Acquired hemophilia is a rare disease resulting from autoantibodies against endogenous factor VIII (FVIII), which associates with bleeding and a high mortality rate. The pathophysiology is still ...unclear. Recent studies suggest genetic and environmental factors trigger the breakdown of immune tolerance. We report a 77-year-old Taiwanese man presented with multiple ecchymoses and some hemorrhagic blisters three weeks after SARS-CoV-2 mRNA (Moderna) vaccination. Isolated activated partial thromboplastin time (aPTT) prolongation was found. Acquired hemophilia A (AHA) was confirmed by low factor VIII (FVIII) activity and high titer of FVIII inhibitor. The pathohistology of skin biopsy further supported the concomitant diagnosis of bullous pemphigoid. To date, 6 cases of acquired hemophilia A following SARS-CoV-2 mRNA vaccination were reported worldwide. We reviewed and summarized the characteristics of these cases. We also discussed the rare finding of concomitant acquired hemophilia A and bullous pemphigoid. Bullous pemphigoid results from autoantibody against epithelial basement membrane zone of skin. In this article, we proposed possibility of SARS-CoV-2 mRNA vaccine associated autoimmunity against FVIII and epithelial basement membrane zone.
The association between dopamine neuron loss and functional change in the striatocortical network was analyzed in 31 patients with Parkinson's disease (PD) mean disease duration 4.03 ± 4.20 years; ...Hoehn and Yahr (HY) stage 2.2 ± 1.2 and 37 age-matched normal control subjects. We performed
Tc-TRODAT-1 SPECT/CT imaging to detect neuron losses and resting-state functional magnetic resonance imaging to detect functional changes. Mean striatal dopamine transporter binding ratios were determined by region of interest analysis. The functional connectivity correlation coefficient (fc-cc) was determined in six striatal subregions, and interactions between these binding ratios and the striatocortical fc-cc values were analyzed. The PD patients had significant functional network alterations in all striatal subregions. Lower striatal dopamine transporter binding correlated significantly with lower fc-cc values in the superior medial frontal (SMF) lobe and superior frontal lobe and higher fc-cc values in the cerebellum and parahippocampus. The difference in fc-cc between the ventral inferior striatum and SMF lobe was significantly correlated with increased disease duration (
= -0.533,
= 0.004), higher HY stage (
= -0.431,
= 0.020), and lower activities of daily living score (
= 0.369,
= 0.049). The correlation of frontostriatal network changes with clinical manifestations suggests that fc-cc may serve as a surrogate marker of disease progression.
New TiC/Co
1.5
CrFeNi
1.5
Ti
0.5
cermet was developed by exploiting the advantages of the high-entropy alloy (HEA) binder. A much finer grain structure and thus improved hardness–toughness ...combination were obtained as compared with two traditional binders, Ni and Ni
13
Mo
7
. From the coarsening behavior of TiC grains, the coarsening process of TiC in these three binders is diffusion-controlled. The activation energy of TiC + 20%Co
1.5
CrFeNi
1.5
Ti
0.5
is the highest and that of TiC + 20%Ni is the lowest. The high activation energy of the Co
1.5
CrFeNi
1.5
Ti
0.5
binder was attributable to its high content of carbon-strong-binding elements, Cr and Ti, and cooperative diffusion and higher packing density of multiple different-sized atoms. Low diffusion coefficient, low surface energy of TiC grains, and low solubility of Ti in the HEA liquid explain the slow coarsening of TiC grains. This study demonstrates that Co
1.5
CrFeNi
1.5
Ti
0.5
is an excellent HEA binder for TiC cermets.
Based on a person-centered care, the relationships between people with dementia and caregivers should be interconnected. There is a need to study what attributes would contribute a higher caregiving ...burden from a comprehensive viewpoint of care recipients and caregivers.
Apriori algorithm is performed with 12 variables for antecedents and caregiving burden for the consequent from the self-built database of a medical center in Taiwan. The minimum support, minimum confidence, and lift of Apriori algorithm are set to 5%, 90%, and > 1, respectively.
