High Sensitivity Research Articles

High-Q Multiband Narrowband Absorbers Based on Two-Dimensional Graphene Metamaterials

In this paper, an absorber with multi-band, tunable, high Q, and high sensitivity, based on terahertz periodic two-dimensional patterned graphene surface plasmon resonance (SPR), is proposed. The absorber consists of a bottom metal film separated by a periodically patterned graphene metamaterial structure and a SiO2 dielectric layer, where the patterned graphene layer is etched by “+” and “L” shapes and circles. It has simple structural features that can greatly simplify the fabrication process. We have analyzed the optical properties of a graphene surface plasmon perfect metamaterial absorber based on graphene in the terahertz region using the finite-difference method in time domain (FDTD). The results show that the absorber device exhibits three perfect absorption peaks in the terahertz bands of f1 = 1.55 THz, f2 = 4.19 THz, and f3 = 6.92 THz, with absorption rates as high as 98.70%, 99.63%, and 99.42%, respectively. By discussing the effects of parameters such as the geometrical dimensions of patterned graphene metamaterial structure “+” width W1, “L” width W2, circular width R, and the thickness of the dielectric layer on the absorption performance of absorber, as well as investigating the chemical potential and relaxation time of patterned-layer graphene material, it was found that the amplitude of the absorption peaks and the frequency of resonance of absorber devices can be dynamically adjusted. Finally, we simulated the spectra as the surrounding refractive index n varied to better evaluate the sensing performance of the structure, yielding structural sensitivities up to 382 GHz/RIU. Based on this study, we find that the results of our research will open new doors for the use of multi-band, tunable, polarization-independent metamaterial absorbers that are insensitive to large-angle oblique incidence.

RESIDUAL CARDIOVASCULAR RISK AND SEVERITY OF CORONARY DISEASE

Abstract Background The presence of residual risk in patients with a history of atherosclerotic cardiovascular disease (ASCVD) is a cause of additional cardiovascular events. The aim of this study is to correlate residual cardiovascular risk with the severity of coronary disease. Methods We enrolled 52 patients hospitalized with a diagnosis of acute coronary syndrome from September to October 2023 at the Clinical and Rehabilitation Cardiology of the San Filippo Neri Hospital. All patients were treated with percutaneous and/or surgical coronary revascularization and had a history of ASCVD. Thirty of these patients had a single–vessel coronary disease and 22 had a multivessel coronary disease. We analyzed the main cardiovascular risk factors and the received therapies in both groups. Results Triglyceride levels were significantly higher in the group with a multivessel coronary disease (132.94 ± 65.41 mg/dl vs 94.06 ± 37.63 mg/dl; p=0.01) as well as the levels of glycated hemoglobin (50.91 ± 15.23 mmol/mol vs 42.92 ± 6.65 mmol/mol; p=0.01) and high–sensitivity C–reactive protein (hs–CRP, 1.25 ± 1.48 mg/dl vs 0.65 ± 0.46 mg/dl; p=0.04). We found no significant differences between the two groups for the other main cardiovascular risk factors and the therapies. Conclusions Our data show that higher levels of triglycerides, glycated hemoglobin and hs–CRP, an inflammatory biomarker, are associated with a more extensive coronary disease. This finding suggests that a better metabolic control, in terms of glycated hemoglobin and triglyceride levels, and inflammation could contribute to the reduction of coronary disease extension.

Correlation between CO2 Sensitivity and Channel-Layer Thickness in In2O3 Thin-Film Transistor Gas Sensors

CO2 monitoring is important for achieving net-zero emissions. Here, we report on a CO2 gas sensor based on an In2O3 thin-film transistor (TFT), which is expected to realize both low-temperature operation and high sensitivity. The effect of channel thickness on TFT performance is well known; however, its effect on CO2 sensitivity has not been fully investigated. We fabricated In2O3 TFTs of various thicknesses to evaluate the effect of channel thickness on CO2 sensitivity. Consequently, TFT gas sensors with thinner channels exhibited higher CO2 sensitivity. This is because the surface effect is more prominent for a thinner film, suggesting that charge transfer between gas molecules and the channel surface through gas adsorption has a significant impact on changes in the TFT parameters in the subthreshold region. The results showed that the In2O3 TFT in thin channels is a promising candidate for CO2-sensitive TFT gas sensors and is useful for understanding an effect of gas adsorption in oxide TFTs with a very thin channel as well.

