Background: Neurologic complications, such as cognitive and emotional dysfunction, have frequently been observed in chronic kidney disease (CKD) patients. Previous research shows that uremic toxins play a role in the pathogenesis of CKD-associated cognitive impairment. Since astrocytes contribute to the protection and survival of neurons, astrocyte function and brain metabolism may contribute to the pathogenesis of neurodegeneration. Indoxyl sulfate (IS) is the most popular uremic toxin. However, how IS-induced astrocyte injury brings about neurologic complications in CKD patients has not been elucidated. Methods: The rate of extracellular acidification was measured in astrocytes when IS (0.5–3 mM, 4 or 7 days) treatment was applied. The hexokinase 1 (HK1), pyruvate kinase isozyme M2 (PKM2), pyruvate dehydrogenase (PDH), and phosphofructokinase (PFKP) protein levels were also measured. The activation of the apoptotic pathway was investigated using a confocal microscope, fluorescence- activated cell sorting, and cell three-dimensional imaging was used. Results: In astrocytes, IS affected glycolysis in not only dose-dependently but also time-dependently. Additionally, HK1, PKM2, PDH, and PFKP levels were decreased in IS-treated group when compared to the control. The results were prominent in cases with higher doses and longer exposure duration. The apoptotic features after IS treatment were also observed. Conclusion: Our results showed that the inhibition of glycolysis by IS in astrocytes leads to cell death via apoptosis. Specifically, longterm and higher-dose exposures had more serious effects on astrocytes. Our results suggest that the glycolysis pathway and related targets could provide a novel approach to cognitive dysfunction in CKD patients.

Background: This study proposes a classification system for predicting chronic obstructive pulmonary disease (COPD) patients and non-patients based on image and text data. Method: This study measured the respiratory volume based on thermal images, stored the respiratory data, and derived features related to respiratory patterns, including the total respiratory volume, average distance between expirations, average distance between inspirations, and total respiratory rate. The data for each feature were stored in text format. The four features saved as text were scaled using Z-score normalization and expressed as scores through weighted summation. These scores were compared to a threshold based on the ROC curve values, classifying participants as patients if the score exceeded the threshold and as non-patients if it fell below. Results: The proposed method achieved an accuracy of 82.5%. To validate the proposed approach, precision, recall, and F1-score were utilized, confirming the high classification performance of the model. The results of this study demonstrate the potential for future applications in non-contact medical examinations and diagnoses of respiratory diseases.

Since the COVID-19 pandemic, interest in non-contact diagnostic technologies has grown, leading to increased research into remote biosignal monitoring. The respiratory rate, widely used in previous studies, offers limited insight into pulmonary volume. To redress this, we propose a thermal imaging-based framework for respiratory segmentation aimed at estimating non-invasive pulmonary function. The proposed method uses an optical flow magnitude-based thresholding technique to automatically extract exhalation frames and segment them into frame sequences. A TransUNet-based network, combining a Convolutional Neural Network (CNN) encoder–decoder architecture with a Transformer module in the bottleneck, is trained on these sequences. The model’s Accuracy, Precision, Recall, IoU, Dice, and F1-score were 0.9832, 0.9833, 0.9830, 0.9651, 0.9822, and 0.9831, respectively, which results demonstrate high segmentation performance. The method enables the respiratory volume to be estimated by detecting exhalation behavior, suggesting its potential as a non-contact tool to monitor pulmonary function and estimate lung volume. Furthermore, research on thermal imaging-based respiratory volume analysis remains limited. This study expands upon conventional respiratory rate-based approaches to provide a new direction for respiratory analysis using vision-based techniques.

Background: Vision-based pulmonary diagnostics present a unique approach for tracking and measuring natural breathing behaviors through remote imaging. While many existing methods correlate chest and diaphragm movements to respiratory behavior, we look at how the direct visualization of thermal CO₂ exhale flow patterns can be tracked to directly measure expiratory flow. Methods: In this work, we present a novel method for isolating and extracting turbulent exhale flow signals from thermal image sequences through flow-field prediction and optical flow measurement. The objective of this work is to introduce a respiratory diagnostic tool that can be used to capture and quantify natural breathing, to identify and measure respiratory metrics such as breathing rate, flow, and volume. One of the primary contributions of this work is a method for capturing and measuring natural exhale behaviors that describe individualized pulmonary traits. By monitoring subtle individualized respiratory traits, we can perform secondary analysis to identify unique personalized signatures and abnormalities to gain insight into pulmonary function. In our study, we perform data acquisition within a clinical setting to train an inference model (FieldNet) that predicts flow-fields to quantify observed exhale behaviors over time. Results: Expiratory flow measurements capturing individualized flow signatures from our initial cohort demonstrate how the proposed flow field model can be used to isolate and analyze turbulent exhale behaviors and measure anomalous behavior. Conclusions: Our results illustrate that detailed spatial flow analysis can contribute to unique signatures for identifying patient specific natural breathing behaviors and abnormality detection. This provides the first-step towards a non-contact respiratory technology that directly captures effort-independent behaviors based on the direct measurement of imaged CO₂ exhaled airflow patterns.