Porous hybrid encapsulation enables high-rate lithium storage for a micron-sized SiO anode.

Establishing a durable interfacial layer between an electrode and electrolyte to enable micron-sized silicon-based lithium-ion battery (LIB) anodes to achieve superior electrochemical performance is highly desired. Recent studies have shown that heterogeneous encapsulation with enhanced ion/electron transport is an effective strategy. However, the structural design of the existing hetero-coated interface lacks a reasonable ion/electron transport channel, resulting in high interfacial impedance. Herein, we designed a heterogenous MXene-mesoporous polypyrrole (mPPy) encapsulation layer onto micron-sized SiO particles. The MXene coating layer functions as a bridging interface that can build a strong chemical link to internal SiO via covalent bonding, thus reinforcing interfacial charge transfer rate. Meanwhile, it forms a dynamic connection with the outer mPPy through hydrogen bonding, which contributes to high interfacial Li+ concentration and ion/electron coupling transport rate. Accordingly, the as-prepared SiO@MXene@mPPy anode delivers a boosted specific capacity of 673.9 mA h g-1 at 2 A g-1 after 1000 cycles and high-rate capability of 777.4 mA h g-1 at 5 A g-1. Further, electrochemical kinetic analysis indicates that the MXene@mPPy coating layer shows a pseudocapacitance controlled Li storage mechanism, thereby displaying improved high-rate capability. This porous hybrid encapsulation strategy offers new possibilities for a micron-sized SiO anode to achieve an excellent performance.

Archaeal communities change responding to anthropogenic and natural treatments of freeze-thawed soils.

The coverage of accumulated snow plays a significant role in inducing changes in both microbial activity and environmental factors within freeze-thaw soil systems. This study aimed to analyze the impact of snow cover on the dynamics of archeal communities in freeze-thaw soil. Furthermore, it seeks to investigate the role of fertilization in freeze-thaw soil. Four treatments were established based on snow cover and fertilization:No snow and no fertilizer (CK-N), snow cover without fertilizer (X-N), fertilizer without snow cover (T-N), and both fertilizer and snow cover (T-X). The research findings indicated that after snow cover treatment, the carbon, nitrogen, and phosphorus content in freeze-thaw soil exhibit periodic fluctuations. Snow covered effectively altered the community composition of bacteria and archaea in the soil, with a greater impact on archaeal communities than on bacterial communities. Snow covered improves the stability of archaeal communities in freeze-thaw soil. Additionally, the arrival of snow also enhanced the correlation between archaea and environmental factors, with the key archaeal phyla involved being Nanoarchaeota and Crenarchaeota. Further research showed that the application of organic fertilizers also had some impact on freeze-thaw soil, but this impact was smaller compared to snow cover. In summary, the arrival of snow could alter the archaeal community and protect nutrient elements in freeze-thaw soil, reducing their loss, and its effect is more pronounced compared to the application of organic fertilizers.

Trends in prevalence, risk factor control and medications in atherosclerotic cardiovascular disease among US Adults, 1999-2018.