AL–AMYLOIDOSIS RELATED ADVANCED HEART FAILURE DIAGNOSED THROUGH F–18–FLUTEMETANOL PET SCAN

Abstract Background Systemic amyloidosis (SA) is a group of rare diseases in which abnormal misfolded proteins, amyloid fibrils, accumulate in tissue. The gold standard for diagnosis is tissue biopsy of the affected organ, but it is invasive and needs specific proteomic or immunohistochemistry analyses to characterize the involved protein. We report a case of a complex diagnosis of SA in an advanced heart failure (HF) patient. Methods and Results A 68–year–old woman with history of recurrent uveitis started to complain dyspnea in 2022, after Covid19. Since her symptoms worsened, in June 2023 she was diagnosed in another center with restrictive cardiomyopathy with preserved left ventricular (LV) ejection fraction. She underwent coronary angiography (unremarkable), cardiac MRI (aspecific fibrosis), and a FDG–PET scan which showed non–homogeneous LV fixation. The patient was treated with steroids for the suspicion of an immunologic–inflammatory disease, without benefit. Fourteen months after the initial presentation, she was admitted to our centre for advanced inotrope–dependent HF. She had mildly increased LV hypertrophy and severe systolic dysfunction with restrictive physiology and, notably, peri–orbital subcutaneous hemorrhages (Figure 1). Hematological screening for amyloidosis showed elevated serum free lambda light chains. Repeated cardiac MRI scan was consistent with infiltrative disease. A total–body PET scan with dual tracer was performed. The control session with F–18–FDG showed mild aspecific cardiac uptake in the basal septum and lateral wall (Figure 2), while off–label use of F–18–Flutemetanol, an Alzheimer‘s disease approved experimental tracer that binds to amyloid fibrils beta sheets with very high sensitivity and specificity, showed intense cardiac, hepatic, pulmonary and muscular uptake, with wash–out–timing diagnostic for AL–SA (Figure 3). Periumbilical fat biopsy confirmed the clinical suspicion of SA. Hematological investigations led to the diagnosis of stage I–A lambda micromolecular multiple myeloma, with systemic amyloidosis and a IIIb cardiac prognostic score. Conclusions Endomyocardial biopsy is an invasive procedure and periumbilical fat biopsy discriminates the amyloid protein type only by proteomic analysis, which is available in very few Italian centres. The off–label use of Alzheimers’ PET tracers could reduce the delay of cardiac AL–SA diagnosis, allowing early disease identification and prompting timely hematological therapy.

Detection of fucosylated extracellular vesicles miR-4732-5p related to diagnosis of early lung adenocarcinoma by the electrochemical biosensor

