IgG4-Related Disease:A Retrospective Chinese Study of Features and Treatment Response of 98 Patients Including 4 Rare Cases

The features and treatment of 98 Chinese patients with immunoglobulin G4 (IgG4)-related disease (IgG4-RD) referred to a single tertiary referring centre were reviewed. Patientsdiagnosed with IgG4-RD according to the comprehensive diagnostic criteria (CDC) were includedin the retrospective study from May 2012 to March 2019. We collcted data on clinical, laboratory,imaging, histological features and treatment. Totally, 98 patients with IgG4-RD were enrolled.The common clinical manifestations included abdominal pain, salivary gland swelling andlymphadenopathy. 51% of the patients had multiple organs involvement. Lymph nodes, pancreasand salivary glands were most commonly involved. Four rare sites including ulna, cerebellum,scalp, and mammary gland were found. The serum IgG4 level was increased by 85.7%. The serumIgG4 level was positively correlated with the number of involved organs, IgG and IgG4/IgG. LowC3 and C4 levels were observed in 37.5% and 12.2% patients respectively, and all patients withkidney involvement had hypocomplementemia. A total of 54 patients underwent tissue biopsies,and 55.6%, 31.5% and 11.1% cases were diagnosed as definite, probable and possible IgG4-RD,respectively. Eighty-eight patients received glucocorticoids (GCs) therapy. Five patients underwentradical surgery to remove the lesion. 73% of them presented a complete or partial remission. IgG4-RD is a systemic fibroinflammatory disease with involvement of multiple organs throughout thebody including some rare sites. Most IgG4-RD patients had increased serum IgG4 levels andpatients with kidney involvement showed bypocomplementermia. GCs therapy is effective. Moreresearch is needed to provide a more reliable basis for the diagnosis and treatment of patients.

Attention Eraser and Quantitative Measures for Automated Bone Age Assessment

Bone age assessment(BAA)aims to determine whether a child’s growth and development are normal concerning their chronological age.To predict bone age more accurately based on radiographs,and for the left-hand X-ray images of different races model can have better adaptability,we propose a neural network in parallel with the quantitative features from the left-hand bone measurements for BAA.In this study,a lightweight feature extractor(LFE)is designed to obtain the featuremaps fromradiographs,and amodule called attention erasermodule(AEM)is proposed to capture the fine-grained features.Meanwhile,the dimensional information of the metacarpal parts in the radiographs is measured to enhance the model’s generalization capability across images fromdifferent races.Ourmodel is trained and validated on the RSNA,RHPE,and digital hand atlas datasets,which include images from various racial groups.The model achieves a mean absolute error(MAE)of 4.42 months on the RSNA dataset and 15.98 months on the RHPE dataset.Compared to ResNet50,InceptionV3,and several state-of-the-art methods,our proposed method shows statistically significant improvements(p<0.05),with a reduction in MAE by 0.2±0.02 years across different racial datasets.Furthermore,t-tests on the features also confirm the statistical significance of our approach(p<0.05).

