bluuebunny/crossref_metadata_2025 huggingface dataset:
Wheat grain width: a clue for re-exploring visual indicators of grain weight
Authors: Haghshenas Abbas , Emam Yahya , Jafarizadeh Saeid
Published: May 2022

Background

Mean grain weight (MGW) is among the most frequently measured parameters in wheat breeding and physiology. Although in the recent decades, various wheat grain analyses (e.g. counting, and determining the size, color, or shape features) have been facilitated, thanks to the automated image processing systems, MGW estimations have been limited to using few number of image-derived indices; i.e. mainly the linear or power models developed based on the projected area (Area). Following a preliminary observation which indicated the potential of grain width in improving the predictions, the present study was conducted to explore more efficient indices for increasing the precision of image-based MGW estimations. For this purpose, an image archive of the grains was processed, which were harvested from a 2-year field experiment carried out with 3 replicates under two irrigation conditions and included 15 cultivar mixture treatments (so the archive was consisted of 180 images including more than 72,000 grains).

Results

It was observed that among the more than 30 evaluated indices of grain size and shape, indicators of grain width (i.e. Minor & MinFeret) along with 8 other empirical indices had a higher correlation with MGW, compared with Area. The most precise MGW predictions were obtained using the Area × Circularity, Perimeter × Circularity, and Area/Perimeter indices. Furthermore, it was found that (i) grain width and the Area/Perimeter ratio were the common factors in the structure of the superior predictive indices; and (ii) the superior indices had the highest correlation with grain width, rather than with their mathematical components. Moreover, comparative efficiency of the superior indices almost remained stable across the 4 environmental conditions. Eventually, using the selected indices, ten simple linear models were developed and validated for MGW prediction, which indicated a relatively higher precision than the current Area-based models. The considerable effect of enhancing image resolution on the precision of the models has been also evidenced.

Conclusions

It is expected that the findings of the present study, along with the simple predictive linear models developed and validated using new image-derived indices, could improve the precision of the image-based MGW estimations, and consequently facilitate wheat breeding and physiological assessments.
High throughput analysis of leaf chlorophyll content in sorghum using RGB, hyperspectral, and fluorescence imaging and sensor fusion
Authors: Zhang Huichun , Ge Yufeng , Xie Xinyan , Atefi Abbas , Wijewardane Nuwan K. , Thapa Suresh
Published: May 2022

Background

Leaf chlorophyll content plays an important role in indicating plant stresses and nutrient status. Traditional approaches for the quantification of chlorophyll content mainly include acetone ethanol extraction, spectrophotometry and high-performance liquid chromatography. Such destructive methods based on laboratory procedures are time consuming, expensive, and not suitable for high-throughput analysis. High throughput imaging techniques are now widely used for non-destructive analysis of plant phenotypic traits. In this study three imaging modules (RGB, hyperspectral, and fluorescence imaging) were, separately and in combination, used to estimate chlorophyll content of sorghum plants in a greenhouse environment. Color features, spectral indices, and chlorophyll fluorescence intensity were extracted from these three types of images, and multiple linear regression models and PLSR (partial least squares regression) models were built to predict leaf chlorophyll content (measured by a handheld leaf chlorophyll meter) from the image features.

Results

The models with a single color feature from RGB images predicted chlorophyll content with R2 ranging from 0.67 to 0.88. The models using the three spectral indices extracted from hyperspectral images (Ration Vegetation Index, Normalized Difference Vegetation Index, and Modified Chlorophyll Absorption Ratio Index) predicted chlorophyll content with R2 ranging from 0.77 to 0.78. The model using the fluorescence intensity extracted from fluorescence images predicted chlorophyll content with R2 of 0.79. The PLSR model that involved all the image features extracted from the three different imaging modules exhibited the best performance for predicting chlorophyll content, with R2 of 0.90. It was also found that inclusion of SLW (Specific Leaf Weight) into the image-based models further improved the chlorophyll prediction accuracy.

Conclusion

All three imaging modules (RGB, hyperspectral, and fluorescence) tested in our study alone could estimate chlorophyll content of sorghum plants reasonably well. Fusing image features from different imaging modules with PLSR modeling significantly improved the predictive performance. Image-based phenotyping could provide a rapid and non-destructive approach for estimating chlorophyll content in sorghum.
Comparison of the knee joint reaction force between individuals with and without acute anterior cruciate ligament rupture during walking
Authors: Aghdam Hossein Akbari , Haghighat Farzaneh , Rezaie Mohammadreza , Kavyani Mahsa , Karimi Mohammad Taghi
Published: May 2022

Background

Anterior cruciate ligament plays a significant role in knee joint stability. It is claimed that the incidence of knee osteoarthritis increases in individuals with anterior cruciate ligament (ACL) rupture. The aim of this study was to evaluate the knee joints reaction force in ACL rupture group compared to normal subjects.

Method

Fifteen patients with acute ACL rupture and 15 healthy subjects participated in this study. The ground reaction force (GRF) and kinematic data were collected at a sampling rate of 120 Hz during level-ground walking. Spatiotemporal parameters, joint angles, muscle forces and moments, and joint reaction force (JRF) of lower extremity were analyzed by OpenSIM software.