Objectives: Trends in prevalence and treatments of atherosclerotic cardiovascular disease (ASCVD) remains to be documented, with frequent update of relevant guidelines. We aimed to characterize trends in prevalence of ASCVD, and risk factor control and medications among ASCVD adults. Methods: We conducted a cross-sectional analysis of data from 55,081 adults in the National Health and Nutrition Examination Surveys (NHANES) 1999-2018. Results: The age-standardized prevalence of ASCVD did not change significantly from 1999-2002 (7.9 %, 95 % CI 7.1 %-8.7 %) to 2015-2018 (7.5 %, CI 6.8 %-8.3 %) (P for trend =0.18), representing an estimated 19.9 million individuals with ASCVD in 2015-2018. The prevalence of premature ASCVD was 2.0 % (CI, 1.6 %-2.5 %). Over 60.0 % of ASCVD participants were at very-high risk. From 1999-2002 to 2015-2018, the percentage with lipid control (non-high-density lipoprotein cholesterol <100 mg/dL) increased from 7.0 % (CI, 3.5 %-12.3 %) to 26.4 % (CI, 16.2 %-38.9 %). The percentage with blood-pressure control (<130/80 mmHg) increased from 51.2 % (CI, 41.0 %-61.3 %) in 1999-2002 to 57.2 % (CI, 48.4 %-65.6 %) in 2011-2014, but then declined to 52.8 % (CI, 44.4 %-81.3 %) in 2015-2018. The percentage with glycemic control (HbA1c <7.0 %) decreased from 95.0 % (CI, 90.2 %-97.9 %) to 84.0 % (CI, 75.9 %-90.3 %). The percentage who achieved all 3 targets was 18.6 % (CI, 8.2 %-33.8 %) in 2015-2018. The percentage of ASCVD participants who were taking statins increased from 1999-2002 to 2011-2014, but then leveled off. Approximately 60 % of individuals with ASCVD and less than 40 % of those with premature ASCVD were taking statins in 2015-2018. The utilization of blood-pressure-lowering drugs remained largely constant over time, whereas the use of glucose-lowering drugs increased. Conclusions: Based on NHANES data from US adults, the estimated prevalence of ASCVD remained relatively stable between 1999 and 2018. Substantial undertreatment with stains was found in individuals with ASCVD, and the percentage achieving optimal lipid control was low.

Association between baseline glycated hemoglobin level and atrial fibrillation recurrence following cryoballoon ablation among patients with and without diabetes.

OBJECTIVES: The study aims to assess the effect of baseline glycated hemoglobin (HbA1c) levels on atrial fibrillation (AF) recurrence following cryoballoon ablation in patients with and without diabetes. METHODS: Consecutive AF patients receiving first cryoballoon ablation between April 2018 and April 2021 were included. AF recurrence and other clinical outcomes were recorded for a minimum of 12 months post-ablation, with regular assessments at 3, 6, and 12 months, followed by annual check-ups. The primary outcome was AF recurrence after ablation at longest follow-up. Multivariate Cox proportional hazards regression models were utilized to calculate the hazard ratio (HR) and 95% CI per standard deviation (SD) increase of baseline HbA1c level. RESULTS: 335 patients were included in the analysis. The mean age was 61.7 years, 61.8% were male. 12.8% had type 2 diabetes, and 81.7% of patients had paroxysmal AF. The median level of HbA1c was 5.3%, and the mean CHA2DS2-VASc score was 1.8. All cryoballoon ablation procedures, utilizing a 28-mm balloon, achieved successful pulmonary vein isolation. Over a median follow-up of 18 months, 105 patients (31.3%) experienced AF recurrence. In multivariate Cox proportional hazards analysis, a higher HbA1c level, persistent AF (HR 1.91, 95% CI 1.08 to 3.39, P = 0.026), alcohol consumption (HR 2.67, 95% CI 1.33 to 5.37, P = 0.006), and Nadir RSPV (HR 1.04, 95% CI 1.00 to 1.08, P = 0.005) were significant predictors of AF recurrence. Per-SD increase of HbA1c was associated with a 1.75-fold increase risk of AF recurrence (HR 1.75, 95% CI 1.39 to 2.21, P < 0.001). Subgroup analysis revealed that a higher HbA1c level was associated with a higher risk of AF recurrence in patients with and without diabetes, and in patients with paroxysmal and persistent AF. CONCLUSION: Baseline HbA1c level was an independent predictor of AF recurrence following cryoablation, both in patients with and without diabetes.

Biotic pathways of reciprocal responses between antibiotic resistance genes and inorganic nitrogen cycling genes in amoxicillin-stressed compost ecosystems.

