Mechanism Exploration of Environmental Pollutants on Premature Ovarian Insufficiency: a Systematic Review and Meta-analysis.

As a public health problem, premature ovarian insufficiency leads to infertility or sub-fertility. In addition to premature ovarian insufficiency (POI) increases the lifetime risk of bone fragility, cardiovascular disease, and cognitive impairment. To investigate the effects of environmental pollutants on the occurrence of POI and explore its mechanism, we conducted a computer search for articles published in electronic databases by December 13, 2022. Three reviewers independently examined all included studies and scored the qualities of included studies using the Newcastle-Ottawa Scale criteria. In this meta-analysis, eight clinical studies as well as ten preclinical findings showed a pooled OR of 2.331 and 95% CI of 1.968-2.760. This confirms that environmental pollutants, including POPs, heavy metals, PAEs, PAHs, cosmetic and pharmaceutical products, and cigarette smoke, are indeed significant risk factors for POI. In addition, it is demonstrated from the results of this study that signaling pathway of calcium and PI3K Akt and Xpnpep2, Col1, Col3, Col4, Cx43, Egr3, Tff1, and Ptgs2 genes may all be involved in the process. Environmental pollutants, including POPs, heavy metals, PAEs, PAHs, cosmetic and pharmaceutical products, and cigarette smoke, are indeed significant risk factors for POI.

Impact of biochar on the antibiotic resistome and associated microbial functions in rhizosphere and bulk soil in water-saving and flooding irrigated paddy fields.

The addition of biochar in paddies under the condition of water-saving irrigation can simultaneously achieve soil improvement and water conservation, but little is known about the role of these two regulations in mediating the fate of antibiotic resistome in paddy soils. Here, metagenomic analysis was conducted to investigate the effects and intrinsic mechanisms of biochar application and irrigation patterns on propagation of antibiotic resistance genes (ARGs) in paddy soils. The addition of biochar in paddy soil resulted in a reduction of approximately 1.32%-8.01% in the total absolute abundance of ARGs and 0.60%-22.09% in the numbers of ARG subtype. Compared with flooding irrigation, the numbers of detected ARG subtype were reduced by 1.60%-22.90%, but the total absolute abundance of ARGs increased by 0.06%-5.79% in water-saving irrigation paddy soils. Moreover, the combined treatments of flooding irrigation and biochar could significantly reduce the abundance of ARGs in paddy soils. The incremental antibiotic resistance in soil induced by water-saving irrigation was likewise mitigated by the addition of biochar. Correlation analyses indicated that, the differences in soil physicochemical properties under biochar addition or irrigation treatments contributed to the corresponding changes in the abundance of ARGs. Moreover, the variations of microbial community diversity, multidrug efflux abundance and transport system-related genes in paddy soil were also important for mediating the corresponding differences in the abundance of ARGs under the conditions of biochar addition or irrigation treatments. The findings of this study demonstrated the effectiveness of biochar application in mitigating antibiotic resistance in paddy soils. However, it also highlighted a potential concern relating to the elevated antibiotic resistance associated with water-saving irrigation in paddy fields. Consequently, these results contribute to a deeper comprehension of the environmental risks posed by ARGs in paddy soils.

Associations between High Protein Intake, Linear Growth, and Stunting in Children and Adolescents: A Cross-Sectional Study.