Results

The hip, knee and ankle joints reaction force at loading response and push-off intervals of the stance phase during walking was significantly higher in individuals with ACL rupture compared to healthy controls (p value < 0.05). Walking velocity (p value < 0.001), knee (p value = 0.065) and ankle (p value = 0.001) range of motion in the sagittal plane were significantly lower in the patients with ACL rupture compared to healthy subjects. The mean value of vertical GRF in the mid-stance, the peak of the hip adduction moment in loading response and push-off phases, the hip abductor, knee flexor and vastus intermedius part of quadriceps muscle forces were significantly higher compared to healthy subjects (p < 0.05) while vastus medialis and vastus lateralis produced significantly lower force (p < 0.001).

Conclusions

Based on results of this study, lower limb JRF was higher in those with ACL rupture compared to healthy subjects may be due to the compensatory mechanisms used by this group of subjects. An increase in knee JRF in patients with ACL rupture may be the reason for the high incidence of knee OA.
Comparison of the efficacy and safety of sedation protocols with the use of dexmedetomidine–remifentanil and propofol–remifentanil during percutaneous closure of atrial septal defects: a randomized clinical trial
Authors: Chen Xiao-Lan , Huang Wen-Hui , Zheng Yi-Han , Zhang Gui-Can
Published: May 2022

Background

The study was aimed to compare the efficacy and safety of different sedation protocols of dexmedetomidine–remifentanil and propofol–remifentanil for percutaneous closure of atrial septal defects (ASD) under transthoracic echocardiography (TTE) guidance.

Material and methods

From March 2020 to January 2021, of 114 patients screened, 59 ASD patients scheduled for percutaneous closure under TTE guidance were randomly allocated into the dexmedetomidine–remifentanil (D–R) group (n = 29) and the propofol–remifentanil (P–R) group (n = 30). The incidence of hemodynamic and respiratory adverse events, arterial blood gas analysis, induction and recovery time, pain score, infusion rate of remifentanil, satisfaction of the surgeon and patient, additional sedatives were collected for analysis and comparison.

Results

The induction time was longer in the D–R group than that in the P–R group (17.66 ± 2.65 min vs 11.43 ± 1.48 min; difference, 6.22 min; 95% CI 5.10 to 7.35; P < 0.001). No differences were observed in the 2 groups in terms of the additional sedatives, infusion rate of remifentanil, pain score, recovery time (P > 0.05). There was no difference between the two groups regarding the incidence of cardiovascular adverse events (6 [20.7%] vs 4 [13.3%]; difference, 7.4%; 95% CI − 11.7 to 26.5%; P = 0.506). Respiratory adverse events occurred in 1 patient (3.4%) in the D–R group, and 8 patients (26.7%) in the P–R group (difference, 23.3%; 95% CI 6.2 to 40.5%; P = 0.026). The incidence of hypercapnia was significantly lower in the D–R group (4 [13.8%]) than in the P–R group (13 [43.3%]; difference, 29.5%; 95% CI 7.8 to 51.2%; P = 0.012).

Conclusions

Except for more rapid the induction time and higher the surgeon satisfaction score in the propofol–remifentanil protocol, the efficacy was similar between two sedation protocols. The hemodynamic stability was comparable, the dexmedetomidine–remifentanil protocol had superior airway security due to fewer hypercapnia and respiratory adverse events.
Clinical results after hybrid coronary revascularization with totally endoscopic coronary surgery
Authors: Claessens Jade , Yilmaz Alaaddin , Awouters Camille , Oosterbos Hanne , Thonnisen Stef , Benit Edouard , Kaya Abdullah , Bataille Yoann
Published: May 2022

Background

The optimal revascularization strategy remains uncertain in multivessel coronary artery disease (MVCAD). The durability of the surgical grafts should be weighed against the decreased invasiveness of percutaneous coronary intervention (PCI). Hybrid coronary revascularization (HCR), a combination of PCI and surgery, could be a feasible alternative. This study aimed to investigate the occurrence of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality after both endoscopic coronary artery bypass grafting (Endo-CABG) and the HCR procedure.

Methods

In this single-center retrospective observational study, 347 consecutive patients have been subjected to an Endo-CABG procedure, of which 103 underwent HCR between January 2016 and January 2018. A propensity score matching analysis was performed to match 103 Endo-CABG alone patients to the 103 HCR patients. The Endo-CABG procedure was performed through 3 endoscopic ports (5 mm) in the 2nd, 3rd, and 4th intercostal space and a utility port of 3 cm.

Results

In both the HCR and matched endo-CABG alone group, the 30-day mortality was acceptable (0% in the HCR group and 1.94% in the matched Endo-CABG alone group, p = 0.155). Additionally, the occurrence of MACCE after a mean follow-up of 1188 ± 538 days was similar in both groups (9.71% and 11.65% for the HCR and matched Endo-CABG alone group, respectively, p = 0.652). Still, the long-term all-cause mortality over this period was significantly higher in the matched Endo-CABG alone group (2.91% after the HCR procedure and 11.65% after matched Endo-CABG alone, p = 0.002).

