as the ROI to analyze their correction with the whole brain voxel time series and obtain the FC value between the ROI and the whole brain by comparison of FC values in resting state be-tween the groups.Pearson correlation analysis was used to explore the relationship between FC value in the brain regions with significant differences with the ROI and clinical variables in the NTG group.Results Compared with the subjects in the HCs group,there were no statistically significant differences in age,gender,body weight,cup-disc ratio and 24 h mean intraocular pressure of patients in the NTG group(all P>0.05),and there were statistically significant differences in the best corrected visual acuity(BCVA)of both eyes and peripapillary retinal nerve fiber layer thickness(RNFLT)(all P<0.05).The Pearson correlation analysis showed that FC value of the brain regions with abnormal FC to V1 region were cor-related with RNFLT in the NTG group(P<0.05).ROI1-left superior frontal gyrus,ROI1-right superior frontal gyrus,ROI2-left cingulate gyrus and ROI2-right middle frontal gyrus were significantly positively correlated with RNFLT(all P<0.05).Compared with the HCs group,the brain regions with reduced FC to the right ROI in the NTG group were the left superior frontal gyrus and right superior frontal gyrus;the brain regions with reduced FC to the left ROI were the left cingulate gyrus and right middle frontal gyrus.Conclusion Compared to healthy individuals,NTG patients have significant changes in the functional connections between certain specific brain regions and V1 region,including bilateral superior frontal gyrus,left cingulate gyrus,and middle frontal gyrus.The changes in brain functional activity may be caused by visual dysfunction caused by NTG,leading to functional impairment of the visual and cognitive emotion processing brain regions,which may be one of the potential neuropathological mechanisms in NTG patients.
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The prevalence of myopia is substantial in China,significantly impacting children's visual health.Current research indicates that extended screen time and inadequate outdoor activities are pivotal factors contributing to childhood myopia.These risk factors are closely associated with light parameters,including intensity,duration,frequency and spec-trum.Moreover,inappropriate nighttime lighting can disturb children's circadian rhythms and sleep and contribute to myo-pia development.This study reviews clinical research and epidemiological data on screen time,outdoor activities,light properties and circadian rhythms,aiming to offer recommendations and guidance for preventing myopia in children.
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Neurotrophic keratopathy (NK) is a degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia and even blindness.Traditional NK treatments aim at supporting corneal healing and preventing progression of corneal damage.In recent years, corneal neurotization has made some progress in NK.Compared with traditional treatment, it can not only solve the problem of corneal nerve defect, and avoid the subsequent keratopathy, but also significantly restore corneal sensitivity, corneal epithelium and vision.Corneal neurotization surgery methods are mainly divided into direct corneal neurotization (DCN) and inderect corneal neurotization (ICN).At present, this surgical method has gradually been used clinically, and has achieved satisfactory effects on unilateral NK caused by herpes virus and neuroma, as well as bilateral NK.However, it is little known about the surgical treatment of NK caused by dry eye, diabetes, and chronic glaucoma.In the future, multi-center prospective randomized studies can be conducted to further improve the treatment of NK with other causes.This article introduces this new surgical technique from three aspects, the specific surgical procedures of corneal neurotization, the selection of surgical methods, and the timing of the operation.
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Due to their prolonged exposure to the external environment, eyes are susceptible to various infectious diseases of the ocular surface.In recent years, the resistance of pathogens to antimicrobial agents has led to poor treatment outcomes and significant deterioration in patients' vision and quality of life.Nowadays, ocular surface infectious diseases have become a global public health concern, necessitating the search for a safe and effective treatment.Antimicrobial peptides (AMPs), which act as antibiotic analogues, exhibit broad-spectrum antibacterial activity and are effective against a range of microbial infections, including bacteria, viruses, fungi, and parasites.AMPs play a crucial role in combating ocular surface infections.This review discusses the structure and function of AMPs, the mechanism of action of AMPs in ocular surface infections, the role of endogenous AMPs in fighting various ocular surface pathogens, the impact of exogenously induced AMPs on ocular surface infections, and recent research advances in AMPs.
