This paper reviews recent progress of portable short-range noncontact microwave radar systems for motion detection, positioning, and imaging applications. With the continuous advancements of modern ...semiconductor technologies and embedded computing, many functionalities that could only be achieved by bulky radar systems in the past are now integrated into portable devices with integrated circuit chips and printed circuits boards. These portable solutions are able to provide high motion detection sensitivity, excellent signal-to-noise ratio, and satisfactory range detection capability. Assisted by on-board signal processing algorithms, they can play important roles in various areas, such as health and elderly care, veterinary monitoring, human-computer interaction, structural monitoring, indoor tracking, and wind engineering. This paper reviews some system architectures and practical implementations for typical wireless sensing applications. It also discusses potential future developments for the next-generation portable smart radar systems.
Monitoring physiological signs in animal testing is crucial for the development of new therapeutic strategies and better understanding of diseases. This paper exploits Doppler radar and nonlinear ...phase demodulation effect to achieve noncontact measurement of both displacements and frequencies of a laboratory rat's cardiorespiratory activities. The implementation of displacement acquisition method relying on demodulation-generated harmonics is described, and this paper provides a guideline of implementing the acquisition method. Demodulation-generated harmonics are analyzed, and the effect of vibration-generated harmonics is studied. To demonstrate the effectiveness, a 60-GHz radar is used that shows good correlation with the instrument-recorded data. Average errors of respiration rate and heart rate (HR) are 0.057% and 0.33%, respectively, using three test subjects. In addition, two drug tests are performed to verify the monitoring function with controlled raised/dropped HR. By observing the time periods before, during, and after drug injection, results of rat's physiological response to drugs reveal the drug efficacy and body reaction over time. The measured cardiorespiratory variations can provide useful information without using implant devices, and the implementation could be an improvement over current invasive methods. The result presented in this paper is believed to be the first reported simultaneous measurements of both frequencies and displacements of both respiration and heartbeat movements of a laboratory animal using microwave radar.
Circadian rhythms modulate growth and development in all organisms through interlocking transcriptional-translational feedback loops. The transcriptional loop involves chromatin modifications of ...central circadian oscillators in mammals and plants. However, the molecular basis for rhythmic epigenetic modifications and circadian regulation is poorly understood.
Here we report a feedback relationship between diurnal regulation of circadian clock genes and histone modifications in Arabidopsis. On one hand, the circadian oscillators CCA1 and LHY regulate diurnal expression of genes coding for the eraser (JMJ14) directly and writer (SDG2) indirectly for H3K4me3 modification, leading to rhythmic H3K4me3 changes in target genes. On the other hand, expression of circadian oscillator genes including CCA1 and LHY is associated with H3K4me3 levels and decreased in the sdg2 mutant but increased in the jmj14 mutant. At the genome-wide level, diurnal rhythms of H3K4me3 and another histone mark H3K9ac are associated with diurnal regulation of 20-30% of the expressed genes. While the majority (86%) of H3K4me3 and H3K9ac target genes overlap, only 13% of morning-phased and 22% of evening-phased genes had both H3K4me3 and H3K9ac peaks, suggesting specific roles of different histone modifications in diurnal gene expression.
Circadian clock genes promote diurnal regulation of SDG2 and JMJ14 expression, which in turn regulate rhythmic histone modification dynamics for the clock and its output genes. This reciprocal regulatory module between chromatin modifiers and circadian clock oscillators orchestrates diurnal gene expression that governs plant growth and development.
Aims
The evidence of hepatotoxicity of antithyroid drugs (ATDs) is limited to case reports or spontaneous reporting. This study aimed to quantify the incidence and comparative risks of hepatotoxicity ...for methimazole (MMI)/carbimazole (CBM) vs. propylthiouracil (PTU) in a population‐based manner.
Methods
We conducted a cohort study of hyperthyroidism patients initially receiving MMI/CBM or PTU between 1 January 2004 and 31 December 2008 using the Taiwan National Health Insurance Research Database. The examined hepatotoxicity consisted of cholestasis, non‐infectious hepatitis, acute liver failure and liver transplant, with the incidences and relative risks being quantified by Poisson exact methods and Cox proportional hazard models, respectively.
Results
The study cohort comprised 71 379 ATD initiators, with a median follow‐up of 196 days. MMI/CBM vs. PTU users had a higher hepatitis incidence rate (3.17/1000 vs. 1.19/1000 person‐years) but a lower incidence of acute liver failure (0.32/1000 vs. 0.68/1000 person‐years). The relative risk analysis indicated that any use of MMI/CBM was associated with a 2.89‐fold (95% CI 1.81, 4.60) increased hepatitis risk compared with PTU, with the risk increasing to 5.08‐fold for high dose MMI/CBM (95% CI 3.15, 8.18). However, any MMI/CBM use vs. PTU was not related to an increased risk of cholestasis (adjusted hazard ratio HR 1.14, 95% CI 0.40, 3.72) or acute liver failure (adjusted HR 0.54, 95% CI 0.24, 1.22).