Conclusion

HCR has some advantages over Endo-CABG alone regarding the all-cause mortality, cross-clamping time, intensive care unit, and hospital length of stay. Therefore, HCR may be a suitable alternative therapy for patients with MVCAD.
Short-term results of percutaneous closure of a patent foramen ovale guided by transoesophageal echocardiography in patients with cryptogenic stroke: a retrospective study
Authors: Guo Yilong , Shi Zhensu , Zheng Yin , Xie Caichan , Yi Jiao , Chen Zelun , Shu Yue , Zhou Dexing
Published: May 2022

Background

A patent foramen ovale (PFO) is a risk factor for cryptogenic stroke (CS), and interventional therapy for PFO can reduce the recurrence rate of CS. However, interventional therapies are primarily guided by X-ray imaging, and data on regular post-surgical follow-up with the transthoracic ultrasound foaming test (UFT) are rare. Thus, this study aimed to assess the short-term (12 months) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular UFTs.

Methods

Clinical records, echocardiographic data, and UFT results of 75 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A (n = 21), small volume of right-to-left shunts; group B (n = 22), moderate volume of right-to-left shunts; and group C (n = 32), large volume of right-to-left shunts. All patients were treated with an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 12 months after surgery.

Results

No significant differences in preoperative data, length of hospital stay, or operative time were noted between the groups (p > 0.05). The length of the PFO and diameter of the occluder differed between the groups as follows: group A = group B < group C (p < 0.001). Notably, 1 patient in group C developed recurrent stroke 11 months postoperatively, and 2 patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. However, 19 patients still had positive UFT results 12 months postoperatively. Furthermore, the positive UFT rate 12 months postoperatively differed between the groups as follows: group A = group B < group C (p < 0.05). A preoperative large-volume shunt was negatively associated with a negative UFT rate 12 months postoperatively (OR = 0.255, 95% CI: 0.104–0.625).

Conclusions

In patients with PFO and CS, interventional therapy guided by TEE could lead to satisfactory short-term (12 months) outcomes. Although the positive UFT rate gradually decreased, some patients still had positive UFT results 12 months postoperatively. Preoperatively, a large volume of right-to-left shunts and a longer PFO were the two risk factors for positive UFT results postoperatively. Further studies are required to clarify the relationship between postoperative positive UFT results and stroke recurrence.
Preoperative Master’s double two-step test may predict survival after lobectomy in patients with lung cancer
Authors: Shiono Satoshi , Endo Makoto , Nakahashi Kenta , Nakatsuka Marina
Published: May 2022

Background

The Master’s double two-step test (MDT), which is used to screen for coronary heart disease, is difficult for physically impaired patients to complete. The purpose of this study was to clarify the relationship between the results of the MDT and prognosis after lung cancer surgery.

Methods

Between May 2004 and September 2019, 1,434 patients underwent complete resection for lung cancer at our hospital. Among them, 418 with pathological stage I disease who underwent lobectomy were evaluated. We defined patients who could accomplish the MDT as the complete MDT group and those who could not as the incomplete MDT group. Patients who could not perform the MDT due to physical problems were included in the incomplete MDT group. We explored the prognostic impact of the MDT results in these patients.

Results

Fifty-three patients (12.7%) were in the incomplete MDT group; compared with the complete MDT group, they were older and had poorer performance status and respiratory function. However, the incidence of postoperative complications and 90-day mortality did not differ significantly between groups. Multivariate analyses revealed that age (p < 0.001), Charlson comorbidity index (p = 0.013), incomplete MDT (p = 0.049) and carcinoembryonic antigen (CEA) level (p = 0.003) were prognostic factors for worse overall survival; age (p < 0.001) and incomplete MDT (p = 0.022) were prognostic factors for worse non-cancer-specific survival.

Conclusions

Although incomplete MDT was not associated with postoperative complications, 90-day mortality or cancer-specific survival, MDT results may be significantly associated with non-cancer-specific survival.
Successful endovascular repair of iliac artery aneurysms with unsuitable anatomy by combining unibody bifurcated endograft and iliac branch systems to preserve hypogastric artery blood flow: a report of two cases
Authors: Akagi Daisuke , Murase Kai
Published: May 2022

Background

To overcome the anatomical limitation of a narrow aorta and short length from the renal artery to the terminal aorta, unibody endograft AFX2 and iliac branch endoprosthesis (IBE) can be combined.

Case presentation

Case 1: The first patient was an 89-year-old woman who had a right saccular common iliac artery (CIA) aneurysm (38 mm); the abdominal aorta was not aneurysmal (diameter, 19 mm). The right CIA’s origin was 10 mm in diameter. A bifurcated AFX2 was placed in an ordinary manner. Then, IBE was inserted in the right leg of the AFX2. Case 2: The second patient was an 87-year-old man diagnosed with an abdominal aortic aneurysm (55 mm), right dissecting CIA aneurysm (20 mm), and right hypogastric artery aneurysm (22 mm) extending to the bifurcation of the superior and inferior gluteal arteries. The length between the renal artery and terminal aorta was 107 mm. The beginning of the right CIA was segmentally stenotic (13 mm). A bifurcated AFX2 was placed in the infrarenal aorta; IBE was advanced to the origin of the right limb of the AFX2. To control the type 1b endoleak, the right superior gluteal artery was embolized with coils and internal iliac components were deployed toward the inferior gluteal artery. Satisfactory results were obtained in both cases.

