Ethylene produced in carpel primordia controls CmHB40 expression to inhibit stamen development.

Sex determination evolved to control the development of unisexual flowers. In agriculture, it conditions how plants are cultivated and bred. We investigated how female flowers develop in monoecious cucurbits. We discovered in melon, Cucumis melo, a mechanism in which ethylene produced in the carpel is perceived in the stamen primordia through spatially differentially expressed ethylene receptors. Subsequently, the CmEIN3/CmEIL1 ethylene signalling module, in stamen primordia, activates the expression of CmHB40, a transcription factor that downregulates genes required for stamen development and upregulates genes associated with organ senescence. Investigation of melon genetic biodiversity revealed a haplotype, originating in Africa, altered in EIN3/EIL1 binding to CmHB40 promoter and associated with bisexual flower development. In contrast to other bisexual mutants in cucurbits, CmHB40 mutations do not alter fruit shape. By disentangling fruit shape and sex-determination pathways, our work opens up new avenues in plant breeding.

How ambient temperature affects the heading date of foxtail millet (Setaria italica).

Foxtail millet (Setaria italica), a short-day plant, is one of the important crops for food security encountering climate change, particularly in regions where it is a staple food. Under the short-day condition in Taiwan, the heading dates (HDs) of foxtail millet accessions varied by genotypes and ambient temperature (AT). The allelic polymorphisms in flowering time (FT)-related genes were associated with HD variations. AT, in the range of 13°C-30°C that was based on field studies at three different latitudes in Taiwan and observations in the phytotron at four different AT regimes, was positively correlated with growth rate, and high AT promoted HD. To elucidate the molecular mechanism of foxtail millet HD, the expression of 14 key FT-related genes in four accessions at different ATs was assessed. We found that the expression levels of SiPRR95, SiPRR1, SiPRR59, SiGhd7-2, SiPHYB, and SiGhd7 were negatively correlated with AT, whereas the expression levels of SiEhd1, SiFT11, and SiCO4 were positively correlated with AT. Furthermore, the expression levels of SiGhd7-2, SiEhd1, SiFT, and SiFT11 were significantly associated with HD. A coexpression regulatory network was identified that shown genes involved in the circadian clock, light and temperature signaling, and regulation of flowering, but not those involved in photoperiod pathway, interacted and were influenced by AT. The results reveal how gene × temperature and gene × gene interactions affect the HD in foxtail millet and could serve as a foundation for breeding foxtail millet cultivars for shift production to increase yield in response to global warming.

Effect of early interventions with manual lymphatic drainage and rehabilitation exercise on morbidity and lymphedema in patients with oral cavity cancer.

BACKGROUND: There are clinical and statistical inconsistencies regarding early intervention with manual lymphatic drainage (MLD). The purpose of this study was to compare the short-term effect of early interventions with rehabilitation exercise versus MLD and rehabilitation exercise in terms of pain, range of motion (ROM) and lymphedema in patients with oral cancer after surgery. METHODS: A total of 39 patients who underwent surgery from December 2014 to December 2018 participated in this randomized single-blind study. There were 20 patients in the rehabilitation (R) group and 19 in the MLD (M) plus rehabilitation group. The R group received 30 minutes of rehabilitation intervention; and the M group received 30 minutes of MLD, in addition to 30 minutes of rehabilitation intervention in a work day. Clinical measures, including the visual analog pain scale (VAS), ROM of the neck and shoulder, ultrasonography and face distance for lymphedema, and the Földi and Miller lymphedema scales, were assessed before surgery, before intervention and when discharged from the hospital. RESULTS: The VAS pain score, ROM of the neck, and internal and external rotation of the right shoulder were significantly improved after the interventions. Right-face distance (P = .005), and skin-to-bone distance (SBD) of the bilateral horizontal mandible and left ascending mandibular ramus were significantly improved after the interventions. Left lateral flexion of the neck (P = .038) and SBD of the right ascending mandibular ramus (P < .001) in the MLD group showed more improvement than that of the rehabilitation group. CONCLUSION: Early intervention with MLD and the rehabilitation program were effective in improving ROM of the neck and controlling lymphedema in acute-phase rehabilitation. The preliminary findings suggest a potential therapeutic role for early intervention with MLD, in addition to rehabilitation exercise, in that they yielded more benefits in lymphedema control and improvement of ROM of the neck in acute care.

Traumatic giant cell tumor of rib: A case report.