Conclusions
MMI/CBM and PTU exert dissimilar incidence rates of hepatotoxicity. Compared to PTU, MMI/CBM are associated in a dose‐dependent manner with an increased risk for hepatitis while the risks are similar for acute liver failure and cholestasis.
Recurrent obscure gastrointestinal bleeding (OGIB) in patients with chronic kidney disease is a challenge often faced by physicians, given the need for repeated hospitalizations, multiple extensive ...examinations, limited treatment options, and high medical costs. The purpose of this study was to identify the clinical characteristics of uremic patients undergoing deep enteroscopy for OGIB and analyze the risk factors for rebleeding in these patients after undergoing single-balloon enteroscopy (SBE).
Out of 765 patients with OGIB who underwent 1004 procedures of SBE in four teaching hospitals, 78 uremic patients with OGIB were enrolled. Clinical characteristics and endoscopic findings were collected, and multiple variables were analyzed to determine the risk of rebleeding after SBE.
The diagnostic yield was 75.6%, and the rebleeding rate was 29.5% in the enrolled uremic patients. The most common etiology was angiodysplasia (74.6%) and the most common site was the jejunum (50.8%). The endoscopic intervention rate was 62.8% and most patients were treated with argon plasma coagulation (75.6%). Among the eight patients with valvular heart disease (VHD), four (50%) had severe aortic stenosis, and the remaining had non-aortic stenosis-VHD. VHD (p < 0.05) and angiodysplasia (p < 0.05) were both associated with a higher rebleeding rate.
VHD may be an independent risk factor associated with rebleeding after SBE in uremic patients with OGIB. Moreover, uremic patients with angiodysplasia-related bleeding appear to have a higher rebleeding rate than those with alternative causes of bleeding.
Liver disease has emerged as a healthcare burden because of high hospitalization rates attributed both to steatohepatitis and to severe hepatic toxicity associated with changes of drug exposure. ...Early detection of hepatic insufficiency is critical to preventing long-term liver damage. The galactose single-point test is recommended by the US FDA as a sensitive means to quantify liver function, yet the conventional method used for quantitation of circulating galactose still relies on the standard colorimetric method, requiring time-consuming and labor-intensive processes, and is confined to the medical laboratory, thus limiting prevalence. To facilitate time- and cost-effective disease management particularly during a pandemic, a pocket-sized rapid quantitative device consisting of a biosensor and electrochemical detection has been developed. An in vitro validation study demonstrated that the coefficient of variation was less than 15% and deviations were between −4 and 14% in the range of 100–1500 μg/mL. The device presented good linear fit (correlation coefficient,
r
= 0.9750) over the range of 150–1150 µg/mL. Moreover, the device was found to be free from interference of common endogenous and exogenous substances, and deviated hematocrit, enabling a direct measurement of galactose in the whole blood without sample pre-treatment steps. The clinical validation comprising 118 subjects showed high concordance (
r
= 0.953) between the device and the conventional colorimetric assay. Thus, this novel miniaturized device is reliable and robust for routine assessment of quantitative liver function intended for follow-up of hepatectomy, drug dose adjustment, and screening for galactosemia, allowing timely and cost-effective clinical management of patients.
Graphical abstract
Single-balloon enteroscopy (SBE) is designed for identifying possible small bowel lesions with balloon-assisted enteroscopy that allows deep intubation of the intestine. However, data regarding the ...outcome and safety of SBE remain limited. We conducted this study to evaluate the outcome and safety of anterograde and retrograde SBE approaches. This retrospective review from a tertiary medical center in Taiwan included endoscopic reports and chart data from 128 patients with 200 anterograde and retrograde procedures from September 2009 to November 2014. In this study, the most common indication for both anterograde and retrograde SBE was obscure gastrointestinal bleeding (64.4% vs. 60.6%). There were no significant differences between anterograde and retrograde approaches in terms of the diagnostic yield (69.3% vs. 52.5%) and intervention rate (23.8% vs. 17.2%). The procedure time was shorter for anterograde SBE than for retrograde SBE (68.1 ± 23.9 vs. 76.8 ± 27.7 min, P = 0.018). In addition, among the subgroup of patients with obscure gastrointestinal bleeding, the most common etiologies for those in different age-groups were angiodysplasia (≥ 65 years), non-specific ulcers (30-64 years), and Meckel's diverticulum (< 30 years). The major complication rate during the study was 1.5%; the rate of asymptomatic hyperamylasemia was higher for patients who underwent anterograde SBE than for those who underwent retrograde SBE (13.9% vs. 2%, P = 0.005). The outcome and safety of anterograde and retrograde SBE are similar. However, anterograde SBE has a shorter procedural time and a higher rate of asymptomatic hyperamylasemia.