This study explored the transformation of inorganic nitrogen, the expression levels of antibiotic resistance genes (ARGs), and the regulatory mechanisms of key species on ARGs and inorganic nitrogen cycling genes (INCGs) under different levels of amoxicillin (AMX) stress. High level of AMX inhibited the accumulation of NH4+-N, which increased by 531 % relative to the initial. Moreover, AMX to some extent increased the levels of nirS and nirK, which could potentially result in nitrogen loss and the accumulation of NO2-. Actinobacteria might serve as potential hosts for ARGs during sludge composting. This stress induced a complex response between INCGs and ARGs more complex due to key species. Under high-level AMX pressure, most species associated with ARGs likely derived from nitrogen cycling functional species. To conclude, high levels of AMX stress might lead to nitrogen cycling imbalance and the dissemination of antibiotic resistance genes in composting systems.

Trends in Prevalence of Thyroid Dysfunction and its Associations With Mortality Among US Participants, 1988-2012.

CONTEXT: Various dynamic factors could influence the prevalence and distribution of thyroid dysfunction. OBJECTIVE: To provide national estimates and temporal trends in prevalence of thyroid dysfunction over the past 3 decades in United States and determine the impact of thyroid dysfunction on mortality in US adults. METHODS: A cross-sectional analysis of data from 33 117 participants aged 12 years or older in the National Health and Nutrition Examination Survey III (1988-1994), 1999-2002, and 2007-2012. RESULTS: The weighted mean age was 41.6 years, and 48.3% were men. In 2007 through 2012, the prevalence of subclinical and overt hypothyroidism, subclinical and overt hyperthyroidism was 4.3%, 0.33%, 3.2%, and 0.2% respectively. Eighty percent of individuals with thyroid dysfunction were previously undiagnosed. The prevalence of subclinical hypothyroidism and hyperthyroidism was stable, whereas overt hypothyroidism (0.54% [95% CI, 0.35-0.8] vs 0.33% [95% CI, 0.23-0.48]) and hyperthyroidism (0.8% [95% CI, 0.58-1.1] vs 0.2% [95% CI, 0.12-0.33]) were less prevalent in 2007-2012 compared to 1988-1994. Older age, White Americans, obesity, and positivity for thyroid peroxidase antibody and thyroglobulin antibody were risk factors for hypothyroidism, whereas older age, women, and Black Americans were risk factors for hyperthyroidism. Over a median follow-up of 17.2 years, no significant association was observed between any type of thyroid dysfunction with the risk of total or cardiovascular mortality. However, among individuals aged 65 years or older, subclinical hypothyroidism was associated with a higher risk of total mortality (hazard ratio, 1.17; 95% CI, 1.00-1.37; P = .05) and cardiovascular mortality (HR, 1.29; 95% CI, 1.04-1.62; P = .02). CONCLUSIONS: The prevalence of subclinical thyroid dysfunction remained relatively unchanged, whereas that of overt thyroid dysfunction decreased. Subclinical hypothyroidism was associated with a higher mortality among individuals aged 65 years or older.

Genome- and transcriptome-wide identification of trehalose-6-phosphate phosphatases (TPP) gene family and their expression patterns under abiotic stress and exogenous trehalose in soybean.

BACKGROUND: Trehalose-6-phosphate phosphatase (TPP) is an essential enzyme catalyzing trehalose synthesis, an important regulatory factor for plant development and stress response in higher plants. However, the TPP gene family in soybean has not been reported. RESULTS: A comprehensive analysis of the TPP gene family identified 18 GmTPPs classified into eight groups based on the phylogenetic relationships and the conservation of protein in six monocot and eudicot plants. The closely linked subfamilies had similar motifs and intron/exon numbers. Segmental duplication was the main driving force of soybean GmTPPs expansion. In addition, analysis of the cis-regulatory elements and promoter regions of GmTPPs revealed that GmTPPs regulated the response to several abiotic stresses. Moreover, RNA-seq and qRT-PCR analysis of the tissue-specific GmTPPs under different abiotic stresses revealed that most GmTPPs were associated with response to different stresses, including cold, drought, saline-alkali, and exogenous trehalose. Notably, exogenous trehalose treatment up-regulated the expression of most TPP genes under saline-alkali conditions while increasing the carbohydrate and trehalose levels and reducing reactive oxygen species (ROS) accumulation in soybean sprouts, especially in the saline-alkali tolerant genotype. Furthermore, the interaction network and miRNA target prediction revealed that GmTPPs interacted with abiotic stress response-related transcription factors. CONCLUSIONS: The findings in this study lay a foundation for further functional studies on TPP-based breeding to improve soybean development and stress tolerance.