THE METAMORPHIC FEATURE,AGE AND MECHANISM OF AMUGANG GROUP IN NORTHERN TIBET

Amugang Group is distributed mainly over Amugang, Jiangai Mountain, Mayigangri,Gemuri and Qiagela,etc. lt includes Gemuri Formation and Qiagela Formation. They had even been thought of the crystalline basement of Qiangtang terrain. However, Gemuri Formation and Qiagela Formation are not alike in the protolithes, metamorphism and deformation, rock association,etc.In fact, they are different in mechanism.Gemuri Formation is composed of high\|Pressure, low\|temperature glaucophane greenschist\|faci metamorphic rocks. The petrolithes of the blueschists are glaciomarine conglomerates and basalts from the Southern Qiagtang area. The typical mineralogy include: glaucophane+ epidote + calcite +stilpnomelane and stilpnomelane+chlorite+sericite+ quartz+ glaucophane. P.T conditions for the metamorphism of blueschist are estimated to be 0 6～0 7GPa and 320～400℃.The 40 Ar/ 39 Ar dating of the crossite has yielded good plateau age of (222 5±3 7)Ma,which represents the formation of Gemuri Formation.Qiagela Formation comprises schist series, marbles, Gneisses and plagioamphiboles. The protolithes of them are a suit of argillaceous sandstones, arkoses, carbonates and mafic volcanic rocks. The Sm\|Nd isochron age of the metamorphic mafic volcanic rocks is (268 0±5 6)Ma, which shows that The age of the protolithes is early Dias. The typical mineralogy include: Muscovite+biotite+plagioclase+quartz; garnet+kyanite+ staurolite+ biotite+ muscovite+plagioclase+quartz; amphibole+ plagioclase±garnet+ quartz. They are meos\|pressure,meso\|temperature low amphibole\|faci metamorphic rocks. Qiagela Formation is coexistent with the late Triassic and the early Jurassic volcano\|magmatic arc in space and overlapped by the triassic limestones of Xiaocaka Formation. So,it is suggested that the formation of Qiagela Formation be between the late Dias and the late Triassic period. Its genesis is relative to the thermal current provided by magmatic activity.

Age estimation from facial images based on Gabor feature fusion and the CIASO-SA algorithm

Aiming at the problem of long time-consuming and low accuracy of existing age estimation approaches,a new age estimation method using Gabor feature fusion,and an improved atomic search algorithm for feature selection is proposed.Firstly,texture features of five scales and eight directions in the face region are extracted by Gabor wavelet transform.The statistical histogram is introduced to encode and fuse the directional index with the largest feature value on Gabor scales.Secondly,a new hybrid feature selection algorithm chaotic improved atom search optimisation with simulated annealing(CIASO-SA)is presented,which is based on an improved atomic search algorithm and the simulated annealing algorithm.Besides,the CIASO-SA algorithm introduces a chaos mechanism during atomic initialisation,significantly improving the convergence speed and accuracy of the algorithm.Finally,a support vector machine(SVM)is used to get classification results of the age group.To verify the performance of the proposed algorithm,face images with three resolutions in the Adience dataset are tested.Using the Gabor real part fusion feature at 48�48 resolution,the average accuracy and 1-off accuracy of age classification exhibit a maximum of 60.4%and 85.9%,respectively.Obtained results prove the superiority of the proposed algorithm over the state-of-the-art methods,which is of great referential value for application to the mobile terminals.

Comparison of clinical features and outcomes of proliferative,fibrotic,and mixed subtypes of IgG4-related disease:A retrospective cohort study

Background:Immunoglobulin G4-related disease(IgG4-RD)is a recently recognized immune-mediated disorder that can affect almost any organ in the human body.IgG4-RD can be categorized into proliferative and fibrotic subtypes based on patients’clinicopathological characteristics.This study aimed to compare the clinical manifestations,laboratory findings,and treatment outcomes of IgG4-RD among different subtypes.Methods:We prospectively enrolled 622 patients with newly diagnosed IgG4-RD at Peking Union Medical College Hospital from March 2011 to August 2021.The patients were divided into three groups according to their clinicopathological characteristics:proliferative,fibrotic,and mixed subtypes.We compared demographic features,clinical manifestations,organ involvement,laboratory tests,and treatment agents across three subtypes.We then assessed the differences in treatment outcomes among 448 patients receiving glucocorticoids alone or in combination with immunosuppressants.Moreover,risk factors of relapse were revealed by applying the univariate and multivariate Cox regression analysis.Results:We classified the 622 patients into three groups consisting of 470 proliferative patients,55 fibrotic patients,and 97 mixed patients,respectively.We found that gender distribution,age,disease duration,and frequency of allergy history were significantly different among subgroups.In terms of organ involvement,submandibular and lacrimal glands were frequently involved in the proliferative subtype,while retroperitoneum was the most commonly involved site in both fibrotic subtype and mixed subtype.The comparison of laboratory tests revealed that eosinophils(P=0.010),total IgE(P=0.006),high-sensitivity C-reactive protein(P<0.001),erythrocyte sedimentation rate(P<0.001),complement C4(P<0.001),IgG(P=0.001),IgG1(P<0.001),IgG4(P<0.001),and IgA(P<0.001),at baseline were significantly different among three subtypes.Compared with proliferative and mixed subtypes,the fibrotic subtype showed the lowest rate of relapse(log-rank P=0.014).Conclusions:Our study revealed the differences in demographic characteristics,clinical manifestations,organ involvement,laboratory tests,treatment agents,and outcomes across proliferative,fibrotic,and mixed subtypes in the retrospective cohort study.Given significant differences in relapse-free survival among the three subtypes,treatment regimens,and follow-up frequency should be considered separately according to different subtypes.Trial Registration:ClinicalTrials.gov,NCT01670695.

