bluuebunny/crossref_metadata_2025 huggingface dataset:
The cotton swab method: an accurate and less invasive way to assess fecal consistency in weaned pigs
Authors: Eriksen Esben Østergaard , Sejersen Martin Friis , Pedersen Ken Steen
Published: February 2024

Background

Researchers and pig veterinarians are interested in assessing pigs’ fecal consistency. This study developed a standardized protocol and scale for the cotton swab method, which is a way of assessing the fecal consistency in pigs. The accuracy of the cotton swab method was evaluated in weaned pigs using fecal dry-matter analysis as a golden standard. The study also proposed fecal dry-matter percentage thresholds for the categorization of fecal consistency on a four-point scale.

Results

The thresholds of 10.3%, 16.6%, and 21.9% fecal dry-matter were suggested for categorization of the consistency of fecal samples on a four-point scale. The accuracy of the cotton swab method was high. The agreement to the four-point fecal consistency score derived from the fecal dry-matter percentage was almost perfect (weighted Gwet’s agreement coefficient = 0.87 [95% confidence interval: 0.84; 0.91]). The cotton swab method had a sensitivity of 85.0% (95% confidence interval: 76.5; 91.4) and a specificity of 95.2% (95% confidence interval: 92.0; 97.3) when used to diagnose whether pigs had diarrhea or not. For non-diarrheic pigs, the method almost always (n = 287/289) required less handling than the collection of a fecal sample by digital rectal manipulation.

Conclusion

The cotton swab method is an accurate way to assess fecal consistency in pigs, both on a four-point scale and as a dichotomous diarrhea score. The method is quick to perform and less invasive than methods relying on the collection of fecal samples. New fecal dry-matter thresholds between feces of different consistencies were proposed.
Intrauterine devices influence prostaglandin secretion by equine uterus: in vitro and in vivo studies
Authors: Piotrowska-Tomala Katarzyna Karolina , Jonczyk Agnieszka Walentyna , Szóstek-Mioduchowska Anna , Hojo Takuo , Żebrowska Ewelina , Katila Terttu , Ferreira-Dias Graca , Skarzynski Dariusz Jan
Published: February 2024

Background

Intrauterine devices (IUD) are used in the veterinary practice as the non-pharmacological method of oestrus suppression in mares. When placed in the uterus, IUD create a physical contact with the endometrium that mimics the presence of an equine embryo. However, the mechanism of their action has not been fully elucidated. The objective of the present study was to examine the effect of mechanical stimulation of IUD on mare`s endometrium in both in vitro and in vivo study. For this purpose, we demonstrated the effect of IUD on prostaglandin (PG) F2α and PGE2 secretion, and mRNA transcription of genes involved in PG synthesis pathway in equine endometrial cells in vitro. In the in vivo study, we aimed to compare short-term effect of IUD inserted on day 0 (oestrus) with day 5–6 post-ovulation (the specific time when embryo reaches uterus after fertilization) on PG secretion from equine endometrium. To determine the long-term effect on PG synthase mRNA transcription, a single endometrial biopsy was taken only once within each group of mares at certain time points of the estrous cycle from mares placement with IUD on days 0 or 5–6 post-ovualtion.

Results

We showed for the first time that the incubation of the endometrial cells with the presence of IUD altered the pattern of PG synthase mRNA transcription in equine epithelial and stromal endometrial cells. In vivo, in mares placement with IUD on day 0, PGE2 concentrations in blood plasma were upregulated between 1 and 6, and at 10 h after the IUD insertion, compared with the control mares (P < 0.05). Moreover, the decrease of PTGFS mRNA transcription on day 16- 18, associated with an elevation in PTGES mRNA transcription on day 20 -21 of the estrous cycle in endometrial biopsies collected from mares placement with IUD on days 5–6 suggest an antiluteolytic action of IUD during the estrous cycle.

Conclusion

We conclude that the application of IUD may mimic the equine conceptus presence through the physical contact with the endometrium altering PG synthase transcription, and act as a potent modulator of endometrial PG secretion both in vitro and in vivo.
Efficacy of H2O2 inactivated bovine virus diarrhoea virus (BVDV) type 1 vaccine in mice
Authors: Li Cunyuan , Yu Jinming , Wang Yue , Li Xiaoyue , Li Yaxin , An Mingxuan , Ni Wei , Liu Kaiping , Hu Shengwei
Published: February 2024

Background

Bovine viral diarrhea (BVD) is an acute febrile infectious disease caused by the bovine viral diarrhea virus (BVDV), which has brought huge economic losses to the world's cattle industry. At present, commercial inactivated BVDV vaccines may cause some adverse reactions during use. This study aims to develop a safer and more efficient inactivated BVDV vaccine.

Methods

Here, we described the generation and preclinical efficacy of a hydrogen peroxide (H2O2) inactivated BVDV type 1 vaccine in mice, and administered it separately with commercial vaccine (formaldehyde inactivated) in mice to study its efficacy.

