Case report and literature analysis: Autoimmune cerebellar ataxia associated with homer-3 antibodies

ObjectiveWe present a case of autoimmune cerebellar ataxia (ACA) associated with Homer protein homolog 3 (Homer-3) antibodies. Then, a review of the literature was conducted to summarize its clinical spectrum to improve clinicians' understanding of this rare entity.Case presentationA 25-year-old man suffered from the subacute onset of cerebellar ataxia and psychiatric symptoms with abnormalities in the cerebellum on initial brain MRI and Homer-3 antibodies titers of 1:100 in the serum. His neurological symptoms did not improve after intravenous methylprednisolone but significantly improved following plasma exchange with a modified Rankin Scale (mRS) score of 1. However, 5 months later, he experienced relapse during oral prednisone tapering with enhanced cerebellar lesions and obvious cerebellar atrophy on repeated MRI. Various immunomodulatory approaches, including corticosteroids and plasma exchange, were utilized with no improvement. Then rituximab was given for the first time to treat Homer-3 autoimmunity with partial improvement of symptoms. However, the patient remained profoundly disabled with an mRS score of 4.ConclusionACA associated with Homer-3 antibodies may have a suboptimal response to corticosteroid therapy. More intense immunotherapy such as rituximab may contribute to the improvement of cerebellar syndrome. Relapsing courses and presentation of cerebellar atrophy may suggest a poor prognosis in this entity

Regional catastrophic health expenditure and health inequality in China.

BackgroundCatastrophic health expenditures (CHE) can trigger illness-caused poverty and compound poverty-caused illness. Our study is the first regional comparative study to analyze CHE trends and health inequality in eastern, central and western China, exploring the differences and disparities across regions to make targeted health policy recommendations.MethodsUsing data from China's Household Panel Study (CFPS), we selected Shanghai, Henan and Gansu as representative eastern-central-western regional provinces to construct a unique 5-year CHE unbalanced panel dataset. CHE incidence was measured by calculating headcount; CHE intensity was measured by overshoot and CHE inequality was estimated by concentration curves (CC) and the concentration index (CI). A random effect model was employed to analyze the impact of household head socio-economic characteristics, the household socio-economic characteristics and household health utilization on CHE incidence across the three regions.ResultsThe study found that the incidence and intensity of CHE decreased, but the degree of CHE inequality increased, across all three regions. For all regions, the trend of inequality first decreased and then increased. We also revealed significant differences across the eastern, central and western regions of China in CHE incidence, intensity, inequality and regional differences in the CHE influencing factors. Affected by factors such as the gap between the rich and the poor and the uneven distribution of medical resources, families in the eastern region who were unmarried, use supplementary medical insurance, and had members receiving outpatient treatment were more likely to experience CHE. Families with chronic diseases in the central and western regions were more likely to suffer CHE, and rural families in the western region were more likely to experience CHE.ConclusionsThe trends and causes of CHE varied across the different regions, which requires a further tilt of medical resources to the central and western regions; improved prevention and financial support for chronic diseases households; and reform of the insurance reimbursement policy of outpatient medical insurance. On a regional basis, health policy should not only address CHE incidence and intensity, but also its inequality

Ultrafast-and-Ultralight ConvNet-Based Intelligent Monitoring System for Diagnosing Early-Stage Mpox Anytime and Anywhere

Due to the lack of more efficient diagnostic tools for monkeypox, its spread remains unchecked, presenting a formidable challenge to global health. While the high efficacy of deep learning models for monkeypox diagnosis has been demonstrated in related studies, the overlook of inference speed, the parameter size and diagnosis performance for early-stage monkeypox renders the models inapplicable in real-world settings. To address these challenges, we proposed an ultrafast and ultralight network named Fast-MpoxNet. Fast-MpoxNet possesses only 0.27M parameters and can process input images at 68 frames per second (FPS) on the CPU. To counteract the diagnostic performance limitation brought about by the small model capacity, it integrates the attention-based feature fusion module and the multiple auxiliary losses enhancement strategy for better detecting subtle image changes and optimizing weights. Using transfer learning and five-fold cross-validation, Fast-MpoxNet achieves 94.26% Accuracy on the Mpox dataset. Notably, its recall for early-stage monkeypox achieves 93.65%. By adopting data augmentation, our model's Accuracy rises to 98.40% and attains a Practicality Score (A new metric for measuring model practicality in real-time diagnosis application) of 0.80. We also developed an application system named Mpox-AISM V2 for both personal computers and mobile phones. Mpox-AISM V2 features ultrafast responses, offline functionality, and easy deployment, enabling accurate and real-time diagnosis for both the public and individuals in various real-world settings, especially in populous settings during the outbreak. Our work could potentially mitigate future monkeypox outbreak and illuminate a fresh paradigm for developing real-time diagnostic tools in the healthcare field

