Multisource Differential Fusion Driven Monocular Endoscope Hybrid 3-D Tracking for Advanced Endoscopic Navigation Surgery.

Surgical navigation systems involve various technologies of segmentation, calibration, registration, tracking, and visualization. These systems aim to superimpose multisource information in the surgical field and provide surgeons with a composite overlay (augmented-reality) view, improving the operative precision and experience. Surgical 3-D tracking is the key to build these systems. Unfortunately, surgical 3-D tracking is still a challenge to endoscopic and robotic navigation systems and easily gets trapped in image artifacts, tissue deformation, and inaccurate positional (e.g., electromagnetic) sensor measurements. This work explores a new monocular endoscope hybrid 3-D tracking method called spatially constrained adaptive differential evolution that combines two spatial constraints with observation-recall adaptive propagation and observation-based fitness computing for stochastic optimization. Specifically, we spatially constraint inaccurate electromagnetic sensor measurements to the centerline of anatomical tubular structures to keep them physically locating inside the tubes, as well as interpolate these measurements to reduce jitter errors for smooth 3-D tracking. We then propose observation-recall adaptive propagation with fitness computing to precisely fuse the constrained sensor measurements, preoperative images, and endoscopic video sequences for accurate hybrid 3-D tracking. Additionally, we also propose a new marker-free hybrid registration strategy to precisely align positional sensor measurements to preoperative images. Our new framework was evaluated on a large amount of clinical data acquired from various surgical endoscopic procedures, with the experimental results showing that it certainly outperforms current surgical 3-D approaches. In particular, the position and rotation errors were significantly reduced from (6.55, 11.4) to (3.02 mm, 8.54 °).

Gingival-derived mesenchymal stem cells alleviate allergic asthma inflammation via HGF in animal models.

Allergic asthma is a chronic non-communicable disease characterized by lung tissue inflammation. Current treatments can alleviate the clinical symptoms to some extent, but there is still no cure. Recently, the transplantation of mesenchymal stem cells (MSCs) has emerged as a potential approach for treating allergic asthma. Gingival-derived mesenchymal stem cells (GMSCs), a type of MSC recently studied, have shown significant therapeutic effects in various experimental models of autoimmune diseases. However, their application in allergic diseases has yet to be fully elucidated. In this study, using an OVA-induced allergic asthma model, we demonstrated that GMSCs decrease CD11b+CD11c+ proinflammatory dendritic cells (DCs), reduce Th2 cells differentiation, and thus effectively diminish eosinophils infiltration. We also identified that the core functional factor, hepatocyte growth factor (HGF) secreted by GMSCs, mediated its effects in relieving airway inflammation. Taken together, our findings indicate GMSCs as a potential therapy for allergic asthma and other related diseases.

Roles of IRF4 in various immune cells in systemic lupus erythematosus.

Interferon regulatory factor 4 (IRF4) is a member of IRF family of transcription factors which mainly regulates the transcription of IFN. IRF4 is restrictively expressed in immune cells such as T and B cells, macrophages, as well as DC. It is essential for the development and function of these cells. Since these cells take part in the homeostasis of the immune system and dysfunction of them contributes to the initiation and progress of systemic lupus erythematosus (SLE), the roles of IRF4 in the SLE development becomes an important topic. Here we systemically discuss the biological characteristics of IRF4 in various immune cells and analyze the pathologic effects of IRF4 alteration in SLE and the potential targeting therapeutics of SLE.

miRNA-148a-containing GMSC-derived EVs modulate Treg/Th17 balance via IKKB/NF-κB pathway and treat a rheumatoid arthritis model.

Mesenchymal stem cells (MSCs) have demonstrated potent immunomodulatory properties that have shown promise in the treatment of autoimmune diseases, including rheumatoid arthritis (RA). However, the inherent heterogeneity of MSCs triggered conflicting therapeutic outcomes, raising safety concerns and limiting their clinical application. This study aimed to investigate the potential of extracellular vesicles derived from human gingival mesenchymal stem cells (GMSC-EVs) as a therapeutic strategy for RA. Through in vivo experiments using an experimental RA model, our results demonstrate that GMSC-EVs selectively homed to inflamed joints and recovered Treg and Th17 cell balance, resulting in the reduction of arthritis progression. Our investigations also uncovered miR-148a-3p as a critical contributor to the Treg/Th17 balance modulation via IKKB/NF-κB signaling orchestrated by GMSC-EVs, which was subsequently validated in a model of human xenograft versus host disease (xGvHD). Furthermore, we successfully developed a humanized animal model by utilizing synovial fibroblasts obtained from patients with RA (RASFs). We found that GMSC-EVs impeded the invasiveness of RASFs and minimized cartilage destruction, indicating their potential therapeutic efficacy in the context of patients with RA. Overall, the unique characteristics - including reduced immunogenicity, simplified administration, and inherent ability to target inflamed tissues - position GMSC-EVs as a viable alternative for RA and other autoimmune diseases.

