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Triboelectric nanogenerators (TENGs) play a crucial role in attaining sustainable energy for various wearable devices. Polymer materials are essential components of TENGs. Biopolymers are suitable materials for TENGs because of their degradability, natural sourcing, and cost-effectiveness. Herein, the latest progress in commonly used biopolymers and well-designed biomimetic techniques for TENG is summarized. The applications of natural rubber, polysaccharides, protein-based biopolymers, and other common synthetic biopolymers in TENG technology are summarized in detail. Each biopolymer is discussed based on its electrification capability, polarity variations, and specific functionalities as active and functional layers of TENGs. Important biomimetic strategies and related applications of specific biopolymers are also summarized to guide the structural and functional design of TENG. In the future, the study of triboelectric biopolymers may focus on exploring alternative candidates, enhancing charge density, and expanding functionality. Various possible applications of biopolymer-based TENGs are proposed in this review. By applying biopolymers and related biomimetic methods to TENG devices, the applications of TENG in the fields of healthcare, environmental monitoring, and wearable/implantable electronics can be further promoted.
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BACKGROUND: Chronic stress induces cognitive deficits. There is a well-established connection between the enteric and central nervous systems through the microbiota-gut-brain (MGB) axis. However, the effects of the gut microbiota on cognitive deficits remain unclear. The present study aimed to elucidate the microbiota composition in cognitive deficits and explore its potential in predicting chronic stress-induced cognitive deficits. METHODS: Mice were randomly divided into control and chronic restraint stress (CRS) groups. The mice subjected to CRS were further divided into cognitive deficit (CRS-CD) and non-cognitive deficit (CRS-NCD) groups using hierarchical cluster analysis of novel object recognition test results. The composition and diversity of the gut microbiota were analyzed. RESULTS: After being subjected to chronic restraint distress, the CRS-CD mice travelled shorter movement distances (p = 0.034 vs. CRS-NCD; p < 0.001 vs. control) and had a lower recognition index than the CRS-NCD (p < 0.0001 vs. CRS-NCD; p < 0.0001 vs. control) and control mice. The results revealed that 5 gut bacteria at genus levels were significantly different in the fecal samples of mice in the three groups. Further analyses demonstrated that Muricomes were not only significantly enriched in the CRS-CD group but also correlated with a decreased cognitive index. The area under the receiver operating curve of Muricomes for CRS-induced cognitive deficits was 0.96. CONCLUSIONS: Our study indicates that the composition of the gut microbiota is involved in the development of cognitive deficits induced by chronic restraint stress. Further analysis revealed that Muricomes have the potential to predict the development of chronic stress-induced cognitive deficits in mice.
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Disfunción Cognitiva , Heces , Microbioma Gastrointestinal , Restricción Física , Estrés Psicológico , Animales , Ratones , Disfunción Cognitiva/microbiología , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/etiología , Masculino , Estrés Psicológico/microbiología , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Heces/microbiología , Bacterias/clasificación , Bacterias/aislamiento & purificación , Bacterias/genética , Ratones Endogámicos C57BL , Modelos Animales de Enfermedad , Eje Cerebro-Intestino/fisiologíaRESUMEN
This study aims to address the issue of high energy consumption in the hydrocyclone separation process. By introducing a novel slotted overflow pipe structure and utilizing experimental and response surface optimization methods, the optimal parameters were determined. The research results indicate that the number of slots, slot angles, and positioning dimensions significantly influence the performance of the hydrocyclone separator. The optimal combination was found to be three layers of slots, a positioning dimension of 5.3 mm, and a slot angle of 58°. In a Φ100mm hydrocyclone separator, validated through multiple experiments, the separation efficiency increased by 0.26% and the pressure drop reduced by 24.88% under a flow rate of 900 ml/s. CFD simulation verified the reduction in internal flow field velocity and pressure drop due to the slotted structure. Therefore, this study provides an effective reference for designing efficient and low-energy hydrocyclone separators.