Our preliminary investigation has identified the potential of serum fucosylated extracellular vesicles (EVs) miR-4732-5p in the early diagnosis of lung adenocarcinoma (LUAD) by a fucose-captured strategy utilizing lentil lectin (LCA)-magnetic beads and subsequent screening of high throughput sequencing and validation of real-time quantitative polymerase chain reaction (RT-qPCR). Considering the relatively complicated procedure, expensive equipment, and stringent laboratory condition, we have constructed an electrochemical biosensor assay for the detection of miR-4732-5p. miR-4732-5p is extremely low in serum, down to the fM level, so it needs to be detected by highly sensitive electrochemical methods based on the Mg2+-dependent DNAzyme splitting nucleic acid lock (NAL) cycle and hybridization chain reaction (HCR) signal amplification. In this study, signal amplification is achieved through the dual amplification reactions using NAL cycle in combination with HCR. In addition, hybridized DNA strands bind to a large number of methylene blue (MB) molecules to enhance signaling. Based on the above strategy, we further enhance our signal amplification strategies to improve detection sensitivity and accuracy. The implementation of this assay proceeded as follows: initially, miR-4732-5p was combined with NAL, and then Mg2+-dependent DNAzyme splitted NAL to release auxiliary DNA (S1) strands, which were subsequently captured by the immobilized capture probe DNA (C1) strands on the electrode surface. Following this, abundant quantities of DNA1 (H1) and DNA2 (H2) tandems were generated by HCR, and S1 strands then hybridized with the H1 and H2 tandems through base complementary pairing. Finally, MB was bonded to the H1 and H2 tandems through π–π stacking interaction, leading to the generation of a signal current upon the detection of a potential capable of inducing a redox change of MB by the electrode. Furthermore, we evaluated the performance of our developed electrochemical biosensor assay. The results demonstrated that our assay is a reliable approach, characterized by its high sensitivity (with a detection limit of 2.6 × 10−17 M), excellent specificity, good accuracy, reproducibility, and stability. Additionally, it is cost-effective, requires simple operation, and is portable, making it suitable for the detection of serum fucosylated extracellular vesicles miR-4732-5p. Ultimately, this development has the potential to enhance the diagnostic efficiency for patients with early-stage LUAD.

Electrochemical Sensors and Biosensors for Identification of Viruses: A Critical Review.

Due to their life cycle, viruses can disrupt the metabolism of their hosts, causing diseases. If we want to disrupt their life cycle, it is necessary to identify their presence. For this purpose, it is possible to use several molecular-biological and bioanalytical methods. The reference selection was performed based on electronic databases (2020-2023). This review focused on electrochemical methods with high sensitivity and selectivity (53% voltammetry/amperometry, 33% impedance, and 12% other methods) which showed their great potential for detecting various viruses. Moreover, the aforementioned electrochemical methods have considerable potential to be applicable for care-point use as they are portable due to their miniaturizability and fast speed analysis (minutes to hours), and are relatively easy to interpret. A total of 2011 articles were found, of which 86 original papers were subsequently evaluated (the majority of which are focused on human pathogens, whereas articles dealing with plant pathogens are in the minority). Thirty-two species of viruses were included in the evaluation. It was found that most of the examined research studies (77%) used nanotechnological modifications. Other ones performed immunological (52%) or genetic analyses (43%) for virus detection. 5% of the reports used peptides to increase the method's sensitivity. When evaluable, 65% of the research studies had LOD values in the order of ng or nM. The vast majority (79%) of the studies represent proof of concept and possibilities with low application potential and a high need of further research experimental work.

High-precision spectra captured by a spectral camera and suppression of their nonlinearity

The high sensitivity of photoplethysmography (PPG) spectral signals provides conditions for extracting dynamic spectra carrying nonlinear information. By the idea of spatial conversion precision, this paper uses a spectral camera to collect highly sensitive spectral data of 24 wavelengths and proposes a method for extracting dynamic spectra of three different optical path lengths and their joint modeling. In the experiment, the models of the red blood cells and white blood cells established by the joint spectra achieved good results, with the correlation coefficients above 0.77. This study has great significance for achieving high-precision noninvasive quantitative analysis of human blood components.

Structural Damage Detection Based on Structural Macro-Strain Mode Shapes Extracted From Non-Stationary Output Responses

Abstract Long-gauge Fiber Bragg grating (FBG) strain sensors have been widely employed because of their broader measuring range and higher sensitivity. However, current structural damage detection methods using macro-strain modal parameters are based on structural frequency response function or stationary power spectrum density, which are not applicable to non-stationary responses. To overcome this limitation, an improved method is proposed in this paper for structural damage detection based on structural macro-strain responses under unknown multi-point non-stationary excitations. First, a new concept of macro-strain energy spectrum transmissibility (MEST) is proposed using structural non-stationary macro-strain responses, and it is derived that MEST at a certain system pole equals the ratio of macro-strain mode shape. Then, the singular value decomposition (SVD) technique is adopted for the MEST matrix to identify structural natural frequencies and macro-strain mode shapes. Finally, two damage detection indicators are constructed based on the identified normalized macro-strain mode shape (NMMS). The first indicator is the difference in structural NMMS before and after structural damage. The second one is based on the curvatures of structural NMMS, which can be used for structures without intact baseline. Numerical verifications are conducted to identify beam-type structural damage under multi-point nonstationary excitations or vehicle loads. Five damage scenarios with different measurement noise levels are investigated, and damage detection results validate the effectiveness of the proposed method.

