Case Analysis of Misdiagnosis in Emergency Internal Medicine

Objective: This paper attempts to determine the clinical factors associated with the diagnosis of stroke in young adults. Method: We registered and examined young patients from the hospital stroke center. Demographic data, past medical history, 3 hours diagnosis time within the time frame, and the outcomes were assessed. We compared the patients with misdiagnosis and those who were correctly diagnosed in order to identify the factors associated with acute stroke. Results: From 2005−2011, 57 patients (16−50 years) were enrolled in the registry. 8 patients (14%; 4 men and 4 women, mean age 38 years) were misdiagnosed. Of these 8 patients, seven were initially discharged from the emergency department. Patients aged less than 35 years old (p = 0.05) and posterior circulation stroke patients (p = 0.006) were more likely to be misdiagnosed. Conclusion: First aid department needs to popularize the awareness of stroke among young adults. Misdiagnosis may cause the patient to lose the best chance of thrombolysis

The matching rule of Panum’s limiting case and its influencing factors

IntroductionPanum’s limiting case is one of the typical configurations of monocular occlusion region. The matching rule of Panum’s limiting case is the key to understanding how monocular occlusion region produces stereopsis. There are currently two main views on the matching rule of Panum’s limiting case, namely double fusion and uniqueness constraint. This paper further discusses its matching mechanism on the basis of previous studies.MethodsIn this study, fold line Panum’s stimuli were used to study the matching rule of Panum’s limiting case. In Experiment 1, fixation position was adopted to present the stimulus in a short time to explore the matching rules in Panum’s limiting case. In Experiment 2, the effect of fixation position on Panum’s limiting case matching results was further investigated.ResultsThe results of Experiment 1 show that when stimuli are presented in a short period of time, the reported result that a single feature in one eye may be matched alternately with two features in the other eye. This matching rule is called “fast alternative matching” in this article. The results of Experiment 2 results show that the position of the fixation could affect the matching result of participants.ConclusionIn conclusion, the matching rule of Panum’s limiting case is fast alternative matching, and the matching result is related to the attention state of the participant. These results not only provide a new perspective for matching rules in Panum’s limiting case, but also show that depth perception results in stereopsis can be influenced by top-down cognitive processing. This study provides a theoretical basis for studying the formation of stereopsis in the monocular region to a certain extent. In summary, the matching rule of Panum’s limiting case is fast alternative matching. In previous studies, the perceived result of double fusion may be caused by fast alternative matching. Also, the matching results are related to the participant’s state of attention, which suggests that the depth perception results of stereopsis are influenced by top-down cognitive processing

Early Detection of Encroaching Woody Juniperus virginiana and Its Classification in Multi-Species Forest Using UAS Imagery and Semantic Segmentation Algorithms

Woody plant encroachment into grasslands ecosystems causes significantly ecological destruction and economic losses. Effective and efficient management largely benefits from accurate and timely detection of encroaching species at an early development stage. Recent advances in unmanned aircraft systems (UAS) enabled easier access to ultra-high spatial resolution images at a centimeter level, together with the latest machine learning based image segmentation algorithms, making it possible to detect small-sized individuals of target species at early development stage and identify them when mixed with other species. However, few studies have investigated the optimal practical spatial resolution of early encroaching species detection. Hence, we investigated the performance of four popular semantic segmentation algorithms (decision tree, DT; random forest, RF; AlexNet; and ResNet) on a multi-species forest classification case with UAS-collected RGB images in original and down-sampled coarser spatial resolutions. The objective of this study was to explore the optimal segmentation algorithm and spatial resolution for eastern redcedar (Juniperus virginiana, ERC) early detection and its classification within a multi-species forest context. To be specific, firstly, we implemented and compared the performance of the four semantic segmentation algorithms with images in the original spatial resolution (0.694 cm). The highest overall accuracy was 0.918 achieved by ResNet with a mean interaction over union at 85.0%. Secondly, we evaluated the performance of ResNet algorithm with images in down-sampled spatial resolutions (1 cm to 5 cm with 0.5 cm interval). When applied on the down-sampled images, ERC segmentation performance decreased with decreasing spatial resolution, especially for those images coarser than 3 cm spatial resolution. The UAS together with the state-of-the-art semantic segmentation algorithms provides a promising tool for early-stage detection and localization of ERC and the development of effective management strategies for mixed-species forest management