Favre-Racouchot Syndrome.

This case report describes multiple solitary open black comedones located bilaterally on the malar cheeks and temples as well as yellowish, smooth-surfaced papulonodular lesions in close association with the comedones.

The current status and prospect of immunotherapy in colorectal cancer

Metastatic colorectal cancer (mCRC) is a heterogeneous disease. We reviewed the current clinical trials on immunotherapy in metastatic colorectal cancer with high microsatellite instability and microsatellite stability. Owing to the advances in immunotherapy, its use has gradually expanded from second- and third-line therapies to first-line, early neoadjuvant, and adjuvant therapies. Based on current research results, immunotherapy has shown very good results in dMMR/MSI-H patients, whether it is neoadjuvant therapy for operable patients or first-line or multi-line therapy for advanced patients. KEYNOTE 016 study also showed that patients with MSS were basically ineffective in single immunotherapy. Moreover, immunotherapy for colorectal cancer may also require identification of new biomarkers (AU)

Infusion of GMSCs relieves autoimmune arthritis by suppressing the externalization of neutrophil extracellular traps via PGE2-PKA-ERK axis.

INTRODUCTION: Rheumatoid arthritis (RA) is a systemic autoimmune disease with limited treatment success, characterized by chronic inflammation and progressive cartilage and bone destruction. Accumulating evidence has shown that neutrophil extracellular traps (NETs) released by activated neutrophils are important for initiating and perpetuating synovial inflammation and thereby could be a promising therapeutic target for RA. K/B × N serum transfer-induced arthritis (STIA) is a rapidly developed joint inflammatory model that somehow mimics the inflammatory response in patients with RA. Human gingival-derived mesenchymal stem cells (GMSCs) have been previously shown to possess immunosuppressive effects in arthritis and humanized animal models. However, it is unknown whether GMSCs can manage neutrophils in autoimmune arthritis. OBJECTIVES: To evaluate whether infusion of GMSCs can alleviate RA by regulating neutrophils and NETs formation. If this is so, we will explore the underlying mechanism(s) in an animal model of inflammatory arthritis. METHODS: The effects of GMSCs on RA were assessed by comparing the symptoms of the K/B × N serum transfer-induced arthritis (STIA) model administered either with GMSCs or with control cells. Phenotypes examined included clinical scores, rear ankle thickness, paw swelling, inflammation, synovial cell proliferation, and immune cell frequency. The regulation of GMSCs on NETs was examined through immunofluorescence and immunoblotting in GMSCs-infused STIA mice and in an in vitro co-culture system of neutrophils with GMSCs. The molecular mechanism(s) by which GMSCs regulate NETs was explored both in vitro and in vivo by silencing experiments. RESULTS: We found in this study that adoptive transfer of GMSCs into STIA mice significantly ameliorated experimental arthritis and reduced neutrophil infiltration and NET formation. In vitro studies also showed that GMSCs inhibited the generation of NETs in neutrophils. Subsequent investigations revealed that GMSCs secreted prostaglandin E2 (PGE2) to activate protein kinase A (PKA), which ultimately inhibited the downstream extracellular signal-regulated kinase (ERK) pathway that is essential for NET formation. CONCLUSION: Our results demonstrate that infusion of GMSCs can ameliorate inflammatory arthritis mainly by suppressing NET formation via the PGE2-PKA-ERK signaling pathway. These findings further support the notion that the manipulation of GMSCs is a promising stem cell-based therapy for patients with RA and other autoimmune and inflammatory diseases.

The current status and prospect of immunotherapy in colorectal cancer.

Metastatic colorectal cancer (mCRC) is a heterogeneous disease. We reviewed the current clinical trials on immunotherapy in metastatic colorectal cancer with high microsatellite instability and microsatellite stability. Owing to the advances in immunotherapy, its use has gradually expanded from second- and third-line therapies to first-line, early neoadjuvant, and adjuvant therapies. Based on current research results, immunotherapy has shown very good results in dMMR/MSI-H patients, whether it is neoadjuvant therapy for operable patients or first-line or multi-line therapy for advanced patients. KEYNOTE 016 study also showed that patients with MSS were basically ineffective in single immunotherapy. Moreover, immunotherapy for colorectal cancer may also require identification of new biomarkers.

