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PurposeThe triglyceride-cholesterol-body weight index (TCBI), a novel and easily computable nutritional index, incorporates serum triglyceride (TG), total cholesterol (TC), and body weight (BW). This study explored the association between TCBI and cognitive impairment in middle-aged and elderly Chinese populations.Patients and methodsThis cross-sectional study employed data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey, including 7,145 participants. TCBI was calculated as TG (mg/dL) × TC (mg/dL) × BW (kg)/1,000. Cognitive function was assessed based on mental status and episodic memory, with a total score below 11 indicating cognitive impairment. The relationship between TCBI and cognitive impairment was examined using multiple logistic regression, smooth curve fitting, and subgroup analyses.ResultsAfter full adjustment, each 1-unit increase in log-transformed TCBI (Lg TCBI) was associated with a 29.7% reduction in cognitive impairment risk [odds ratio (OR) = 0.703, 95% confidence interval (CI): 0.529–0.933; p = 0.015]. When Lg TCBI was categorized into quartiles, the Q2, Q3, and Q4 groups exhibited a reduced risk of cognitive impairment by 19.9, 16.3, and 22.9%, respectively (p for trend = 0.043), compared to the Q1 group. Smooth curve fitting revealed a consistent decrease in cognitive impairment risk with higher Lg TCBI levels. Subgroup analysis indicated that the association was stronger among participants aged ≥60 years (OR = 0.655, 95% CI: 0.438–0.979), non-current drinkers (OR = 0.643, 95% CI: 0.451–0.917), and those who engaged in socializing (OR = 0.568, 95% CI: 0.371–0.871).ConclusionTCBI was significantly and negatively associated with cognitive impairment in Chinese middle-aged and elderly individuals, with the effect more pronounced in those aged ≥60 years, non-current drinkers, and socially active participants.

Solid solution strengthening theory is essential for designing steel with high microhardness. Experimental determination is quite time consuming and costly. It is necessary to develop an alternate approach to rapidly and accurately predict new solid solution strengthening theory for steel. In this study, a data-driven model combining machine learning (ML), firefly optimization algorithm (FA) and conditional generative adversarial networks (CGANs) were proposed to predict solid solution strengthening theory of Fe-C-Cr-Mn-Si steel. Three alloys were fabricated using cladding to validate the predict accuracy of the models. The results show that the trained support vector regression (SVR) model demonstrated the highest prediction precision for microhardness. The coefficient of determination (R2) value increased from 0.85 to 0.89 and root mean square error (RMSE) decreased from 0.39 to 0.31 after introducing the modified solid solution strengthening theory. The experimental validation revealed a minimum error of 1.17% between the predicted value and the experimental value. The investigation provides a valuable method to expedite design of Fe-C-Cr-Mn-Si steel with extreme high accuracy.

We reported a case of ovarian teratoma-associated Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis with recurrent epileptic seizures and disturbance of consciousness. Although surgical excision of the tumor remains the established standard of care, unlike other reported cases, the patient exhibited limited response to early oophorocystectomy, as well as IVIG and steroid therapy; however, a favorable response was observed with Plasma exchange (PE) initiated on postoperative day 12. Literature review revealed no definite recommended surgical extent for ovarian teratomas, and outstanding improvement in patients with anti-NMDAR encephalitis following PE. Our case raises the question regarding the optimal surgical extent for tumor resection, necessitating careful consideration when deciding between oophorectomy and adnexectomy as the preferred surgical procedure for anti-NMDAR encephalitis in female teens and adults. Furthermore, for refractory patients who fail to respond following tumor resection, PE can be performed early instead of immediately initiating second-line therapy.

Composition regulation of zeotropic mixture working fluid for a thermodynamic cycle is an effective way to improve energy conversion efficiency, which offers the potential to construct efficient, flexible and intelligent cycles. Current research on cycle construction of zeotropic mixture composition regulation still heavily relies on construction methods using pure working fluids, where the characteristics of flexible composition variations fail to be utilized. In this paper, the research progress of cycle construction methods and composition regulated structures are comprehensively reviewed, aiming to clarify the potential for enhancing a thermodynamic cycle based on composition regulation. The characteristics of different cycle construction methods are firstly summarized and compared. Then, the composition-regulated structures of a physical-based method and chemical-based method are introduced, and the composition regulation performance are also concluded. Finally, a future outlook on the cycle design and structure design is provided. The review results show that the combination of 3D construction method and superstructure/intelligences construction method has the potential to maximize the cycle performance, where the improvement of each thermal process and the optimization of complex cycles can be considered simultaneously. The composition regulation based on a passive physical method has the advantage of being readily applicable; however, the composition regulation range is limited. In addition, the distillation and hydrate method have a wider regulation range through extra energy input, where the trade-off between energy consumption and cycle performance improvement should be considered in the future. This study greatly assists in the design of thermodynamic cycles involving zeotropic mixture composition regulation and the corresponding composition regulation structures.