Results

The BVDV type 1 IgG, IFN- γ, IL-4 and neutralizing antibody in the serum of the H2O2 inactivated vaccine group can be maintained in mice for 70 days. The IgG level reached its maximum value of 0.67 on the 42nd day, significantly higher than the commercial formaldehyde inactivated BVDV type 1 vaccine. IFN- γ and IL-4 reached their maximum values on the 28th day after immunization, at 123.16 pg/ml and 143.80 pg/ml, respectively, slightly higher than commercial vaccines, but the effect was not significant. At the same time the BVDV—1 neutralizing antibody titer reached a maximum of 12 Nu on the 42nd day post vaccination.

Conclusions

The H2O2 inactivated BVDV vaccine has good safety and immunogenicity, which provides a potential solution for the further development of an efficient and safe BVDV vaccine.
Association of plasma proteomics with incident coronary heart disease in individuals with and without type 2 diabetes: results from the population-based KORA study
Authors: Luo Hong , Huemer Marie-Theres , Petrera Agnese , Hauck Stefanie M. , Rathmann Wolfgang , Herder Christian , Koenig Wolfgang , Hoyer Annika , Peters Annette , Thorand Barbara
Published: February 2024

Background

Coronary heart disease (CHD) is a major global health concern, especially among individuals with type 2 diabetes (T2D). Given the crucial role of proteins in various biological processes, this study aimed to elucidate the aetiological role and predictive performance of protein biomarkers on incident CHD in individuals with and without T2D.

Methods

The discovery cohort included 1492 participants from the Cooperative Health Research in the Region of Augsburg (KORA) S4 study with 147 incident CHD cases (45 vs. 102 cases in the group with T2D and without T2D, respectively) during 15.6 years of follow-up. The validation cohort included 888 participants from the KORA-Age1 study with 70 incident CHD cases (19 vs. 51 cases in the group with T2D and without T2D, respectively) during 6.9 years of follow-up. We measured 233 plasma proteins related to cardiovascular disease and inflammation using proximity extension assay technology. Associations of proteins with incident CHD were assessed using Cox regression and Mendelian randomization (MR) analysis. Predictive models were developed using priority-Lasso and were evaluated on top of Framingham risk score variables using the C-index, category-free net reclassification index (cfNRI), and relative integrated discrimination improvement (IDI).

Results

We identified two proteins associated with incident CHD in individuals with and 29 in those without baseline T2D, respectively. Six of these proteins are novel candidates for incident CHD. MR suggested a potential causal role for hepatocyte growth factor in CHD development. The developed four-protein-enriched model for individuals with baseline T2D (ΔC-index: 0.017; cfNRI: 0.253; IDI: 0.051) and the 12-protein-enriched model for individuals without baseline T2D (ΔC-index: 0.054; cfNRI: 0.462; IDI: 0.024) consistently improved CHD prediction in the discovery cohort, while in the validation cohort, significant improvements were only observed for selected performance measures (with T2D: cfNRI: 0.633; without T2D: ΔC-index: 0.038; cfNRI: 0.465).

Conclusions

This study identified novel protein biomarkers associated with incident CHD in individuals with and without T2D and reaffirmed previously reported protein candidates. These findings enhance our understanding of CHD pathophysiology and provide potential targets for prevention and treatment.
Advantages of transformer and its application for medical image segmentation: a survey
Authors: Pu Qiumei , Xi Zuoxin , Yin Shuai , Zhao Zhe , Zhao Lina
Published: February 2024

Purpose

Convolution operator-based neural networks have shown great success in medical image segmentation over the past decade. The U-shaped network with a codec structure is one of the most widely used models. Transformer, a technology used in natural language processing, can capture long-distance dependencies and has been applied in Vision Transformer to achieve state-of-the-art performance on image classification tasks. Recently, researchers have extended transformer to medical image segmentation tasks, resulting in good models.

Methods

This review comprises publications selected through a Web of Science search. We focused on papers published since 2018 that applied the transformer architecture to medical image segmentation. We conducted a systematic analysis of these studies and summarized the results.

Results

To better comprehend the benefits of convolutional neural networks and transformers, the construction of the codec and transformer modules is first explained. Second, the medical image segmentation model based on transformer is summarized. The typically used assessment markers for medical image segmentation tasks are then listed. Finally, a large number of medical segmentation datasets are described.

Conclusion

Even if there is a pure transformer model without any convolution operator, the sample size of medical picture segmentation still restricts the growth of the transformer, even though it can be relieved by a pretraining model. More often than not, researchers are still designing models using transformer and convolution operators.
Telehealth program for symptomatic COVID-19 patients in Mindanao, Philippines: a whole-of-system, pragmatic interventional study on patient monitoring from isolation facilities to community reintegration
Authors: Punzalan Jaime Kristoffer , Guingona Monserrat , Gregorio Elgie , Ferraren Jhufel , Sta. Elena Mark Anthony , Valaquio Marvin , Arnuco Floro Dave , Punzalan Mary Germeyn , Arciaga Rosemarie , Woolley Torres , Kunting Afdal , Miravite Dulce Amor , Cristobal Fortunato
Published: February 2024

The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic.
Progesterone-induced progesterone receptor membrane component 1 rise-to-decline changes are essential for decidualization
Authors: Liu Hailun , Franken André , Bielfeld Alexandra P. , Fehm Tanja , Niederacher Dieter , Cheng Zhongping , Neubauer Hans , Stamm Nadia
Published: February 2024

Background

Decidualization of endometrial cells is the prerequisite for embryo implantation and subsequent placenta formation and is induced by rising progesterone levels following ovulation. One of the hormone receptors contributing to endometrial homeostasis is Progesterone Receptor Membrane Component 1 (PGRMC1), a non-classical membrane-bound progesterone receptor with yet unclear function. In this study, we aimed to investigate how PGRMC1 contributes to human decidualization.

