Deep learning-based prediction of coronary artery calcium scoring in hemodialysis patients using radial artery calcification.

OBJECTIVE: This study used random forest model to explore the feasibility of radial artery calcification in prediction of coronary artery calcification in hemodialysis patients. MATERIAL AND METHODS: We enrolled hemodialysis patients and performed ultrasound examinations on their radial arteries to evaluate the calcification status using a calcification index. All involved patients received coronary artery computed tomography scans to generate coronary artery calcification scores (CACS). Clinical variables were collected from all patients. We constructed both a random forest model and a logistic regression model to predict CACS. Logistic regression model was used to identify the risk factors of radial artery calcification. RESULTS: One hundred eighteen patients were included in our analysis. In random forest model, the radial artery calcification index, age, serum C-reactive protein, body mass index (BMI), diabetes, and hypertension history were related to CACS based on the average decrease of the Gini coefficient. The random forest model achieved a sensitivity of 76.9%, specificity of 75.0%, and area under receiver operating characteristic of 0.869, while the logistic regression model achieved a sensitivity of 75.2%, specificity of 68.7%, and area under receiver operating characteristic of 0.742 in prediction of CACS. Sex, BMI index, smoking history, hypertension history, diabetes history, and serum total calcium were all the risk factors related to radial artery calcification. CONCLUSIONS: A random forest model based on radial artery calcification could be used to predict CACS in hemodialysis patients, providing a potential method for rapid screening and prediction of coronary artery calcification.

Local atomic stacking and symmetry in twisted graphene trilayers.

Moiré superlattices formed by twisting trilayers of graphene are a useful model for studying correlated electron behaviour and offer several advantages over their formative bilayer analogues, including a more diverse collection of correlated phases and more robust superconductivity. Spontaneous structural relaxation alters the behaviour of moiré superlattices considerably and has been suggested to play an important role in the relative stability of superconductivity in trilayers. Here we use an interferometric four-dimensional scanning transmission electron microscopy approach to directly probe the local graphene layer alignment over a wide range of trilayer graphene structures. Our results inform a thorough understanding of how reconstruction modulates the local lattice symmetries crucial for establishing correlated phases in twisted graphene trilayers, evincing a relaxed structure that is markedly different from that proposed previously.

Strain-modulated Ru-O Covalency in Ru-Sn Oxide Enabling Efficient and Stable Water Oxidation in Acidic Solution.

RuO2 is one of the benchmark electrocatalysts used as the anode material in proton exchange membrane water electrolyser. However, its long-term stability is compromised due to the participation of lattice oxygen and metal dissolution during oxygen evolution reaction (OER). In this work, weakened covalency of Ru-O bond was tailored by introducing tensile strain to RuO6 octahedrons in a binary Ru-Sn oxide matrix, prohibiting the participation of lattice oxygen and the dissolution of Ru, thereby significantly improving the long-term stability. Moreover, the tensile strain also optimized the adsorption energy of intermediates and boosted the OER activity. Remarkably, the RuSnOx electrocatalyst exhibited excellent OER activity in 0.1 M HClO4 and required merely 184 mV overpotential at a current density of 10 mA cm-2 . Moreover, it delivered a current density of 10 mA cm-2 for at least 150 h with negligible potential increase. This work exemplifies an effective strategy for engineering Ru-based catalysts with extraordinary performance toward water splitting.

Dealuminated Beta zeolite reverses Ostwald ripening for durable copper nanoparticle catalysts.

Copper nanoparticle-based catalysts have been extensively applied in industry, but the nanoparticles tend to sinter into larger ones in the chemical atmospheres, which is detrimental to catalyst performance. In this work, we used dealuminated Beta zeolite to support copper nanoparticles (Cu/Beta-deAl) and showed that these particles become smaller in methanol vapor at 200°C, decreasing from ~5.6 to ~2.4 nanometers in diameter, which is opposite to the general sintering phenomenon. A reverse ripening process was discovered, whereby migratable copper sites activated by methanol were trapped by silanol nests and the copper species in the nests acted as new nucleation sites for the formation of small nanoparticles. This feature reversed the general sintering channel, resulting in robust catalysts for dimethyl oxalate hydrogenation performed with supported copper nanoparticles for use in industry.