BACKGROUND: Giant cell tumor (GCT) of the anterior rib origin is extremely rare. We report the first case of trauma-induced GCT of the rib. CASE SUMMARY: A 22-year-old female developed a mass over the right anterior chest wall with pain 3 mo after a falling injury with blunt trauma of the right chest wall. Chest computed tomography (CT) showed a tumor originating from the right 6th rib with bony destruction, and a CT-guided needle biopsy revealed a GCT. We completely resected the tumor with chest wall and performed reconstruction. The pathological diagnosis was GCT of the bone. Twelve months after surgery, no signs of recurrence were observed. CONCLUSION: GCT of the rib after trauma has not been reported. Meticulous history-taking and image evaluation are essential for the differential diagnosis of unusual chest wall tumors.

High SUVmax Is an Independent Predictor of Higher Diagnostic Accuracy of ROSE in EBUS-TBNA for Patients with NSCLC.

Introduction: This study aimed to verify the predictors of the diagnostic accuracy of rapid on-site evaluation (ROSE) in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) among patients with non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed consecutive patients with NSCLC who underwent EBUS-TBNA for staging or diagnosis at our hospital from June 2016 to June 2018. The patients were divided into two groups­those with a correct diagnosis and an incorrect diagnosis after ROSE. Kaplan−Meier plots and log-rank tests were used to estimate outcomes. Results: A total of 84 patients underwent EBUS-TBNA for staging and diagnosis. Sixty patients with demonstrated malignant mediastinal lymph nodes were enrolled. In the univariate analysis, lymph nodes < 1.5 cm (HR = 3.667, p = 0.031) and a SUVmax > 5 (HR = 41, p = 0.001) were statistically significant for diagnostic accuracy of ROSE. In the multivariate Cox regression analysis, only a SUVmax > 5 (HR = 20.258, p = 0.016) was statistically significant. Conclusions: A SUVmax > 5 is an independent predictor of higher diagnostic accuracy of ROSE in EBUS-TBNA in patients with NSCLC with malignant mediastinal lymph nodes. Therefore, ROSE in patients with a SUVmax < 5 might not be reliable and requires further prudent assessment (more shots or repeated biopsies at mediastinal LNs) in clinical practice.

Overbooking for physical examination considering late cancellation and set-resource relationship.

BACKGROUND: Late cancellations of physical examination has severe impact on the operations of a physical examination center since it is often too late to fill vacancy. A booking control policy that considers overbooking is then one natural solution. Unlike appointment scheduling problems for clinics and hospitals, in which treating a patient mostly requires only one type of resource, a physical examination set typically requires multiple types of resources. Traditional methods that do not consider set-resource relationship thus may be inapplicable. METHODS: We formulate a stochastic mathematical programming model that maximizes the expected net reward, which is the examination revenue minus overage cost. A complete search algorithm and a greedy search algorithm are designed to search for optimal booking limits for all examination sets. To estimate the late cancellation probability for each individual consumer, we apply logistic regression to identify significant factors affecting the probability. After clustering is used to estimate individual probabilities, Monte Carlo simulation is conducted to generate probability distributions for the number of consumers without late cancellations. A discrete-event simulation is performance to evaluate the effectiveness of our proposed solution. RESULTS: We collaborate with a leading physical examination center to collect real data to evaluate our proposed overbooking policies. We show that the proposed overbooking policy may significantly increase the expected net reward. Our simulation results also help us understand the impact of overbooking on the expected number of customers and expected overage. A sensitivity analysis is conducted to demonstrate that the benefit of overbooking is insensitive to the accuracy of cost estimation. A Pareto efficiency analysis gives practitioners suggestions regarding policy determination considering multiple performance indications. CONCLUSIONS: Our proposed overbooking policies may greatly enhance the overall performance of a physical examination center.

Incorporating the Breast Imaging Reporting and Data System Lexicon with a Fully Convolutional Network for Malignancy Detection on Breast Ultrasound.

In this study, we applied semantic segmentation using a fully convolutional deep learning network to identify characteristics of the Breast Imaging Reporting and Data System (BI-RADS) lexicon from breast ultrasound images to facilitate clinical malignancy tumor classification. Among 378 images (204 benign and 174 malignant images) from 189 patients (102 benign breast tumor patients and 87 malignant patients), we identified seven malignant characteristics related to the BI-RADS lexicon in breast ultrasound. The mean accuracy and mean IU of the semantic segmentation were 32.82% and 28.88, respectively. The weighted intersection over union was 85.35%, and the area under the curve was 89.47%, showing better performance than similar semantic segmentation networks, SegNet and U-Net, in the same dataset. Our results suggest that the utilization of a deep learning network in combination with the BI-RADS lexicon can be an important supplemental tool when using ultrasound to diagnose breast malignancy.

Three novel alleles of FLOURY ENDOSPERM2 (FLO2) confer dull grains with low amylose content in rice.