Conclusion

The AFX2 main body and IBE could be combined to preserve hypogastric blood flow and overcome anatomical limitations.
Clinical and genetic characterization of a cohort of 97 CLN6 patients tested at a single center
Authors: Rus Corina-Marcela , Weissensteiner Thomas , Pereira Catarina , Susnea Iuliana , Danquah Bright D. , Morales Torres Galina , Rocha Maria Eugenia , Cozma Claudia , Saravanakumar Deepa , Mannepalli Sumanth , Kandaswamy Krishna K. , Di Bucchianico Sebastiano , Zimmermann Ralf , Rolfs Arndt , Bauer Peter , Beetz Christian
Published: May 2022

Background

Ceroid lipofuscinoses neuronal 6 (CLN6) disease belongs to the neuronal ceroid lipofuscinoses (NCLs), complex and genetically heterogeneous disorders with wide geographical and phenotypic variation. The first clinical signs usually appear between 18 months and 8 years, but examples of later-onset have also been reported. Common manifestations include ataxia, seizures, vision impairment, and developmental regression. Because these are shared by other neurological diseases, identification of CLN6 genetic variants is imperative for early diagnosis.

Results

We present one of the largest cohorts to date of genetically diagnosed CLN6 patients screened at a single center. In total 97 subjects, originating from 20 countries were screened between 2010 and 2020. They comprised 86 late-infantile, eight juvenile, and three adult-onset cases (two patients with Kufs disease type A, and one with teenage progressive myoclonic epilepsy). The male to female ratio was 1.06: 1.00. The age at referral was between six months and 33 years. The time from disease onset to referral ranged from less than 1 month to 8.3 years. The clinical phenotype consisted of a combination of symptoms, as reported before. We characterized a total of 45 distinct variants defining 45 distinct genotypes. Twenty-four were novel variants, some with distinct geographic associations. Remarkably, c.257A > G (p.H86R) was present in five out of 23 unrelated Egyptian individuals but in no patients from other countries. The most common genotype was homozygosity for the c.794_796del in-frame deletion. It was present in about one-third of CLN6 patients (28 unrelated cases, and 2 familial cases), all with late-infantile onset. Variants with a high likelihood of causing loss of CLN6 function were found in 21% of cases and made up 33% of all distinct variants. Forty-four percent of variants were classified as pathogenic or likely pathogenic.

Conclusions

Our study significantly expands the number of published clinical cases and the mutational spectrum of disease-associated CLN6 variants, especially for the Middle Eastern and North African regions. We confirm previous observations regarding the most prevalent symptoms and recommend including CLN6 in the genetic diagnosis of patients presenting with early-onset abnormalities of the nervous system, musculoskeletal system, and eye.
A cost-effectiveness and value of information analysis to inform future research of tranexamic acid for older adults experiencing mild traumatic brain injury
Authors: Williams Jack , Ker Katharine , Roberts Ian , Shakur-Still Haleema , Miners Alec
Published: May 2022

Background

Tranexamic acid reduces head injury deaths in patients with CT scan evidence of intracranial bleeding after mild traumatic brain injury (TBI). However, the cost-effectiveness of tranexamic acid for people with mild TBI in the pre-hospital setting, prior to CT scanning, is uncertain. A large randomised controlled trial (CRASH-4) is planned to address this issue, but the economic justification for it has not been established. The aim of the analysis was to estimate the likelihood of tranexamic acid being cost-effective given current evidence, the treatment effects required for cost-effectiveness, and the expected value of performing further research.

Methods

An early economic decision model compared usual care for mild TBI with and without tranexamic acid, for adults aged 70 and above. The evaluation was performed from a UK healthcare perspective over a lifetime time horizon, with costs reported in 2020 pounds (GBP) and outcomes reported as quality-adjusted life years (QALYs). All analyses used a £20,000 per QALY cost-effectiveness threshold.

Results

In the base case analysis, tranexamic acid was associated with an incremental cost-effectiveness ratio of £4885 per QALY gained, but the likelihood of it being cost-effective was highly dependent on the all-cause mortality treatment effect. The value of perfect information was £22.4 million, and the value of perfect information for parameters that could be collected in a trial was £21.9 million. The all-cause mortality risk ratio for tranexamic acid and the functional outcomes following TBI had the most impact on cost-effectiveness.

Conclusions

There is a high degree of uncertainty in the cost-effectiveness of tranexamic acid for older adults experiencing mild TBI, meaning there is a high value of performing future research in the UK. The value in a global context is likely to be far higher.
Optimization of measurement-based care (OMBC) for depression based on all-round and continuous assessment: rationale and protocol for a multicenter randomized control clinical trial
Authors: Zhou Jingjing , Wang Xiao , Yang Jian , Zhu Xuequan , Xiao Le , Feng Lei , Wang Gang
Published: May 2022

Background

Despite the recent findings presenting the benefits of measurement-based care (MBC) compared to treatment as usual (TAU), MBC is still not the standard of care used in clinical settings. The aim of the present study was to achieve the optimization of MBC (OMBC) for major depressive disorder (MDD) by establishing a comprehensive MBC framework based on all-round, continuous assessment for depression.