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BACKGROUND: The incidence of coronary heart disease (CHD) in youth is rapidly increasing but difficultly recognized in the early stage. METHODS AND RESULTS: In this retrospective study, 194 CHD patients under the age of 45 who previously experienced chest pain symptoms and 170 non-CHD patients were included and demographic data were collected. Systemic inflammation index (SII) and systemic inflammation response index (SIRI) were increased in young CHD patients (p < 001). Spearman's correlation analysis showed that both SII and SIRI were negatively correlated with HDL and positively correlated with hypertension, Gensini score, and hsTnI. Logistic regression analysis indicated that SII and SIRI were independently associated with the presence of CHD in youth with chest pain symptoms. The area under the ROC curve (AUC) of the SII model for young CHD patients was 0.805 (0.728-0.869), and the sensitivity and specificity were 0.65 and 0.823, respectively. Meanwhile, the AUC for the SIRI model was 0.812 (0.739-0.872), and the sensitivity and specificity were 0.673 and 0.8022. The calibration curves of both SII and SIRI models are in good agreement with the actual curves. And the decision curves of both models indicated their clinical practicality. CONCLUSION: SII and SIRI are independent risk factors for CHD in young adults, which can quickly and effectively identify CHD patients among young adults who have previously experienced chest pain symptoms.
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Enfermedad Coronaria , Inflamación , Humanos , Masculino , Femenino , Enfermedad Coronaria/inmunología , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/sangre , Estudios Retrospectivos , Inflamación/inmunología , Inflamación/sangre , Inflamación/diagnóstico , Adulto , Adulto Joven , Curva ROC , Adolescente , Factores de Riesgo , Dolor en el Pecho/inmunología , Dolor en el Pecho/diagnóstico , Dolor en el Pecho/epidemiología , Dolor en el Pecho/etiología , Biomarcadores/sangreRESUMEN
The depletion of nutrient sources in fertilizers demands a paradigm shift in the treatment of nutrient-rich wastewater, such as urine, to enable efficient resource recovery and high-value conversion. This study presented an integrated bipolar membrane electrodialysis (BMED) and hollow fiber membrane (HFM) system for near-complete resource recovery and zero-discharge from urine treatment. Computational simulations and experimental validations demonstrated that a higher voltage (20 V) significantly enhanced energy utilization, while an optimal flow rate of 0.4 L/min effectively mitigated the negative effects of concentration polarization and electro-osmosis on system performance. Within 40 min, the process separated 90.13% of the salts in urine, with an energy consumption of only 8.45 kWh/kgbase. Utilizing a multi-chamber structure for selective separation, the system achieved recovery efficiencies of 89% for nitrogen, 96% for phosphorus, and 95% for potassium from fresh urine, converting them into high-value products such as 85 mM acid, 69.5 mM base, and liquid fertilizer. According to techno-economic analysis, the cost of treating urine using this system at the lab-scale was $6.29/kg of products (including acid, base, and (NH4)2SO4), which was significantly lower than the $20.44/kg cost for the precipitation method to produce struvite. Excluding fixed costs, a net profit of $18.24/m3 was achieved through the recovery of valuable products from urine using this system. The pilot-scale assessment showed that the net benefit amounts to $19.90/m3 of urine, demonstrating significant economic feasibility. This study presents an effective approach for the near-complete resource recovery and zero-discharge treatment of urine, offering a practical solution for sustainable nutrient recycling and wastewater management.
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Membranas Artificiales , Orina , Orina/química , Eliminación de Residuos Líquidos/métodos , Aguas Residuales/química , Fósforo , Técnicas Electroquímicas/métodos , Nitrógeno , Purificación del Agua/métodos , Fertilizantes , Potasio/orinaRESUMEN
The MASS cohort comprises 2000 ICU patients with severe pneumonia, covering community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, sourced from 19 hospitals across 10 cities in three provinces. A wide array of samples including bronchoalveolar lavage fluid, sputum, feces, and whole blood are longitudinally collected throughout patients' ICU stays. The cohort study seeks to uncover the dynamics of lung and gut microbiomes and their associations with severe pneumonia and host susceptibility, integrating deep metagenomics and transcriptomics with detailed clinical data.