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AIM: To evaluate the performance of three distinct large language models(LLM), including GPT-3.5, GPT-4, and PaLM2, in responding to queries within the field of ophthalmology, and to compare their performance with three different levels of medical professionals: medical undergraduates, master of medicine, and attending physicians.METHODS: A total of 100 ophthalmic multiple-choice tests, which covered ophthalmic basic knowledge, clinical knowledge, ophthalmic examination and diagnostic methods, and treatment for ocular disease, were conducted on three different kinds of LLM and three different levels of medical professionals(9 undergraduates, 6 postgraduates and 3 attending physicians), respectively. The performance of LLM was comprehensively evaluated from the aspects of mean scores, consistency and confidence of response, and it was compared with human.RESULTS: Notably, each LLM surpassed the average performance of undergraduate medical students(GPT-4:56, GPT-3.5:42, PaLM2:47, undergraduate students:40). Specifically, performance of GPT-3.5 and PaLM2 was slightly lower than those of master's students(51), while GPT-4 exhibited a performance comparable to attending physicians(62). Furthermore, GPT-4 showed significantly higher response consistency and self-confidence compared with GPT-3.5 and PaLM2.CONCLUSION: LLM represented by GPT-4 performs well in the field of ophthalmology, and the LLM model can provide clinical decision-making and teaching aids for clinicians and medical education.
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Orbital disorders include conditions originating from the orbital bones, surrounding tissues, and post-orbital septum. They also include systemic ailments affecting the orbit. Different clinical symptoms make up the complex range of orbital disorders. Because these disorders mostly impact the orbital area instead of the intraocular compartment, there is little diagnostic usefulness for typical ophthalmic visual tests. As such, the primary instruments for diagnosing and evaluating orbital illnesses have become ophthalmic imaging modalities, including ocular ultrasonography(B-scan), computed tomography(CT), and magnetic resonance imaging(MRI). One way to improve the precision and promptness of diagnosing orbital diseases is to standardize the functioning of widely used imaging equipment and define the radiological features of orbital abnormalities. Such programs are crucial for the care of patients with orbital disorders since they considerably reduce the number of misdiagnoses and missed diagnoses in these individuals. The underlying concepts, operational techniques, and normal and pathological imaging findings associated with common diagnostic tools for orbital illnesses are all thoroughly reviewed in this guideline. The objective is to improve primary healthcare settings' diagnostic competence in the field of orbital pathology and to standardize procedures for diagnosing orbital disorders.
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The G-protein-coupled receptor GPR84, activated by medium-chain fatty acids, primarily expressed in macrophages and microglia, is involved in inflammatory responses and retinal development in mammals and amphibians. However, our understanding of its structure, function, tissue expression, and signaling pathways in fish is limited. In this study, we cloned and characterized the coding sequence of GPR84 (ciGPR84) in grass carp. A phylogenetic analysis revealed its close relationship with bony fishes. High expression levels of GPR84 were observed in the liver and spleen. The transfection of HEK293T cells with ciGPR84 demonstrated its responsiveness to medium-chain fatty acids and diindolylmethane (DIM). Capric acid, undecanoic acid, and lauric acid activated ERK and inhibited cAMP signaling. Lauric acid showed the highest efficiency in activating the ERK pathway, while capric acid was the most effective in inhibiting cAMP signaling. Notably, DIM did not activate GPR84 in grass carp, unlike in mammals. These findings provide valuable insights for mitigating chronic inflammation in grass carp farming and warrant further exploration of the role of medium-chain fatty acids in inflammation regulation in this species.