Methods

The target recruitment size is 900 patients, and the study is conducted at 8 centers in China. The patients are randomly assigned to the MBC and TAU groups at a 2:1 ratio. The subjects are scheduled to remain for 12 weeks in the acute phase and for 12 months in the maintenance phase. The primary outcomes are the complete remission rate and the proportion of patients with a 16-item Quick Inventory of Depressive Symptomatology–Self-Report (QIDS-SR 16) total score ≤ 5 of the MBC and TAU groups at the acute phase, and the recurrence rate/time between the two groups is measured at the maintenance phase. Secondary outcomes included the changes in the parameters QIDS-SR 16, Patient Health Questionnaire-9 (PHQ-9), and 17-item Hamilton Rating Scale for Depression (HAMD-17) from baseline and the response rate between the two groups at the acute phase as well as the comparison of recurrence rate between the two groups at the end of the study.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-OOC-17012566. The registration was performed retrospectively on 4 September 2017.
B7-H4 reduction induced by Toxoplasma gondii infection results in dysfunction of decidual dendritic cells by regulating the JAK2/STAT3 pathway
Authors: Sun Xinyue , Xie Hongbing , Zhang Haixia , Li Zhidan , Qi Houbao , Yang Chunyan , Liu Xianbing , Ren Liqin , Jiang Yuzhu , Hu Xuemei
Published: May 2022

Background

Primary infection of Toxoplasma gondii can cause serious abnormal pregnancy outcomes such as miscarriage and stillbirth. Inhibitory molecule B7-H4 is abundantly expressed in dendritic cells (DCs) and plays an important role in maintaining immune tolerance. However, the role of B7-H4 in decidual DCs (dDCs) in T. gondii-induced abnormal pregnancy outcomes is not clear.

Methods

We established T. gondii-infected abnormal pregnancy model in wild-type (WT) and B7-H4 knockout (B7-H4−/−) pregnant mice in vivo and cultured primary human dDCs in vitro. The abnormal pregnancy outcomes were observed and the expression of B7-H4, functional molecules (CD80, CD86, and MHC-II or HLA-DR), indoleamine 2,3-dioxygenase (IDO), cytokines (IL-10 and IL-12), and signaling molecules JAK2/STAT3 in dDCs was detected by flow cytometry and Western blot.

Results

Our results showed that T. gondii infection significantly decreased B7-H4 expression in dDCs. In addition, B7-H4−/− infected pregnant mice showed much more severe abnormal pregnancy outcomes than their counterparts. Importantly, B7-H4−/− infection further regulated the expression of molecules (CD80, CD86, and MHC-II or HLA-DR), enzyme IDO, and cytokines (IL-10 and IL-12) in dDCs. We further discovered that B7-H4−/− infection impairs the JAK2/STAT3 pathway, contributing to dDC dysfunction.

Conclusions

Taken together, the results show that reduction of B7-H4 by T. gondii infection significantly modulates the decrease in cytokine IL-10 and enzyme IDO and the increase in cytokine IL-12, contributing to dDC dysfunction. Moreover, the JAK2/STAT3 pathway is involved in the regulation of B7-H4 by T. gondii infection and in the subsequent IDO and cytokine production, which ultimately contributes to abnormal pregnancy outcomes.

Graphical Abstract
Frequency of flash glucose monitoring and glucose metrics: real-world observational data from Saudi Arabia
Authors: Al-Harbi Mohammad Y. , Albunyan Abdulhameed , Alnahari Ahmed , Kao Kalvin , Brandner Laura , El Jammal Manal , Dunn Timothy C.
Published: May 2022

Background

This real-world data study analyzed glucose metrics from FreeStyle Libre® flash glucose monitoring in relation to scanning frequency, time in range (TIR) and estimated A1c (eA1c) in Saudi Arabia.

Methods

Anonymized reader data were analyzed according to scanning frequency quartiles, eA1c categories (<7%,≥7%‒≤9% or>9%) and TIR categories (<50%,≥50%‒≤70% or>70%). Sensors, grouped by reader, were required to have≥120 h of operation. Differences in scanning frequency, eA1c, TIR, time in hypoglycemia and hyperglycemia, and glucose variability (standard deviation [SD] and coefficient of variation [CV]) were analyzed between groups.

Results

6097 readers, 35,747 sensors, and 40 million automatic glucose measurements were analyzed. Patients in the highest scanning frequency quartile (Q4, mean 32.0 scans/day) had lower eA1c (8.47%), greater TIR (46.4%) and lower glucose variation (SD 75.0 mg/dL, CV 38.2%) compared to the lowest quartile (Q1, mean 5.2 scans/day; eA1c 9.77%, TIR 32.8%, SD 94.9 mg/dL, CV 41.3%). Lower eA1c and higher TIR were associated with greater scanning frequency, lower glucose variability and less time in hyperglycemia.

Conclusions

Higher scanning frequency in flash glucose users from Saudi Arabia is associated with lower eA1c, higher TIR, lower glucose variability and less time in hypoglycemia or hyperglycemia.
Comparative analysis of machine learning algorithms for multi-syndrome classification of neurodegenerative syndromes
Authors: Lampe Leonie , Niehaus Sebastian , Huppertz Hans-Jürgen , Merola Alberto , Reinelt Janis , Mueller Karsten , Anderl-Straub Sarah , Fassbender Klaus , Fliessbach Klaus , Jahn Holger , Kornhuber Johannes , Lauer Martin , Prudlo Johannes , Schneider Anja , Synofzik Matthis , Danek Adrian , Diehl-Schmid Janine , Otto Markus ,   FTLD-Consortium Germany, Villringer Arno , Egger Karl , Hattingen Elke , Hilker-Roggendorf Rüdiger , Schnitzler Alfons , Südmeyer Martin , Oertel Wolfgang ,   German Atypical Parkinson Consortium Study Group, Kassubek Jan , Höglinger Günter , Schroeter Matthias L.
Published: May 2022

Importance

The entry of artificial intelligence into medicine is pending. Several methods have been used for the predictions of structured neuroimaging data, yet nobody compared them in this context.

