A 0.4 nJ Excitation Energy Bridge-to-Digital Converter for Implantable Pulmonary Artery Pressure Monitoring

This paper presents an energy-efficient, duty-cycled, and spinning excitation bridge-to-digital converter (BDC) suitable for measuring the pulmonary artery pressure of heart failure patients with an implantable system. The duty-cycled bridge uses resistances of 6.2 kΩ and, with a supply of 1.2 V, consumes 0.4 nJ excitation energy. A novel spinning method is applied to the bridge and the capacitive DAC simultaneously in such a way to achieve an offset-independent digital output and to eliminate the need for complex instrumentation amplifiers with offset-reduction techniques or calibration. The SAR ADC fabricated in 0.18-μm CMOS consumes 19 nW at 1.2 V. With a sampling rate of 1 kS/s, the converter achieves the ENOB of 9.2 bits

A 16-Channel Wireless Neural Recording System-on-Chip with CHT Feature Extraction Processor in 65nm CMOS

Wireless implantable neural recording chips enable multichannel data acquisition with high spatiotemporal resolution in situ. Recently, the use of machine learning approaches on neural data for diagnosis and prosthesis control have renewed the interest in this field, and increased even more the demand for multichannel data. However, simultaneous data acquisition from many channels is a grand challenge due to data rate and power limitations on wireless transmission for implants. As a result, recent studies have focused on on-chip classifiers, despite the fact that only primitive classifiers can be placed on resource-constrained chips. Moreover, robustness of the chosen algorithm cannot be guaranteed pre-implantation due to the scarcity of patient-specific data; waveforms can change over time due to electrode micro migration or tissue reaction, highlighting the need for robust adaptive features

β2M Signals Monocytes Through Non-Canonical TGFβ Receptor Signal Transduction.

Rationale: Circulating monocytes can have pro-inflammatory or pro-reparative phenotypes. The endogenous signaling molecules and pathways that regulate monocyte polarization in vivo are poorly understood. We have shown that platelet derived beta-2 microglobulin (β2M) and transforming growth factor beta (TGFβ) have opposing effects on monocytes by inducing inflammatory and reparative phenotypes respectively, but each bind and signal through the same receptor. We now define the signaling pathways involved. Objective: To determine the molecular mechanisms and signal transduction pathways by which β2M and TGFβ regulate monocyte responses both in vitro and in vivo. Methods and Results: Wild-type (WT) and platelet specific β2M knockout (Plt-β2M-/-) mice were treated intravenously with either β2M or TGFβ to increase plasma concentrations to those in cardiovascular diseases. Elevated plasma β2M increased pro-inflammatory monocytes, while increased plasma TGFβ increased pro-reparative monocytes. TGFβ receptor (TGFβR) inhibition blunted monocyte responses to both β2M and TGFβ in vivo. Using imaging flow cytometry, we found that β2M decreased monocyte SMAD2/3 nuclear localization, while TGFβ promoted SMAD nuclear translocation, but decreased noncanonical/ inflammatory (JNK and NFκB nuclear localization). This was confirmed in vitro using both imaging flow cytometry and immunoblots. β2M, but not TGFβ, promoted ubiquitination of SMAD3 and SMAD4, that inhibited their nuclear trafficking. Inhibition of ubiquitin ligase activity blocked noncanonical SMAD-independent monocyte signaling and skewed monocytes towards a pro-reparative monocyte response. Conclusions: Our findings indicate that elevated plasma β2M and TGFβ dichotomously polarize monocytes. Furthermore, these immune molecules share a common receptor, but induce SMAD-dependent canonical signaling (TGFβ) versus non-canonical SMAD-independent signaling (β2M) in a ubiquitin ligase dependent manner. This work has broad implications as β2M is increased in several inflammatory conditions, while TGFβ is increased in fibrotic diseases.pre-print3451 K

Hybrid of swarm intelligent algorithms in medical applications

In this paper, we designed a hybrid of swarm intelligence algorithms to diagnose hepatitis, breast tissue, and dermatology conditions in patients with such infection. The effectiveness of hybrid swarm intelligent algorithms was studied since no single algorithm is effective in solving all types of problems. In this study, feed forward and Elman recurrent neural network (ERN) with swarm intelligent algorithms is used for the classification of the mentioned diseases. The capabilities of six (6) global optimization learning algorithms were studied and their performances in training as well as testing were compared. These algorithms include: hybrid of Cuckoo Search algorithm and Levenberg-Marquardt (LM) (CSLM), Cuckoo Search algorithm (CS) and backpropagation (BP) (CSBP), CS and ERN (CSERN), Artificial Bee Colony (ABC) and LM (ABCLM), ABC and BP (ABCBP), Genetic Algorithm (GA) and BP (GANN). Simulation comparative results indicated that the classification accuracy and run time of the CSLM outperform the CSERN, GANN, ABCBP, ABCLM, and CSBP in the breast tissue dataset. On the other hand, the CSERN performs better than the CSLM, GANN, ABCBP, ABCLM, and CSBP in both th

Lung Megakaryocytes are Immune Modulatory Cells that Present Antigen to CD4+ T cells.