BACKGROUND AND AIMS: Childhood and adolescence are critical periods for linear growth and preventing stunting. Current evidence indicates that dietary protein intake in children and adolescents is often two to three times higher than the recommendations in many regions worldwide. However, few studies have focused on the association between high protein intake and linear growth and stunting in this population. We aim to investigate this association in children and adolescents aged 6 to 18 years in a population with relatively high protein consumption. METHODS: We conducted a large cross-sectional study involving 3299 participants from Shenzhen, a modern metropolis of China. Protein intake, including total protein, animal protein, and plant protein, was evaluated by a food-frequency questionnaire and expressed as grams per kilogram of body weight per day (g·kg-1·d-1) and as a percentage of total energy intake (%E). The primary outcomes were body height and height-for-age Z score (HAZ). Generalized linear models and logistic regression analyses were employed to examine the associations between protein intake and outcomes. We also conducted stratified analyses across different genders and pubertal stages in the aforementioned associations. RESULTS: The mean protein intake was 1.81 g·kg-1·d-1 (17% E). After adjusting for serum calcium, zinc, vitamin D3, vitamin A levels, birth outcomes, lifestyle, and parental characteristics, each standard deviation increase of 1 in protein intake (0.64 kg-1·d-1) is found to be associated with a -5.78 cm change in body height (95% CI: -6.12, -5.45) and a -0.79 change in HAZ (95% CI: -0.84, -0.74). Consistent results were observed when protein intake was expressed as %E or specifically as animal or plant protein. Moreover, the relationship between protein intake and linear growth remained consistent across genders in different pubertal stages, similar to that of the overall participants. CONCLUSIONS: Our findings highlight the potential hazards of high protein intake on linear growth in children and adolescents. Caution should be exercised when promoting increased protein consumption in children and adolescents who already have a high intake of protein.

A vendor-agnostic, PACS integrated, and DICOM-compatible software-server pipeline for testing segmentation algorithms within the clinical radiology workflow.

Background: Reproducible approaches are needed to bring AI/ML for medical image analysis closer to the bedside. Investigators wishing to shadow test cross-sectional medical imaging segmentation algorithms on new studies in real-time will benefit from simple tools that integrate PACS with on-premises image processing, allowing visualization of DICOM-compatible segmentation results and volumetric data at the radiology workstation. Purpose: In this work, we develop and release a simple containerized and easily deployable pipeline for shadow testing of segmentation algorithms within the clinical workflow. Methods: Our end-to-end automated pipeline has two major components- 1. A router/listener and anonymizer and an OHIF web viewer backstopped by a DCM4CHEE DICOM query/retrieve archive deployed in the virtual infrastructure of our secure hospital intranet, and 2. An on-premises single GPU workstation host for DICOM/NIfTI conversion steps, and image processing. DICOM images are visualized in OHIF along with their segmentation masks and associated volumetry measurements (in mL) using DICOM SEG and structured report (SR) elements. Since nnU-net has emerged as a widely-used out-of-the-box method for training segmentation models with state-of-the-art performance, feasibility of our pipleine is demonstrated by recording clock times for a traumatic pelvic hematoma nnU-net model. Results: Mean total clock time from PACS send by user to completion of transfer to the DCM4CHEE query/retrieve archive was 5 min 32 s (± SD of 1 min 26 s). This compares favorably to the report turnaround times for whole-body CT exams, which often exceed 30 min, and illustrates feasibility in the clinical setting where quantitative results would be expected prior to report sign-off. Inference times accounted for most of the total clock time, ranging from 2 min 41 s to 8 min 27 s. All other virtual and on-premises host steps combined ranged from a minimum of 34 s to a maximum of 48 s. Conclusion: The software worked seamlessly with an existing PACS and could be used for deployment of DL models within the radiology workflow for prospective testing on newly scanned patients. Once configured, the pipeline is executed through one command using a single shell script. The code is made publicly available through an open-source license at "https://github.com/vastc/," and includes a readme file providing pipeline config instructions for host names, series filter, other parameters, and citation instructions for this work.

Accelerating voxelwise annotation of cross-sectional imaging through AI collaborative labeling with quality assurance and bias mitigation.