A synergistic combination of 2D MXene and MoO3 nanoparticles for improved gas sensing at room temperature

MXene Ti3C2T x (30% HF-etched, named Ti3C2T x -30) plays a pivotal role in the substantial enhancement of the structural modification of molybdenum trioxide (MoO3). Additionally, as the surface MoO3 molecules come into contact with reducing gas moieties, they actively participate in gas sensing at room temperature. The percentage of Ti3C2T x -30 in the MoO3 matrix was varied at 10%, 20%, and 40%, denoted as MM-10, MM-20, and MM-40, respectively. Structural analysis confirmed the composition of the basic elements and evolution of TiO2 at a higher percentage of Ti3C2T x -30. Spectroscopy analysis showed the interactions between Ti3C2T x -30 and MoO3, showcasing work functions of 6.91 eV, 6.75 eV, and 7.21 eV for MM-10, MM-20, and MM-40, respectively, confirming MM-20 to be an optimum composition. When the samples were exposed to ammonia gas, MM-20 showed a high response (93% for 100 ppm) at room temperature, with a response time of ∼10 s. Compared to bare MoO3, these samples showed ten-fold improvement. The excess electrons on the surface of Ti3C2T x -30 facilitate the formation of O2− species, which also provides stability to the otherwise highly reactive MXene surface. These species actively react with ammonia molecules in the presence of adsorbed MoO3, thereby changing the resistance of the system. This can be a significant step towards imparting high gas sensitivity to metal oxides at room temperature via incorporation of an optimum percentage of optimized Ti3C2T x .

An Imidazo[1, 2-a]Pyridine Based Fluorescent Probe for the Continuous "on-off-on" Detection of Fe3+ and F.

An "on-off-on" fluorescent probe LK was synthesized from 2-benzoylpyridine and o-vanillin, which could sequentially detect Fe3+ and F- in DMSO/H2O solutions (v/v = 1/1, HEPES buffer, 1.0 mM, pH 7.0) with large Stokes shift (178nm). LK exhibited not only high selectivity and sensitivity towards Fe3+ and F-, but also strong anti-interference ability to other ions. LK was coordinated with Fe3+ at a ratio of 2:1, with a binding constant (Ka) of 1.3 × 104 M- 1. The detection limits for Fe3+ and F- were 6.9 × 10- 8 M and 3.0 × 10- 7 M, respectively. Due to its excellent sensing performance, LK was successfully applied in actual water samples and test papers for the detection of Fe3+ and F-.

Practical lessons from implementing a top-down, drone-based methane emissions quantification technology into global oil and gas operations

Reliable top-down quantification of methane emissions from oil and gas operations is increasingly crucial but challenging. Many new technologies are emerging that aim to offer solutions, but they vary widely in their actual field performance, cost, and breadth of applicability. Operators need to evaluate and test different technologies, which can be time-consuming and complex. Once a technology has been selected for use, then typically field trials follow before wider introduction to the operation. This process takes considerable time and effort, and frequently requires extensive learning by the teams involved. Additionally, interpretation of performance often depends upon measurement use-case (e.g. regulatory, voluntary, or leak detection and repair). This paper will share some of the learnings made by the users and technology provider in the assessment and global introduction of a high sensitivity drone-based methane emissions detection, localisation, and quantification technology. There will be a particular focus on practical, operational considerations for such introductions to help accelerate the ongoing efforts of others interested in implementing emissions quantification technologies. Examples from Australia and further afield (both onshore and offshore) will be used to illustrate key points within the paper which include the value of third-party technology validation, consistency across multiple operations and scalability/availability of services.