Methods

We first analyzed PGRMC1 expression profile during a regular menstrual cycle in RNA-sequencing datasets. To further explore the function of PGRMC1 in human decidualization, we implemented an inducible decidualization system, which is achieved by culturing two human endometrial stromal cell lines in decidualization-inducing medium containing medroxyprogesterone acetate and 8-Br-cAMP. In our system, we measured PGRMC1 expression during hormone induction as well as decidualization status upon PGRMC1 knockdown at different time points. We further conferred proximity ligation assay to identify PGRMC1 interaction partners.

Results

In a regular menstrual cycle, PGRMC1 mRNA expression is gradually decreased from the proliferative phase to the secretory phase. In in vitro experiments, we observed that PGRMC1 expression follows a rise-to-decline pattern, in which its expression level initially increased during the first 6 days after induction (PGRMC1 increasing phase) and decreased in the following days (PGRMC1 decreasing phase). Knockdown of PGRMC1 expression before the induction led to a failed decidualization, while its knockdown after induction did not inhibit decidualization, suggesting that the progestin-induced ‘PGRMC1 increasing phase’ is essential for normal decidualization. Furthermore, we found that the interactions of prohibitin 1 and prohibitin 2 with PGRMC1 were induced upon progestin treatment. Knocking down each of the prohibitins slowed down the decidualization process compared to the control, suggesting that PGRMC1 cooperates with prohibitins to regulate decidualization.

Conclusions

According to our findings, PGRMC1 expression followed a progestin-induced rise-to-decline expression pattern during human endometrial decidualization process; and the correct execution of this expression program was crucial for successful decidualization. Thereby, the results of our in vitro model explained how PGRMC1 dysregulation during decidualization may present a new perspective on infertility-related diseases.
Impact of oil-based contrast agents in hysterosalpingography on fertility outcomes in endometriosis: a retrospective cohort study
Authors: Xie Baoli , Huang Yingqin , Hang Fu , Yu Jiaxin , Hu Qianwen , Li Jiaxu , Qin Aiping
Published: February 2024

Background

Previous studies have suggested that oil-based contrast agents used during hysterosalpingography (HSG) in infertile patients can enhance fertility. However, limited research has investigated the effect of oil-based contrast medium specifically in individuals with endometriosis-related infertility.

Objective

This study aims to explore the impact of oil-based contrast medium on fertility outcomes in women with endometriosis-related infertility.

Methods

Conducted at the First Affiliated Hospital of Guangxi Medical University (January 2020 to June 2022), the study included 512 patients undergoing HSG. Patients were categorized into oil-based and non-oil-based groups, and after propensity score matching, demographic characteristics were compared. Main outcomes included clinical pregnancy rates, live birth rates, early miscarriage rates, and ectopic pregnancy rates.

Results

In our analysis, the Oil-based group showed significantly better outcomes compared to the Non-oil-based group. Specifically, the Oil-based group had higher clinical pregnancy rates (51.39% vs. 27.36%) and increased live birth rates (31.48% vs. 19.93%). This trend held true for expectant treatment, IUI, and IVF/ICSI, except for surgical treatment where no significant difference was observed. After adjusting for various factors using propensity score matching, the Non-oil-based group consistently exhibited lower clinical pregnancy rates compared to the Oil-based group. The Odds Ratio (OR) was 0.38 (95%CI: 0.27–0.55) without adjustment, 0.34 (0.22–0.51) in multivariable analysis, 0.39 (0.27–0.57) using inverse probability of treatment weighting (IPTW), and 0.22 (0.14–0.35) in propensity score matching.

Conclusion

Oil-based contrast medium used in HSG for women with endometriosis-related infertility is associated with higher clinical pregnancy rates and live birth rates compared to Non-oil-based contrast medium.
Integrating cfDNA liquid biopsy and organoid-based drug screening reveals PI3K signaling as a promising therapeutic target in colorectal cancer
Authors: Yang Huan , Xiao Xing , Zeng Leli , Zeng Haiteng , Zheng Yueyuan , Wang Jingshu , Li Guanghua , Dai Weigang , He Yulong , Wang Suihai , Peng Jianjun , Chen Wei
Published: February 2024

Background

The current precision medicine relies on biomarkers, which are mainly obtained through next-generation sequencing (NGS). However, this model failed to find effective drugs for most cancer patients. This study tried to combine liquid biopsy with functional drug tests using organoid models to find potential drugs for cancer patients.

