Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study

BackgroundRight-to-left shunt (RLS) is associated with several conditions and causes morbidity. In this study, we aimed to evaluate the effectiveness of synchronous multimode ultrasonography in detecting RLS.MethodsWe prospectively enrolled 423 patients with high clinical suspicion of RLS and divided them into the contrast transcranial Doppler (cTCD) group and synchronous multimode ultrasound group, in which both cTCD and contrast transthoracic echocardiography (cTTE) were performed during the same process of contrast-enhanced ultrasound imaging. The simultaneous test results were compared with those of cTCD alone.ResultsThe positive rates of grade II (22.0%:10.0%) and III (12.7%:10.8%) shunts and the total positive rate (82.1748%) in the synchronous multimode ultrasound group were higher than those in the cTCD alone group. Among patients with RLS grade I in the synchronous multimode ultrasound group, 23 had RLS grade I in cTCD but grade 0 in synchronous cTTE, whereas four had grade I in cTCD but grade 0 in synchronous cTTE. Among patients with RLS grade II in the synchronous multimode ultrasound group, 28 had RLS grade I in cTCD but grade II in synchronous cTTE. Among patients with RLS grade III in the synchronous multimode ultrasound group, four had RLS grade I in cTCD but grade III in synchronous cTTE. Synchronous multimode ultrasound had a sensitivity of 87.5% and specificity of 60.6% in the patent foramen ovale (PFO) diagnosis. Binary logistic regression analyses showed that age (odds ratio [OR] = 1.041) and risk of paradoxical embolism score ≥ 7 (OR = 7.798) were risk factors for stroke recurrence, whereas antiplatelets (OR = 0.590) and PFO closure with antiplatelets (OR = 0.109) were protective factors.ConclusionSynchronous multimodal ultrasound significantly improves the detection rate and test efficiency, quantifies RLS more accurately, and reduces testing risks and medical costs. We conclude that synchronous multimodal ultrasound has significant potential for clinical applications

Targeted gene sanger sequencing should remain the first-tier genetic test for children suspected to have the five common X-linked inborn errors of immunity

DATA AVAILABILITY STATEMENT : The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.To address inborn errors of immunity (IEI) which were underdiagnosed in resource-limited regions, our centre developed and offered free genetic testing for the most common IEI by Sanger sequencing (SS) since 2001. With the establishment of The Asian Primary Immunodeficiency (APID) Network in 2009, the awareness and definitive diagnosis of IEI were further improved with collaboration among centres caring for IEI patients from East and Southeast Asia. We also started to use whole exome sequencing (WES) for undiagnosed cases and further extended our collaboration with centres from South Asia and Africa. With the increased use of Next Generation Sequencing (NGS), we have shifted our diagnostic practice from SS to WES. However, SS was still one of the key diagnostic tools for IEI for the past two decades. Our centre has performed 2,024 IEI SS genetic tests, with in-house protocol designed specifically for 84 genes, in 1,376 patients with 744 identified to have disease-causing mutations (54.1%). The high diagnostic rate after just one round of targeted gene SS for each of the 5 common IEI (X-linked agammaglobulinemia (XLA) 77.4%, Wiskott–Aldrich syndrome (WAS) 69.2%, X-linked chronic granulomatous disease (XCGD) 59.5%, X-linked severe combined immunodeficiency (XSCID) 51.1%, and X-linked hyper-IgM syndrome (HIGM1) 58.1%) demonstrated targeted gene SS should remain the first-tier genetic test for the 5 common X-linked IEI.The Hong Kong Society for Relief of Disabled Children and Jeffrey Modell Foundation.http://www.frontiersin.org/Immunologyam2023Paediatrics and Child Healt

Application of Molecular Imprinting Technique in Separation and Detection of Natural Products

The content of effective components of natural products is small, generally requiring to be extracted and purified using complex technology, and the detection method is both time-consuming and costly. Molecular imprinting technology is an effective means to prepare highly selective media. Molecularly imprinted polymers have the advantages of strong selectivity, simple preparation, reusability and have shown a good prospect in the separation and detection of various natural products. Based on the types of active ingredients of natural products, this paper reviews the separation and detection of natural products via molecular imprinting technology in recent years, and discusses the advantages and disadvantages of molecular imprinting technology, in order to provide reference for the subsequent application of molecular imprinting technology

State-of-the-Art Review of Utilization of Microbial-Induced Calcite Precipitation for Improving Moisture-Dependent Properties of Unsaturated Soils