ROLE OF THE MOLECULAR TESTS FOR PATIENTS WITH INFECTIVE ENDOCARDITIS UNDERGOING CARDIAC SURGERY: AN EXPANDING HORIZON

Abstract Background Molecular tests have been proven to be a highly sensible tool to identify the pathogen of infective endocarditis (IE). However, their usefulness in the management of both blood culture positive and valve culture negative IE remains unclear. Methods We prospectively enrolled 100 consecutive patients with IE who underwent cardiac surgery between April 2020 and June 2023. Molecular testing (broad–range PCR 16S rRNA) was systematically performed and results were collected together with those of preoperative blood culture, valve culture and histopathological analysis of the specimen. Results Blood culture, valve culture and molecular testing were positive in 83%, 47% and 76% of patients, respectively. Both the sensitivity of valve culture and 16S rRNA PCR decreased significantly with increasing duration of preoperative antibiotic therapy. In 7% of cases, molecular test was the only positive test, allowing an etiological diagnosis. In 33% of cases, valve culture was negative but molecular test was positive. In the majority of these patients, histopathological analysis documented acute inflammation. Finally, molecular test clarified discrepancies between the results of blood cultures and those of valve cultures in 12.5% of patients. Conclusions The molecular tests showed high sensitivity. Although it decreased as the duration of preoperative antibiotic therapy increased, it was still higher than that of valve culture 28 days after the start of treatment. In addition to patients without an etiological diagnosis, the molecular test proved useful in other circumstances: 1) when the valve culture was negative because, together to the results of the histopathological analysis, it allowed to identify those patients who could benefit from a prolongation of antibiotic treatment; 2) in cases of discordance between the results of blood cultures and those of valve cultures, because it allowed the type of antibiotic treatment to be directed. Figure 1: Usefulness of molecular tests (PCR) according to the results of blood and valve cultures. Figure 2: Valve cultures are of paramount importance in the management of antibiotic therapy (ABT). However, their sensibility is low and the risk of under–treatment exists. Molecular tests may help targeting the duration of ABT but they could be persistently positive leading to an over–treatment. Figure 3: Flow–chart showing the possible role of molecular test in the management of patients with infective endocarditis.

ROLE OF CORONARY CT IN THE EMERGENCY ROOM IN THE PATIENTS WITH CHEST PAIN

Abstract Objective Assess the use of Coronary CT in patients attending the emergency room (ED) with chest pain and/or doubtful signs/symptoms of acute coronary syndrome (ACS). Background Patients coming to the ED for chest pain are an important challenge. According to the guidelines (ESC 2023) it is necessary a fast selection between those who need hospitalization and urgent coronary angiography (rule–in) and those who can be discharged home (rule–out). However, it is difficult to obtain an early diagnosis and therefore patients often need a prolonged observation. Materials and Methods We subjected to Coronary CT 104 patients (pts) with symptoms and/or alteration of parameters suspected for ACS (ECG, echocardiography, high sensitivity troponin) arrived in the cardiological holding (cardiological observation) of the San Camillo Forlanini Hospital from the emergency room. Clinical–instrumental data, incidence of positive results on Coronary CT and concordance with coronary angiography, waiting time for the examination and length of hospitalization were retrospectively evaluated. Results The average age of the pts was 56 ± 2 years, 65 men (62.5%) 39 women (37.5%). Coronary CT exams were performed on the first day after admission to the ED in 83% of cases. Pts presented with chest pain (61% noncardiac, 13% cardiac), and/or palpitations (10%), and/or dyspnea, presyncope, or syncope (overall 16%). CT was performed in 79% of cases due to the association of symptoms and instrumental findings (ECG 54% of cases, hs troponin 34%, echocardiogram 12%); in 21% only for clinical findings. Coronary CT excluded obstructive coronary artery disease in 95 out of 104 pts (91.3%) and was positive in 6/104 pts (5.8%), with coronary angiographic correspondence in 5 cases. In 3/104 (2.9%) the test resulted doubtful/positive (angiographic confirmation in a single case). Only 8.7% of pts underwent coronary angiography (those with positive or doubtful CT result). In all pts with chest pain only (21%) the Coronary CT was negative. Troponin positivity (34% of pts) was not strictly associated with the presence of coronary artery disease: in 94% of pts with positive hs troponin (average value 500 pg/mL) the CT scan did not show critical lesions. The average stay of pts with negative Coronary CT was 1.5 days. Conclusions Coronary CT can significantly reduce the use of coronary angiography and the length of stay in pts coming in ED with chest pain and/or doubtful signs/symptoms of ACS.