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Heteromeric pore-forming proteins often contain recognition patterns or stereospecific selection filters. However, the construction of heteromeric pore-forming proteins for single-molecule sensing is challenging due to the uncontrollability of producing position isomers and difficulties in purification of regio-defined products. To overcome these preparation obstacles, we present an in situ strategy involving single-molecule chemical modification of a heptameric pore-forming protein to build a stereo- and regio-specific heteromeric nanopore (hetero-nanopore) with a subunit stoichiometric ratio of 3:4. The steric hindrance inherent in the homo-nanopore of K238C aerolysin directs the stereo- and regio-selective modification of maleimide derivatives. Our method utilizes real-time ionic current recording to facilitate controlled voltage manipulation for stoichiometric modification and position-based side-isomer removal. Single-molecule experiments and all-atom molecular dynamics simulations revealed that the hetero-nanopore features an asymmetric stereo- and regio-defined residue structure. The hetero-nanopore produced was characterized by mass spectrometry and single-particle cryogenic electron microscopy. In a proof-of-concept single-molecule sensing experiment, the hetero-nanopore exhibited 95% accuracy for label-free discrimination of four peptide stereoisomers with single-amino-acid structural and chiral differences in the mixtures. The customized hetero-nanopores could advance single-molecule sensing.
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Patterns of BOLD response can be decoded using the population receptive field (PRF) model to reveal how visual input is represented on the cortex (Dumoulin and Wandell, 2008). The time cost of evaluating the PRF model is high, often requiring days to decode BOLD signals for a small cohort of subjects. We introduce the qPRF, an efficient method for decoding that reduced the computation time by a factor of 1436 when compared to another widely available PRF decoder (Kay, Winawer, Mezer and Wandell, 2013) on a benchmark of data from the Human Connectome Project (HCP; Van Essen, Smith, Barch, Behrens, Yacoub and Ugurbil, 2013). With a specially designed data structure and an efficient search algorithm, the qPRF optimizes the five PRF model parameters according to a least-squares criterion. To verify the accuracy of the qPRF solutions, we compared them to those provided by Benson, Jamison, Arcaro, Vu, Glasser, Coalson, Van Essen, Yacoub, Ugurbil, Winawer and Kay (2018). Both hemispheres of the 181 subjects in the HCP data set (a total of 10,753,572 vertices, each with a unique BOLD time series of 1800 frames) were decoded by qPRF in 15.2 hours on an ordinary CPU. The absolute difference in R 2 reported by Benson et al. and achieved by the qPRF was negligible, with a median of 0.39% ( R 2 units being between 0% and 100%). In general, the qPRF yielded a slightly better fitting solution, achieving a greater R 2 on 99.7% of vertices. The qPRF may facilitate the development and computation of more elaborate models based on the PRF framework, as well as the exploration of novel clinical applications. Highlights: We describe a novel software system, qPRF, which can perform population receptive field (PRF) decoding of BOLD fMRI at speeds about 1400 times faster than the conventional systems designed for PRF decoding.We show that qPRF yields estimates of PRF model parameters that, in terms of goodness-of-fit, are equivalent to estimates derived using the conventional systems.An efficient similarity-based search strategy, underlies the accelerated computations of qPRF, supported by a specially designed data structure wherein tens of millions of pre-computed prediction curves are stored.
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The Augmented Hebbian Reweighting Model (AHRM) has been effectively utilized to model the collective performance of observers in various perceptual learning studies. In this work, we have introduced a novel hierarchical Bayesian Augmented Hebbian Reweighting Model (HB-AHRM) to simultaneously model the learning curves of individual participants and the entire population within a single framework. We have compared its performance to that of a Bayesian Inference Procedure (BIP), which independently estimates the posterior distributions of model parameters for each individual subject without employing a hierarchical structure. To cope with the substantial computational demands, we developed an approach to approximate the likelihood function in the AHRM with feature engineering and linear regression, increasing the speed of the estimation procedure by 20,000 times. The HB-AHRM has enabled us to compute the joint posterior distribution of hyperparameters and parameters at the population, observer, and test levels, facilitating statistical inferences across these levels. While we have developed this methodology within the context of a single experiment, the HB-AHRM and the associated modeling techniques can be readily applied to analyze data from various perceptual learning experiments and provide predictions of human performance at both the population and individual levels. The likelihood approximation concept introduced in this study may have broader utility in fitting other stochastic models lacking analytic forms.