Heterogeneous ferroptosis susceptibility of macrophages caused by focal iron overload exacerbates rheumatoid arthritis.

Focal iron overload is frequently observed in patients with rheumatoid arthritis (RA), yet its functional significance remains elusive. Herein, we report that iron deposition in lesion aggravates arthritis by inducing macrophage ferroptosis. We show that excessive iron in synovial fluid positively correlates with RA disease severity as does lipid hyperoxidation of focal monocyte/macrophages. Further study reveals high susceptibility to iron induced ferroptosis of the anti-inflammatory macrophages M2, while pro-inflammatory M1 are less affected. Distinct glutathione peroxidase 4 (GPX4) degradation depending on p62/SQSTM1 in the two cell types make great contribution mechanically. Of note, ferroptosis inhibitor liproxstatin-1 (LPX-1) can alleviate the progression of K/BxN serum-transfer induced arthritis (STIA) mice accompanied with increasing M2 macrophages proportion. We thus propose that the heterogeneous ferroptosis susceptibility of macrophage subtypes as well as consequent inflammation and immune disorders are potential biomarkers and therapeutic targets in RA.

Epithelial SIRT6 governs IL-17A pathogenicity and drives allergic airway inflammation and remodeling.

Dysregulation of IL-17A is closely associated with airway inflammation and remodeling in severe asthma. However, the molecular mechanisms by which IL-17A is regulated remain unclear. Here we identify epithelial sirtuin 6 (SIRT6) as an epigenetic regulator that governs IL-17A pathogenicity in severe asthma. Mice with airway epithelial cell-specific deletion of Sirt6 are protected against allergen-induced airway inflammation and remodeling via inhibiting IL-17A-mediated inflammatory chemokines and mesenchymal reprogramming. Mechanistically, SIRT6 directly interacts with RORγt and mediates RORγt deacetylation at lysine 192 via its PPXY motifs. SIRT6 promotes RORγt recruitment to the IL-17A gene promoter and enhances its transcription. In severe asthma patients, high expression of SIRT6 positively correlates with airway remodeling and disease severity. SIRT6 inhibitor (OSS_128167) treatment significantly attenuates airway inflammation and remodeling in mice. Collectively, these results uncover a function for SIRT6 in regulating IL-17A pathogenicity in severe asthma, implicating SIRT6 as a potential therapeutic target for severe asthma.

Targeting kinase ITK treats autoimmune arthritis via orchestrating T cell differentiation and function.

IL-2 inducible T cell kinase (ITK) is critical in T helper subset differentiation and its inhibition has been suggested for the treatment of T cell-mediated inflammatory diseases. T follicular helper (Tfh), Th17 and regulatory T cells (Treg) also play important roles in the development of rheumatoid arthritis (RA), while the role of ITK in the development of RA and the intricate balance between effector T and regulatory T cells remains unclear. Here, we found that CD4+ T cells from RA patients presented with an elevated ITK activation. ITK inhibitor alleviated existing collagen-induced arthritis (CIA) and reduced antigen specific antibody production. Blocking ITK kinase activity interferes Tfh cell generation. Moreover, ITK inhibitor effectively rebalances Th17 and Treg cells by regulating Foxo1 translocation. Furthermore, we identified dihydroartemisinin (DHA) as a potential ITK inhibitor, which could inhibit PLC-γ1 phosphorylation and the progression of CIA by rebalancing Th17 and Treg cells. Out data imply that ITK activation is upregulated in RA patients, and therefore blocking ITK signal may provide an effective strategy to treat RA patients and highlight the role of ITK on the Tfh induction and RA progression.

Phase-field lattice Boltzmann equation for wettable particle fluid dynamics.

In this paper a phase-field based lattice Boltzmann equation (LBE) is developed to simulate wettable particles fluid dynamics together with the smoothed-profile method (SPM). In this model the evolution of a fluid-fluid interface is captured by the conservative Allen-Cahn equation (CACE) LBE, and the flow field is solved by a classical incompressible LBE. The solid particle is represent by SPM, and the fluid-solid interaction force is calculated by direct force method. Some benchmark tests including a single wettable particle trapped at the fluid-fluid interface without gravity, capillary interactions between two wettable particles under gravity, and sinking of a horizontal cylinder through an air-water interface are carried out to validate present CACE LBE for fluid-fluid-solid flows. Raft sinking of multiple horizontal cylinders (up to five cylinders) through an air-water interface is further investigated with the present CACE LBE, and a nontrivial dynamics with an unusual nonmonotonic motion of the multiple cylinders is observed in the vertical plane. Numerical results show that the predictions by the present LBE are in good agreement with theoretical solutions and experimental data.