MYOCARDIAL INFARCTION DUE TO LEFT CIRCUMFLEX ARTERY OCCLUSION: A SUBTLE TROJAN HORSE

Abstract A 47–year–old man presented to the emergency department complaining of recurrent chest pain (CP) since the previous day. His medical history included active smoking and dyslipidemia. The ECG revealed sinus bradycardia (56 bpm) with widespread ST elevation, consistent with benign early repolarization, and hyperacute and broad–based T waves in V2–V3 (Fig. A). The echocardiography showed normal left and right ventricular systolic function and no valvular abnormalities. A low but abnormal initial high–sensitivity cardiac troponin I value (40 pg/mL, normal range: 1.7– 34,2 pg/mL) and a slightly and early increase after two hours (52 pg/ml) were seen. Therefore, the patient was admitted to our intensive cardiac care unit (ICCU) with a working diagnosis of non–ST–segment elevation myocardial infarction (NSTEMI). No sign or symptoms of heart failure on physical examination were recorded. GraceScore 2.0 was calculated as 68 points and coronary angiography was organized within 24h. Two hours after admission to the ICCU, the patient experienced a new episode of CP. Consequently, ECG and echo were repeated. Compared to the previous results, ECG showed dynamic changes in V2–V3, with the resolution of hyperacute T waves (Fig B); bedside echo remained unchanged. Considering the unresponsiveness to nitrate therapy, the cath lab was activated for a time–dependent coronary angiography. The exam showed an acute total thrombotic occlusion of the mid–segment of the circumflex branch (LCx) in the setting left–sided dominant circulation. A drug eluting stent was deployed into the culprit lesion (Fig. C), and the coronary flow was restored completely (TIMI Flow 3). The subsequent hospital stay proceeded without complications. The peak troponin level was 60’000 pg/ml. The patient was discharged on the fifth day, asymptomatic and hemodynamically stable, with instructions to continue dual antiplatelet therapy. The case report focuses on the electrocardiographic and angiographic expression of LCx total occlusion. Despite acute myocardial infarction (AMI) size was large, as confirmed by the abnormal troponin I values and the angiographic total occlusion, the first and the repeated ECGs showed only vague repolarization changes without clear ST–segment modifications. LCx occlusion is often characterized by the absence of significant ST–elevation, therefore categorized as NSTEMI. Greater awareness of the presentation of LCx–related AMI can be crucial to avoid delays in reperfusion.

Harnessing Graphdiyne for Selective Cu2+ Detection: A Promising Tool for Parkinson's Disease Diagnostics and Pathogenesis.

Cu2+ accelerates the viral-like propagation of α-synuclein fibrils and plays a key role in the pathogenesis of Parkinson's disease (PD). Therefore, the accurate detection of Cu2+ is essential for the diagnosis of PD and other neurological diseases. The Cu2+ detection process is impeded by substances that have similar electrochemical properties. In this study, graphdiyne (GDY), a new kind of carbon allotrope with strong electron-donating ability, was utilized for the highly selective detection of Cu2+ by taking advantage of its outstanding adsorption capacity for Cu2+. Density functional theory (DFT) calculations show that Cu atoms are adsorbed in the cavity of GDY, and the absorption energy between Cu and C atoms is higher than that of graphene (GR), indicating that the cavity of GDY is favorable for the adsorption of Cu atoms and electrochemical sensing. The GDY-based electrochemical sensor can effectively avoid the interference of amino acids, metal ions and neurotransmitters and has a high sensitivity of 9.77 μA·μM-1·cm-2, with a minimum detectable concentration of 200 nM. During the investigating pathogenesis and therapeutic process of PD with α-synuclein as the diagnostic standard, the concentration of Cu2+ in cells before and after L-DOPA and GSH treatments were examined, and it was found that Cu2+ exhibits high potential as a biomarker for PD. This study not only harnesses the favorable adsorption of the GDY and Cu2+ to improve the specificity of ion detection but also provide clues for deeper understanding of the role of Cu2+ in neurobiology and neurological diseases.