Adsorption equilibrium, isotherm, kinetics, and thermodynamic of modified bentonite for removing Rhodamine B

116-125Anionic and cationic surfactant modified sodium bentonite (Na-Bt) has been prepared by the cationic surfactant cetyltrimethyl ammonium bromide (CTAB) and the anionic surfactant sodium dodecyl benzene sulfonate (SDBS) to sodium bentonite, respectively. The properties of the modified samples are characterized by XRD, SEM, BET and FT-IR. The results of characterization shown that the cationic surfactant had changed the structure and properties of natural sodium bentonite, which proved that surfactants had been successfully implanted into sodium bentonite. But anionic surfactant had no change, this manifested SDBS didn’t insert the layers of bentonite. In addition, adsorption experiments of Rhodamine B (RhB) proved that the modified sodium bentonite adsorption performance is greatly improved. The adsorption experiments also indicated that CTAB-bentonite had the largest adsorption capacity compared with SDBS-bentonite due to the formation of a highly effective partition medium by cationic surfactant micelle. The adsorption data of RhB is analyzed with the isothermal model, thermodynamics and kinetics. Overall, this study provided high-efficiency method for the removal RhB by the surfactant modified bentonite

Identification of Immunogenic Epitopes That Permit the Detection of Antigen-Specific T Cell Responses in Multiple Serotypes of Group B Coxsackievirus Infections

Coxsackievirus group B (CVB) contains six serotypes that can affect various organs. Some of these organ-specific diseases such as myocarditis and pancreatitis can be caused by more than one serotype. Thus, development of immunological tools common to multiple serotypes is desired. This is especially critical for analyzing antigen-specific T cell responses at a single cell level. To this end, we made efforts to identify the immunogenic epitopes of CVB3 leading us to localize three T cell epitopes within the viral protein 1 (VP1) namely, VP1 681–700, VP1 721–740 and VP1 771–790. First, we confirmed their immunogenicity in the immunization settings. Second, we sought to verify the ability of VP1 epitopes to bind major histocompatibility complex (MHC) class II (IAk) molecules. Third, we created MHC class II (IAk) dextramers and tetramers and ascertained the T cell responses to be antigen-specific. Fourth, we analyzed the T cell responses in animals infected with CVB3 and noted the magnitude of antigen-specific T cell responses occurring in the order of VP1 721–740 and VP1 681–700 followed by VP1 771–790 as verified by proliferation assay and IAk tetramer staining. All epitopes induced interferon (IFN)- as a major cytokine. Finally, we investigated whether the VP1 tools generated for CVB3 can also be used to verify T cell responses in infections caused by other serotypes. To this end, we established the CVB4 infection model in A/J mice and found that the CVB4 infection led to the induction of IFN- -producing T cell responses primarily for VP1 721–740 and VP1 681–700. Thus, the VP1-specific tools, particularly IAk tetramers can be used to monitor anti-viral T cell responses in multiple CVB serotypes

Gonadotropin-releasing hormone analogue and recombinant human growth hormone treatment for idiopathic central precocious puberty in girls

