Current status and countermeasures of diagnosis and treatment of mild bronchial asthma in China

In China, bronchial asthma has emerged as the second most prevalent respiratory disease, with mild asthma constituting 50%-70% of the reported cases. The challenges in diagnosing mild asthma arise from the subtle or atypical symptoms exhibited by patients, coupled with the absence of characteristic wheezing sounds. Notably, pulmonary function tests frequently yield normal indices for large airway functions, contributing to a significant misdiagnosis rate exceeding 70%. This high misdiagnosis rate results in patients seeking medical care repeatedly， and some cases receiving inappropriate treatments, with incresed the risk of progressing to moderate or severe asthma, experiencing acute attacks, and facing the potential threat of mortalitydeath. About one-third of asthma deaths occur in mild asthma. Furthermore, the predominant focus on symptom relief rather than the effective control of airway inflammation raises significant concerns regar-ding the diagnosis and treatment of mild asthma in China. In response, the "Expert consensus on the diagnosis, treatment and management of mild bronchial asthma in China (2023 edition)" introduces two diagnostic pathways, namely definitive and presumptive diagnosis, with the aim of enhancing diagnostic accuracy and standardizing treatment approaches. Based on the limitations associated with methods for definitive diagnosis (such as a bronchodilator test's positive rate less than 10% in mild asthma patients and the low clinical implementation rate of bronchial provocation tests)， and an understanding of the pathophysiological mechanisms of small airway dysfunction, a presumptive diagnosis pathway to address these inherent shortcomings is proposed. Initially, a singular pulmonary function test is employed for presumptive diagnosis, integrating small airway function with airway inflammation indices. The model is fine-tuned based on age and gender considerations. The assessment of large and small airway reversibility in patients with negative bronchodilator tests serves as a pivotal guide for diagnostic treatment, minimizing the risks of misdiagnosis and overdiagnosis. Treatment and management strategies are selected based on the level of symptom control, with an emphasis on anti-inflammatory approaches. Employing a patient-centered shared decision-making model and implementing an "assessment-adjustment-review" asthma management cycle to individualize precision management is executed to establish diagnostic and treatment strategies for mild asthma, enhancing the overall standard of care for mild asthma

Convolutional Hierarchical Attention Network for Query-Focused Video Summarization

Previous approaches for video summarization mainly concentrate on finding the most diverse and representative visual contents as video summary without considering the user's preference. This paper addresses the task of query-focused video summarization, which takes user's query and a long video as inputs and aims to generate a query-focused video summary. In this paper, we consider the task as a problem of computing similarity between video shots and query. To this end, we propose a method, named Convolutional Hierarchical Attention Network (CHAN), which consists of two parts: feature encoding network and query-relevance computing module. In the encoding network, we employ a convolutional network with local self-attention mechanism and query-aware global attention mechanism to learns visual information of each shot. The encoded features will be sent to query-relevance computing module to generate queryfocused video summary. Extensive experiments on the benchmark dataset demonstrate the competitive performance and show the effectiveness of our approach.Comment: Accepted by AAAI 2020 Conferenc

Influence of Post-Treatment with 75% (v/v) Ethanol Vapor on the Properties of SF/P(LLA-CL) Nanofibrous Scaffolds

In order to improve the water-resistant ability of silk fibroin (SF) and SF/P(LLA-CL) blended nanofibrous scaffolds for tissue engineering applications, 75% (v/v) ethanol vapor was used to post-treat electrospun nanofibers. SEM indicated that the treated SF and SF/P(LLA-CL) nanofibrous scaffolds maintained a nanofibrous structure and possessed good water-resistant ability. Characterization of 13C CP-MAS NMR clarified that 75% (v/v) ethanol vapor could induce SF conformation from random coil or α-helix to β-sheet. Although the water contact showed that treated SF/P(LLA-CL) blended nanofibrous scaffolds were hydrophobic, the water uptake demonstrated that their hydrophilicity was greatly superior to those of pure P(LLA-CL) nanofibrous scaffolds. Furthermore, the treated SF/P(LLA-CL) nanofibrous scaffolds, both in dry state and wet state, could retain good mechanical properties. Therefore, 75% (v/v) ethanol vapor treatment might be an ideal method to treat SF and SF/P(LLA-CL) nanofibrous scaffolds for biomedical applications