Intranasal Delivery of Endothelial Cell-Derived Extracellular Vesicles with Supramolecular Gel Attenuates Myocardial Ischemia-Reperfusion Injury.

Purpose: Myocardial ischemia-reperfusion injury after myocardial infarction has always been a difficult problem in clinical practice. Endothelial cells and their secreted extracellular vesicles are closely related to inflammation, thrombosis formation, and other processes after injury. Meanwhile, low-molecular-weight gelators have shown great potential for nasal administration. This study aims to explore the therapeutic effects and significance of endothelial cell-derived extracellular vesicles combined with a hydrogel for nasal administration on myocardial ischemia-reperfusion injury. Methods: We chose a gel system composed of a derivative of glutamine amide and benzaldehyde as the extracellular vesicle delivery vehicle. This hydrogel was combined with extracellular vesicles extracted from mouse aortic endothelial cells and administered multiple times intranasally in a mouse model of ischemia-reperfusion injury to the heart. The delivery efficiency of the extracellular vesicle-hydrogel combination was evaluated by flow cytometry and immunofluorescence. Echocardiography, TTC Evan's Blue and Masson's staining were used to assess mouse cardiac function, infarct area, and cardiac fibrosis level. Flow cytometry, ELISA, and immunofluorescence staining were used to investigate changes in mouse inflammatory cells, cytokines, and vascular neogenesis. Results: The vesicles combined with the hydrogel have good absorption in the nasal cavity. The hydrogel combined with vesicles reduces the levels of pro-inflammatory Ly6C (high) monocytes/macrophages and neutrophils. It can also reduce the formation of microcirculation thrombi in the infarcted area, improve endothelial barrier function, and increase microvascular density in the injured area. As a result, the heart function of mice is improved and the infarct area is reduced. Conclusion: We first demonstrated that the combination of extracellular vesicles and hydrogel has a better absorption efficiency in the nasal cavity, which can improve myocardial ischemia-reperfusion injury by inhibiting inflammatory reactions and protecting endothelial function. Nasal administration of vesicles combined with hydrogel is a potential therapeutic direction.

Exogenous melatonin mitigates saline-alkali stress by decreasing DNA oxidative damage and enhancing photosynthetic carbon metabolism in soybean (Glycine max [L.] Merr.) leaves.

Saline-alkali stress (SS) is a common abiotic stress affecting crop cultivation worldwide, seriously inhibiting plant growth and biomass accumulation. Melatonin has been proven to relieve the inhibition of multiple abiotic stresses on plant growth. Therefore, soybean cultivars Heihe 49 (HH49, SS-tolerant) and Henong 95 (HN95, SS-sensitive) were pot-cultured in SS soil and then treated with 300 µM melatonin at the V1 stage, when the first trifoliate leaves were fully unfolded, to investigate if melatonin has an effect on SS. SS increased reactive oxygen species (ROS) accumulation in soybean leaves and thereby induced DNA oxidative damage. In addition, SS retarded cell growth and decreased the mesophyll cell size, chloroplast number, photosynthetic pigment content, which further reduced the light energy capture and electron transport rate in soybean leaves, and affected carbohydrate accumulation and metabolism. However, melatonin treatment reduced SS-induced ROS accumulation in the soybean leaves by increasing antioxidant content and oxidase activity. Effective removal of ROS reduced SS-induced DNA oxidative damage in the soybean leaf genome, which was represented by decreased random-amplified polymorphic DNA polymorphism, 8-hydroxy-20-deoxyguanine content, and relative density of apurinic/apyrimidinic-sites. Melatonin treatment also increased the volume of mesophyll cells, the numbers of chloroplast and starch grains, the contents of chlorophyll a and b and carotenoids in soybean seedling leaves treated with SS, thereby increasing the efficiency of effective light capture and electron transfer and improving photosynthesis. Subsequently, carbohydrate accumulation and metabolism in soybean leaves under SS were improved by melatonin treatment, which contributes to providing basic substances and energy for cell growth and metabolism, ultimately improving soybean SS tolerance.