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The nanoscale electrical double layer plays a crucial role in macroscopic ion adsorption and reaction kinetics. In this study, we achieve controllable ion migration by dynamically regulating asymmetric electrical double layer formation. This tailors the ionic-electronic coupling interface, leading to the development of triboiontronics. Controlling the charge-collecting layer coverage on dielectric substrates allows for charge collection and adjustment of the substrate-liquid contact electrification property. By dynamically managing the asymmetric electrical double layer formation between the dielectric substrate and liquids, we develop a direct-current triboiontronic nanogenerator. This nanogenerator produces a transferred charge density of 412.54 mC/m2, significantly exceeding that of current hydrovoltaic technology and conventional triboelectric nanogenerators. Additionally, incorporating redox reactions to the process enhances the peak power and transferred charge density to 38.64 W/m2 and 540.70 mC/m2, respectively.
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Goblet cell adenocarcinoma (GCA) is a distinctive type of endocrine-exocrine mixed tumor, exhibiting intermediate morphological features between neuroendocrine tumor and adenocarcinoma. It predominantly arises in the appendix, but primary extra-appendiceal GCA is extremely rare. Here, we presented six cases of primary extra-appendiceal GCA from 2016 to 2022. Notably, one case was originating in the bladder which was the first report of primary GCA to occur outside the digestive tract. The tumors frequently displayed variable goblet cell morphology, characterized by cytoplasmic mucin accumulation and basally located nucleus. Low-grade components typically exhibited glandular or clustered patterns without prominent fibrotic responses. High-grade components demonstrated cribriform, cluster and single-file arrangement accompanied by marked fibrous reactions. Immunohistochemically, the tumors showed positivity for both neuroendocrine markersï¼synaptophysin, chromogranin A, CD56 ï¼and adenoids markersï¼CDX-2, CK20ï¼. Next-generation sequencing revealed the most prevalent mutated genes within GCAs were TP53. Due to their morphological and immunohistochemical similarities to primary appendiceal GCA counterparts, we propose a distinct category for extra-appendiceal Goblet cell adenocarcinoma.
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Adenocarcinoma , Biomarcadores de Tumor , Células Caliciformes , Humanos , Masculino , Anciano , Persona de Mediana Edad , Femenino , Adenocarcinoma/patología , Adenocarcinoma/genética , Biomarcadores de Tumor/análisis , Células Caliciformes/patología , Células Caliciformes/metabolismo , Inmunohistoquímica , Anciano de 80 o más Años , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/metabolismoRESUMEN
Triboelectric nanogenerator (TENG) operates on the principle of utilizing contact electrification and electrostatic induction. However, visualization and standardized quantification of surface charges for triboelectric materials remain challenging. Here, we report a surface charge visualization and standardized quantification method using electrostatic surface potential measured by Kevin probe and the iterative regularization strategy. Moreover, a tuning strategy on surface charge is demonstrated based on the corona discharge with a three-electrode design. The long-term stability and dissipation mechanisms of the injected negative or positive charges demonstrate high dependence on deep carrier traps in triboelectric materials. Typically, we achieved a 70-fold enhancement on the output voltage (~135.7 V) for the identical polytetrafluoroethylene (PTFE) based TENG (neg-PTFE/PTFE or posi-PTFE/PTFE triboelectric pair) with stable surface charge density (5% decay after 140 days). The charged PTFE was demonstrated as a robot e-skins for non-contact perception of object geometrics. This work provides valuable tools for surface charge visualization and quantification, giving a new strategy for a deeper understanding of contact electrification.
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The endothelial glycocalyx is damaged in postcardiac arrest syndrome (PCAS), but the prognostic value is unknown. We aimed to observe the expression and prognostic value of glycocalyx shedding products, including syndecan-1 (SDC-1), hyaluronan (HA), and heparan sulfate (HS) in PCAS. Data on clinical and 28-day outcomes of seventy-one consecutive patients with out-of-hospital cardiac arrest (OHCA) after the return of spontaneous circulation (ROSC) were collected. SDC-1, HA, and HS were measured on days 0, 1, and 3 after ROSC. Thirty healthy individuals were controls. Glycocalyx shedding was observed in human umbilical vein endothelial cells (HUVECs) stimulated during hypoxia and reoxygenation in vitro. Within 4 h of ROSC, SDC-1 and HA levels, significantly increased. In the 28-day non-survivors, HA levels showed a gradual upward trend, SDC-1 remained at a high level, and HS levels first increased, then decreased. Kaplan-Meier curves and binary logistic regression analysis showed the prognostic value of SDC-1 levels on days 0, 1, and 3, HA levels on days 1 and 3, and HS levels on day 1. Only HS levels on day 1 showed a prognostic value for 28-day neurological outcomes. SDC-1 and HA levels were positively correlated with the no-flow time. In vitro, HUVECs showed shedding of SDC-1 and HS during a prolonged duration of hypoxia. After ROSC, SDC-1, HA, and HS levels may predict the 28-day survival after PCAS, and HS levels are associated with functional outcomes.