Thirty-two rules that satisfy the threshold values are found. Our findings show that clinical dementia rating of care recipients, type of dementia of care recipients, and age of caregivers are not the attributing variables to affect the caregiving burden. In contrast, the highest burden results from a female spouse or a sole caregiver. Moreover, the burden is associated with the type of primary care, frequency of care, and help of key activities.
Digital video recorder (DVR) systems are novel security products with significant potential for application in the surveillance market, which, like many other areas of security technology, is ...changing quickly. Consumer demand and procuring budgets of system development firms are increasingly being emphasized, motivating upgrades to system quality. Digital surveillance systems include both hardware and software. Procurers have difficulty complying with these standards due to the wide gap between the descriptions in the standards and interpretations of evaluations of digital video recorder systems such as the functions of channel, recording, playback and display, communication and remote transmission. A case study compares the analytic hierarchy process (AHP) and analytic network process (ANP) decision models, and the comparison results indicate that interdependencies can affect real decisions. For network-like decision models (i.e., decision problems that can be structured in a network model form), ANP represents an effective tool for providing an accurate solution for administrators or managers of this case.
A novel photoluminescence electron beam resist made from the blend of poly(3-hexylthiophene) (P3HT) and poly(methyl methacrylate) (PMMA) has been successfully developed in this study. In order to ...optimize the resolution of the electron beam resist, the variations of nanophase separated morphology produced by differing blending ratios were examined carefully. Concave P3HT-rich island-like domains were observed in the thin film of the resist. The size of concave island-like domains decreased from 350 to 100 nm when decreasing the blending ratio of P3HT/PMMA from 1:5 to 1:50 or lower, concurrently accompanied by significant changes in optical properties and morphological behaviors. The λmax of the film absorption is blue-shifted from 520 to 470 nm, and its λmax of photoluminescence (PL) is also shifted from 660 to 550 nm. The radiative lifetime is shorter while the luminescence efficiency is higher when the P3HT/PMMA ratio decreases. These results are attributed to the quantum confinement effect of single P3HT chain isolated in PMMA matrix, which effectively suppresses the energy transfer between the well-separated polymer chains of P3HT. The factors affecting the resolution of the P3HT/PMMA electron beam resists were systematically investigated, including blending ratios and molecular weight. The photoluminescence resist with the best resolution was fabricated by using a molecular weight of 13 500 Da of P3HT and a blending ratio of 1:1000. Furthermore, high-resolution patterns can be obtained on both flat silicon wafers and rough substrates made from 20 nm Au nanoparticles self-assembled on APTMS (3-aminopropyltrimethoxysilane)-coated silicon wafers. Our newly developed electron beam resist provides a simple and convenient approach for the fabrication of nanoscale photoluminescent periodic arrays, which can underpin many optoelectronic applications awaiting future exploration.
Hepatocellular carcinoma (HCC) is highly prevalent in Asia. Antidepressants have been associated with increase in hepatocellular carcinoma. This is the first Asian population-based study to evaluate ...the association between antidepressant use and risk of HCC. Based on Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study. A total of 49,998 cases with HCC were identified and paired with 244,236 randomly selected controls. The data was analyzed via the conditional logistic regression model adjusting for several confounding factors. Use of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) was associated with lower risk for HCC. No apparent association was found between use of other classes of antidepressants and HCC, including monoamine oxidase inhibitors (MAOIs), serotonin norepinephrine reuptake inhibitors (SNRIs), trazodone, mirtazapine and bupropion. The findings of a protective effect of TCAs and SSRIs for HCC should be interpreted with caution and warrants further research.
This paper proposes a new optical design that will cooperate with 3D image technology, infrared spectrum technology, future medical diagnostics, the cloud, and big data analysis. We first conducted ...image recognition experiments to compare the pros and cons of 2D and 3D frameworks in order to make sure that the optical and mechanical framework of a glasses-type 3D ophthalmoscope would be a better choice. The experimental results showed that a 3D image recognition rate (90%) was higher than a 2D image recognition rate (84%), and hence the 3D mechanism design was selected. The glasses-type 3D ophthalmoscope design is primarily based on the specification of indirect ophthalmoscope requirements and two working spectrums: a near infrared and a visible spectrum. The design is a 2.5x magnification fixed focal telecentric relay system with a right-angle prism, which uses a large aperture to increase the amount of incident light (F/# = 2.0). As the infrared spectrums that have better transmittance towards human eye tissue are 965 nm and 985 nm, so that we took account of the visible spectrum and the near-infrared spectrum simultaneously to increase the basis of the physician’s diagnosis. In this research, we conclude that a wearable ophthalmoscope can be designed optically and mechanically with 3D technology, an infrared and a visible working spectrum and further, possibly in cooperation with the cloud and big data analysis.