Periampullary tumors in a patient with pancreatic divisum and neurofibromatosis type 1: a case report.

INTRODUCTION: We present a case of a male patient with neurofibromatosis type 1 diagnosed with pancreatic divisum and several gastrointestinal tumors. A 55-year-old man was admitted to the hospital with recurrent chronic pancreatitis, indicating a large mass in the ampulla. In addition, genetic testing revealed two unique germline mutations in the neurofibromin (NF1) gene, and their potential interaction in promoting cancer was further investigated. CONCLUSION: The first similar case was reported in 2020. The current case was distinct from other cases since an additional two NF1 mutations were found in the patient. In conjunction with prior case reports, our findings imply that genetic testing in patients diagnosed with neurofibromatosis type 1 could be helpful in the development of effective treatments.

Learning how to detect: A deep reinforcement learning method for whole-slide melanoma histopathology images.

Cutaneous melanoma represents one of the most life-threatening malignancies. Histopathological image analysis serves as a vital tool for early melanoma detection. Deep neural network (DNN) models are frequently employed to aid pathologists in enhancing the efficiency and accuracy of diagnoses. However, due to the paucity of well-annotated, high-resolution, whole-slide histopathology image (WSI) datasets, WSIs are typically fragmented into numerous patches during the model training and testing stages. This process disregards the inherent interconnectedness among patches, potentially impeding the models' performance. Additionally, the presence of excess, non-contributing patches extends processing times and introduces substantial computational burdens. To mitigate these issues, we draw inspiration from the clinical decision-making processes of dermatopathologists to propose an innovative, weakly supervised deep reinforcement learning framework, titled Fast medical decision-making in melanoma histopathology images (FastMDP-RL). This framework expedites model inference by reducing the number of irrelevant patches identified within WSIs. FastMDP-RL integrates two DNN-based agents: the search agent (SeAgent) and the decision agent (DeAgent). The SeAgent initiates actions, steered by the image features observed in the current viewing field at various magnifications. Simultaneously, the DeAgent provides labeling probabilities for each patch. We utilize multi-instance learning (MIL) to construct a teacher-guided model (MILTG), serving a dual purpose: rewarding the SeAgent and guiding the DeAgent. Our evaluations were conducted using two melanoma datasets: the publicly accessible TCIA-CM dataset and the proprietary MELSC dataset. Our experimental findings affirm FastMDP-RL's ability to expedite inference and accurately predict WSIs, even in the absence of pixel-level annotations. Moreover, our research investigates the WSI-based interactive environment, encompassing the design of agents, state and reward functions, and feature extractors suitable for melanoma tissue images. This investigation offers valuable insights and references for researchers engaged in related studies. The code is available at: https://github.com/titizheng/FastMDP-RL.

Atomically Precise Copper Nanoclusters for Highly Efficient Electroreduction of CO2 towards Hydrocarbons via Breaking the Coordination Symmetry of Cu Site.

We propose an effective highest occupied d-orbital modulation strategy engendered by breaking the coordination symmetry of sites in the atomically precise Cu nanocluster (NC) to switch the product of CO2 electroreduction from HCOOH/CO to higher-valued hydrocarbons. An atomically well-defined Cu6 NC with symmetry-broken Cu-S2 N1 active sites (named Cu6 (MBD)6 , MBD=2-mercaptobenzimidazole) was designed and synthesized by a judicious choice of ligand containing both S and N coordination atoms. Different from the previously reported high HCOOH selectivity of Cu NCs with Cu-S3 sites, the Cu6 (MBD)6 with Cu-S2 N1 coordination structure shows a high Faradaic efficiency toward hydrocarbons of 65.5 % at -1.4 V versus the reversible hydrogen electrode (including 42.5 % CH4 and 23 % C2 H4 ), with the hydrocarbons partial current density of -183.4 mA cm-2 . Theoretical calculations reveal that the symmetry-broken Cu-S2 N1 sites can rearrange the Cu 3d orbitals with d x 2 - y 2 ${d_{x^2 - y^2 } }$ as the highest occupied d-orbital, thus favoring the generation of key intermediate *COOH instead of *OCHO to favor *CO formation, followed by hydrogenation and/or C-C coupling to produce hydrocarbons. This is the first attempt to regulate the coordination mode of Cu atom in Cu NCs for hydrocarbons generation, and provides new inspiration for designing atomically precise NCs for efficient CO2 RR towards highly-valued products.