Although platelets are the cellular mediators of thrombosis, they are also immune cells. Platelets interact both directly and indirectly with immune cells, impacting their activation and differentiation, as well as all phases of the immune response. Megakaryocytes (Mks) are the cell source of circulating platelets, and until recently Mks were typically only considered bone marrow–resident (BM-resident) cells. However, platelet-producing Mks also reside in the lung, and lung Mks express greater levels of immune molecules compared with BM Mks. We therefore sought to define the immune functions of lung Mks. Using single-cell RNA sequencing of BM and lung myeloid-enriched cells, we found that lung Mks, which we term MkL, had gene expression patterns that are similar to antigen-presenting cells. This was confirmed using imaging and conventional flow cytometry. The immune phenotype of Mks was plastic and driven by the tissue immune environment, as evidenced by BM Mks having an MkL-like phenotype under the influence of pathogen receptor challenge and lung-associated immune molecules, such as IL-33. Our in vitro and in vivo assays demonstrated that MkL internalized and processed both antigenic proteins and bacterial pathogens. Furthermore, MkL induced CD4+ T cell activation in an MHC II–dependent manner both in vitro and in vivo. These data indicated that MkL had key immune regulatory roles dictated in part by the tissue environment.pre-print236 K

Microsurgical and tractographic anatomical study of insular and transsylvian transinsular approach

This study is to define the operative anatomy of the insula with emphasis on the transsylvian transinsular approach. The anatomy was studied in 15 brain specimens, among five were dissected by use of fiber dissection technique; diffusion tensor imaging of 10 healthy volunteers was obtained with a 1.5-T MR system. The temporal stem consists mainly of the uncinate fasciculus, inferior occipitofrontal fasciculus, Meyer’s loop of the optic radiation and anterior commissure. The transinsular approach requires an incision of the inferior limiting sulcus. In this procedure, the fibers of the temporal stem can be interrupted to various degrees. The fiber dissection technique is a very relevant and reliable method for neurosurgeons to study the details of brain anatomic features. The DTI fiber tracking technique can identify the fiber tracts of the temporal stem. Moreover, it will also help further functional study of human insula

Genetic and clinical basis for two distinct subtypes of primary Sjögren's syndrome

Objectives Clinical presentation of primary Sjögren’s syndrome (pSS) varies considerably. A shortage of evidence-based objective markers hinders efficient drug development and most clinical trials have failed to reach primary endpoints. Methods We performed a multicentre study to identify patient subgroups based on clinical, immunological and genetic features. Targeted DNA sequencing of 1853 autoimmune-related loci was performed. After quality control, 918 patients with pSS, 1264 controls and 107 045 single nucleotide variants remained for analysis. Replication was performed in 177 patients with pSS and 7672 controls. Results We found strong signals of association with pSS in the HLA region. Principal component analysis of clinical data distinguished two patient subgroups defined by the presence of SSA/SSB antibodies. We observed an unprecedented high risk of pSS for an association in the HLA-DQA1 locus of odds ratio 6.10 (95% CI: 4.93, 7.54, P=2.2×10−62) in the SSA/SSB-positive subgroup, while absent in the antibody negative group. Three independent signals within the MHC were observed. The two most significant variants in MHC class I and II respectively, identified patients with a higher risk of hypergammaglobulinaemia, leukopenia, anaemia, purpura, major salivary gland swelling and lymphadenopathy. Replication confirmed the association with both MHC class I and II signals confined to SSA/SSB antibody positive pSS. Conclusion Two subgroups of patients with pSS with distinct clinical manifestations can be defined by the presence or absence of SSA/SSB antibodies and genetic markers in the HLA locus. These subgroups should be considered in clinical follow-up, drug development and trial outcomes, for the benefit of both subgroups.publishedVersio

Clash of pans: pan-Africanism and pan-Anglo-Saxonism and the global colour line, 1919–1945

The article demonstrates both conceptually and empirically that pan-Anglo-Saxonist knowledge networks reconstructed and reimagined an apparently de-racialised, scientific, sober and liberal world order that outwardly abandoned, but did not eradicate the twin phenomena of racism and imperialism. Rather the new liberal (imperial) internationalists, organised in newly formed “think tanks” such as Chatham House and the Council on Foreign Relations, and through their increasingly global elite networks, mounted a top-down battle for minds at home and in the wider world. Operating in state-private elite networks, they drove the movement to manage change and develop a new liberal world order particularly to contain pan-Africanists who combatted the domination and exploitation of Africans worldwide. More broadly, we indicate that the pragmatic response to the extremes of Nazi ideology and a countering movement from the cadres of Asian, African and African American intellectuals, anti-colonial and anti-racist struggles within the national and global context, forced the Anglo-centric elites to promote change, albeit limited