A CASE REPORT OF AN ASYMPTOMATIC PATIENT WITH TYPE 2 WELLENS’ SYNDROME AND RENAL CARCINOMA

Abstract A 65–year–old male with renal cell carcinoma, previously treated with nephrectomy and recently diagnosed with lung metastases, presented to the cardiology clinic for investigations before starting chemotherapy. He reported a history of ischemic heart disease, a non–ST–elevation myocardial infarction for which he refused coronary angiography in 2005, and a negative maximal stress test for ischemia in 2017. Additionally, the patient reported insulin–dependent type 2 diabetes mellitus and well–controlled arterial hypertension. The patient was referred for a cardiological evaluation due to a reported short–term rhythmic heartbeat without other cardiological symptoms. Cardiological parameters were stable (blood pressure: 140/95 mmHg; heart rate: 42 bpm, and oxygen saturation without oxygen supplementation: 98%). Physical examination was normal. Laboratory investigations did not show elevated levels of high–sensitivity troponin I, and only signs of mild chronic kidney disease were observed. The initial ECG showed sinus bradycardia with deeply inverted T–waves in the extended anterior area (Fig. 1), which were not present in an ECG performed one month earlier. There was no reported chest pain. An echocardiogram examination demonstrated hypertensive heart disease with marked hypokinesia of the mid–apical portion of the anterior wall and anterior interventricular septum, together with a moderate reduction in global systolic function (LV ejection fraction: 40%). The patient was hospitalized, and underwent coronary angiography the following day. He had a low–risk score (GRACE: 95 pts) As shown in Fig. 2, there was evidence of long sub–occlusive stenosis of the proximal part of the anterior descending coronary artery that was treated with angioplasty and a single drug–eluted stent placement, resulting in a good angiographic result. After the procedure, there was a rapid recovery of regional kinetics but a slower normalization of the electrocardiographic morphology (Fig. 3). Comment Wellens‘ syndrome identifies a particular subtype of unstable angina characterized by the appearance of ischemic changes on the ECG,. The clinical risk assessment of this subgroup of patients with ACS, apparently having a more benign prognosis due to their definition as unstable angina with a low GRACE risk score, potentially has an evolution toward a large myocardial infarction if not promptly diagnosed.

Early gastric cancer with RhoGAP fusion is linked to frequent nodal metastasis and a part of microtubular-mucocellular histology.

Gastric cancer with fusion genes involving the Rho GTPase-activating protein domain (RhoGAP-GC) is mainly included in the genomically stable type of The Cancer Genome Atlas classification. Clinical implications and histological characteristics of RhoGAP-GC in the early phase remain unclear. We analyzed 878 consecutive pT1b GCs for RhoGAP and its partner genes using fluorescence in situ hybridization assay. RhoGAP fusion was detected in 57 (6.5%) GCs. Univariate analysis revealed that female sex, middle-lower third tumor location, advanced macroscopic type, tumor diameter > 2cm, pT1b2, lymphatic invasion, venous invasion, negative EBER-ISH, and RhoGAP fusion were significantly associated with lymph node metastasis (LNM). Multivariate analysis presented RhoGAP fusion, lymphatic invasion, tumor diameter > 2cm, advanced macroscopic type, venous invasion, and middle-lower third tumor location as independent risk factors for LNM. Notably, RhoGAP fusion had the highest odds ratio (3.92) for LNM among analyzed parameters (95% CI 2.12-7.27; p < 0.001). Compared to non-RhoGAP-GCs, RhoGAP-GCs were significantly frequent in younger females and showed the highest incidence of lymphatic invasion (56.2%) and LNM (49.1%) (p < 0.001). Histologically, microtubular architecture with pseudo-trabecular interconnection and small aggregations of tumor cells with a varied amount of cytoplasmic mucin, named "microtubular-mucocellular (MTMC) histology," was found in 93.0% (53 of 57) of RhoGAP-GCs in the intramucosal area. MTMC histology showed high sensitivity and negative predictive value (93.0% and 99.4%, respectively) for RhoGAP fusion, albeit positive predictive value is low (34.9%). RhoGAP-GC is linked to a characteristic MTMC histology and a high incidence of LNM.