Background: precision-medicine quantitative tools for cross-sectional imaging require painstaking labeling of targets that vary considerably in volume, prohibiting scaling of data annotation efforts and supervised training to large datasets for robust and generalizable clinical performance. A straight-forward time-saving strategy involves manual editing of AI-generated labels, which we call AI-collaborative labeling (AICL). Factors affecting the efficacy and utility of such an approach are unknown. Reduction in time effort is not well documented. Further, edited AI labels may be prone to automation bias. Purpose: In this pilot, using a cohort of CTs with intracavitary hemorrhage, we evaluate both time savings and AICL label quality and propose criteria that must be met for using AICL annotations as a high-throughput, high-quality ground truth. Methods: 57 CT scans of patients with traumatic intracavitary hemorrhage were included. No participant recruited for this study had previously interpreted the scans. nnU-net models trained on small existing datasets for each feature (hemothorax/hemoperitoneum/pelvic hematoma; n = 77-253) were used in inference. Two common scenarios served as baseline comparison- de novo expert manual labeling, and expert edits of trained staff labels. Parameters included time effort and image quality graded by a blinded independent expert using a 9-point scale. The observer also attempted to discriminate AICL and expert labels in a random subset (n = 18). Data were compared with ANOVA and post-hoc paired signed rank tests with Bonferroni correction. Results: AICL reduced time effort 2.8-fold compared to staff label editing, and 8.7-fold compared to expert labeling (corrected p < 0.0006). Mean Likert grades for AICL (8.4, SD:0.6) were significantly higher than for expert labels (7.8, SD:0.9) and edited staff labels (7.7, SD:0.8) (corrected p < 0.0006). The independent observer failed to correctly discriminate AI and human labels. Conclusion: For our use case and annotators, AICL facilitates rapid large-scale curation of high-quality ground truth. The proposed quality control regime can be employed by other investigators prior to embarking on AICL for segmentation tasks in large datasets.

Multifunctionality of Jasmonic Acid Accumulation during Aphid Infestation in Altering the Plant Physiological Traits That Suppress the Plant Defenses in Wheat Cultivar XN979.

Crop plants have coevolved phytohormone-mediated defenses to combat and/or repel their colonizers. The present study determined the effects of jasmonic acid (JA) accumulation during aphid infestation on the preference and performance of Sitobion miscanthi Takahashi (Hemiptera: Aphididae), and its potential role in fine-tuning hormone-dependent responses in XN979 wheat cultivar seedlings was evaluated via the transcriptional profiles of marker genes related to JA- and salicylic acid (SA)-dependent responses. The preference experiment and the life table data reveal that direct foliage spraying of 2.5 mM methyl jasmonate (MeJA) exhibited weak negative or positive effects on the preferential selection and the population dynamics and oviposition parameters of S. miscanthi. The transcription level of phytohormone biosynthesis genes shows that foliage spraying of MeJA significantly upregulated the marker genes in the JA biosynthesis pathway while downregulating the SA pathway. In addition, either MeJA treatment or previous aphid infestation significantly induced upregulated transcription of the genes involved in the JA- and SA-dependent defense responses, and the transcription level of the tryptophan decarboxylase (TaTDC) gene, which facilitates the conversion of L-tryptophan to tryptamine, was rapidly upregulated after the treatments as well. The main products of tryptamine conversion could play a crucial role in suppressing SA-dependent defense responses. These results will provide more experimental evidence to enable understanding of the antagonistic interaction between hormone signaling processes in cereals under aphid infestation.

A vendor-agnostic, PACS integrated, and DICOMcompatible software-server pipeline for testing segmentation algorithms within the clinical radiology workflow.