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Biomarcadores , Glicocálix , Heparitina Sulfato , Células Endoteliales de la Vena Umbilical Humana , Paro Cardíaco Extrahospitalario , Sindecano-1 , Humanos , Paro Cardíaco Extrahospitalario/sangre , Glicocálix/metabolismo , Masculino , Femenino , Biomarcadores/sangre , Persona de Mediana Edad , Pronóstico , Sindecano-1/sangre , Sindecano-1/metabolismo , Anciano , Heparitina Sulfato/sangre , Heparitina Sulfato/metabolismo , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Retorno de la Circulación Espontánea , Ácido Hialurónico/sangre , Ácido Hialurónico/metabolismoRESUMEN
Triboelectric nanogenerators (TENGs) as an avant-garde technology that transforms mechanical energy into electrical energy, offering a new direction for green energy and sustainable development. By means of high-efficiency TENGs, conventional materials as new triboelectric materials have exhibited multi-attribute characteristics, achieving innovative applications in the field of micro-nano energy harvesting and self-powered sensing. The progress of TENGs technology with the triboelectric materials is complementary and mutually promoting. On the one hand, one of the cruxes of TENGs lies in the triboelectric materials, which have a decisive impact on their performance. On the other hand, as the research and application of TENGs continue to deepen, higher demands are placed on triboelectric materials, which in turn promotes the advancement of the entire material system as well as the fields of materials science and physics. This work aims to delve into the characteristics, types, preferred choices, and modification treatments of triboelectric materials on the performances of TENGs, hoping to provide guidance and insights for future research and applications.
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INTRODUCTION: Laparoscopic proximal gastrectomy with double flap technique (LPG-DFT) reconstruction has been used for proximal early gastric cancer in recent years. However, its feasibility and safety remain uncertain, as only a few retrospective studies have contained postoperative complications and long-term survival data. LPG-DFT for proximal early gastric cancer is still in the early stages of research. Large-scale, prospective randomised controlled trials (RCTs) are necessary to assess the value of LPG-DFT for proximal early gastric cancer. METHODS AND ANALYSIS: This study is a multicentre, prospective, open-label, RCT that investigates the antireflux effect of LPG-DFT compared with laparoscopic total gastrectomy with Roux-en-Y (LTG-RY) reconstruction for proximal early gastric cancer. A total of 216 eligible patients will be randomly assigned to the LPG-DFT group or the LTG-RY group at a 1:1 ratio using a central, dynamic and stratified block randomisation method, if inclusion criteria are met. General and clinical data will be collected when the patient is enrolled in the study and keep pace with the patient at each stage of his medical and follow-up pathway. The primary endpoint is the proportion of patients with reflux esophagitis (Los Angeles Grade B or more) within 12 months postoperatively. The secondary endpoints included intraoperative outcomes, postoperative recovery, postoperative pain assessment, pathological outcomes, postoperative quality of life, postoperative nutrition status, morbidity and mortality rate, and oncological outcomes (3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year DFS and 5-year OS). ETHICS AND DISSEMINATION: The protocol is approved by the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University ethics committee (registration number: SYSKY-2022-276-02) on 28 September 2022.We will report the positive as well as negative findings in international peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05890339.