Methods

Colorectal cancer (CRC) patients were prospectively enrolled and blood samples were collected from patients before the start of treatment. Targeted deep sequencing of cfDNA samples was performed using a 14-gene panel. Gastrointestinal (GI) cancer organoids were established and PI3K and mTOR inhibitors were evaluated on organoid models.

Results

A total of 195 mutations were detected across 58 cfDNA samples. The most frequently mutated genes were KRAS, TP53, PIK3CA, and BRAF, all of which exhibited higher mutation rates than tissue biopsy. Although 81% of variants had an allele frequency of less than 1%, certain mutations in KRAS, TP53, and SMAD4 had high allele frequencies exceeding 10%. Notably, among the seven patients with high allele frequency mutations, six had metastatic tumors, indicating that a high allele frequency of ctDNA could potentially serve as a biomarker of later-stage cancer. A high rate of PIK3CA mutation (31 out of 67, or 46.3%) was discovered in CRC patients, suggesting possible tumor progression mechanisms and targeted therapy opportunities. To evaluate the value of anti PI3K strategy in GI cancer, different lines of GI cancer organoids were established. The organoids recapitulated the morphologies of the original tumors. Organoids were generally insensitive to PI3K inhibitors. However, CRC-3 and GC-4 showed response to mTOR inhibitor Everolimus, and GC-3 was sensitive to PI3Kδ inhibitor Idelalisib. The CRC organoid with a PIK3CA mutation showed greater sensitivity to the PI3K inhibitor Alpelisib than wildtype organoids, suggesting potential treatment options for the corresponding patients.

Conclusion

Liquid biopsy holds significant promise for improving precision treatment and tumor prognosis in colorectal cancer patients. The combination of biomarker-based drug prediction with organoid-based functional drug sensitivity assay may lead to more effective cancer treatment.
Pathogenomics for accurate diagnosis, treatment, prognosis of oncology: a cutting edge overview
Authors: Feng Xiaobing , Shu Wen , Li Mingya , Li Junyu , Xu Junyao , He Min
Published: February 2024

The capability to gather heterogeneous data, alongside the increasing power of artificial intelligence to examine it, leading a revolution in harnessing multimodal data in the life sciences. However, most approaches are limited to unimodal data, leaving integrated approaches across modalities relatively underdeveloped in computational pathology. Pathogenomics, as an invasive method to integrate advanced molecular diagnostics from genomic data, morphological information from histopathological imaging, and codified clinical data enable the discovery of new multimodal cancer biomarkers to propel the field of precision oncology in the coming decade. In this perspective, we offer our opinions on synthesizing complementary modalities of data with emerging multimodal artificial intelligence methods in pathogenomics. It includes correlation between the pathological and genomic profile of cancer, fusion of histology, and genomics profile of cancer. We also present challenges, opportunities, and avenues for future work.
Monocyte alteration in elderly hip fracture healing: monocyte promising role in bone regeneration
Authors: Shema Clement , Lu Yining , Wang Ling , Zhang Yingze
Published: February 2024

Individual aged with various change in cell and cellular microenvironments and the skeletal system undergoes physiological changes that affect the process of bone fracture healing. These changes are accompanied by alterations in regulating critical genes involved in this healing process. Unfortunately, the elderly are particularly susceptible to hip bone fractures, which pose a significant burden associated with higher morbidity and mortality rates. A notable change in older adults is the increased expression of activation, adhesion, and migration markers in circulating monocytes. However, there is a decrease in the expression of co-inhibitory molecules. Recently, research evidence has shown that the migration of specific monocyte subsets to the site of hip fracture plays a crucial role in bone resorption and remodeling, especially concerning age-related factors. In this review, we summarize the current knowledge about uniqueness characteristics of monocytes, and their potential regulation and moderation to enhance the healing process of hip fractures. This breakthrough could significantly contribute to the comprehension of aging process at a fundamental aging mechanism through this initiative would represent a crucial stride for diagnosing and treating age related hip fracture.
NSF DARE—transforming modeling in neurorehabilitation: perspectives and opportunities from US funding agencies
Authors: Hwang Grace M. , Kulwatno Jonathan , Cruz Theresa H. , Chen Daofen , Ajisafe Toyin , Monaco Joseph D. , Nitkin Ralph , George Stephanie M. , Lucas Carol , Zehnder Steven M. , Zhang Lucy T.
Published: February 2024