Magnesium-Rich Calcium Phosphate Derived from Tilapia Bone Has Superior Osteogenic Potential

We extracted magnesium-rich calcium phosphate bioceramics from tilapia bone using a gradient thermal treatment approach and investigated their chemical and physicochemical properties. X-ray diffraction showed that tilapia fish bone-derived hydroxyapatite (FHA) was generated through the first stage of thermal processing at 600–800 °C. Using FHA as a precursor, fish bone biphasic calcium phosphate (FBCP) was produced after the second stage of thermal processing at 900–1200 °C. The beta-tricalcium phosphate content in the FBCP increased with an increasing calcination temperature. The fact that the lattice spacing of the FHA and FBCP was smaller than that of commercial hydroxyapatite (CHA) suggests that Mg-substituted calcium phosphate was produced via the gradient thermal treatment. Both the FHA and FBCP contained considerable quantities of magnesium, with the FHA having a higher concentration. In addition, the FHA and FBCP, particularly the FBCP, degraded faster than the CHA. After one day of degradation, both the FHA and FBCP released Mg2+, with cumulative amounts of 4.38 mg/L and 0.58 mg/L, respectively. Furthermore, the FHA and FBCP demonstrated superior bone-like apatite formation; they are non-toxic and exhibit better osteoconductive activity than the CHA. In light of our findings, bioceramics originating from tilapia bone appear to be promising in biomedical applications such as fabricating tissue engineering scaffolds

Molecular epidemiology and clinical characteristics of respiratory syncytial virus in hospitalized children during winter 2021–2022 in Bengbu, China

ObjectiveThis study aimed to study the molecular epidemiology and clinical characteristics of respiratory syncytial virus (RSV) infection from hospitalized children with ARTI in Bengbu.MethodsOne hundred twenty-four nasopharyngeal swab specimens and clinical data from children with ARTI cases were collected in Bengbu, China, during winter 2021–2022. The samples were detected by qPCR of 13 respiratory viruses. Phylogenetic analysis was constructed using MEGA 7.0. All analyses were performed using SAS software, version 9.4.ResultsIn winter 2021–2022, URTI, NSCAP, SCAP, and bronchiolitis accounted for 41.03%, 27.35%, 17.09%, and 14.53% of hospitalized children in Bengbu, China. The detection rates of the top three were RSV (41.94%), ADV (5.65%), and FluB (5.65%) in hospitalized children through 13 virus detection. RSV is the main pathogen of hospitalized children under 2 years old. Forty-eight sequences of G protein of RSV were obtained through PCR amplification, including RSV-A 37 strains and RSV-B 11 strains. Phylogenetic analysis showed that all RSV-A and RSV-B were ON1 and BA9 genotypes, respectively. ON1 genotypes were further divided into two clades. The majority of ON1 strains formed a unique genetic clade with T113I, V131D, N178 G, and H258Q mutations. Furthermore, RSV infection was an independent risk factor for ventilator use (OR = 9.55, 95% CI 1.87–48.64).ConclusionThere was a high incidence of RSV among hospitalized children during winter 2021–2022 in Bengbu with ON1 and BA9 being the dominant strains. This study demonstrated the molecular epidemiological characteristics of RSV in children with respiratory infections in Bengbu, China

A CsI hodoscope on CSHINE for Bremsstrahlung {\gamma}-rays in Heavy Ion Reactions