Objective

Multi-class prediction is key for building computational aid systems for differential diagnosis. We compared support vector machine, random forest, gradient boosting, and deep feed-forward neural networks for the classification of different neurodegenerative syndromes based on structural magnetic resonance imaging.

Design, setting, and participants

Atlas-based volumetry was performed on multi-centric T1-weighted MRI data from 940 subjects, i.e., 124 healthy controls and 816 patients with ten different neurodegenerative diseases, leading to a multi-diagnostic multi-class classification task with eleven different classes.

Interventions

N.A.

Main outcomes and measures

Cohen’s kappa, accuracy, and F1-score to assess model performance.

Results

Overall, the neural network produced both the best performance measures and the most robust results. The smaller classes however were better classified by either the ensemble learning methods or the support vector machine, while performance measures for small classes were comparatively low, as expected. Diseases with regionally specific and pronounced atrophy patterns were generally better classified than diseases with widespread and rather weak atrophy.

Conclusions and relevance

Our study furthermore underlines the necessity of larger data sets but also calls for a careful consideration of different machine learning methods that can handle the type of data and the classification task best.
Drug resistance in cancer therapy: the Pandora's Box of cancer stem cells
Authors: Rezayatmand Hamed , Razmkhah Mahboobeh , Razeghian-Jahromi Iman
Published: May 2022

Drug resistance is the main culprit of failure in cancer therapy that may lead to cancer relapse. This resistance mostly originates from rare, but impactful presence of cancer stem cells (CSCs). Ability to self-renewal and differentiation into heterogeneous cancer cells, and harboring morphologically and phenotypically distinct cells are prominent features of CSCs. Also, CSCs substantially contribute to metastatic dissemination. They possess several mechanisms that help them to survive even after exposure to chemotherapy drugs. Although chemotherapy is able to destroy the bulk of tumor cells, CSCs are left almost intact, and make tumor entity resistant to treatment. Eradication of a tumor mass needs complete removal of tumor cells as well as CSCs. Therefore, it is important to elucidate key features underlying drug resistance raised by CSCs in order to apply effective treatment strategies. However, the challenging point that threatens safety and specificity of chemotherapy is the common characteristics between CSCs and normal peers such as signaling pathways and markers. In the present study, we tried to present a comprehensive appraisal on CSCs, mechanisms of their drug resistance, and recent therapeutic methods targeting this type of noxious cells.
Studies on human body composition in Russia: past and present
Authors: Rudnev Sergey G. , Godina Elena Z.
Published: May 2022

Despite the presence of body composition studies in Russia, there are no current reviews on this topic, and the results are relatively rarely published abroad. Our aim was to describe the history and current state of this research work, to list unresolved problems, and to outline possible developmental trends. For completeness, in the initial part of the review, traditional research areas indirectly related to body composition studies are considered, namely, the analysis of biological variation of anthropometric parameters and somatotyping.

It can be seen that anthropometry and bioimpedance analysis (BIA) are mainly used to assess body composition in Russia. Other methods, such as double-energy X-ray absorptiometry (DXA), are utilized less often. The achievements include the common use of comprehensive anthropometry in anthropological studies, some advancements in clinical studies, approbation of potentially important methods such as the deuterium dilution method and three-dimensional laser-based photonic scanning, and ongoing mass population BIA measurements in health centers. Various bioimpedance instruments are manufactured, the local reference BIA body composition data are available, and a large updated BIA database is ready for international comparisons.

Among major limitations of body composition research in Russia, one can note the lack of validation studies using reference methods, so that foreign regression formulas are used with the double indirect methods, such as anthropometry and BIA, despite the fact that their accuracy has not yet been checked in our population. Conventional reference body composition assessment methods, such as three- or four-component molecular-level models and whole-body in vivo neutron activation analysis, were not applied yet, despite the technical feasibility.

In general, it can be argued that the body composition research in Russia follows the observed global trends. Along with the achievements, there are a number of unresolved methodological and organizational issues. Prospects for further research include validation studies, updating reference population body composition data, and establishing local cut-offs for malnutrition and disease risks. In our view, further development could be facilitated with the establishment of well-equipped Human Body Composition Units in major Russian research centers, such as Moscow State University, which could be
assigned a coordinating and methodical role.
A systematic review and research perspective on recommender systems
Authors: Roy Deepjyoti , Dutta Mala
Published: May 2022

Recommender systems are efficient tools for filtering online information, which is widespread owing to the changing habits of computer users, personalization trends, and emerging access to the internet. Even though the recent recommender systems are eminent in giving precise recommendations, they suffer from various limitations and challenges like scalability, cold-start, sparsity, etc. Due to the existence of various techniques, the selection of techniques becomes a complex work while building application-focused recommender systems. In addition, each technique comes with its own set of features, advantages and disadvantages which raises even more questions, which should be addressed. This paper aims to undergo a systematic review on various recent contributions in the domain of recommender systems, focusing on diverse applications like books, movies, products, etc. Initially, the various applications of each recommender system are analysed. Then, the algorithmic analysis on various recommender systems is performed and a taxonomy is framed that accounts for various components required for developing an effective recommender system. In addition, the datasets gathered, simulation platform, and performance metrics focused on each contribution are evaluated and noted. Finally, this review provides a much-needed overview of the current state of research in this field and points out the existing gaps and challenges to help posterity in developing an efficient recommender system.
Infra-tentorial brain tumor subtypes in children and adults—surgical outcome in an ethnic population with a single regional tertiary center
Authors: Bhat Abdul Rashid , Wani Muhammed Afzal , Kirmani Altaf Rehman
Published: May 2022

Background

To analyze clinically and radiologically the surgical outcome like residual disease, progression of disease, recurrence, disabilities, event-free survival (EFS), and mortality of different infra-tentorial tumor subtypes in children and adults of a strictly non-migratory and ethnic population.