Unsaturated soil is a form of natural soil whose pores are filled by air and water. Different from saturated soil, the microstructure of unsaturated soil consists of three phases, namely, the solid phase (soil particle), vapor phase, and liquid phase. Due to the matric suction of soil pores, the hydraulic and mechanical behaviors of unsaturated soils present a significant dependence on the moisture condition, which usually results in a series of unpredictable risks, including foundation settlement, landslide, and dam collapse. Microbial-induced calcite precipitation (MICP) is a novel and environmentally friendly technology that can improve the water stability of unsaturated soft or expansive soils. This paper reviews the microscopic mechanisms of MICP and its effect on the mechanical properties of unsaturated soils. The MICP process is mainly affected by the concentration of calcium ions and urea, apart from the concentration of bacteria. The moisture-dependent properties were comparatively analyzed through mechanical models and influence factors on the experimental data among various unsaturated soils. It suggests that the variations in resilient modulus and permanent deformation are strongly related to the extent of MICP applied on unsaturated soils. Finally, the problems in the MICP application, environmental challenges, and further research directions are suggested

Impacts of Climate Change and Human Activities on Runoff and Sediment Load of the Xiliugou Basin in the Upper Yellow River

Using data of temperature, wind, precipitation, water discharge, and sediment load, the changes in runoff and sediment load of the Xiliugou basin in the upper Yellow River were investigated and the contributions of climate change and human activities to these changes were quantitatively estimated. Results show that the runoff and sediment load of the stream declined gradually in 1960–2012. According to the abrupt change point detected, the runoff and sediment series were divided into two periods: 1960–1998 and 1999–2012. The reductions of runoff and sediment load in 1999–2012 were found to be related to climate change and human activities, and the latter played a dominant role with a contribution of about 68% and 75%, respectively. The effects of rainfall intensity should be considered to avoid overestimating or underestimating the contributions of rainfall changes to the variations of runoff and sediment load in the semiarid region. An inspection of changes in water discharge and sediment regime indicated that the frequency of discharge between 0 and 5 m3/s increased while that between 5 and 1000 m3/s decreased in 2006–2012. This phenomenon can be attributed principally to the soil and water conservation practices

Impacts of Climate Change and Human Activities on Runoff and Sediment Load of the Xiliugou Basin in the Upper Yellow River

Using data of temperature, wind, precipitation, water discharge, and sediment load, the changes in runoff and sediment load of the Xiliugou basin in the upper Yellow River were investigated and the contributions of climate change and human activities to these changes were quantitatively estimated. Results show that the runoff and sediment load of the stream declined gradually in 1960-2012. According to the abrupt change point detected, the runoff and sediment series were divided into two periods: 1960-1998 and 1999-2012. The reductions of runoff and sediment load in 1999-2012 were found to be related to climate change and human activities, and the latter played a dominant role with a contribution of about 68% and 75%, respectively. The effects of rainfall intensity should be considered to avoid overestimating or underestimating the contributions of rainfall changes to the variations of runoff and sediment load in the semiarid region. An inspection of changes in water discharge and sediment regime indicated that the frequency of discharge between 0 and 5 m 3 /s increased while that between 5 and 1000 m 3 /s decreased in 2006-2012. This phenomenon can be attributed principally to the soil and water conservation practices

Detecting Adversarial Spectrum Attacks via Distance to Decision Boundary Statistics

Machine learning has been adopted for efficient cooperative spectrum sensing. However, it incurs an additional security risk due to attacks leveraging adversarial machine learning to create malicious spectrum sensing values to deceive the fusion center, called adversarial spectrum attacks. In this paper, we propose an efficient framework for detecting adversarial spectrum attacks. Our design leverages the concept of the distance to the decision boundary (DDB) observed at the fusion center and compares the training and testing DDB distributions to identify adversarial spectrum attacks. We create a computationally efficient way to compute the DDB for machine learning based spectrum sensing systems. Experimental results based on realistic spectrum data show that our method, under typical settings, achieves a high detection rate of up to 99% and maintains a low false alarm rate of less than 1%. In addition, our method to compute the DDB based on spectrum data achieves 54%-64% improvements in computational efficiency over existing distance calculation methods. The proposed DDB-based detection framework offers a practical and efficient solution for identifying malicious sensing values created by adversarial spectrum attacks

Optimization of aqueous enzymatic extraction of oil from shrimp processing by-products using response surface methodology

<div><p>Abstract The aqueous enzymatic extraction (AEE) of oil from shrimp processing by-products was investigated. Four kinds of proteases, including alkaline protease, neutral protease, flavor protease and compound protease, were applied to hydrolysis shrimp processing by-products. The results showed that flavor protease was the best hydrolysis enzyme for shrimp processing by-products to obtain high oil recovery. The influences of four factors, including enzyme amount, liquid/solid ratio, hydrolysis time and hydrolysis temperature, on shrimp oil extraction yield were also studied. The flavor enzyme hydrolysis condition was optimized as following: enzyme amount of 2.0% (w/w), liquid/solid ratio of 9.0ml/g, hydrolysis time of 2.6 h and hydrolysis temperature of 50 °C. Under these optimum hydrolysis conditions, the experimental oil extraction yield was 88.9%.</p></div