In this paper, the dynamic pressure characteristics induced by an internal solitary wave (ISW) in a two-layer fluid of finite depth are studied. A method for detecting ISWs by dynamic pressure is proposed. First, an accurate controllable ISW numerical flume is established based on the applicability conditions of three kinds of ISW theories. Then the relationship between the maximum dynamic pressure and the amplitude of the ISW under four density stratifications is studied. The results show that the dynamic pressure variation induced by the ISW is synchronous with that of interface displacement. Under the same density stratification, the maximum dynamic pressure has a strong linear relationship with the corresponding amplitude. Furthermore, the nonlinear error is less than 7%, and the relationship is not affected by the ocean structure. According to the above characteristics of dynamic pressure, a series of dynamic pressure measurement experiments were carried out in a large internal wave flume (IWF) using a very low frequency (VLF) piezoelectric sensor. The experimental results show that the dynamic pressure measurement results are in good agreement with the numerical simulation results. Last, the Miyata-Choi-Camassa (MCC) theory is used to invert the measured maximum dynamic pressure to the amplitude of ISW, and compared with the measured amplitude, the maximum error is less than 6%, which verifies the feasibility of the inversion method of ISW amplitude by using dynamic pressure measurement proposed in this paper, and provides a new method and idea for detecting ISW at sea in the future.

Background and purposeWe previously established a radiological protocol to discriminate multiple system atrophy-parkinsonian subtype (MSA-P) from Parkinson’s disease (PD). However, we do not know if it can differentiate early stage disease. This study aimed to investigate whether the morphological and intensity changes in susceptibility weighted imaging (SWI) of the lentiform nucleus (LN) could discriminate MSA-P from PD at early stages.MethodsWe retrospectively enrolled patients with MSA-P, PD and sex- and age-matched controls whose brain MRI included SWI, between January 2015 and July 2020 at the Movement Disorder Center. Two specialists at the center reviewed the medical records and made the final diagnosis, and two experienced neuroradiologists performed MRI analysis, based on a defined and revised protocol for conducting morphological measurements of the LN and signal intensity.ResultsNineteen patients with MSA-P and 19 patients with PD, with less than 2 years of disease duration, and 19 control individuals were enrolled in this study. We found that patients with MSA- P presented significantly decreased size in the short line (SL) and corrected short line (cSL), ratio of the SL to the long line (SLLr) and corrected SLLr (cSLLr) of the LN, increased standard deviation of signal intensity (SIsd_LN, cSIsd_LN) compared to patients with PD and controls (P < 0.05). With receiver operating characteristic (ROC) analysis, this finding had a sensitivity of 89.5% and a specificity of 73.7% to distinguish MSA- P from PD.ConclusionCompared to PD and controls, patients with MSA-P are characterized by a narrowing morphology of the posterior region of the LN. Quantitative morphological changes provide a reference for clinical auxiliary diagnosis.

EGFR mutations are common in non-small cell lung cancer and patients with these mutations are treated with tyrosine kinase inhibitors. Here, the authors show that EGFR mutation status can be predicted from 18F-FDG-PET/CT images, which may enable the stratification of patients for treatment.

Abstract Background Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late onset, X-linked genetic, neurodegenerative disorder caused by a “premutation (PM)” in the fragile X mental retardation 1 (FMR1) gene. Here we report a case of FXTAS from mainland of China who presented with rare orthostatic tremor. A review of tremor of FXTAS in the literature is also included. Case presentation A 67-year-old right-handed farmer started with tremor of both legs 8 years ago which was present while standing but absent when sitting or lying and progressed with unsteady gait one and a half years ago. The brain MRI showed high intensity signal in the bilateral middle cerebellar peduncles (MCP) in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images and gene test for premutation for FMR1 was positive with 101 CGG repeats. The patient met the the diagnosis of definite FXTAS. Clonazepam and topiramate were administered to control tremor. We reviewed the literature and identified 64 cases with detailed clinical and genetic information. Orthostatic tremor associated with FXTAS is very rare. We found 85.2% patients reported tremor,42.6% with intention tremor,36.1% with kinetic tremor,32.8% with rest tremor and 29.5% with posture tremor. 37.7% of patients who have tremor showed at least two types of tremor. There were 6 patients with isolated rest tremor. There was 2 patient with voice tremor and 6 with head tremor. We also found that 74.6% FXTAS patients had family history of FMR1 gene associated diseases including Fragile X syndrome (FXS), FXTAS or fragile X-associated primary ovarian insufficiency (FXPOI). Conclusions Adding our data to the available literature suggests that orthostatic tremor could be a rare initial manifestation of FXTAS and the review will increasing our understanding the phenotype of tremor in FXTAS. Family history of FMR1 gene associated diseases might be an important clue to the diagnosis.