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OBJECTIVE: Body fluid mixtures are complex biological samples that frequently occur in crime scenes, and can provide important clues for criminal case analysis. DNA methylation assay has been applied in the identification of human body fluids, and has exhibited excellent performance in predicting single-source body fluids. The present study aims to develop a methylation SNaPshot multiplex system for body fluid identification, and accurately predict the mixture samples. In addition, the value of DNA methylation in the prediction of body fluid mixtures was further explored. METHODS: In the present study, 420 samples of body fluid mixtures and 250 samples of single body fluids were tested using an optimized multiplex methylation system. Each kind of body fluid sample presented the specific methylation profiles of the 10 markers. RESULTS: Significant differences in methylation levels were observed between the mixtures and single body fluids. For all kinds of mixtures, the Spearman's correlation analysis revealed a significantly strong correlation between the methylation levels and component proportions (1:20, 1:10, 1:5, 1:1, 5:1, 10:1 and 20:1). Two random forest classification models were trained for the prediction of mixture types and the prediction of the mixture proportion of 2 components, based on the methylation levels of 10 markers. For the mixture prediction, Model-1 presented outstanding prediction accuracy, which reached up to 99.3% in 427 training samples, and had a remarkable accuracy of 100% in 243 independent test samples. For the mixture proportion prediction, Model-2 demonstrated an excellent accuracy of 98.8% in 252 training samples, and 98.2% in 168 independent test samples. The total prediction accuracy reached 99.3% for body fluid mixtures and 98.6% for the mixture proportions. CONCLUSION: These results indicate the excellent capability and powerful value of the multiplex methylation system in the identification of forensic body fluid mixtures.
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INTRODUCTION: Due to the improved overall survival and life expectancy of older women with breast cancer, cardiovascular disease (CVD) arose as the primary cause of non-cancer-related deaths in this population. Therefore, assessing the health-related quality of life (HRQoL) of breast cancer patients with comorbid CVD is becoming increasingly vital. Our study aimed to evaluate the association between comorbid CVD and HRQoL among older women with early-stage breast cancer who are receiving adjuvant endocrine therapy (AET) in the United States. MATERIALS AND METHODS: We conducted a retrospective cohort study using the 2006-2017 Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data. We identified female patients over the age of 65 who were diagnosed with stage I-III hormone receptor-positive breast cancer and treated with AET. HRQoL was assessed by the physical and mental component summary (PCS & MCS) in the health survey. CVD was defined as a history of acute myocardial infarction (AMI), congestive heart failure (CHF), angina, stroke, or other heart-related conditions. We performed multivariate linear regression models while controlling for covariates. RESULTS: Among 3,904 older women, a history of CHF [ß = -1.97, p = 0.025], stroke [ß = -3.00, p < 0.010], or other heart-related condition [ß = -1.10, p = 0.046] was significantly associated with lower PCS. However, no significant differences in PCS scores were found between women with a history of AMI or angina and those without these conditions. Having a history of CHF [ß = -1.72, p = 0.033] or stroke [ß = -1.48, p = 0.038] was significantly associated with lower MCS, whereas a history of angina, AMI, or other heart conditions was not associated with significant differences in MCS. Our study did not observe any significant differences in PCS and MCS between the two types AETs. DISCUSSION: The study found that older women with early-stage breast cancer who were being treated with AETs had a lower HRQoL if they had a history of CHF or stroke. These comorbidities were identified as strong predictors for decreased HRQoL. The findings highlight the significance of managing cardiovascular diseases in such patients for better HRQoL while they receive AET treatment.