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Gastrectomía , Laparoscopía , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirugía , Gastrectomía/métodos , Laparoscopía/métodos , Estudios Prospectivos , Estudios Multicéntricos como Asunto , Colgajos Quirúrgicos , Complicaciones Posoperatorias/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Anastomosis en-Y de Roux/métodos , Reflujo Gastroesofágico/cirugía , Calidad de Vida , Masculino , Adulto , FemeninoRESUMEN
Metal implants require an elastic modulus close to cortical bone (<30 GPa) to avoid stress shielding and ensure adequate load-bearing strength. The metastable ß-type Ti-25Nb-8Sn alloy has a low elastic modulus (52 GPa), but its yield strength (<500 MPa) needs enhancement. This study enhances Ti-25Nb-8Sn's elastic admissible strain through cold rolling and aging heat treatments, investigating the microstructure's impact on mechanical and corrosion properties. The results show that lower-temperature aging (<450 °C) leads to ω-phase precipitation, yielding a 300% increase in yield strength (>1900 MPa). However, this also increases the elastic modulus (~80 GPa), limiting the deformation ability. Higher-temperature aging (>500 °C) eliminates the ω phase, transforming it into α precipitates, resulting in a lower elastic modulus (~65 GPa) and improved deformation ability, with substantial yield strength (>1000 MPa). In summary, the optimal process conditions are determined as 90% cold rolling followed by aging treatment at 550 °C. Under these conditions, Ti-25Nb-8Sn achieves the most suitable yield strength (1207 MPa) and high corrosion resistance, retaining a relatively low elastic modulus (64.7 GPa) and high elastic admissible strain (1.93%). This positions it as an ideal material for biomedical implants.
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CD320, which is a transmembrane protein responsible for facilitating the absorption of vitamin B12, plays a key role in this process. However, the relationships between CD320 and immune cell infiltration levels remain unclear, with limited studies investigating the diagnostic and prognostic significance of CD320 in hepatocellular carcinoma. We used various databases, including the TIMER, GEPIA, UALCAN and TCGA databases to investigate the expression levels of CD320 in hepatocellular carcinoma. Subsequently, we analyzed the prognosis of hepatocellular carcinoma patients with different expression levels of CD320. Furthermore, we also performed Western blot, immunohistochemistry, and immunofluorescence analyses to validate the results of the database analysis. Finally, the functions of CD320 in hepatocellular carcinoma were also confirmed via relevant cell experiments and angiogenesis assays. We found that CD320 expression was significantly upregulated in tumor vascular endothelial cells. Moreover, the knockdown of CD320 led to a reduction in angiogenesis in endothelial cells. Increased expression of CD320 was also correlated with a poor prognosis in patients with hepatocellular carcinoma, which suggested that CD320 may be a potential prognostic marker. Finally, TIMER analysis demonstrated that the infiltration of six immune cell types was significantly associated with high expression levels of CD320 in hepatocellular carcinoma. Herein, we demonstrated that CD320 may play an important role in angiogenesis in hepatocellular carcinoma. These findings suggested that CD320 may be a potential clinical prognostic marker and immunotherapy target for hepatocellular carcinoma.
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OBJECTIVES: To locate the most valuable sites for shear wave elastography (SWE) evaluation and to develop a clinically applicable scoring system based on SWE for systemic sclerosis (SSc) and to verify the accuracy for detection and subdivision and the correlation by modified Rodnan total skin score (mRTSS). METHODS: SSc patients with limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) and symptomatic other rheumatic diseases (ORD) patients were included in this cross-sectional study. We assessed the skin stiffness at forehead, chest, abdomen, and bilateral fingers, hands, forearm, arms, thighs, legs, and feet, by palpation and SWE. Logistic regression was used to screen the most valuable sites for detection of SSc and subdivision of lcSSc and dcSSc, on which a scoring system was developed and verified. RESULTS: A total of 49 lcSSc, 51 dcSSc, and 36 ORD patients were included. The SWE-derived scoring system, including finger, hand, foot, arm, chest, and abdomen, reached a sensitivity and specificity of 80.0% and 94.4%, respectively, for diagnosing SSc at the cut-off value >24. The scoring system, including arm, chest, and abdomen, reached a sensitivity of 72.5% and specificity of 98.0% for subdividing dcSSc at the cut-off value >11. The kappa coefficient between the SWE-derived diagnosis and clinical diagnosis was 0.636 (P<0.001). The SWE-derived total scores of six sites had a strong correlation with mRTSS (r=0.757, p<0.001). CONCLUSIONS: The SWE-derived scoring system can be valuable in detection and evaluation of SSc in clinical application.