High sensitivity distributed dynamic pressure sensor based on dual-linear frequency modulated optical frequency domain reflectometry

High sensitivity distributed dynamic pressure sensor based on dual-linear frequency modulated optical frequency domain reflectometry

Schistosoma japonicum extracellular vesicle proteins serve as effective biomarkers for diagnosing parasite infection

Schistosoma species are the causative agent of schistosomiasis and shows worldwide distribution. There is a great need to develop a sensitive diagnostic approach for controlling the disease. Previously, we identified large numbers of Extracellular Vesicle (EV) proteins from Schistosoma japonicum (S. japonicum), but rarely these proteins have been evaluated for their diagnostic potential. In the present study, we performed bioinformatic analyses of S. japonicum identified EV-associated proteins from the previous study and then identified Schistosoma-specific proteins with potentially secreted capability. Among them, we selected SJCHGC02838 protein, SJCHGC05593 protein, SJCHGC05668 protein and a hypothetical protein (SJHYP) to evaluate their diagnostic potential for detecting S. japonicum infection. First, we determined the expression of these four proteins at the transcript levels using qRT-PCR and revealed that all these genes showed higher expression in adult stage. Then, we cloned the full-length cDNA for each protein into a prokaryotic expression vector and successfully generated the recombinant proteins. Upon the purification of recombinant proteins, we developed an indirect ELISA method to evaluate the diagnostic potential of these purified recombinant proteins. The results showed high sensitivity for detecting Schistosoma infection. Additionally, these proteins also displayed a good potential for detecting Schistosoma infection, especially SJCHGC05668 protein at an early stage. The diagnostic potentials of these recombinant proteins were further evaluated by Western blot and comparatively analyzed by our previously developed cfDNA methods.

Liver fibrosis automatic diagnosis utilizing dense-fusion attention contrastive learning network.

Liver fibrosis poses a significant public health challenge given its elevated incidence and associated mortality rates. Diffusion-Weighted Imaging (DWI) serves as a non-invasive diagnostic tool for supporting the identification of liver fibrosis. Deep learning, as a computer-aided diagnostic technology, can assist in recognizing the stage of liver fibrosis by extracting abstract features from DWI images. However, gathering samples is often challenging, posing a common dilemma in previous research. Moreover, previous studies frequently overlooked the cross-comparison information and latent connections among different DWI parameters. Thus, it is becoming a challenge to identify effective DWI parameters and dig potential features from multiple categories in a dataset with limited samples. A self-defined Multi-view Contrastive Learning Network is developed to automatically classify multi-parameter DWI images and explore synergies between different DWI parameters. A Dense-fusion Attention Contrastive Learning Network (DACLN) is designed and used to recognize DWI images. Concretely, a multi-view contrastive learning framework is constructed to train and extract features from raw multi-parameter DWI. Besides, a Dense-fusion module is designed to integrate feature and output predicted labels. We evaluated the performance of the proposed model on a set of real clinical data and analyzed the interpretability by Grad-CAM and annotation analysis, achieving average scores of 0.8825, 0.8702, 0.8933, 0.8727, and 0.8779 for accuracy, precision, recall, specificity and F-1 score. Of note, the experimental results revealed that IVIM-f, CTRW-β, and MONO-ADC exhibited significant recognition ability and complementarity. Our method achieves competitive accuracy in liver fibrosis diagnosis using the limited multi-parameter DWI dataset and finds three types of DWI parameters with high sensitivity for diagnosing liver fibrosis, which suggests potential directions for future research.