SNR-based adaptive acquisition method for fast Fourier ptychographic microscopy

Fourier ptychographic microscopy (FPM) is a computational imaging technique with both high resolution and large field-of-view. However, the effective numerical aperture (NA) achievable with a typical LED panel is ambiguous and usually relies on the repeated tests of different illumination NAs. The imaging quality of each raw image usually depends on the visual assessments, which is subjective and inaccurate especially for those dark field images. Moreover, the acquisition process is really time-consuming.In this paper, we propose a SNR-based adaptive acquisition method for quantitative evaluation and adaptive collection of each raw image according to the signal-to-noise ration (SNR) value, to improve the FPM's acquisition efficiency and automatically obtain the maximum achievable NA, reducing the time of collection, storage and subsequent calculation. The widely used EPRY-FPM algorithm is applied without adding any algorithm complexity and computational burden. The performance has been demonstrated in both USAF targets and biological samples with different imaging sensors respectively, which have either Poisson or Gaussian noises model. Further combined with the sparse LEDs strategy, the number of collection images can be shorten to around 25 frames while the former needs 361 images, the reduction ratio can reach over 90%. This method will make FPM more practical and automatic, and can also be used in different configurations of FPM.Comment: 11 pages, 6 figure

Effects of nebulized ketamine on allergen-induced airway hyperresponsiveness and inflammation in actively sensitized Brown-Norway rats

Since airway hyperresponsiveness (AHR) and allergic inflammatory changes are regarded as the primary manifestations of asthma, the main goals of asthma treatment are to decrease inflammation and maximize bronchodilation. These goals can be achieved with aerosol therapy. Intravenous administration of the anesthetic, ketamine, has been shown to trigger bronchial smooth muscle relaxation. Furthermore, increasing evidence suggests that the anti-inflammatory properties of ketamine may protect against lung injury. However, ketamine inhalation might yield the same or better results at higher airway and lower ketamine plasma concentrations for the treatment of asthma. Here, we studied the effect of ketamine inhalation on bronchial hyperresponsiveness and airway inflammation in a Brown-Norway rat model of ovalbumin(OVA)-induced allergic asthma. Animals were actively sensitized by subcutaneous injection of OVA and challenged by repeated intermittent (thrice weekly) exposure to aerosolized OVA for two weeks. Before challenge, the sensitizened rats received inhalation of aerosol of phosphate-buffered saline (PBS) or aerosol of ketamine or injection of ketamine respectivity. Airway reactivity to acetylcholine (Ach) was measured in vivo, and various inflammatory markers, including Th2 cytokines in bronchoalveolar lavage fluid (BALF), as well as induciable nitric oxide synthase (iNOS) and nitric oxide (NO) in lungs were examined. Our results revealed that delivery of aerosolized ketamine using an ultrasonic nebulizer markedly suppressed allergen-mediated airway hyperreactivity, airway inflammation and airway inflammatory cell infiltration into the BALF, and significantly decreased the levels of interleukin-4 (IL-4) in the BALF and expression of iNOS and the concentration of NO in the inflamed airways from OVA-treated rats. These findings collectively indicate that nebulized ketamine attenuated many of the central components of inflammatory changes and AHR in OVA-provoked experimental asthma, potentially providing a new therapeutic approach against asthma

Is SEMG recorded “hyperactivity” during mandibular rest a sign of dysfunctional jaw muscle activity and temporomandibular disorders (TMD)?

BackgroundSome authors state that above‐normal surface electromyography (SEMG) levels during mandibular rest (MR) are a general sign of temporomandibular disorders (TMD).ObjectiveThe aim was to compare SEMG levels in the masseter and anterior temporalis areas during MR between patients with disc displacement (DD) and subjects identified as healthy. The hypothesis was that average SEMG levels would be higher in the patients during MR before and after repeated clenches with maximal effort.MethodsThirty‐six healthy subjects, and 42 patients with DD, were included. SEMG levels were recorded bilaterally in the temporalis and masseter areas during MR before clenching and after repeated clenches with maximal effort. Multivariate analysis of variance (MANOVA) was used to compare the means of the log‐transformed SEMG‐values for the subject groups.ResultsThe mean MR levels in the four areas before clenching ranged from −0.19 log (µV) to 1.20 log(µV) in healthy subjects and from −0.22 log(µV) to 0.96 log(µV) in patients. The mean MR levels in the four areas after repeated clenches ranged from −0.19 log (µV) to 1.04 log(µV) in healthy subjects and from −0.27 log(µV) to 0.93 log(µV) in patients. The MANOVA test showed no significant differences in the means for MR for the four areas between the groups at the 5% significance level.ConclusionThe hypothesis that jaw muscle SEMG levels during MR are on average generally higher in TMD patients is not supported. A possible explanation for the previous findings is that activity in other muscles was mislabelled as jaw muscle activity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156203/2/joor13032_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156203/1/joor13032.pd