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Diagnóstico por Imagen de Elasticidad , Índice de Severidad de la Enfermedad , Humanos , Femenino , Persona de Mediana Edad , Masculino , Diagnóstico por Imagen de Elasticidad/métodos , Estudios Transversales , Adulto , Reproducibilidad de los Resultados , Piel/diagnóstico por imagen , Piel/patología , Esclerodermia Difusa/diagnóstico por imagen , Anciano , Valor Predictivo de las Pruebas , Esclerodermia Limitada/diagnóstico por imagen , Esclerodermia Sistémica/diagnóstico por imagenRESUMEN
BACKGROUND: For decades, the incidence and clinical characteristics of Pneumocystis jirovecii colonization in patients with severe pneumonia was unclear. RESEARCH QUESTION: What are the clinical features and outcomes associated with P jirovecii colonization in individuals diagnosed with severe pneumonia? STUDY DESIGN AND METHODS: In this multicenter, retrospective, matched study, patients with severe pneumonia who underwent BAL clinical metagenomics from 2019 to 2023 in the ICUs of 17 medical centers were enrolled. Patients were diagnosed based on clinical metagenomics, pulmonary CT scans, and clinical presentations. Clinical data were collected retrospectively, and according to propensity score matching and Cox multivariate regression analysis, the prognosis of patients with P jirovecii colonization was compared with that of patients who were P jirovecii-negative. RESULTS: A total of 40% of P jirovecii-positive patients are considered to have P jirovecii colonization. The P jirovecii colonization group had a higher proportion of patients with immunosuppression and a lower lymphocyte count than the P jirovecii-negative group. More frequent detection of cytomegalovirus, Epstein-Barr virus, human herpesvirus-6B, human herpesvirus-7, and torque teno virus in the lungs was associated with P jirovecii colonization than with P jirovecii negativity. By constructing two cohorts through propensity score matching, we incorporated codetected microorganisms and clinical features into a Cox proportional hazards model and revealed that P jirovecii colonization was an independent risk factor for mortality in patients with severe pneumonia. According to sensitivity analyses, which included or excluded codetected microorganisms, and patients not receiving trimethoprim-sulfamethoxazole treatment, similar conclusions were reached. INTERPRETATION: Immunosuppression and a reduced lymphocyte count were identified as risk factors for P jirovecii colonization in patients with non-Pneumocystis pneumonia. More frequent detection of various viruses was observed in patients colonized with P jirovecii, and P jirovecii colonization was associated with an increased 28-day mortality in patients with severe pneumonia.
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Contrast sensitivity, the amount of contrast required to detect or discriminate an object, depends on spatial frequency (SF): The Contrast Sensitivity Function (CSF) peaks at intermediate SFs and drops at lower and higher SFs and is the basis of computational models of visual object recognition. The CSF varies from foveal to peripheral vision, but only a couple studies have assessed changes around polar angle of the visual field. Sensitivity is generally better along the horizontal than the vertical meridian, and better at the lower vertical than the upper vertical meridian, yielding polar angle asymmetries. Here, we investigate CSF attributes at polar angle locations at both group and individual levels, using Hierarchical Bayesian Modeling. This method enables precise estimation of CSF parameters by decomposing the variability of the dataset into multiple levels and analyzing covariance across observers. At the group level, peak contrast sensitivity and corresponding spatial frequency with the highest sensitivity are higher at the horizontal than vertical meridian, and at the lower than upper vertical meridian. At an individual level, CSF attributes (e.g., maximum sensitivity, the most preferred SF) across locations are highly correlated, indicating that although the CSFs differ across locations, the CSF at one location is predictive of the CSF at another location. Within each location, the CSF attributes co-vary, indicating that CSFs across individuals vary in a consistent manner (e.g., as maximum sensitivity increases, so does the SF at which sensitivity peaks), but more so at the horizontal than the vertical meridian locations. These results show similarities and uncover some critical polar angle differences across locations and individuals, suggesting that the CSF should not be generalized across iso-eccentric locations around the visual field. Our window of visibility varies with polar angle: It is enhanced and more consistent at the horizontal meridian.