Comparison of exenatide alone or combined with metformin versus metformin in the treatment of polycystic ovaries: a systematic review and meta-analysis.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of childbearing age. Randomized controlled trials (RCTs) have reported that exenatide and metformin are effective in the treatment of PCOS. In this meta-analysis, we aimed to compare the effectiveness and safety of exenatide alone or in combination with metformin versus metformin in patients suffering from PCOS. METHODS: RCTs of exenatide therapy were identified through a search of electronic databases in November 2022 and updated in October 2023. Eligible studies were identified independently by the reviewers. Outcomes were analysed with Revman 5.4. RESULTS: Nine RCTs among 214 studies on 1059 women with PCOS were included in the analysis, and among the nine RCTs, eight studies compared exenatide with metformin. Our meta-analysis demonstrated that exenatide was more effective than metformin in terms of pregnancy rate (RR 1.85 [95% CI 1.19,2.86] P = 0.006), sex hormone-binding globulin (SHBG) (MD 5 [95% CI 3.82,6.18] P < 0.001), and follicle-stimulating hormone (FSH) (MD 0.82 [95% 0.41,1.24] P < 0.001). The reductions in total testosterone (TT) (SMD -0.43 [95% CI -0.84, -0.03] P = 0.04) was more significant after treatment with exenatide than after treatment with metformin. In terms of safety, exenatide had a lower diarrhea rate (RR 0.11 [95% CI 0.01, 0.84]) than metformin. In the other three studies, exenatide plus metformin was compared with metformin. Exenatide combined with metformin was more effective in improving SHBG (MD 10.38[95%CI 6.7,14.06] P < 0.001), Matsuda index (MD 0.21[95%CI 0.05,0.37]) and reducing free androgen index (FAI) (MD -3.34 [-4.84, -1.83] P < 0.001), Weight (MD -2.32 [95%CI -3.89, -0.66]) and WC (MD-5.61[95%CI -8.4, -2.82] P < 0.001). The incidence of side effects between exenatide plus metformin and metformin was not statistically significant. CONCLUSIONS: Exenatide alone or in combination with metformin is more effective than metformin for women with PCOS. Considering the evidence on effectiveness and safety, exenatide alone or in combination with metformin may be a better treatment approach than metformin for women with PCOS. TRIAL REGISTRATION: INPLASY https://inplasy.com/inplasy-protocols/ ID: 10.37766/inplasy2022.11.0055.

Calcification detection on upper extremity arteries: a comparison of ultrasonic and X-ray methods.

Background: Vascular calcification (VC) has been observed in patients with hemodialysis, whereas few studies have investigated calcification in the upper extremity vasculature. Both ultrasound and X-ray are used to investigate the calcification of arteries in patients. However, there is a lack of data on the consistency between these two methods. The aim of this study was to investigate the occurrence of VC in the radial and ulnar arteries of hemodialysis patients and investigate the detection consistency in VC between ultrasound and X-ray. Methods: Ultrasound and X-ray examinations were performed in the radial and ulnar arteries of both the left and right upper extremities of 40 patients on hemodialysis. The calcification status of arteries was evaluated by the calcification index from ultrasound and X-ray respectively. Clinical variables of patients were collected from all the involved patients. Results: Of the 40 patients, VC was detected in 31 patients by ultrasound, while X-ray detected VC in 22 patients. Compared to ultrasound assessment, X-ray assessment was 73.21% sensitive but only 66.35% specific with a positive predictive value of 53.95% for detecting calcifications in the radial or ulnar artery. The level of agreement between ultrasound and X-ray results was fair. In addition, our data showed that more ulnar arteries had VCs than the corresponding radial arteries. Conclusion: Ultrasound is more sensitive in detecting the presence of calcified atherosclerotic lesions. Ultrasound and X-ray exhibited fair consistency. Ultrasound screening for upper extremity radial and ulnar arteries in hemodialysis patients may deserve attention to explore its clinical significance.

Anomalous Interfacial Electron-Transfer Kinetics in Twisted Trilayer Graphene Caused by Layer-Specific Localization.

