The electrocardiogram (ECG) is an efficient and noninvasive indicator for arrhythmia detection and prevention. In real-world scenarios, ECG signals are prone to be contaminated with various noises, ...which may lead to wrong interpretation. Therefore, significant attention has been paid on denoising of ECG for accurate diagnosis and analysis. A denoising autoencoder (DAE) can be applied to reconstruct the clean data from its noisy version. In this paper, a DAE using the fully convolutional network (FCN) is proposed for ECG signal denoising. Meanwhile, the proposed FCN-based DAE can perform compression with regard to the DAE architecture. The proposed approach is applied to ECG signals from the MIT-BIH Arrhythmia database and the added noise signals are obtained from the MIT-BIH Noise Stress Test database. The denoising performance is evaluated using the root-mean-square error (RMSE), percentage-root-mean-square difference (PRD), and improvement in signal-to-noise ratio (SNR<inline-formula> <tex-math notation="LaTeX">_{\textit{imp}} </tex-math></inline-formula>). The results of the experiments conducted on noisy ECG signals of different levels of input SNR show that the FCN acquires better performance as compared to the deep fully connected neural network- and convolutional neural network-based denoising models. Moreover, the proposed FCN-based DAE reduces the size of the input ECG signals, where the compressed data is 32 times smaller than the original. The results of the study demonstrate the superiority of FCN in denoising, with lower RMSE and PRD, as well as higher SNR<inline-formula> <tex-math notation="LaTeX">_{\textit{imp}} </tex-math></inline-formula>. According to the results, we believe that the proposed FCN-based DAE has a good application prospect in clinical practice.
Symmetry‐protected quasi‐bound states in the continuum (BIC) controlled by metasurfaces with broken in‐plane symmetry are widely exploited to achieve highly surface‐sensitive and spectrally sharp ...resonances for nanophotonic biosensors. Through the engineering of silicon‐based asymmetric nanobar pairs, a quasi‐BIC mode is excited showing a dominant toroidal dipole (TD) and electric quadrupole (EQ) resonant feature in the near‐infrared and performs ultrahigh sensitivity in the refractometric monitoring of local environment changes. Contrary to the typical electric and magnetic Mie‐type resonances of dielectric resonators with the enhanced field mostly inside the resonator volume, the TD‐EQ quasi‐BIC mode is found to exhibit strong and tightly confined optical fields at the surface of tilted nanobar pairs, and its refractive‐index (RI) sensitivity can be dramatically increased for nanopillars with larger aspect‐ratio. The measured (simulated) sensitivity and figure of merit for nanobar pairs with a height of 450 nm reach 608 nm/RIU and 46 (612 nm/RIU and 85), respectively. Such ultrahigh sensitive all‐dielectric platform can be fabricated through complementary metal‐oxide‐semiconductor compatible process and is promising for on‐chip integration and sensor miniaturization to a wide range of diagnostic applications.
Quasi‐bound states in the continuum modes in periodic amorphous silicon tilted nanobar pairs are found to exhibit a dominant toroidal dipole and electric quadrupole resonant property. Such higher‐order resonant mode exhibits intriguing near‐field distributions accompanied by a strong electric field tightly confined at the surface of nanobar width and results in ultrahigh refractive index sensitivity for high aspect‐ratio nanopillars.
To examine the effect of de-escalation of P2Y12 inhibitor in dual antiplatelet therapy (DAPT) on major adverse cardiovascular events (MACE) and bleeding complications after acute myocardial ...infarction (AMI) in Taiwanese patients undergoing percutaneous coronary intervention (PCI). Patients who had received PCI during hospitalization for AMI (between 2013 and 2016) and were initially treated with aspirin and ticagrelor and without adverse events after 3 months of treatment were retrospectively evaluated. In total, 1,901 and 8,199 patients were identified as "de-escalated DAPT" (switched to aspirin and clopidogrel) and "unchanged DAPT" (continued on aspirin and ticagrelor) cohorts, respectively. With a mean follow-up of 8 months, the incidence rates (per 100 person-year) of death, AMI readmission and MACE were 2.89, 3.68, and 4.91 in the de-escalated cohort and 2.42, 3.28, and 4.72 in the unchanged cohort, respectively, based on an inverse probability of treatment weighted approach that adjusting for baseline characteristics of the patients. Multivariate Cox regression analyses showed the two groups had no significant differences in the hazard risk of death, AMI admission, and MACE. Additionally, there was no observed difference in the risk of bleeding, including major or clinically relevant non-major bleeding. The real-world data revealed that de-escalation of P2Y12 inhibitor in DAPT was not associated with a higher risk of death or AMI readmission in Taiwanese patients with AMI undergoing successful PCI.
Acute coronary syndrome (ACS) patients with diabetes have significantly worse cardiovascular outcomes than those without diabetes. This study aimed to compare the performance of The Thrombolysis In ...Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), Primary Angioplasty in Myocardial Infarction (PAMI), and Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) risk scores in predicting long-term cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction (STEMI). From the Acute Coronary Syndrome-Diabetes Mellitus Registry of the Taiwan Society of Cardiology, patients with STEMI were included. The TIMI, GRACE, PAMI, and CADILLAC risk scores were calculated. The discriminative potential of risk scores was analyzed using the area under the receiver-operating characteristics curve (AUC). In the 455 patients included, all four risk score systems demonstrated predictive accuracy for 6-, 12- and 24-month mortality with AUC values of 0.67-0.82. The CADILLAC score had the best discriminative accuracy, with an AUC of 0.8207 (p<0.0001), 0.8210 (p<0.0001), and 0.8192 (p<0.0001) for 6-, 12-, and 24-month mortality, respectively. It also had the best predictive value for bleeding and acute renal failure, with an AUC of 0.7919 (p<0.05) and 0.9764 (p<0.0001), respectively. Patients with CADILLAC risk scores >8 had poorer 2-year survival than those with lower scores (log-rank p<0.0001). In conclusion, the CADILLAC risk score is more effective than other risk scores in predicting 6-month, 1-year, and 2-year all-cause mortality in diabetic patients with STEMI. It also had the best predictive value for in-hospital bleeding and acute renal failure.