s Early-onset in Major Depression a Predictor of Specific Clinical Features with More Impaired Social Function？

Background:Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features,accompanying impaired social function,protracted recovery time,and frequent recurrence.This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia.Methods:In total,547 out-patients aged 18-65 years who were from 13 study sites in five Asian countries were included.These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders,4th Edition criteria.Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS).Quality of life was assessed by a 36-item Short-form Health Survey (SF-36).Analyses were performed using a continuous or dichotomous (cut-off:30 years)age-of-onset indicator.Results:Early-onset MDD (EOD,＜30 years) was associated with longer illness (P =0.003),unmarried status (P ＜ 0.001),higher neuroticism (P ≤ 0.002) based on the SCL-90-R,and more limited social function and mental health (P =0.006,P =0.007) based on the SF-36 and SDS.The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages.Special clinical features and more impaired social function and quality of life were associated with EOD,as in western studies.Conclusions:EOD often follows higher levels of neuroticism.Age of onset of MDD may be a predictor of clinical features and impaired social function,allowing earlier diagnosis and treatment.

Quantifying Creep of Concrete Filled Steel Tubes

Using age adjusted effective modulus(AAEM)method,creep of concrete filled steel tube(CFST)member was formulated considering of creep coefficient and aging coefficient.Ten CFST specimens were tested including eight for creep and two for shrinkage.The experimental result was compared with the computed result using AAEM in which the creep coefficient was taken from calibration of ACI model based on experimental result on sealed concrete,and aging coefficient was supplied from relaxation test on sealed concrete specimen.Furthermore,the creep of CFST member was analyzed using author's own subroutine to input concrete properties through user programmable feature(UPF)in ANSYS software.Comparison was made on authors' own experimental database,some existing experimental results,and results from AAEM and numerical analysis.Finally,the conditions of applicability of AAEM method are put forward,and numerical approach to compute creep of CFST specimen is delineated.