Interfacial electron-transfer (ET) reactions underpin the interconversion of electrical and chemical energy. It is known that the electronic state of electrodes strongly influences ET rates because of differences in the electronic density of states (DOS) across metals, semimetals, and semiconductors. Here, by controlling interlayer twists in well-defined trilayer graphene moirés, we show that ET rates are strikingly dependent on electronic localization in each atomic layer and not the overall DOS. The large degree of tunability inherent to moiré electrodes leads to local ET kinetics that range over 3 orders of magnitude across different constructions of only three atomic layers, even exceeding rates at bulk metals. Our results demonstrate that beyond the ensemble DOS, electronic localization is critical in facilitating interfacial ET, with implications for understanding the origin of high interfacial reactivity typically exhibited by defects at electrode-electrolyte interfaces.

Large-scale time-lapse scanning electron microscopy image mosaic using a smooth stitching strategy.

Due to the trade-off between the field of view and resolution of various microscopes, obtaining a wide-view panoramic image through high-resolution image tiles is frequently encountered and demanded in numerous applications. Here, we propose an automatic image mosaic strategy for sequential 2D time-lapse scanning electron microscopy (SEM) images. This method can accurately compute pairwise translations among serial image tiles with indeterminate overlapping areas. The detection and matching of feature points are limited by geographical coordinates, thus avoiding accidental mismatching. Moreover, the nonlinear deformation of the mosaic part is also taken into account. A smooth stitching field is utilized to gradually transform the perspective transformation in overlapping regions into the linear transformation in non-overlapping regions. Experimental results demonstrate that better image stitching accuracy can be achieved compared with some other image mosaic algorithms. Such a method has potential applications in high-resolution large-area analysis using serial microscopy images. RESEARCH HIGHLIGHTS: An automatic image mosaic strategy for processing sequential scanning electron microscopy images is proposed. A smooth stitching field is applied in the image mosaic. Improved stitching accuracy is achieved compared with other conventional mosaic methods.

A green and facile one-step hydration method based on ZIF-8-PDA to prepare melamine composite sponges with excellent hydrophobicity for oil-water separation.

Frequent crude oil spills and illegal discharges of industrial organic pollutants cause serious damage to the ecological environment and considerable loss of valuable resources. Therefore, there is an urgent need to develop efficient strategies to separate and recover oils or reagents from sewage. Herein, a green, facile and rapid one-step hydration method was applied to obtain the composite sponge (ZIF-8-PDA@MS) that monodispersed zeolitic imidazolate framework-8 nanoparticles with high porosity and large specific surface area were firmly loaded onto the melamine sponge by ligand exchange and the self-assembly of dopamine. The water contact angle of ZIF-8-PDA@MS with multiscale hierarchical porous structure could reach 162°, which remained stable over a long period of time and a wide pH range. ZIF-8-PDA@MS displayed excellent adsorption capacities (up to 85.45-168.95 g⋅g-1), and could be reused at least 40 times. Besides, ZIF-8-PDA@MS exhibited remarkable photothermal effect. Simultaneously, Silver nanoparticle-immobilized composite sponges were also prepared via in-situ reduction of silver ions to inhibit bacterial contamination. The composite sponge developed in this work can be used not only for the treatment of industrial sewage, but also for the emergency response of large-scale marine oil spill accidents, which has inestimable practical value for water decontamination.

Tunable angle-dependent electrochemistry at twisted bilayer graphene with moiré flat bands.

Tailoring electron transfer dynamics across solid-liquid interfaces is fundamental to the interconversion of electrical and chemical energy. Stacking atomically thin layers with a small azimuthal misorientation to produce moiré superlattices enables the controlled engineering of electronic band structures and the formation of extremely flat electronic bands. Here, we report a strong twist-angle dependence of heterogeneous charge transfer kinetics at twisted bilayer graphene electrodes with the greatest enhancement observed near the 'magic angle' (~1.1°). This effect is driven by the angle-dependent tuning of moiré-derived flat bands that modulate electron transfer processes with the solution-phase redox couple. Combined experimental and computational analysis reveals that the variation in electrochemical activity with moiré angle is controlled by a structural relaxation of the moiré superlattice at twist angles of <2°, and 'topological defect' AA stacking regions, where flat bands are localized, produce a large anomalous local electrochemical enhancement that cannot be accounted for by the elevated local density of states alone.

Diagnosis and Treatment Rules of Chronic Kidney Disease and Nursing Intervention Models of Related Mental Diseases Using Electronic Medical Records and Data Mining.