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Breast Neoplasms , Cardiovascular Diseases , Heart Failure , Myocardial Infarction , Stroke , Humans , Female , Aged , United States , Quality of Life , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Cardiovascular Diseases/epidemiology , Retrospective Studies , MedicareABSTRACT
The multiple metastable excited states provided by excited-state intramolecular proton transfer (ESIPT) molecules are beneficial to bring temperature-dependent and color-tunable long persistent luminescence (LPL). Meanwhile, ESIPT molecules are intrinsically suitable to be modulated as D-π-A structure to obtain both one/two-photon excitation and LPL emission simultaneously. Herein, we report the rational design of a dynamic CdII coordination polymer (LIFM-106) from ESIPT ligand to achieve the above goals. By comparing LIFM-106 with the counterparts, we established a temperature-regulated competitive relationship between singlet excimer and triplet LPL emission. The optimization of ligand aggregation mode effectively boost the competitiveness of the latter. In result, LIFM-106 shows outstanding one/two-photon excited LPL performance with wide temperature range (100-380â K) and tunable color (green to red). The multichannel radiation process was further elucidated by transient absorption and theoretical calculations, benefiting for the application in anti-counterfeiting systems.
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Photocatalytic reduction of excess CO2 in the atmosphere to value-added chemicals by visible light can be an effective solution to fuel shortage and global warming. Considering these issues, we designed and successfully synthesized a trinuclear Re(I)-coordinated organic cage (Re-C4R) as the supramolecular photocatalyst. Photophysical, electrochemical properties, and photocatalytic performance comparison of Re-C4R and its mononuclear analogue Re-bpy are discussed in detail. Notably, the covalent linkage of three Re(I) subunits in Re-C4R leads to TONCO = 691 (per Re(I) site in 4 h) more than three times as much as TONCO = 208 of Re-bpy. Compared to Re-bpy, higher current enhancement in the control CV experiments under CO2 was observed for Re-C4R. CO2 adsorption process can be promoted because of the cryptand structure and multiple amine groups of Re-C4R. Moreover, decay lifetimes of Re-C4R are shorter than those of Re-bpy in the ultrafast transient absorption (TA) and photoluminescence (PL) decay spectra, indicating that the trinuclear cryptate structure of Re-C4R could facilitate electron transfer efficiency during CO2 reduction.
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INTRODUCTION: The objective of this systematic review is to summarize the use of machine learning (ML) in predicting overall survival (OS) in patients with bladder cancer. METHODS: Search terms for bladder cancer, ML algorithms, and mortality were used to identify studies in PubMed and Web of Science as of February 2022. Notable inclusion/exclusion criteria contained the inclusion of studies that utilized patient-level datasets and exclusion of primary gene expression-related dataset studies. Study quality and bias were assessed using the International Journal of Medical Informatics (IJMEDI) checklist. RESULTS: Of the 14 included studies, the most common algorithms were artificial neural networks (n = 8) and logistic regression (n = 4). Nine articles described missing data handling, with five articles removing patients with missing data entirely. With respect to feature selection, the most common sociodemographic variables were age (n = 9), gender (n = 9), and smoking status (n = 3), with clinical variables most commonly including tumor stage (n = 8), grade (n = 7), and lymph node involvement (n = 6). Most studies (n = 10) were of medium IJMEDI quality, with common areas of improvement being the descriptions of data preparation and deployment. CONCLUSIONS: ML holds promise for optimizing bladder cancer care through accurate OS predictions, but challenges related to data processing, feature selection, and data source quality must be resolved to develop robust models. While this review is limited by its inability to compare models across studies, this systematic review will inform decision-making by various stakeholders to improve understanding of ML-based OS prediction in bladder cancer and foster interpretability of future models.
An analysis type known as machine learning has recently become popular to predict survival in bladder cancer patients. However, there is debate on how to best use this method, as well as how to report the results of studies. This review looks at recently published machine learning studies, comparing various model details. Most studies found used hospital data, were clear about model factors, and used a model type called artificial neural networks. While these studies may be better at prediction compared to previous methods, there are consistency and clarity issues. Future studies should ensure that models are explainable and relevant to healthcare leaders.