CoTrFuse: a novel framework by fusing CNN and transformer for medical image segmentation.

Medical image segmentation is a crucial and intricate process in medical image processing and analysis. With the advancements in artificial intelligence, deep learning techniques have been widely used in recent years for medical image segmentation. One such technique is the U-Net framework based on the U-shaped convolutional neural networks (CNN) and its variants. However, these methods have limitations in simultaneously capturing both the global and the remote semantic information due to the restricted receptive domain caused by the convolution operation's intrinsic features. Transformers are attention-based models with excellent global modeling capabilities, but their ability to acquire local information is limited. To address this, we propose a network that combines the strengths of both CNN and Transformer, called CoTrFuse. The proposed CoTrFuse network uses EfficientNet and Swin Transformer as dual encoders. The Swin Transformer and CNN Fusion module are combined to fuse the features of both branches before the skip connection structure. We evaluated the proposed network on two datasets: the ISIC-2017 challenge dataset and the COVID-QU-Ex dataset. Our experimental results demonstrate that the proposed CoTrFuse outperforms several state-of-the-art segmentation methods, indicating its superiority in medical image segmentation. The codes are available athttps://github.com/BinYCn/CoTrFuse.

Fate of dissolved organic matter affected by oxytetracycline tolerant microorganisms during chicken manure composting.

This study explored the interaction among the components of dissolved organic matter (DOM), environmental factors and oxytetracycline (OTC) tolerant bacteria during chicken manure composting using Parallel Factor Analysis (PARAFAC) and 16S rRNA sequencing analysis. The results revealed that the OTC residues in chicken manure may affect the transformation between the protein-like component (C1) and humus-like component (C2 and C3) during composting. The transformation of DOM components under the OTC stress was indirect by affecting the microbial community activity. The OTC tolerant bacteria that still exist after the high temperature period of composting had a significant positive correlation between the humification process. The correlations of the dissolved organic carbon (DOC), total nitrogen (TN), and core OTC tolerant bacteria with DOM components, which enhanced the cooperative function of DOM component transformation. To clarify the influence of OTC residue on the humification process can promote the composting carbon fixation and improve composting quality.

The Influence of Decision-Making Logic on Employees' Innovative Behaviour: The Mediating Role of Positive Error Orientation and the Moderating Role of Environmental Dynamics.

Purpose: The derivation of employees' innovative behaviour is a complex multi-stage process influenced by decision logic. However, previous research on the relationship between the two has not been comprehensive without considering the individual level of employees, and the mechanism of action between the two is still unclear. Based on the behavioral decision theory, the broaden-and-build theory of positive emotions and triadic reciprocal determinism. This study investigates the mediating effects of positive error orientation between decision-making logic and employees' innovative behavior, and the moderating effects of environmental dynamics between decision-making logic and employees' innovative behavior, focusing on the individual level. Methods: The questionnaire data was obtained from 403 employees randomly selected from 100 companies in Nanchang, China, in various industries such as manufacturing, transportation, storage and postal services, trade, and wholesale and retail trade. Hypotheses were tested using structural equation modeling. Results: Effectual logic had a significantly positive impact on employees' innovative behavior. The direct effect of causal logic on employees' innovative behavior was not significant, but the total effect was significantly positive. Positive error orientation played a mediating role between both types of decision-making logic and employees' innovative behavior. Moreover, environmental dynamics played a negative moderating role between effectual logic and employees' innovative behavior. Originality/Value: This study expands the application of behavioral decision theory, the broaden-and-build theory of positive emotions and triadic reciprocal determinism in employees' innovative behaviour, enriches the research on the mediating and moderating mechanism between employees' decision-making logic and innovative behaviour, and provides a new research perspective and empirical support for subsequent related research. Practical Implications: The results of this study provide practical suggestions for promoting employees' innovative behaviour. For example, employees need to cultivate logical thinking, train their decision-making ability, form a positive error orientation, and objectively assess the external environment.