In recognition of the importance and timeliness of computational models for accelerating progress in neurorehabilitation, the U.S. National Science Foundation (NSF) and the National Institutes of Health (NIH) sponsored a conference in March 2023 at the University of Southern California that drew global participation from engineers, scientists, clinicians, and trainees. This commentary highlights promising applications of computational models to understand neurorehabilitation (“Using computational models to understand complex mechanisms in neurorehabilitation” section), improve rehabilitation care in the context of digital twin frameworks (“Using computational models to improve delivery and implementation of rehabilitation care” section), and empower future interdisciplinary workforces to deliver higher-quality clinical care using computational models (“Using computational models in neurorehabilitation requires an interdisciplinary workforce” section). The authors describe near-term gaps and opportunities, all of which encourage interdisciplinary team science. Four major opportunities were identified including (1) deciphering the relationship between engineering figures of merit—a term commonly used by engineers to objectively quantify the performance of a device, system, method, or material relative to existing state of the art—and clinical outcome measures, (2) validating computational models from engineering and patient perspectives, (3) creating and curating datasets that are made publicly accessible, and (4) developing new transdisciplinary frameworks, theories, and models that incorporate the complexities of the nervous and musculoskeletal systems. This commentary summarizes U.S. funding opportunities by two Federal agencies that support computational research in neurorehabilitation. The NSF has funding programs that support high-risk/high-reward research proposals on computational methods in neurorehabilitation informed by theory- and data-driven approaches. The NIH supports the development of new interventions and therapies for a wide range of nervous system injuries and impairments informed by the field of computational modeling. The conference materials can be found at https://dare2023.usc.edu/.
Completing the picture of field-grown cereal crops: a new method for detailed leaf surface models in wheat
Authors: Theiß Marie , Steier Angelina , Rascher Uwe , Müller-Linow Mark
Published: February 2024

Background

The leaf angle distribution (LAD) is an important structural parameter of agricultural crops that influences light interception, radiation fluxes and consequently plant performance. Therefore, LAD and its parametrized form, the Beta distribution, is used in many photosynthesis models. However, in field cultivations, these parameters are difficult to assess and cereal crops in particular pose challenges since their leaves are thin, flexible, and often bent and twisted around their own axis. To our knowledge, there is only a very limited set of methods currently available to calculate LADs of field-grown cereal crops that explicitly takes these special morphological properties into account.

Results

In this study, a new processing pipeline is introduced that allows for the generation of realistic leaf surface models and the analysis of LADs of field-grown cereal crops from 3D point clouds. The data acquisition is based on a convenient stereo imaging setup. The approach was validated with different artificial targets and results on the accuracy of the 3D reconstruction, leaf surface modeling and calculated LAD are given. The mean error of the 3D reconstruction was below 1 mm for an inclination angle range between 0° and 75° and the leaf surface could be quantified with an average accuracy of 90%. The concordance correlation coefficient (CCC) of 99.6% (p-value = $$1.5* {10}^{-29}$$1.5∗10-29) indicated a high correlation between the reconstructed inclination angle and the identity line. The LADs for bent leaves were reconstructed with a mean error of 0.21° and a standard deviation of 1.55°. As an additional parameter, the insertion angle was reconstructed for the artificial leaf model with an average error < 5°. Finally, the method was tested with images of field-grown cereal crops and Beta functions were approximated from the calculated LADs. The mean CCC between reconstructed LAD and calculated Beta function was 0.66. According to Cohen, this indicates a high correlation.

Conclusion

This study shows that our image processing pipeline can reconstruct the complex leaf shape of cereal crops from stereo images. The high accuracy of the approach was demonstrated with several validation experiments including artificial leaf targets. The derived leaf models were used to calculate LADs for artificial leaves and naturally grown cereal crops. This helps to better understand the influence of the canopy structure on light absorption and plant performance and allows for a more precise parametrization of photosynthesis models via the derived Beta distributions.
A hyperspectral deep learning attention model for predicting lettuce chlorophyll content
Authors: Ye Ziran , Tan Xiangfeng , Dai Mengdi , Chen Xuting , Zhong Yuanxiang , Zhang Yi , Ruan Yunjie , Kong Dedong
Published: February 2024

Background

The phenotypic traits of leaves are the direct reflection of the agronomic traits in the growth process of leafy vegetables, which plays a vital role in the selection of high-quality leafy vegetable varieties. The current image-based phenotypic traits extraction research mainly focuses on the morphological and structural traits of plants or leaves, and there are few studies on the phenotypes of physiological traits of leaves. The current research has developed a deep learning model aimed at predicting the total chlorophyll of greenhouse lettuce directly from the full spectrum of hyperspectral images.

Results

A CNN-based one-dimensional deep learning model with spectral attention module was utilized for the estimate of the total chlorophyll of greenhouse lettuce from the full spectrum of hyperspectral images. Experimental results demonstrate that the deep neural network with spectral attention module outperformed the existing standard approaches, including partial least squares regression (PLSR) and random forest (RF), with an average R2 of 0.746 and an average RMSE of 2.018.

Conclusions

This study unveils the capability of leveraging deep attention networks and hyperspectral imaging for estimating lettuce chlorophyll levels. This approach offers a convenient, non-destructive, and effective estimation method for the automatic monitoring and production management of leafy vegetables.
Bidirectional two-sample Mendelian randomization analysis identifies causal associations between cardiovascular diseases and frozen shoulder
Authors: Lu WeiSong , Pu Bin , Wang Sen , Li MengZe , An Yue , Lian Jie , Wang YongQuan
Published: February 2024

Background

Although prior observational studies indicate an association between cardiovascular diseases (CVDs) and frozen shoulder (FS), the potential causal relationship between them remains uncertain. This study aims to explore the genetic causal relationship between CVDs and FS using Mendelian randomization (MR).