Objective: On the basis of electronic medical records, the data mining technology was adopted to explore the law of chronic kidney disease (CKD) and the intervention mode of mental health of patients. Methods: Based on the electronic medical records, the corresponding data extraction, database establishment, and data cleaning of CKD were performed. After that, the related data analysis, frequency analysis, cluster analysis, and nonparametric analysis were used to explore the laws of CKD diagnosis and treatment and nursing intervention mode of mental illness. The most common causes of CKD were chronic glomerulonephritis (43.76%), aristolochic acid nephritis (16.34%), diabetic nephritis (12.87%), and hypertensive nephritis (11.58%). The major treatment method for end-stage patients was alternative therapies, accounting for 46%. Compared with the depression score before intervention, that of the patients after the mindfulness therapy (50.99 ± 9.77 vs. 47.01 ± 9.33, P=0.024 < 0.5) and target behaviour nursing intervention (52.21 ± 8.12 vs. 48.01 ± 9.33, P=0.032 < 0.05) was obviously decreased. Conclusion: The data mining technology based on electronic records showed a good application prospect in the analysis of the diagnosis and treatment of CKD; and target behaviour nursing and mindfulness intervention were effective psychological intervention models.

Measurement of Film-Elastomer Interface Adhesion by Continuous Buckling.

Measurement of interfacial properties between thin films and elastomers is investigated. As a prototype, the interface adhesion between a graphite nanoflake and an elastic polymer is determined by topography imaging of the induced graphite buckles using atomic force microscopy. A theoretical analysis is carried out to establish the relationship among interface adhesion, elastic strain energy, and buckle surface area. The strain energy of the graphite is obtained by employing an elastic plate deflection theory. To introduce the buckles, different methods are applied, including thermal contraction, bending, and stretching, and different substrate materials, namely, polydimethylsiloxane and polystyrene, are used. The uncertainty in measuring the interface adhesion is discussed. These investigations provide a promising approach to characterize the interfacial properties of multilayer samples.

Solution for Mass Production of High-Throughput Digital Microfluidic Chip Based on a-Si TFT with In-Pixel Boost Circuit.

As one of the most popular research hotspot of lab-on-chip, digital microfluidic (DMF) technology based on the principle of electrowetting has unique advantages of high-precision, low cost and programmable control. However, due to the limitation of electrodes number, the throughput is hard to further upgrade. Therefore, active matrix electrowetting-on-dielectric (AM-EWOD) technology is a solution to acquire larger scale of driving electrodes. However, the process of manufacturing of AM-EWOD based on thin-film-transistor (TFT) is complex and expensive. Besides, the driving voltage of DMF chip is usually much higher than that of common display products.In this paper, a solution for mass production of AM-EWOD based on amorphous silicon (a-Si) is provided. Samples of 32 × 32 matrix AM-EWOD chips was designed and manufactured. A boost circuit was integrated into the pixel, which can raise the pixel voltage up by about 50%. Customized designed Printed Circuit Board (PCB) was used to supply the timing signals and driving voltage to make the motion of droplets programmable. The process of moving, mixing and generation of droplets was demonstrated.The minimum voltage in need was about 20 V and a velocity of up to 96 mm/s was achieved. Such an DMF device with large-scale matrix and low driving voltage will be very suitable for POCT applications.

Internalization and membrane activity of the antimicrobial peptide CGA-N12.

Antimicrobial peptides (AMPs) are conventional antibiotic alternatives due to their broad-spectrum antimicrobial activities and special mechanisms of action against pathogens. The antifungal peptide CGA-N12 was originally derived from human chromogranin A (CGA) and consists of the 65th to 76th amino acids of the CGA N-terminal region. In the present study, we found that CGA-N12 had fungicidal activity and exhibited time-dependent inhibition activity against Candida tropicalis. CGA-N12 entered the cells to exert its antagonist activity. The internalization of CGA-N12 was energy-dependent and accompanied by actin cytoskeleton-, clathrin-, sulfate proteoglycan-, endosome-, and lipid-depleting agent-mediated endocytosis. Moreover, the CGA-N12 internalization pathway was related to the peptide concentration. The effects of CGA-N12 on the cell membrane were investigated. CGA-N12 at a low concentration less than 4 × MIC100 did not destroy the cell membrane. While with increasing concentration, the damage to the cell membrane caused by CGA-N12 became more serious. At concentrations greater than 4 × MIC100, CGA-N12 destroyed the cell membrane integrity. Therefore, the membrane activity of CGA-N12 is concentration dependant.