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Algorithms , Urinary Bladder Neoplasms , Humans , Neural Networks, Computer , Urinary Bladder Neoplasms/therapy , Research , Machine LearningABSTRACT
We epigenotyped 211 individuals from 17 Zingiber kawagoii populations using methylation-sensitive amplification polymorphism (MSAP) and investigated the associations of methylated (mMSAP) and unmethylated (uMSAP) loci with 16 environmental variables. Data regarding genetic variation based on amplified fragment length polymorphism (AFLP) were obtained from an earlier study. We found a significant positive correlation between genetic and epigenetic variation. Significantly higher mean mMSAP and uMSAP uHE (unbiased expected heterozygosity: 0.223 and 0.131, respectively, p < 0.001) per locus than that estimated based on AFLP (uHE = 0.104) were found. Genome scans detected 10 mMSAP and 9 uMSAP FST outliers associated with various environmental variables. A significant linear fit for 11 and 12 environmental variables with outlier mMSAP and uMSAP ordination, respectively, generated using full model redundancy analysis (RDA) was found. When conditioned on geography, partial RDA revealed that five and six environmental variables, respectively, were the most important variables influencing outlier mMSAP and uMSAP variation. We found higher genetic (average FST = 0.298) than epigenetic (mMSAP and uMSAP average FST = 0.044 and 0.106, respectively) differentiation and higher genetic isolation-by-distance (IBD) than epigenetic IBD. Strong epigenetic isolation-by-environment (IBE) was found, particularly based on the outlier data, controlling either for geography (mMSAP and uMSAP ßE = 0.128 and 0.132, respectively, p = 0.001) or for genetic structure (mMSAP and uMSAP ßE = 0.105 and 0.136, respectively, p = 0.001). Our results suggest that epigenetic variants can be substrates for natural selection linked to environmental variables and complement genetic changes in the adaptive evolution of Z. kawagoii populations.
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A new design was applied for the facile synthesis of pure organic photoluminescent molecules with dual excited-state intramolecular proton transfer (ESIPT) sites. In this novel class of emitters, full-color panel emission from blue, green, and yellow to red, including white light, can be achieved in different solvents as modulated by the enol-keto(1st)-keto(2nd) tautomer emissions. A comprehensive transient photophysical study verifies that keto(1st) and keto(2nd) have a precursor (<0.8 ps)-successor (â¼20 ps)-relayed absorbance relationship, and then a fast equilibrium between the two is established, resulting in dual emissions in the nanosecond scale (â¼1900 ps). Through the research on copper ions' selective PL response, the dual-ESIPT mechanism was further verified; in addition, the study of solid-state PL changes upon the stimulus of organic vapor manifests the potential application sensitivity of the molecules as dual-ESIPT sensors. Theoretical results including reaction potential energy surface analyses manifest the fact that dual-proton transfer goes along a sequential route with a smaller energy barrier, firmly supporting the experimental results. An intrinsic system that undergoes intramolecular double proton relayed transfer is thus established for the achievement of much broadened optical responses and full-color display, providing reference for the design and application of advanced dual-ESIPT optical materials.
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With the upsurge of artificial intelligence(AI)technology in the medical field, its application in ophthalmology has become a cutting-edge research field. Notably, machine learning techniques have shown remarkable achievements in diagnosing, intervening, and predicting ophthalmic diseases. To meet the requirements of clinical research and fit the actual progress of clinical diagnosis and treatment of ophthalmic AI, the Ophthalmic Imaging and Intelligent Medicine Branch and the Intelligent Medicine Special Committee of Chinese Medicine Education Association organized experts to integrate recent evaluation reports of clinical AI research at home and abroad and formed a guideline on clinical research evaluation of AI in ophthalmology after several rounds of discussion and modification. The main content includes the background and method of developing this guideline, introduction to international guidelines on the clinical research evaluation of AI, and the evaluation methods of ophthalmic AI models. This guideline introduces general evaluation methods of clinical ophthalmic AI research, evaluation methods of clinical AI models, and common indices and formulae for clinical AI model evaluation in detail, and amply elaborates the evaluation method of clinical ophthalmic AI trials. This guideline aims to provide guidance and norms for clinical researchers of ophthalmic AI, promote the development of regularization and standardization, and further improve the overall level of clinical ophthalmic AI research evaluations.