A Paired Phase and Magnitude Reconstruction for Advanced Diffusion-Weighted Imaging.

OBJECTIVE: Multi-shot interleaved echo planer imaging (Ms-iEPI) can obtain diffusion-weighted images (DWI) with high spatial resolution and low distortion, but suffers from ghost artifacts introduced by phase variations between shots. In this work, we aim at solving the ms-iEPI DWI reconstructions under inter-shot motions and ultra-high b-values. METHODS: An iteratively joint estimation model with paired phase and magnitude priors is proposed to regularize the reconstruction (PAIR). The former prior is low-rankness in the k-space domain. The latter explores similar edges among multi-b-value and multi-direction DWI with weighted total variation in the image domain. The weighted total variation transfers edge information from the high SNR images (b-value = 0) to DWI reconstructions, achieving simultaneously noise suppression and image edges preservation. RESULTS: Results on simulated and in vivo data show that PAIR can remove inter-shot motion artifacts very well (8 shots) and suppress the noise under the ultra-high b-value (4000 s/mm2) significantly. CONCLUSION: The joint estimation model PAIR with complementary priors has a good performance on challenging reconstructions under inter-shot motions and a low signal-to-noise ratio. SIGNIFICANCE: PAIR has potential in advanced clinical DWI applications and microstructure research.

Deciphering the turnover of bacterial groups in winter agricultural soils.

In winter, snowpack is an important driver of soil bacterial processes. Amending soil through the addition of organic compost has also been reported to affect soil properties and bacterial communities. However, the effects of snow and organic compost on soils have not been systematically researched and compared. To investigate the effects of these two activities on the succession of bacterial communities in the soil and on important soil nutrients, four treatment groups were established in this study: no snow without compost (CK-N), no snow with compost (T1-N), snow without compost (CK-X) and snow with compost (T1-X). Four representative time periods were also selected according to the extent of snow accumulation, including the first snow and melt. In addition, the compost pile was treated with fertilizer made from decomposing food waste. The results indicate that Proteobacteria was more affected by temperature and that fertilization increased its proportional abundance. The abundance of Acidobacteriota was increased by snow. Ralstonia could depend on nutrients provided by organic fertilizers, which prevented them from ceasing to breed at low temperatures, while snow cover was still able to reduce their survival. However, snowpack increased the abundance of RB41. Snow reduced the point and connectivity of the bacterial community and increased the association with environmental factors, especially the negative correlation with total nitrogen (TN); the prefertilizer application made the community network larger while maintaining association with environmental factors. Specifically, more key nodes in sparse communities after snow cover were identified by Zi-Pi analysis. The present study systematically assessed soil bacterial community succession in the context of snow cover and fertilizer application and interpreted the farm environment from a microscopic perspective through the winter. We found that snowpack affects TN through bacterial community succession. This study offers new insight into soil management.

MOF-Based Active Packaging Materials for Extending Post-Harvest Shelf-Life of Fruits and Vegetables.

Active packaging that can extend the shelf-life of fresh fruits and vegetables after picking can assure food quality and avoid food waste. Such packaging can prevent the growth of microbial and bacterial pathogens or delay the production of ethylene, which accelerates the ripening of fruits and vegetables after harvesting. Proposed technologies include packaging that enables the degradation of ethylene, modified atmosphere packaging, and bioactive packaging. Packaging that can efficiently adsorb/desorb ethylene, and thus control its concentration, is particularly promising. However, there are still large challenges around toxicity, low selectivity, and consumer acceptability. Metal-organic framework (MOF) materials are porous, have a specific surface area, and have excellent gas adsorption/desorption performance. They can encapsulate and release ethylene and are thus good candidates for use in ethylene-adjusting packaging. This review focuses on MOF-based active-packaging materials and their applications in post-harvest fruit and vegetable packaging. The fabrication and characterization of MOF-based materials and the ethylene adsorption/desorption mechanism of MOF-based packaging and its role in fruit and vegetable preservation are described. The design of MOF-based packaging and its applications are reviewed. Finally, the potential future uses of MOF-based active materials in fresh food packaging are considered.