BackgroundIt is reported that radiomic features extracted from quantitative susceptibility mapping (QSM) had promising clinical value for the diagnosis of Parkinson’s disease (PD). We aimed to explore the usefulness of radiomics features based on magnitude images to distinguish PD from non-PD controls.MethodsWe retrospectively recruited PD patients and controls who underwent brain 3.0T MR including susceptibility-weighted imaging (SWI). A total of 396 radiomics features were extracted from the SN of 95 PD patients and 95 non-PD controls based on SWI. Intra-/inter-observer correlation coefficients (ICCs) were applied to measure the observer agreement for the radiomic feature extraction. Then the patients were randomly grouped into training and validation sets in a ratio of 7:3. In the training set, the maximum correlation minimum redundancy algorithm (mRMR) and the least absolute shrinkage and selection operator (LASSO) were conducted to filter and choose the optimized subset of features, and a radiomics signature was constructed. Moreover, radiomics signatures were constructed by different machine learning models. Area under the ROC curves (AUCs) were applied to evaluate the predictive performance of the models. Then correlation analysis was performed to evaluate the correlation between the optimized features and clinical factors.ResultsThe intro-observer CC ranged from 0.82 to 1.0, and the inter-observer CC ranged from 0.77 to 0.99. The LASSO logistic regression model showed good prediction efficacy in the training set [AUC = 0.82, 95% confidence interval (CI, 0.74–0.88)] and the validation set [AUC = 0.81, 95% CI (0.68–0.91)]. One radiomic feature showed a moderate negative correlation with Hoehn-Yahr stage (r = −0.49, P = 0.012).ConclusionRadiomic predictive features based on SWI magnitude images could reflect the Hoehn-Yahr stage of PD to some extent.

There are multitudes of web resources that are quite useful for the microbial scientific research community. Here, we provide a brief introduction on some of the most notable microbial web resources and an evaluation of them based upon our own user experience.

Breast cancer is recognized as a major public health problem in developing countries; however, there is very little evidence of behavioral factors associated with breast cancer risk. This study was conducted to identify lifestyles as risk factors for breast cancer among Central African women. A case-control study was conducted with 174 cases confirmed histologically by the pathology unit of the National Laboratory and 348 age-matched controls. Data collection tools included a questionnaire with interviews and medical records of patients. Data were analyzed using SPSS software version 20. Odd ratio (OR) and 95% confidence intervals (95% CI) were obtained by unconditional logistic regression. In total, 522 women were studied with a mean age of 45.8 (SD = 13.4) years. By unconditional logistic regression model, women with breast cancer were more likely to have attained illiterate and elementary education level [11.23 (95% CI, 4.65-27.14) and 2.40 (95% CI, 1.15-4.99)], married [2.09 (95% CI, 1.18-3.71)], positive family history [2.31 (95% CI, 1.36-3.91)], radiation exposure [8.21 (95% CI, 5.04-13.38)], consumption charcuterie [10.82 (95% CI, 2.39-48.90)], fresh fish consumption [4.26 (95% CI, 1.56-11.65)], groundnut consumption [6.46 (95% CI, 2.57-16.27)], soybean consumption [16.74 (95% CI, 8.03-39.84)], alcohol [2.53 (95% CI, 1.39-4.60)], habit of keeping money in bras[3.57 (95% CI, 2.24-5.69)], overweight [5.36 (95% CI, 4.46-24.57)] and obesity [3.11(95% CI, 2.39-20.42)]. However, decreased risk of breast cancer was associated with being employed [0.32 (95% CI, 0.19-0.56)], urban residence [0.16 (95% CI, 0.07-0.37)], groundnut oil consumption [0.05 (95% CI, 0.02-0.14)], wine consumption [0.16 (95% CI, 0.09-0.26)], non habit of keeping cell phone in bras [0.56 (95% CI, 0.35-0.89)] and physical activity [0.71(95% CI, 0.14-0.84)]. The study showed that little or no education, marriage, positive family history of cancer, radiation exposure, charcuterie, fresh fish, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with breast cancer risk among Central African women living in Bangui. Women living in Bangui should be more cautious on the behavioral risk associated with breast cancer.

The current report describes the development of a dual modality tomographic agent for both positron emission tomography and magnetic resonance imaging (PET/MRI). The dual-modality agent in this study was based on a 124I (PET) radiolabeled tri-gadolinium endohedral metallofullerene Gd3N@C80 (MRI) nanoprobe platform. The outer surface of the fullerene cage of the Gd3N@C80 metallofullerenes was surface functionalized with carboxyl and hydroxyl groups (f-Gd3N@C80) using previously developed procedures and subsequently iodinated with 124I to produce 124I-f-Gd3N@C80 nanoprobe. Orthotopic tumor-bearing rats were infused intratumorally by convection-enhanced delivery (CED) with the 124I-f-Gd3N@C80 agent and imaged by MRI or micro PET. The anatomical positioning and distribution of the 124I-f-Gd3N@C80 agent were comparable between the MRI and PET scans. The 124I-f-Gd3N@C80­ dual-agent distribution and infusion site within the tumor was clearly evident in both T1- and T2-weighted MR images. The results demonstrate the successful preparation of a dual-modality imaging agent, 124I-f-Gd3N@C80, which could ultimately be used for simultaneous PET/MR imaging.