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With the development of high technology, people spend more and more time on screens. Most screens contain a lot of blue light. As one of the important components of visible light, blue light has high energy. It may lead to many ocular diseases, such as myopia, cataract, dry eye, glaucoma and keratitis when eyes exposure to blue light for a long time. At present, the harm of blue light and how to prevent blue light have become a hot topic. Its mechanism mainly includes increasing the photosensitivity of lipofuscin, destroying the mitochondria, lysosome, lens and tear film. According to the mechanism of blue light damage, physical protective measures can be adopted. And the antioxidant, free radical scavengers, anti-inflammatory drugs and gene therapy can be used to protect eye tissue. This paper mainly summarizes the harmful mechanism of blue light to eye and the corresponding prevention and treatment measures.
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Super-Pulsed Fiber Thulium Laser (SP TFL) has provided a new option for minimally invasive treatment of urinary tract stones. Compared to holmium laser, SP TFL has higher efficiency, more comprehensive parameter settings, and smaller equipment with versatility. Standardized application of super-pulse fiber thulium laser and being familiar with common complications, using personalized parameters and corresponding techniques according to different surgical treatment, can reduce not only the equipment damage, but also improve the effectiveness and safety of lithotripsy.
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Objective:To investigate clinical and histopathological differences between mycosis fungoides with large cell transformation (MF-LCT) and primary cutaneous anaplastic large cell lymphoma (PC-ALCL) .Methods:Clinical and pathological data were collected from 16 patients with MF-LCT and 7 with PC-ALCL in the Department of Dermatology, Xijing Hospital, Air Forth Medical University from January 2015 to November 2022, and retrospectively analyzed.Results:Similarities between MF-LCT and PC-ALCL were as follows: plaques were observed in 16 MF-LCT patients and 5 PC-ALCL patients, nodules in 2 MF-LCT patients and 8 PC-ALCL patients, masses in 9 MF-LCT patients and 2 PC-ALCL patients, and surface ulcers in 11 MF-LCT patients and 3 PC-ALCL patients; the CD3 + CD4 + CD8 - immunophenotype was identified in 14 MF-LCT patients and 4 PC-ALCL patients; no death was found in both groups during the follow-up period. Differences between MF-LCT and PC-ALCL were as follows: MF-LCT showed older ages at onset (55.38 ± 11.98 years, range: 34 - 80 years) and longer disease courses (6.03 ± 4.86 years, range: 0.5 - 16 years) compared with PC-ALCL (ages at onset: 52.43 ± 24.53 years, range: 16 - 80 years; disease courses: 2.20 ± 2.42 years, range: 0.1 - 6 years) ; skin lesions were more widespread and mostly affected the trunk (13 cases) in MF-LCT, while the lower leg was mostly affected (5 cases) in PC-ALCL. Histopathological findings in MF-LCT showed that the epidermotropic phenomenon was more common (15 cases), Pautrier microabscesses were observed in most patients (9 cases), tumor cell infiltration could only be observed in the superficial to middle dermis (5 cases) or deep into the subcutaneous fat layer (4 cases), and eosinophil infiltration was found in all 16 cases; in PC-ALCL, tumor cells infiltrated the whole dermis in all 7 cases, which infiltrated the subcutaneous fat layer in 4 cases, necrosis was observed in 6 cases, and mixed infiltration of abundant eosinophils and neutrophils was found in 6 cases. Conclusions:MF-LCT and PC-ALCL can only be distinguished by systematically considering the patient′s age, medical history, sites of lesions, disease outcomes, and histopathological and histochemical characteristics. The epidermotropism of tumor cells was more likely to be observed in MF-LCT.