In recent years, the development of biodegradable hydrogels as an alternative over the traditional wound dressing has become increasingly significant. These specific hydrogels are able to offer ...suitable microenvironments to further aid the process of tissue or organ regeneration. However, application of biodegradable hydrogels in clinical medicine remains uncommon due to most biodegradable hydrogels struggle with achieving satisfactory adhesiveness property, high mechanical support and cell compatibility simultaneously. In order to overcome these constraints and enhance the applicability of biodegradable hydrogels, methods have been employed in this study.
By reacting gellan gum with methacrylic anhydride and incorporating a biodegradable protein, keratin, we endowed the hydrogels with high pliability via photo-polymerization chain extension, thereby obtaining a biodegradable hydrogel with exceptional properties. Through a series of in vitro tests, GGMA/keratin hydrogels exhibited great cell compatibility via providing an appropriate environment for cell proliferation. Furthermore, this hydrogel not only exhibits extraordinary adhesive ability on visceral tissues but also extends to scenarios involving skin or organ damage, offering valuable assistance in wound healing. Our design provides a suitable platform for cell proliferation and tissue regeneration, which shows prospects for future medical research and clinical applications.
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•Gellan gum methacrylate/keratin hydrogels have been successfully prepared.•The incorporation of keratin into gellan gum methacrylate improved cell adhesion and proliferation of GGMA hydrogel meanwhile retained its mechanical properties.•The GGMA/keratin hydrogels exhibited positive therapeutic effects toward skin repair.•The GGMA/keratin hydrogels possess a great tissue adhesion property and exhibit the potential in immediate hemostasis of damaged liver tissue.
Abstract
Diabetic kidney disease is the leading cause of end-stage kidney disease worldwide; however, the integration of high-dimensional trans-omics data to predict this diabetic complication is ...rare. We develop artificial intelligence (AI)-assisted models using machine learning algorithms to identify a biomarker signature that predisposes high risk patients with diabetes mellitus (DM) to diabetic kidney disease based on clinical information, untargeted metabolomics, targeted lipidomics and genome-wide single nucleotide polymorphism (SNP) datasets. This involves 618 individuals who are split into training and testing cohorts of 557 and 61 subjects, respectively. Three models are developed. In model 1, the top 20 features selected by AI give an accuracy rate of 0.83 and an area under curve (AUC) of 0.89 when differentiating DM and non-DM individuals. In model 2, among DM patients, a biomarker signature of 10 AI-selected features gives an accuracy rate of 0.70 and an AUC of 0.76 when identifying subjects at high risk of renal impairment. In model 3, among non-DM patients, a biomarker signature of 25 AI-selected features gives an accuracy rate of 0.82 and an AUC of 0.76 when pinpointing subjects at high risk of chronic kidney disease. In addition, the performance of the three models is rigorously verified using an independent validation cohort. Intriguingly, analysis of the protein–protein interaction network of the genes containing the identified SNPs (RPTOR, CLPTM1L, ALDH1L1, LY6D, PCDH9, B3GNTL1, CDS1, ADCYAP and FAM53A) reveals that, at the molecular level, there seems to be interconnected factors that have an effect on the progression of renal impairment among DM patients. In conclusion, our findings reveal the potential of employing machine learning algorithms to augment traditional methods and our findings suggest what molecular mechanisms may underlie the complex interaction between DM and chronic kidney disease. Moreover, the development of our AI-assisted models will improve precision when diagnosing renal impairment in predisposed patients, both DM and non-DM. Finally, a large prospective cohort study is needed to validate the clinical utility and mechanistic implications of these biomarker signatures.
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