In clinical applications, mucosal healing is a therapeutic goal in patients with ulcerative colitis (UC). Endoscopic remission is associated with lower rates of colectomy, relapse, hospitalization, ...and colorectal cancer. Differentiation of mucosal inflammatory status depends on the experience and subjective judgments of clinical physicians. We developed a computer-aided diagnostic system using deep learning and machine learning (DLML-CAD) to accurately diagnose mucosal healing in UC patients.
We selected 856 endoscopic colon images from 54 UC patients (643 images with endoscopic score 0-1 and 213 with score 2-3) from the endoscopic image database at Tri-Service General Hospital, Taiwan. Endoscopic grading using the Mayo endoscopic subscore (MES 0-3) was performed by two reviewers. A pretrained neural network extracted image features, which were used to train three different classifiers-deep neural network (DNN), support vector machine (SVM), and k-nearest neighbor (k-NN) network.
DNN classified MES 0 to 1, representing mucosal healing, vs MES 2 to 3 images with 93.8% accuracy (sensitivity 84.6%, specificity 96.9%); SVM had 94.1% accuracy (sensitivity 89.2%, specificity 95.8%); and k-NN had 93.4% accuracy (sensitivity 86.2%, specificity 95.8%). Combined, ensemble learning achieved 94.5% accuracy (sensitivity 89.2%, specificity 96.3%). The system further differentiated between MES 0, representing complete mucosal healing, and MES 1 images with 89.1% accuracy (sensitivity 82.3%, specificity 92.2%).
Our DLML-CAD diagnosis achieved 94.5% accuracy for endoscopic mucosal healing and 89.0% accuracy for complete mucosal healing. This system can provide clinical physicians with an accurate auxiliary diagnosis in treating UC.
Background and Aims
The incidence and disease burden of colorectal cancer (CRC) in young adults were increasing. However, there was a dearth of advice on how to identify young population at risk for ...neoplastic colonic polyps (NCPs) and CRC. We aimed to identify risk factors for NCPs and CRC in young adults presenting with bloody stool.
Methods
A total of 1496 subjects younger than 40 years old who underwent colonoscopy due to bloody stool from 2005 to 2014 were enrolled in this retrospective study as the study group, and 1481 age‐matched and gender‐matched asymptomatic subjects who underwent colonoscopy for health checkup from 2011 to 2016 were enrolled as the control group at a tertiary center hospital.
Results
Multivariate analysis results showed that increasing age (odds ratio OR = 1.11, 95% confidence interval CI: 1.07–1.15, P < 0.001), higher body mass index (BMI) (OR = 1.07, 95%CI: 1.03–1.12, P = 0.001), diabetes mellitus (OR = 2.80, 95%CI: 1.06–7.42, P = 0.038), and positive family history of CRC (OR = 13.28, 95%CI: 5.70–30.97, P < 0.001) were identified as independent risk factors for NCPs in study group. The best cut‐off values by receiver operating characteristic curve for age and BMI were 32 years old and 24.8 kg/m2, respectively. More risk factors were associated with the higher risk for NCPs (OR = 2.17 every increasing one risk factor, P < 0.001). In the control group, no independent risk factors were identified.
Conclusions
Adults aged ≤ 40 years with bloody stool who had increasing age (> 32 years old), higher BMI (> 24.8 kg/m2), diabetes mellitus, and positive family history of CRC had a higher detection rate of NCPs and CRC.
Hepatitis C virus (HCV) infection is a major cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). HCV core protein is considered as a positive regulator of telomerase ...activity. In this study, we focused on the deregulated microRNA-138 (miR-138) in HCV-associated HCC. Differential expression of miR-138 was determined by TaqMan quantitative real-time PCR. The target gene of miR-138 was verified by luciferase reporter assay, quantitative real-time PCR, and Western blotting. Moreover, three assays based on telomerase activity, cell proliferation, and senescence-associated β-galactosidase activity were performed. The correlation analysis revealed a significantly negative correlation between miR-138 and telomerase reverse transcriptase (TERT) mRNA expression in HCC. Further, we showed that mature HCV core protein of 173 amino acids, but not full-length form of 191 amino acids, suppressed miR-138 expression. TERT was verified as a direct target of miR-138 in HCC cells. Furthermore, TERT-targeting miR-138 supplementation can prevent HCV core protein from repressing HCC cell replicative senescence. Collectively, HCV core protein can enhance TERT protein expression through downregulating TERT-targeting miR-138 expression, which in turn inhibits HCC cell replicative senescence. This study may further help our understanding on the pathogenic mechanisms of HCV core protein in HCV-associated HCC development.
Key message
miR-138 is downregulated in HCV-associated HCC.
Mature HCV core protein plays a pathogenic role in suppressing miR-138 expression.
Telomerase reverse transcriptase represents a direct target of miR-138 in HCC cells.
miR-138 promotes HCC cell senescence, suggesting potential for HCC treatment.
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