Rice is a major food source for much of the world, and expanding our knowledge of genes conferring specific rice grain attributes will benefit both farmer and consumer. Here we present novel dull grain mutants with a low amylose content (AC) derived from mutagenesis of Oryza sativa, ssp. japonica cv. Taikeng 8 (TK8). Positional cloning of the gene conferring the dull grain phenotype revealed a point mutation located at the acceptor splice site of intron 11 of FLOURY ENDOSPERM2 (FLO2), encoding a tetratricopeptide repeat domain (TPR)-containing protein. Three novel flo2 alleles were identified herein, which surprisingly conferred dull rather than floury grains. The allelic diversity of flo2 perturbed the expression of starch synthesis-related genes including OsAGPL2, OsAGPS2b, OsGBSSI, OsBEI, OsBEIIb, OsISA1, and OsPUL. The effect of the flo2 mutations on the physicochemical properties of the grain included a low breakdown, setback, and consistency of rice, indicating a good elasticity and soft texture of cooked rice grains. The effects of FLO2, combined with the genetic background of the germplasm and environmental effects, resulted in a variety of different amylose content levels, grain appearance, and physicochemical properties of rice, providing a host of useful information to future grain-quality research and breeding.

The effect of long-term conventional physical therapy and independent predictive factors analysis in children with cerebral palsy.

OBJECTIVES: This study evaluated the effect of long-term conventional physical therapy (PT) on cerebral palsy (CP) children and to identify the predictors of therapy's response. METHODS: We performed a retrospective review of CP children treated with PT, and their motor function was assessed every 3 months between 2008 and 2011. RESULTS: Fifty-six children with a mean age of 4.2 ± 2.8 years, gross motor function classification system (GMFCS) levels were level I (n = 14), level II (n = 20), level III (n = 5), level IV (n = 8), and level V (n = 9). In the generalized estimating equations model, there was a significant improvement in the Gross Motor Function Measure (GMFM-66) score (p < 0.001); the improvement was different in five GMFCS levels (p < 0.001) and GMFCS level II had faster progression. The younger CP children had better PT efficacy, and the GMFM-66 score continued improving until 8.4 years old in the older group. CONCLUSION: The long-term conventional PT is effective even in older CP children, and PT was most efficient in younger children and GMFCS level II.

The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL).

BCRL is the most common morbidity in women with breast cancer. We performed a retrospective analysis of 107 BCRL patients to identify the efficacy of CDP and the predictors of lymphedema severity and response to CDP. The patients received 12 sessions of CDP, the duration of lymphedema was 22.4 months, and 56% of BCRL occurred within 2 years after surgery. Lymphedema severity, baseline and post-CDP percentage of excess volume (PEV), was 27.7% and 14.9%. The baseline PEV was correlated with the duration of lymphedema. The CDP efficacy, percentage reduction of excess volume (PREV), was 50.5%, and was correlated with PEV, duration of lymphedema and age. Baseline lymphedema severity was the most important predictive factor for CDP efficacy. The breast cancer therapy characteristics did not affect PEV or PREV. This study showed the effectiveness of an intensive CDP interventions. The key to predicting successful lymphedema treatment is the baseline PEV.

The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of response to CDP in lower limb lymphedema (LLL) after pelvic cancer treatment.

OBJECTIVE: The aim of this study was to estimate the efficacy of an intensive CDP program, as well as to identify the predictors associated with lymphedema severity and response to CDP in lower limb lymphedema (LLL) after pelvic cancer therapy. METHODS: We performed a retrospective review of post-pelvic cancer LLL patients that were treated with a CDP program between January 2004 and March 2011. RESULTS: Twenty-seven (61.4%) of the total 44 patients had cervical cancer, 9 (20.5%) had endometrial cancer, and 8 (18.2%) had ovarian cancer. The mean age was 62.2 years, 18 (40.9%) patients received radiotherapy and a mean of 12.6 sessions of daily CDP, and mean lymphedema duration was 34.8 months. The interval from pelvic cancer treatment to LLL development was 63.4 months. Lymphedema severity, baseline and post-CDP percentage of excess volume (PEV) were 32.9% ± 18.4% and 18.8%± 16.7%. Baseline PEV was not correlated with duration of lymphedema, number of CDP sessions, age or radiotherapy, and was significantly different to post-CDP PEV (p<0.001). CDP efficacy, percentage reduction of excess volume (PREV), was -55.1%, and was correlated with baseline PEV, but not with the number of CDP sessions, duration of lymphedema, or age. PEV (p<0.001) was the only predictive factor for CDP efficacy. CONCLUSIONS: The key to predicting successful lymphedema treatment of LLL is the initial PEV. The intensive CDP program was effective and successful. We should encourage and refer patients to undergo treatment for LLL, even when the LLL is mild.