Non-Classical 21-Hydroxylase Deficiency: Analysis of a Mutant Gene in a Uyghur Family and Literature Review.

OBJECTIVE: The gene mutation and clinical characteristics of a patient with non-classical 21-hydroxylase deficiency and his family were analyzed. METHODS: A patient was diagnosed with non-classical 21-hydroxylase deficiency in the Department of Endocrinology of People's Hospital of Xinjiang Uygur Autonomous Region in December 2016. The clinical data and related gene-sequencing results were analyzed. The detected mutations were verified in nine members of the family. RESULTS: Gene-sequencing results revealed that the proband and the other three members of the family (proband, proband's mother's younger brother and the proband's mother's younger brother's younger daughter, and proband's second elder sister) shared the following mutations: Ile173Asn, Ile237Asn, Val238Glu, Met240Lys, Val282Leu, Leu308Phefs*6, Gln319Ter, Arg357Trp, and Arg484Profs. The Val282Leu mutation was heterozygous in the proband's mother's younger brother's younger daughter, but homozygous in the other three individuals. The father of the proband, the elder brother of the father of the proband, the third younger brother of the father of the proband, and the elder sister of the proband all carried only the Val282Leu mutation. CONCLUSION: Val282Leu is the gene responsible for non-classical 21-hydroxylase deficiency. Screening for this gene in the offspring of patients with non-classical 21-hydroxylase deficiency may help to identify cases early.

Plant volatiles as regulators of plant defense and herbivore immunity: molecular mechanisms and unanswered questions.

Plants release distinct blends of herbivore-induced plant volatiles (HIPVs) upon herbivore attack. HIPVs have long been known to influence the behavior of herbivores and natural enemies. In addition, HIPVs can act as physiological regulators that induce or prime plant defenses. Recent work indicates that the regulatory capacity of HIPVs may extend to herbivore immunity: herbivores that are exposed to HIPVs can become more resistant or susceptible to parasitoids and pathogens. While the mechanisms of HIPV-mediated plant defense regulation are being unraveled, the mechanisms underlying the regulation of herbivore immunity are unclear. Evidence so far suggests a high degree of context dependency. Here, we review the mechanisms by which HIPVs regulate plant defense and herbivore immunity. We address major gaps of knowledge and discuss directions for future mechanistic research to facilitate efforts to use the regulatory capacity of HIPVs for the biological control of insect pests.

Multifunctional cantilevers for simultaneous enhancement of contact resonance and harmonic atomic force microscopy.

To enhance contact resonance atomic force microscopy (CR-AFM) and harmonic AFM imaging simultaneously, we design a multifunctional cantilever. Precise tailoring of the cantilever's dynamic properties is realized by either mass-removing or mass-adding. As prototypes, focused ion beam drilling or depositing is used to fabricate the optimized structures. CR-AFM subsurface imaging on circular cavities covered by a piece of highly oriented pyrolytic graphite validates the improved CR frequency to contact stiffness sensitivity. The detectable subsurface depth and cavity radius increase accordingly by using the multifunctional cantilever. At the same time, the free resonance frequency of the second mode is tuned to an integer multiple of the fundamental one. Harmonic AFM imaging on polystyrene and low-density polystyrene mixture shows the improved harmonic amplitude contrast and signal strength on the two material phases. The multifunctional cantilever can be extended to enhance other similar AFM operation modes and it has potential applications in relevant fields such as mechanical characterization and subsurface imaging.

Detection of ion implantation in focused ion beam processing by scattering-type scanning near-field optical microscopy.

We employed scattering-type scanning near-field optical microscopy (s-SNOM) to explore the implantation of gallium ions in a silicon substrate after focused ion beam (FIB) etching. Different ion doses were applied, and the s-SNOM amplitude image contrast between the processed and unprocessed regions was investigated. The results demonstrate that the contrast decreases along with the increase of the ion dose. A similar dependence of the residual gallium element concentration on the ion dose is found from the energy dispersive spectroscopy. Such comparisons imply that s-SNOM imaging is sensitive to the implanted ions. The s-SNOM aided analysis of FIB etching can benefit the fabrication optimization, especially when the processed materials' properties are of critical importance.