Methods

Genetic variations closely associated with FS were obtained from the FinnGen Consortium. Summary data for CVD, including atrial fibrillation (AF), coronary artery disease (CAD), heart failure (HF), myocardial infarction (MI), stroke, and ischemic stroke (IS), were sourced from several large-scale genome-wide association studies (GWAS). MR analysis was performed using inverse variance weighting (IVW), MR Egger, and weighted median methods. IVW, as the primary MR analysis method, complemented by other sensitivity analyses, was utilized to validate the robustness of the results. Further reverse MR analysis was conducted to explore the presence of reverse causal relationships.

Results

In the forward MR analysis, genetically determined risk of stroke and IS was positively associated with FS (OR [95% CI] = 1.58 (1.23–2.03), P < 0.01; OR [95% CI] = 1.46 (1.16–1.85), P < 0.01, respectively). There was no strong evidence of an effect of genetically predicted other CVDs on FS risk. Sensitivity analyses confirmed the robustness of the results. In the reverse MR analysis, no causal relationships were observed between FS and various CVDs.

Conclusion

The study suggests that stroke increases the risk of developing FS. However, further basic and clinical research is needed to substantiate our findings.
Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap
Authors: Zhu Lixi , Zhou Feiya , Zhang Xian , Zhang Xue , Jin Pinghu
Published: February 2024

Purpose

The reconstruction of medium-sized soft tissue defects of the fingertip remains a challenge for hand surgeons. The aim of this study was to compare the outcomes of modified triangular neurovascular unilateral advancement flap and digital artery dorsal perforator flap in the treatment of this injury.

Methods

From May 2018 to May 2022, 70 patients with medium-sized volar soft tissue defects were enrolled. The patients were divided into two groups based on the flap type: modified triangular neurovascular unilateral advancement flap (Group A) and digital artery dorsal perforator flap (Group B). The debridement times, defect size, operation time, and flap survival rate were recorded. At follow-up, hand function, aesthetics, and complications were evaluated. Function was evaluated using the TAM score. The aesthetics of the reconstructed and donor sites were assessed using the vancouver scar scale (VSS). The static two-point discrimination of the finger pulp served as a measure of tactile agnosia.

Results

A total of 10 patients were lost to follow-up for various reasons, resulting in 30 cases remaining in each group. The general information of the two groups showed no significant differences in age, sex, injury side, cause of injury, time from injury to surgery, and operation time (P > 0.05). Additionally, the debridement times and size of the defect were similar between the groups (P > 0.05). However, the operation time was significantly shorter in Group A compared to Group B (P = 0.001). With regard to complications, there was no significant difference between them. At one-month follow-up, TAM scores indicated that Group B performed significantly better than Group A. However, at the final follow-up period, there was no significant difference in TAM scores between the two groups. When considering the VSS, significant differences were observed between the two groups in both the reconstructed site and donor site.

Conclusion

Both flaps can effectively repair medium-sized fingertip defects. Furthermore, the modified triangular neurovascular unilateral advancement flap offers anatomical reconstruction possibilities, ensuring satisfactory sensation and cosmetic contour.
No cupid, just an arrow: a penetrating injury into the interventricular septum
Authors: Lehtinen Miia , Nykänen Antti , Raivio Peter
Published: February 2024

Background

Penetrating cardiac injuries are rare but often fatal, with 16–55% mortality. We report a patient who suffered a non-fatal occupational cardiac injury.

Case presentation

A 47-year-old man was operating an ironworker machine. A thin 3-cm metal fragment catapulted from the machine piercing the chest wall and the right ventricular outflow tract (RVOT), burrowing into the interventricular septum (IVS). The patient remained hemodynamically stable and walked to the nearest hospital. ECG-gated computed tomography revealed the exact location of the fragment within the IVS, allowing for detailed preoperative planning. The fragment was removed through a sternotomy and an incision through the RVOT. The postoperative course was uneventful.

Conclusions

This case underscores the value of detailed preoperative imaging and the wide spectrum of clinical scenarios of penetrating cardiac injuries.
Right-sided infective endocarditis or thrombus? Report of two cases diagnosed by transthoracic echocardiography
Authors: Ge Wenjing , Wu Bijun , Wang Zhen , Zhang Haichun
Published: February 2024

Background

Right-sided infective endocarditis (RSIE) is a relatively uncommon condition which is difficult to distinguish from thrombus, particularly when the site of infection or the patient’s symptoms are atypical. There have been few reports exploring the differential diagnostic and analytical features between RSIE and thrombus.

Case presentation

Here, we presented two cases of RSIE—one involving the tricuspid valve and the other affecting the pulmonary artery. Notably, the second case was initially misdiagnosed as thrombus based on the findings of by computed tomography angiography(CTA).