Methods

The 410 histologically proved, out of 589, infra-tentorial brain tumor patients were analyzed clinically and by the imaging post-surgically in a single tertiary center for an ethnic region. In this analytico-observational study, retrospectively postoperative records of 589 infra-tentorial brain tumors from November 1998 to December 2018 (20 years) were retrieved, scrutinized, and compiled. The post-operative clinic-radiological records of 410 patients with proved histopathological examination results were included. Statistical law of variance was applied where-ever necessary.

Results

The 63.2% of the all 410 operated infra-tentorial brain tumors were males while females predominated in meningiomas and pineoblastomas. About 31.7% infra-tentorial tumors were children (below 18 years). About 54.1% cases were histologically malignant. The residual tumors comprised 40.2% and symptoms of disease-progression occurred in 10.9%. The tumor recurrence occurred in 14.3% while 6.0% patients developed severe disability. The overall mortality was 11.4% but 18.9% in malignant tumors. The event-free survival (EFS) for all the patients was 66.0%, patients with malignancies had 47.7% and benign group had 87.7%.

Conclusion

The study, surgical outcome of infra-tentorial brain tumor subtypes in children and adults (approx. 1/3rd of patients being children), conducted in a tertiary center at a remote land-locked location with non-migratory ethnic population as its catchment area, has a significant epidemiological value for the community and the region.
Internal electrical fault detection techniques in DFIG-based wind turbines: a review
Authors: Bebars Abdelwahab D. , Eladl Abdelfattah A. , Abdulsalam Gabr M. , Badran Ebrahim A.
Published: May 2022

The keys factor in making wind power one of the main power sources to meet the world's growing energy demands is the reliability improvement of wind turbines (WTs). However, the eventuality of fault occurrence on WT components cannot be avoided, especially for doubly-fed induction generator (DFIG) based WTs, which are operating in severe environments. The maintenance need increases due to unexpected faults, which in turn leads to higher operating cost and poor reliability. Extensive investigation into DFIG internal fault detection techniques has been carried out in the last decade. This paper presents a detailed review of these techniques. It discusses the methods that can be used to detect internal electrical faults in a DFIG stator, rotor, or both. A novel sorting technique is presented which takes into consideration different parameters such as fault location, detection technique, and DFIG modelling. The main mathematical representation used to detect these faults is presented to allow an easier and faster understanding of each method. In addition, a comparison is carried out in every section to illustrate the main differences, advantages, and disadvantages of every method and/or model. Some real monitoring systems available in the market are presented. Finally, recommendations for the challenges, future work, and main gaps in the field of internal faults in a DFIG are presented. This review is organized in a tutorial manner, to be an effective guide for future research for enhancing the reliability of DFIG-based WTs.
Factors associated with hospitalizations for Covid-19 in patients with rheumatoid arthritis: data from the Reumacov Brazil registry
Authors: Gomides Ana Paula Monteiro , de Albuquerque Cleandro Pires , da Mota Licia Maria Henrique , Devidé Guilherme , Dias Laiza Hombre , Duarte Angela Luzia Branco Pinto , Giovelli Raquel Altoé , Karnopp Thais Evelyn , de Lima Hugo Deleon , Marinho Adriana , de Oliveira Marianne Schrader , Omura Felipe , Ranzolin Aline , Resende Gustavo , Ribeiro Francinne Machado , Ribeiro Sandra Lúcia Euzébio , de Carvalho Sacilotto Nathália , dos Santos Wander Gonzaga , Shinjo Samuel Katsuyuki , de Sousa Studart Samia Araujo , Teixeira Flávia Patricia Sena , Yazbek Michel Alexandre , Ferreira Gilda Aparecida , Monticielo Odirlei A. , Paiva Eduardo , Pileggi Gecilmara Cristina Salviato , dos Reis-Neto Edgard Torres , de Medeiros Pinheiro Marcelo , Marques Claudia D. L. ,   On behalf of ReumaCoV Brasil Registry
Published: May 2022

Background

Patients using immunosuppressive drugs may have unfavorable results after infections. However, there is a lack of information regarding COVID-19 in these patients, especially in patients with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the risk factors associated with COVID-19 hospitalizations in patients with RA.

Methods

This multicenter, prospective cohort study is within the ReumaCoV Brazil registry and included 489 patients with RA. In this context, 269 patients who tested positive for COVID-19 were compared to 220 patients who tested negative for COVID-19 (control group). All patient data were collected from the Research Electronic Data Capture database.