PurposeTo investigate the effectiveness and safety of gonadotropin-releasing hormone analogue (GnRHa) in combination with recombinant human growth hormone (rhGH) in girls with central precocious puberty (CPP).MethodsClinical data of 80 girls diagnosed with idiopathic central precocious puberty (ICPP) between January 2017 and June 2021 were retrospectively analyzed. Treatment strategy involved GnRHa alone (group A: n=34) and GnRHa+rhGH (group B: n=46). Children’s heights (Ht), weights (Wt) and sex hormone levels were measured every 3 months after treatment and bone age (BA) every six months. Heights, growth velocity (GV), predicted adult height (PAH), weights, body mass index (BMI), sex hormone levels and bone age were compared between the two groups.ResultsChildren in group B showed greater height gain at the 12th, 24th and 30th months after treatment (p<0.05) than those in group A, had faster growth rates in the first and second year following treatment (p<0.05) and better PAH (p<0.05). No statistical differences in weight or BMI were found between the two groups before treatment or at any time after treatment (p>0.05). Levels of LH and FSH were lower in both groups after treatment with no statistical differences between groups (p>0.05). The gap between bone age and chronological age gradually decreased in both groups and no abnormal progression of bone age or other adverse side effects occurred.ConclusionsThe combination of GnRHa with rhGH produced better height gains than GnRHa alone for patients with CPP. The gonadal axis was suppressed and progression of bone age delayed with good safety and efficacy

The α7 nicotinic acetylcholine receptor agonist PNU-282987 ameliorates sepsis-induced acute kidney injury through CD4+CD25+ regulatory T cells in rats

The ameliorative effects of α7 nicotinic acetylcholine receptor (α7nAChR) agonists have been demonstrated in acute kidney injury (AKI) caused by multiple stimulations. However, the ameliorative effect of α7nAChR on sepsis-induced acute kidney injury (SAKI) in the cecal ligation and puncture (CLP) model is unclear. Previous studies have demonstrated that α7nAChR is highly expressed on the surface of CD4+CD25+ regulatory T cells (Tregs). However, the role of Tregs in SAKI is unclear. We hypothesized that Tregs might play a role in the ameliorative effect of α7nAChR on SAKI. Hence, in this study, we determined the effects of PNU-282987 (a selective α7nAchR agonist) on SAKI and evaluated whether PNU-282987 would attenuate SAKI via regulating Tregs. Our study showed that immediate administration of PNU-282987 after CLP surgery in rats improved renal function, reduced levels of systemic inflammatory factors (tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), etc.), inflammatory cell infiltration and tubular apoptosis in renal tissues, and increased forkhead/winged helix transcription factor p3 (Foxp3) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) expression indicating activated Tregs. Moreover, in in vitro experiments, isolated Tregs co-cultured with PNU-282987 also displayed enhanced expression of CTLA-4 and Foxp3. Furthermore, Tregs were co-cultured with PNU-282987 for 24 hours and then reinfused into rats through the tail vein immediately after CLP surgery, and a significant renal protective effect was observed 24 hours postoperatively. These results demonstrate that PNU-282987 exerts its renal protective effects on SAKI through activation of Tregs

Changes in DNA methylation assessed by genomic bisulfite sequencing suggest a role for DNA methylation in cotton fruiting branch development

Cotton plant architecture, including fruit branch formation and flowering pattern, influences plant light exploitation, cotton yield and planting cost. DNA methylation has been widely observed at different developmental stages in both plants and animals and is associated with regulation of gene expression, chromatin remodelling, genome protection and other functions. Here, we investigated the global epigenetic reprogramming during the development of fruiting branches and floral buds at three developmental stages: the seedling stage, the pre-squaring stage and the squaring stage. We first identified 22 cotton genes which potentially encode DNA methyltransferases and demethylases. Among them, the homologous genes of CMT, DRM2 and MET1 were upregulated at pre-squaring and squaring stages, suggesting that DNA methylation is involved in the development of floral buds and fruit branches. Although the global methylation at all of three developmental stages was not changed, the CHG-type methylation of non-expressed genes was higher than those of expressed genes. In addition, we found that the expression of the homologous genes of the key circadian rhythm regulators, including CRY, LHY and CO, was associated with changes of DNA methylation at three developmental stages