In-situ producing CsPbBr3 nanocrystals on (001)-faceted TiO2 nanosheets as S­scheme heterostructure for bifunctional photocatalysis.

Fabricating a cost-effective yet highly active photocatalyst to reduce CO2 to CO and oxidize benzyl alcohol to benzaldehyde simultaneously, is challenging. Herein, we construct an S-scheme 0D/2D CsPbBr3/TiO2 heterostructure for bifunctional photocatalysis. An in-situ synthetic route is used, which enables the precise integration between CsPbBr3 nanocrystals and ultrathin TiO2 nanosheets exposed with (001) facets (termed as TiO2-001), resulting in a tightly coupled heterointerface and desirable band offsets. The as-prepared CsPbBr3/TiO2-001heterojunctions exhibit boosted charge carrier kinetics, particularly, quick carrier separation/transfer and efficient utilization. Experimental results and theoretical calculations validate the S-scheme route in CsPbBr3/TiO2-001, which allows the enrichment of strongly conserved electrons-holes at conduction and valence bands of CsPbBr3 and TiO2-001, respectively. Consequently, compared to its counterparts, an excellent bifunctional activity (with 24 h reusability) is realized over CsPbBr3/TiO2-001, where the production rate of CO and benzaldehyde reach up to 78.06 µmol g-1h-1 and 1.77 mmol g-1h-1 respectively, without employing any sacrificial agents. This work highlights the development of perovskite-based heterostructures and describes the efficient harnessing of redox potentials and charge carriers towards combined photocatalytic systems.

In Situ Constructed Perovskite-Chalcogenide Heterojunction for Photocatalytic CO2 Reduction.

Perovskite nanocrystals (PNCs) are promising candidates for solar-to-fuel conversions yet exhibit low photocatalytic activities mainly due to serious recombination of photogenerated charge carriers. Constructing heterojunction is regarded as an effective method to promote the separation of charge carriers in PNCs. However, the low interfacial quality and non-directional charge transfer in heterojunction lead to low charge transfer efficiency. Herein, a CsPbBr3 -CdZnS heterojunction is designed and prepared via an in situ hot-injection method for photocatalytic CO2 reduction. It is found that the high-quality interface in heterojunction and anisotropic charge transfer of CdZnS nanorods (NRs) enable efficient spatial separation of charge carriers in CsPbBr3 -CdZnS heterojunction. The CsPbBr3 -CdZnS heterojunction achieves a higher CO yield (55.8 µmol g-1  h-1 ) than that of the pristine CsPbBr3 NCs (13.9 µmol g-1  h-1 ). Furthermore, spectroscopic experiments and density functional theory (DFT) simulations further confirm that the suppressed recombination of charge carriers and lowered energy barrier for CO2 reduction contribute to the improved photocatalytic activity of the CsPbBr3 -CdZnS heterojunction. This work demonstrates a valid method to construct high-quality heterojunction with directional charge transfer for photocatalytic CO2 reduction. This study is expected to pave a new avenue to design perovskite-chalcogenide heterojunction.

Ultra-Narrow-Bandwidth Deep-Red Electroluminescence Based on Green Plant-Derived Carbon Dots.

Deep-red light-emitting diodes (DR-LEDs, >660 nm) with high color-purity and narrow-bandwidth emission are promising for full-color displays and solid-state lighting applications. Currently, the DR-LEDs are mainly based on conventional emitters such as organic materials and heavy-metal based quantum dots (QDs) and perovskites. However, the organic materials always suffer from the complicated synthesis, inferior color purity with full-width at half-maximum (FWHM) more than 40 nm, and the QDs and perovskites still suffer from serious problems related to toxicity. Herein, this work reports the synthesis of efficient and high color-purity deep-red carbon dots (CDs) with a record narrow FWHM of 21 nm and a high quantum yield of more than 50% from readily available green plants. Moreover, an exciplex host is further established using a polymer and small molecular blend, which has been shown to be an efficient strategy for producing high color-purity monochrome emission from deep-red CDs via Förster energy transfer (FET). The deep-red CD-LEDs display high color-purity with Commission Internationale de l'Eclairage (CIE) coordinates of (0.692, 0.307). To the best of the knowledge, this is the first report of high color-purity CD-LEDs in the deep-red region, opening the door for the application of CDs in the development of high-resolution light-emitting display technologies.