Conclusions

Vegetation and thrombus can be distinguished according to the nature of the mass, its attachment location, and the clinical manifestation. Echocardiography can observe both the location and size of the mass, and the dynamic changes in cardiac hemodynamics and cardiac morphology, thereby facilitating an effective distinction between vegetation and thrombus.
Tracheal resection anastomosis for rare tracheal inflammatory lesions mimicking malignancy: report of 2 cases
Authors: Abd-Elfattah Ahmed Musaad , Gaafar Alaa , Ebada Hisham Atef , Seif-Elnasr Mahmoud , Domain Ahmed , Habaza Fedaey Ramadan , Zalata Khaled , Tawfik Ali
Published: February 2024

Background

Tumor-like lesions of the trachea are rare and challenging in diagnosis and management. Inflammatory myofibroblastoma, also known as Inflammatory pseudo tumors (IPTs), as well as Rosai Dorfman Disease (RDD) are inflammatory lesions that may involve the central airways with variable non-specific clinical features mimicking tumors.

Case presentation

In this study 2 cases with tumor-like lesions are presented. One case with an inflammatory pseudotumor and the other one with Rosai–Dorfman disease affecting the upper trachea. Both cases were successfully managed with tracheal resection anastomosis.

Conclusion

Tracheal Inflammatory myofibroblastoma, and Rosai–Dorfman diseases are rare tumor like lesions that present with upper airway obstruction. Despite being benign, these lesions may have features suggestive of malignancy, requiring prompt management. Complete surgical excision by segmental resection and primary anastomosis (if feasible) is the treatment of choice with an optimum outcome.
Asymptomatic esophageal perforation discovered after elective cardiac surgery: the importance of clinical awareness
Authors: Hasami N. A. , Li W. W. L. , Smith T. , Verhagen A. F. T. M. , Ko K. , Heijmen R. H.
Published: February 2024

Transesophageal echocardiography (TEE) has become an indispensable part of cardiothoracic surgery at present and is considered to be a safe procedure, rarely associated with complications. However, TEE may cause serious and life threatening complications, as presented in this case report. We describe a patient who developed an empyema after elective cardiac surgery due to an esophageal perforation caused by TEE, without any clinical symptoms. Risk factors for TEE-related complications, identified in recent literature, will be discussed as well as the remarkable absence of clinical symptoms in this particular patient.
Integrated traditional Chinese and Western medicine in the prevention and treatment of non-alcoholic fatty liver disease: future directions and strategies
Authors: Ding Xin , He Xu , Tang Bulang , Lan Tian
Published: February 2024

Traditional Chinese medicine (TCM) has been widely used for several centuries for metabolic diseases, including non-alcoholic fatty liver disease (NAFLD). At present, NAFLD has become the most prevalent form of chronic liver disease worldwide and can progress to non-alcoholic steatohepatitis (NASH), cirrhosis, and even hepatocellular carcinoma. However, there is still a lack of effective treatment strategies in Western medicine. The development of NAFLD is driven by multiple mechanisms, including genetic factors, insulin resistance, lipotoxicity, mitochondrial dysfunction, endoplasmic reticulum stress, inflammation, gut microbiota dysbiosis, and adipose tissue dysfunction. Currently, certain drugs, including insulin sensitizers, statins, vitamin E, ursodeoxycholic acid and betaine, are proven to be beneficial for the clinical treatment of NAFLD. Due to its complex pathogenesis, personalized medicine that integrates various mechanisms may provide better benefits to patients with NAFLD. The holistic view and syndrome differentiation of TCM have advantages in treating NAFLD, which are similar to the principles of personalized medicine. In TCM, NAFLD is primarily classified into five types based on clinical experience. It is located in the liver and is closely related to spleen and kidney functions. However, due to the multi-component characteristics of traditional Chinese medicine, its application in the treatment of NAFLD has been considerably limited. In this review, we summarize the advances in the pathogenesis and treatment of NAFLD, drawn from both the Western medicine and TCM perspectives. We highlight that Chinese and Western medicine have complementary advantages and should receive increased attention in the prevention and treatment of NAFLD.
Anticipating and strategizing to address potential bottlenecks during clinical research projects in sub-Saharan Africa: a case for adapting approaches and tools used in the entrepreneurial and development sectors
Authors: Saidu Yauba , Nchinjoh Sangwe Clovis , Adidja Amani , Besong Andreas Frambo , Netongo Palmer Masumbe , Ndom Paul , Liebermann Marya
Published: February 2024