Bremsstrahlung $\gamma$ production in heavy ion reactions at Fermi energies carries important physical information including the nuclear symmetry energy at supra-saturation densities. In order to detect the high energy Bremsstrahlung $\gamma$ rays, a hodoscope consisting of 15 CsI(Tl) crystal read out by photo multiplier tubes has been built, tested and operated in experiment. The resolution, efficiency and linear response of the units to $\gamma$ rays have been studied using radioactive source and $({\rm p},\gamma)$ reactions. The inherent energy resolution of $1.6\%+2\%/E_{\gamma}^{1/2}$ is obtained. Reconstruction method has been established through Geant 4 simulations, reproducing the experimental results where comparison can be made. Using the reconstruction method developed, the whole efficiency of the hodoscope is about $2.6\times 10^{-4}$ against the $4\pi$ emissions at the target position, exhibiting insignificant dependence on the energy of incident $\gamma$ rays above 20 MeV. The hodoscope is operated in the experiment of $^{86}$Kr + $^{124}$Sn at 25 MeV/u, and a full $\gamma$ energy spectrum up to 80 MeV has been obtained.Comment: 9 pages, 19 figure

Probing high-momentum component in nucleon momentum distribution by neutron-proton bremsstrahlung {\gamma}-rays in heavy ion reactions

The high momentum tail (HMT) of nucleons, as a signature of the short-range correlations in nuclei, has been investigated by the high-energy bremsstrahlung $\gamma$ rays produced in $^{86}$Kr + $^{124}$Sn at 25 MeV/u. The energetic photons are measured by a CsI(Tl) hodoscope mounted on the spectrometer CSHINE. The energy spectrum above 30 MeV can be reproduced by the IBUU model calculations incorporating the photon production channel from $np$ process in which the HMTs of nucleons is considered. A non-zero HMT ratio of about $15\%$ is favored by the data. The effect of the capture channel $np \to d\gamma$ is demonstrated

Revisit to the yield ratio of triton and 3^3He as an indicator of neutron-rich neck emission

The neutron rich neck zone created in heavy ion reaction is experimentally probed by the production of the $A=3$ isobars. The energy spectra and angular distributions of triton and $^3$He are measured with the CSHINE detector in $^{86}$Kr +$^{208}$Pb reactions at 25 MeV/u. While the energy spectrum of $^{3}$He is harder than that of triton, known as "$^{3}$He-puzzle", the yield ratio $R({\rm t/^3He})$ presents a robust rising trend with the polar angle in laboratory. Using the fission fragments to reconstruct the fission plane, the enhancement of out-plane $R({\rm t/^3He})$ is confirmed in comparison to the in-plane ratios. Transport model simulations reproduce qualitatively the experimental trends, but the quantitative agreement is not achieved. The results demonstrate that a neutron rich neck zone is formed in the reactions. Further studies are called for to understand the clustering and the isospin dynamics related to neck formation

Genome and secretome analysis of Pochonia chlamydosporia provide new insight into egg-parasitic mechanisms

Pochonia chlamydosporia infects eggs and females of economically important plant-parasitic nematodes. The fungal isolates parasitizing different nematodes are genetically distinct. To understand their intraspecific genetic differentiation, parasitic mechanisms, and adaptive evolution, we assembled seven putative chromosomes of P. chlamydosporia strain 170 isolated from root-knot nematode eggs (~44 Mb, including 7.19% of transposable elements) and compared them with the genome of the strain 123 (~41 Mb) isolated from cereal cyst nematode. We focus on secretomes of the fungus, which play important roles in pathogenicity and fungus-host/environment interactions, and identified 1,750 secreted proteins, with a high proportion of carboxypeptidases, subtilisins, and chitinases. We analyzed the phylogenies of these genes and predicted new pathogenic molecules. By comparative transcriptome analysis, we found that secreted proteins involved in responses to nutrient stress are mainly comprised of proteases and glycoside hydrolases. Moreover, 32 secreted proteins undergoing positive selection and 71 duplicated gene pairs encoding secreted proteins are identified. Two duplicated pairs encoding secreted glycosyl hydrolases (GH30), which may be related to fungal endophytic process and lost in many insect-pathogenic fungi but exist in nematophagous fungi, are putatively acquired from bacteria by horizontal gene transfer. The results help understanding genetic origins and evolution of parasitism-related genes.This work was supported by the National Key Research and Development (R&D) Plan of China (2016YFC1201100), and the Science and Technology Innovation Program of the Chinese Academy of Agricultural Sciences (CAAS-ASTIP-IVFCAAS)