Anti-Diabetic Drugs Inhibit Bulimia Induced Obesity.

BACKGROUND: Obesity is primarily a consequence of food addiction. Drugs have been confirmed effective for weight loss more or less related to the functional connectivity in neural networks and metabolic patterns. Recent studies have shown that some anti-diabetic drugs, such as Metformin and Dapagliflozin have similar weight loss effects, however, their mechanisms are unclear. We hypothesized that the functional connectivity and energy metabolism might be associated with the mechanisms. METHODS: Male ob/ob mice were fed with high-fructose-fat-diet (HFFD) for 4 weeks to esteblish obesity model. Then mice were divided into normal saline (NS, as control), Metformin (Metformin, 50 mg/kg/day by gavage), and Dapagliflozin (Dapagliflozin, 10 mg/kg/day by gavage) groups. Functional connectivity amplitude of low-frequency signal fluctuations and regional cerebral blood volume (rCBV) quantification were statistically analyzed in the linear mixed model, meanwhile, metabolic pattern of intestinal cells (IECs) were also tested. RESULTS: Our results showed that Blood Oxygen on Level Depending (Bold) signaling responses, functional connectivity, and rCBV quantification tended to be attenuated in the Metformin group compared to the control and Dapagliflozin groups. While only Dapagliflozin prevented HFFD induced hyper survival of intestinal cells and hypertrophy of intestinal villus by reducing glycolysis levels. Both Metformin and Dapagliflozin are effective for weight loss. CONCLUSIONS: Our findings showed that Dapagliflozin and Metformin may inhibit bulimia induced obesity with different mechanisms. We speculate that Metformin may affect appetite regulation, while Dapagliflozin can affect the survival and metabolic patterns of intestinal cells, thus significantly affecting the absorption of nutrients. So, combining Metformin and Dapgliflozin may be more beneficial for clinical improvement in bulimia induced obesity.

Refractory ventricular tachycardia and heart failure due to anti-mitochondrial antibody-positive inflammatory myopathy.

BACKGROUND: Anti-mitochondrial antibody (AMA)-positive inflammatory myopathy, a rare type of idiopathic inflammatory myopathy which was frequently difficult to diagnose, can affect muscles and the structure and electrical conduction of the heart. Early identification and treatment of this myopathy can prevent serious cardiovascular adverse events and improve cardiac function. CASE PRESENTATION: We report a patient who experienced repeated syncope, ventricular tachycardia (VT) and heart failure accompanied by weakness and muscle atrophy. He was initially diagnosed with dilated cardiomyopathy and received implantable cardioverter-defibrillator therapy. He was subsequently misdiagnosed as muscular dystrophy due to progressive muscular atrophy. However, the patient developed repeated and refractory VT storms that were not alleviated by conventional therapy. Finally, he was diagnosed with AMA-positive inflammatory myopathy with cardiac injuries. The patient was markedly recovered by being treated with immunosuppressive and immunomodulatory therapy. CONCLUSION: AMA could be screened when discovering myopathies accompanied by unexplained cardiac symptoms. Our findings provide insights into the diagnosis and therapy of this rare and severe disease.

The correlation of the neutrophil-lymphocyte ratio to clinical and imaging parameters in patients with thyroid eye disease.