This single-centered, retrospective cohort study investigated the timing of involution of retinopathy of prematurity (ROP) and retinal vascularization to zone III after intravitreal bevacizumab (IVB) ...treatment and its possible impacts on postnatal growth and neurodevelopment. Premature infants with birth weight ≤1500 g, born between 2008 to 2014 and diagnosed with ROP were enrolled. All patients with type 1 ROP underwent IVB as 1st line treatment and were recruited as the study group; those with any stage of ROP except type 1 ROP without treatment served as controls. Neurodevelopmental outcomes were assessed using the Bayley Score of Infant Development (BSID) editions II or III. The study group included 35 eyes from 18 patients; the control group included 86 patients. Twenty-three eyes (65.7%) exhibited ROP regression after a single dose of IVB. The majority of plus sign and extraretinal neovascularization regressed within two weeks. The length of time for retinal vascularization to reach zone III was significantly longer in the treatment group compared with the control (mean post-menstruation age 54.5 vs. 47.0 weeks, p<0.001). Long-term follow-up showed no significant differences in body weight and neurodevelopment between the study and control groups up to the 2-year corrected age.
Glioblastoma is one of the most common and most aggressive brain cancers. The current treatment is mainly surgery, chemotherapy, and radiation therapy, but the results are not satisfactory.
(
), also ...called "Lingzhi", is a medicinal mushroom that has been used as a therapeutic agent for the treatment of numerous diseases, including cancer. However, whether it is effective for treating cancer is still unclear. In the present study, the anti-tumor effect of a water extract of
was investigated using brain tumor cells. We used an analysis of cell viability, flow cytometry, the IncuCyte live-cell analysis system, and Western blotting to study its effects. The water extract from
inhibited cell proliferation in a dose- and time-dependent manner, and it induced mitochondria-mediated apoptosis and cell cycle arrest at S phase via the cyclin-CDK2 pathway in human brain tumor cells. In addition, the
extract significantly inhibited cell migration and mesenchymal marker expression based on the IncuCyte live-cell assay and qRT-PCR analysis. In summary, these anti-tumor effects in brain tumor cells suggest that
may be useful for treating brain tumors.
Patients with remitted psychosis face a dilemma between the wish to discontinue antipsychotics and the risk of relapse. We test if an operationalized guided-dose-reduction algorithm can help reach a ...lower effective dose without increased risks of relapse.
A 2-year open-label randomized prospective comparative cohort trial from Aug 2017 to Sep 2022. Patients with a history of schizophrenia-related psychotic disorders under stable medications and symptoms were eligible, randomized 2:1 into guided dose reduction group (GDR)
maintenance treatment group (MT1), together with a group of naturalistic maintenance controls (MT2). We observed if the relapse rates would be different between 3 groups, to what extent the dose could be reduced, and if GDR patients could have improved functioning and quality of life.
A total of 96 patients, comprised 51, 24, and 21 patients in GDR, MT1, and MT2 groups, respectively. During follow-up, 14 patients (14.6%) relapsed, including 6, 4, and 4 from GDR, MT1, and MT2, statistically no difference between groups. In total, 74.5% of GDR patients could stay well under a lower dose, including 18 patients (35.3%) conducting 4 consecutive dose-tapering and staying well after reducing 58.5% of their baseline dose. The GDR group exhibited improved clinical outcomes and endorsed better quality of life.
GDR is a feasible approach as the majority of patients had a chance to taper antipsychotics to certain extents. Still, 25.5% of GDR patients could not successfully decrease any dose, including 11.8% experienced relapse, a risk comparable to their maintenance counterparts.
Patients with remitted psychosis wish to reduce antipsychotic doses yet facing increased risks of relapse. Examining dose-tapering processes may provide insights to re-evaluate the risk-to-benefit ...balance. We aimed to depict and subgroup tapering trajectories, and explore factors associated with different dose-reduction patterns.
A 2-year open-label randomized prospective comparative trial from August 2017 to September 2022 in Taiwan. Patients with a history of schizophrenia-related psychotic disorders under stable medications and symptoms were eligible, randomizing a proportion to conduct guided dose reduction. We depicted the trajectories of individual patients and named subgroups based on dose-tapering patterns. Predictors of baseline characteristics for designated subgroups were examined by logistic regression analysis; changes in outcomes were compared by paired t-test.
Fifty-one patients undergoing guided dose reduction, 18 (35.3%) reduced 4 steps consecutively (sequential reducers, SR), 14 (27.5%) reduced 1 to 3 steps (modest reducers, MR), 3 (5.9%) re-escalated to previous level (alert reducers, AR), 7 (13.7%) returned to baseline level (baseline returners, BR), 6 (11.7%) relapsed (failed reducers, FR) and 3 (5.9%) withdrew without relapse (early exits, EE). Patients with a history of relapse assumed a conservative dose-tapering pace; only the SR subgroup exhibited significant improvements in functioning and quality of life while failing to identify variables for predicting who would become SR or FR.
Guided dose reduction comprises dynamic processes with differences between individual trajectories. The proposed naming of dose-tapering patterns/subgroups provides a framework depicting patients undergoing dose-tapering. Longer-term observation and more flexible tapering approaches are anticipated to reveal favorable outcomes.
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