Results

The participants were predominantly female (90.6%) with a mean age of 53 ± 12 years. Of the patients with COVID-19, 54 (20.1%) required hospitalization. After multiple adjustments, the final regression model showed that heart disease (OR = 4.61, 95% CI 1.06–20.02. P < 0.001) and current use of glucocorticoids (OR = 20.66, 95% CI 3.09–138. P < 0.002) were the risk factors associated with hospitalization. In addition, anosmia was associated with a lower chance of hospitalization (OR = 0.26; 95% CI 0.10–0.67, P < 0.005).

Conclusion

Our results demonstrated that heart disease and the use of glucocorticoids were associated with a higher number of hospital admissions for COVID-19 in patients with RA.

Trial registration: Brazilian Registry of Clinical Trials - RBR-33YTQC.
Innovative Approaches to the Management of Acute Lymphoblastic Leukemia Across the Age Spectrum
Authors: Curran Emily , Muffly Lori , Luskin Marlise R.
Published: May 2022

Adults compose nearly half of all patients diagnosed with acute lymphoblastic leukemia (ALL) and historically have had poor survival compared with pediatric patients. Recently approved therapies, such as monoclonal antibodies, CAR T-cell constructs, and next-generation tyrosine kinase inhibitors, have improved survival in relapsed and refractory ALL, and studies are now examining incorporating these treatments and others into the upfront setting. In adolescent and young adult patients, use of pediatric-based regimens has already improved survival compared with historical controls, and the addition of monoclonal antibodies, such as inotuzumab ozogamicin and blinatumomab, may further enhance this survival benefit. In older adults, approaches have centered on minimizing conventional chemotherapy to decrease toxicity by incorporating monoclonal antibodies and other novel therapies to increase efficacy. With the addition of tyrosine kinase inhibitors to chemotherapy for patients with Philadelphia chromosome–positive ALL, survival of this once poor-prognosis ALL subtype now approaches or exceeds outcomes of other subtypes of adult ALL. Further refinements in the backbone treatment regimen and optimal consolidation approaches will likely improve survival further. Although allogeneic hematopoietic stem cell transplant was previously routinely used as consolidation for adults with ALL, incorporation of measurable residual disease and other risk stratification strategies has enabled better identification of patients who will benefit from allogeneic hematopoietic stem cell transplant. Ongoing clinical trials investigating these approaches will continue the evolution of treatment approaches for adults with ALL, with further improvement in outcomes anticipated.
Leveraging Digital Technology to Reduce Cancer Care Inequities
Authors: Arora Sanjeev , Ryals Cleo , Rodriguez Jorge A. , Byers Emily , Clewett Elizabeth
Published: May 2022

The rise of digital technologies such as telehealth, mobile apps, electronic medical records, and telementoring for rural primary care providers could provide opportunities for improving equity in cancer care delivery and outcomes. Benefitting from new technologies requires access to broadband internet, appropriate devices (smartphones, computers, etc.) along with basic digital literacy skills to use the devices. When these requirements are not met, the likelihood of widening existing inequities in access to care increases. This article introduces opportunities for improving cancer care using health informatics systems for engaging patients and flagging bias and existing videoconferencing technology to build workforce capacity. Policy recommendations for expanding evidence-based interventions are also highlighted, with the aim of mitigating the effects of workforce shortages and reducing persistent inequities in access to and quality of care.
Non-traditional roles of immune cells in regeneration: an evolutionary perspective
Authors: Arinda Beryl N. , Innabi Yacoub A. , Grasis Juris A. , Oviedo Néstor J.
Published: May 2022

Immune cells are known to engage in pathogen defense. However, emerging research has revealed additional roles for immune cells, which are independent of their function in the immune response. Here, we underscore the ability of cells outside of the adaptive immune system to respond to recurring infections through the lens of evolution and cellular memory. With this in mind, we then discuss the bidirectional crosstalk between the immune cells and stem cells and present examples where these interactions regulate tissue repair and regeneration. We conclude by suggesting that comprehensive analyses of the immune system may enable biomedical applications in stem cell biology and regenerative medicine.
The origins and roles of osteoclasts in bone development, homeostasis and repair
Authors: Yahara Yasuhito , Nguyen Tuyet , Ishikawa Koji , Kamei Katsuhiko , Alman Benjamin A.
Published: May 2022

The mechanisms underlying bone development, repair and regeneration are reliant on the interplay and communication between osteoclasts and other surrounding cells. Osteoclasts are multinucleated monocyte lineage cells with resorptive abilities, forming the bone marrow cavity during development. This marrow cavity, essential to hematopoiesis and osteoclast-osteoblast interactions, provides a setting to investigate the origin of osteoclasts and their multi-faceted roles. This Review examines recent developments in the embryonic understanding of osteoclast origin, as well as interactions within the immune environment to regulate normal and pathological bone development, homeostasis and repair.
Immune cell-stem cell interactions in regeneration and repair: who's calling the shots?
Authors: Samperio Ventayol Pilar , Bartfeld Sina
Published: May 2022

In November 2021, the Institute for Regenerative Medicine (IRM) and the Institute for Immunology (IFI) at the University of Pennsylvania, USA, joined forces and organized a symposium featuring external speakers as well as locally based scientists to discuss how the immune system influences tissue stem cell biology. As we review here, the presentations highlighted emerging concepts in the field, revealing how tissue-specific immune cell activation can guide stem cells in regeneration and repair.