Thyroid eye disease (TED) is the major extrathyroidal manifestation of Graves' disease (GD). Treatment choice is based on clinical activity and severity of TED, as evaluated with clinical activity score (CAS) and magnetic resonance (MR) imaging. We aimed to determine the relationship between neutrophil-to-lymphocyte ratio (NLR), a readily available indicator of systemic inflammation, and clinical and MR imaging parameters in TED patients. Eighty-seven consecutive TED patients were included. The average signal intensity ratio (SIR), average extraocular muscle (EOM) diameter, and proptosis of the study eye were extracted from MR images. A baseline NLR ≥ 2.0 was recorded in 37 (42.5%) patients and NLR < 2.0 in 50 (57.5%) patients. TED patients with NLR ≥ 2.0 were older, had a higher CAS, average SIR, average EOM diameter and proptosis, and a lower serum thyrotrophin receptor antibody level than patients with NLR < 2.0 (all P < 0.05). All MR parameters showed significant correlation with CAS (P < 0.05). NLR correlated significantly with CAS (P = 0.001), average SIR (P = 0.004), average EOM diameter (P = 0.007), and proptosis (P = 0.007). Multiple regression revealed a significant correlation between NLR and CAS (P = 0.001), average SIR (P = 0.029), and proptosis (P = 0.037). Cox regression analysis showed that a high NLR at baseline was associated with a worse clinical outcome of TED (hazard ratio 3.7, 95% CI 1.22-11.2, P = 0.02), at a median follow-up of 25 months. In conclusion, NLR was correlated with CAS and MR imaging parameters and was associated with a worse clinical outcome of TED at follow-up in patients with TED. Additional prospective studies are needed to validate our findings.

Jointly estimating bias field and reconstructing uniform MRI image by deep learning.

Bias field is one of the main artifacts that degrade the quality of magnetic resonance images. It introduces intensity inhomogeneity and affects image analysis such as segmentation. In this work, we proposed a deep learning approach to jointly estimate bias field and reconstruct uniform image. By modeling the quality degradation process as the product of a spatially varying field and a uniform image, the network was trained on 800 images with true bias fields from 12 healthy subjects. A network structure of bias field estimation and uniform image reconstruction was designed to compensate for the intensity loss. To further evaluate the benefit of bias field correction, a quantitative analysis was made on image segmentation. Experimental results show that the proposed BFCNet improves the image uniformity by 8.3% and 10.1%, the segmentation accuracy by 4.1% and 6.8% on white and grey matter in T2-weighted brain images. Moreover, BFCNet outperforms the state-of-the-art traditional methods and deep learning methods on estimating bias field and preserving image structure, and BFCNet is robust to different levels of bias field and noise.

Risk factors and diagnostic prediction models for papillary thyroid carcinoma.

Thyroid nodules (TNs) represent a common scenario. More accurate pre-operative diagnosis of malignancy has become an overriding concern. This study incorporated demographic, serological, ultrasound, and biopsy data and aimed to compare a new diagnostic prediction model based on Back Propagation Neural Network (BPNN) with multivariate logistic regression model, to guide the decision of surgery. Records of 2,090 patients with TNs who underwent thyroid surgery were retrospectively reviewed. Multivariate logistic regression analysis indicated that Bethesda category (OR=1.90, P<0.001), TIRADS (OR=2.55, P<0.001), age (OR=0.97, P=0.002), nodule size (OR=0.53, P<0.001), and serum levels of Tg (OR=0.994, P=0.004) and HDL-C (OR=0.23, P=0.001) were statistically significant independent differentiators for patients with PTC and benign nodules. Both BPNN and regression models showed good accuracy in differentiating PTC from benign nodules (area under the curve [AUC], 0.948 and 0.924, respectively). Notably, the BPNN model showed a higher specificity (88.3% vs. 73.9%) and negative predictive value (83.7% vs. 45.8%) than the regression model, while the sensitivity (93.1% vs. 93.9%) was similar between two models. Stratified analysis based on Bethesda indeterminate cytology categories showed similar findings. Therefore, BPNN and regression models based on a combination of demographic, serological, ultrasound, and biopsy data, all of which were readily available in routine clinical practice, might help guide the decision of surgery for TNs.