Many research funders have invested billions of US dollars in building research capacity in sub-Saharan Africa (SSA). Despite these colossal investments, many well-intentioned and designed clinical research projects have either failed to kick off or ended abruptly. Although obstacles to clinical research in SSA are well known, there is limited information on frameworks and tools that can be used to anticipate and avert these systemic bottlenecks, particularly those related to socio-politics. In this paper, we leveraged lessons from entrepreneurs and development experts in harsh and uncertain business environments to develop a framework for anticipating and addressing potential bottlenecks to clinical research in SSA. More so, to illustrate and build a case for this framework, we shared our experience in supporting clinicians and regulators to adopt a point-of-use care tool, the “chemoPAD,” to screen for the quality of anticancer medications rapidly and systematically in Cameroon despite resistance from some stakeholders. The critical steps in this framework involve identifying stakeholders, categorizing them based on their potential reactions to the study (adversary, supporters, and indifferents), and developing critical strategies to engage or deal with each stakeholder’s reactions, starting with adversaries. This approach may be useful in complex research projects, especially clinical trials, which often involve many stakeholders with different interests and perceptions.
Cancer Precision-Prevention trial of Metformin in adults with Li Fraumeni syndrome (MILI) undergoing yearly MRI surveillance: a randomised controlled trial protocol
Authors: Dixon-Zegeye Miriam , Shaw Rachel , Collins Linda , Perez-Smith Kendra , Ooms Alexander , Qiao Maggie , Pantziarka Pan , Izatt Louise , Tischkowitz Marc , Harrison Rachel E. , George Angela , Woodward Emma R. , Lord Simon , Hawkes Lara , Evans D. Gareth , Franklin James , Hanson Helen , Blagden Sarah P.
Published: February 2024

Background

Li-Fraumeni syndrome (LFS) is a rare autosomal dominant disease caused by inherited or de novo germline pathogenic variants in TP53. Individuals with LFS have a 70–100% lifetime risk of developing cancer. The current standard of care involves annual surveillance with whole-body and brain MRI (WB-MRI) and clinical review; however, there are no chemoprevention agents licensed for individuals with LFS. Preclinical studies in LFS murine models show that the anti-diabetic drug metformin is chemopreventive and, in a pilot intervention trial, short-term use of metformin was well-tolerated in adults with LFS. However, metformin’s mechanism of anticancer activity in this context is unclear.

Methods

Metformin in adults with Li-Fraumeni syndrome (MILI) is a Precision-Prevention phase II open-labelled unblinded randomised clinical trial in which 224 adults aged ≥ 16 years with LFS are randomised 1:1 to oral metformin (up to 2 mg daily) plus annual MRI surveillance or annual MRI surveillance alone for up to 5 years. The primary endpoint is to compare cumulative cancer-free survival up to 5 years (60 months) from randomisation between the intervention (metformin) and control (no metformin) arms. Secondary endpoints include a comparison of cumulative tumour-free survival at 5 years, overall survival at 5 years and clinical characteristics of emerging cancers between trial arms. Safety, toxicity and acceptability of metformin; impact of metformin on quality of life; and impact of baseline lifestyle risk factors on cancer incidence will be assessed. Exploratory end-points will evaluate the mechanism of action of metformin as a cancer preventative, identify biomarkers of response or carcinogenesis and assess WB-MRI performance as a diagnostic tool for detecting cancers in participants with LFS by assessing yield and diagnostic accuracy of WB-MRI.

Discussion

Alongside a parallel MILI study being conducted by collaborators at the National Cancer Institute (NCI), MILI is the first prevention trial to be conducted in this high-risk group. The MILI study provides a unique opportunity to evaluate the efficacy of metformin as a chemopreventive alongside exploring its mechanism of anticancer action and the biological process of mutated P53-driven tumourigenesis.

Trial registration

ISRCTN16699730. Registered on 28 November 2022. URL: https://www.isrctn.com/ EudraCT/CTIS number 2022-000165-41.
A multicenter double-blind randomized crossover study comparing the impact of dorsal subthalamic nucleus deep brain stimulation versus standard care on apathy in Parkinson’s disease: a study protocol
Authors: Zoon T. J. C. , van Rooijen G. , Contarino M. F. , van der Gaag S. , Zutt R. , van Asseldonk J. T. , van den Munckhof P. , Schuurman P. R. , Denys D. A. J. P. , de Bie R. M. A.
Published: February 2024

Background

Neuroimaging studies suggest an association between apathy after deep brain stimulation (DBS) and stimulation of the ventral part of the subthalamic nucleus (STN) due to the associative fibers connected to the non-motor limbic circuits that are involved in emotion regulation and motivation. We have previously described three patients with severe apathy that could be fully treated after switching stimulation from a ventral electrode contact point to a more dorsal contact point.

Objectives

To determine whether more dorsal stimulation of the STN decreases apathy compared to standard care in a multicenter randomized controlled trial with a crossover design.

Methods

We will include 26 patients with a Starkstein Apathy Scale (SAS) score of 14 or more after subthalamic nucleus (STN) deep brain stimulation (DBS) for refractory Parkinson’s disease. This is a multicenter trial conducted in two teaching hospitals and one university medical center in the Netherlands after at least 3 months of STN DBS. Our intervention will consist of 1 month of unilateral dorsal STN stimulation compared to treatment as usual. The primary outcome is a change in SAS score following 1 month of DBS on the original contact compared to the SAS score following 1 month of DBS on the more dorsal contact. Secondary outcomes are symptom changes on the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale motor part III, Montgomery-Åsberg Depression Rating Scale, 39-item Parkinson’s disease questionnaire, Parkinson’s disease impulsive-compulsive disorders questionnaire, changes in levodopa-equivalent daily dosage, apathy rated by the caregiver, and burden and quality of life of the caregiver.

Trial registration

ClinicalTrials.gov NL8279. Registered on January 10, 2020.