IgG N-糖基心血管年龄独立于真实年龄精准表征心血管事件风险

亚临床动脉粥样硬化和代谢紊乱是心血管健康的重要风险因素,应用免疫球蛋白G(IgG)N-聚糖模式作为炎症指标表征其发病风险已有研究报道。然而,对于IgG N-糖基谱在心血管疾病(CVD)风险分层中的能力仍然未知。本研究旨在利用IgG N-糖基标志物开发追踪心血管疾病风险的年龄指数。本研究基于横断面调查,从Busselton健康和老龄研究中共招募1465名40~70岁之间的个体。使用机器学习递归特征消除和惩罚回归算法逐步筛选特征糖基,并开发IgG N-糖基化心血管年龄(GlyCage)指数,以反映归因于心血管风险的与真实年龄间的偏差。结果显示,对GlyCage指数贡献最大的是具有双分叉N-乙酰葡萄糖胺(GlcNAc)的岩藻糖基化N-聚糖(GP6,FA2B)和具有双分叉GlcNAc的双半乳糖基化N-聚糖(GP13,A2BG2)。GlyCage独立于真实年龄,与较高的Framingham十年心血管风险[优势比(OR)为1.09;95%CI:1.05~1.13]和患心血管疾病概率(OR,1.07;95%CI:1.01~1.13)显著相关。GlyCage大于真实年龄三年及以上的个体,其心血管风险和心血管疾病患病概率增加,调整后的OR值分别为2.22(95%CI:1.41~3.53)和2.71(95%CI:1.25~6.41)。GlyCage指数区分十年心血管风险和事件的ROC曲线下面积(AUC)值分别为0.73和0.65,而真实年龄为0.65和0.63。因此,本研究开发的GlyCage指数利用IgG N-糖基谱追踪心血管健康水平。GlyCage和真实年龄之间的差距能够独立地表征心血管风险,提示IgG N-糖基化在心血管疾病的发病机制中起作用。GlyCage指数对心血管风险的预测能力需要在其他人群中进行外部和纵向验证。

Geological Characteristics and Model Ages of Marius Hills on the Moon

Marius Hills is a volcanic plateau on the nearside of the Moon. It is of great interest for its high concentration of volcanic features, including domes, cones, ridges, and rilles. However, the morphological and chronological characteristics of this plateau were not well studied due to the low resolution of early mission data. This study describes the detailed morphology of the volcanic features using the latest high spatial resolution images of the Terrain Camera （TC） onboard Selene-1 （10 m/pix） and Narrow Angle Camera （NAC） onboard the Lunar Reconnaissance Orbiter （LRO） （0.5 m/pix）. We report here some new structures such as skylights and remnants of lava tubes. We have divided spectrally homogenous areas with Clementine UVVIS data and did crater size frequency distribution （CSFD） measurements with Lunar Orbiter （LO） IV and TC images in every spectral unit. We first report absolute model ages of 1.10 Ga for Marius basalt 1, 1.49 Ga for Fiamsteed basalt, and 1.46 Ga for Schiaparelli Basalt. In addition, we have identified several younger lava events： they are Marius basalt 2 （814 Ma）, medium to low titanium basalt （949 Ma）, and undifferentiated medium titanium basalt （687 Ma）. Finally, we propose a mantle plume scenario for the formation of Marius Hills, which could solve the inconsistency of previous models.

Clinical characteristics of 310 SARS-CoV-2 Omicron variant patients and comparison with Delta and Beta variant patients in China

Although the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant has spread,data on the clinical characteristics of infected patients are limited.In this study,the demographic,clinical characteristics,and laboratory data of 310 SARS-CoV-2 Omicron variant patients treated at Haihe Hospital of Tianjin were collected and analyzed.Information on these patients was compared to 96 patients with the Delta variant of concern(VOC)and 326 patients with the Beta VOC during the previous coronavirus disease 2019(COVID-19)outbreak in Harbin.Of the 310 patients infected with the Omicron variant,the median age was 35 years.Most patients were clinically classified as mild(57.74%),and the most common symptoms were cough(48.71%),fever(39.35%),and sore throat(38.26%).The results for different vaccination groups in the Omicron group showed that the median of“SARS-CoV-2 specific IgG”after 2 or 3 doses of vaccination was higher than the unvaccinated group(all Ps<0.05).Older age was associated with a higher proportion of moderate cases and lower asymptomatic and mild cases based on clinical classifications.Compared to the Delta and Beta groups,the median age of the Omicron group was younger.The total number of asymptomatic patients and mild patients in the Omicron virus group was higher than the Delta and Beta groups(60.97%vs.54.17%vs.47.55%).This study presented the clinical characteristics of the first group of patients infected with the Omicron variant in Tianjin,China,and compared their clinical features with patients infected by the Delta and Beta variants,which would increase our understanding of the characteristics of SARS-CoV-2 Omicron variant.