Background: Reproducible approaches are needed to bring AI/ML for medical image analysis closer to the bedside. Investigators wishing to shadow test cross-sectional medical imaging segmentation algorithms on new studies in real-time will benefit from simple tools that integrate PACS with on-premises image processing, allowing visualization of DICOM-compatible segmentation results and volumetric data at the radiology workstation. Purpose: In this work, we develop and release a simple containerized and easily deployable pipeline for shadow testing of segmentation algorithms within the clinical workflow. Methods: Our end-to-end automated pipeline has two major components-1. a router/listener and anonymizer and an OHIF web viewer backstopped by a DCM4CHEE DICOM query/retrieve archive deployed in the virtual infrastructure of our secure hospital intranet, and 2. An on-premises single GPU workstation host for DICOM/NIfTI conversion steps, and image processing. DICOM images are visualized in OHIF along with their segmentation masks and associated volumetry measurements (in mL) using DICOM SEG and structured report (SR) elements. Feasibility is demonstrated by recording clock times for a traumatic pelvic hematoma cascaded nnU-net model. Results: Mean total clock time from PACS send by user to completion of transfer to the DCM4CHEE query/retrieve archive was 5 minutes 32 seconds (+/- SD of 1 min 26 sec). This compares favorably to the report turnaround times for whole-body CT exams, which often exceed 30 minutes. Inference times accounted for most of the total clock time, ranging from 2 minutes 41 seconds to 8 minutes 27 seconds. All other virtual and on-premises host steps combined ranged from a minimum of 34 seconds to a maximum of 48 seconds. Conclusion: The software worked seamlessly with an existing PACS and could be used for deployment of DL models within the radiology workflow for prospective testing on newly scanned patients. Once configured, the pipeline is executed through one command using a single shell script. The code is made publicly available through an open-source license at "https://github.com/vastc/", and includes a readme file providing pipeline config instructions for host names, series filter, other parameters, and citation instructions for this work.

Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study.

Background: Minimally invasive carpal tunnel release has recently emerged as the primary surgical approach for recalcitrant carpal tunnel syndrome. A major concern related to surgical failure with this technique is the incomplete release of the flexor retinaculum. Case presentation: We developed a technique using dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release. This novel imaging method was applied to two patients who showed significant symptom relief after the intervention. This case study also provides details of the dynamic ultrasound protocol and highlights the advantages of this technique. Conclusion: Dynamic ultrasound imaging can be used to confirm the completeness of carpal tunnel decompression. A large-scale prospective trial should be conducted to validate whether additional dynamic ultrasound examination can improve the outcome of minimally invasive carpal tunnel release.

Two new dihydro-ß-agarofuran sesquiterpenes from the roots of Celastrus angulatus.

Two new dihydro-ß-agarofuran sesquiterpenes chiapen T (1) and chiapen U (2), along with chiapen A (3), 1ß-hydroxy-2ß,6α,12-triacetoxy-8ß-(ß-nicotinoyloxy)-9ß-(benzoyloxy)-ß-dihydroagarofuran (4), wilforlide B (5), 3-hydroxy-2-oxo-3-friedelen-29-oic acid (6), epikatonic acid (7), 22-epi-maytenfolic acid (8), maytenoic acid (9), wilforic acid F (10), wilforic acid B (11), were reported for the first time from the Celastrus angulatus. The structures of all the compounds were elucidated by HR-ESI-MS, 1 D and 2 D NMR spectra, as well as single-crystal X-ray diffraction analyses. Compounds 1 and 2 were examined for anti-inflammatory activity, respectively. None of them showed potent activity.

Soil nitrogen functional transformation microbial genes response to biochar application in different irrigation paddy field in southern China.

Growing evidence points to the controlled irrigation (CI) and biochar application (BA) having agricultural economic value and ecological benefits, but their synergistic effect and microbial mechanism of nitrogen conversion remain unknown in paddy fields. The effects of different BA (0, 20, 40 t/hm2) on the soil nitrogen functional transformation microbial genes (nifH, AOA-amoA, AOB-amoA) in different irrigation (CI, flooding irrigation) were clarified. After one seasonal growth of paddy, the correlation between the abundance of functional genes OUT and soil nitrogen transformation environment factors during the typical growth period was analyzed. High-throughput sequencing results illustrated that the application of CC (40 t/hm2 biochar) increased the nifH genes bacterial community abundance; the abundance of dominant microorganism increased by 79.68~86.19%. Because biochar can potentially control the rates of N cycling in soil systems by adsorbing ammonia and increasing NH4+ storage, it increased soil NH4+-N and NO3--N content by 60.77% and 26.14%, improving microbial nitrogen fixation. Rare species Nitrosopumilus, Nitrosococcus, and Methylocystis appeared in biochar treatments group, which increased the diversity of microbial in paddy. The combined use of CI and BA affected soil inorganic nitrogen content, temperature (T), pH, Eh, etc., which affected urease, urea hydrolysis, and nitrogen functional transformation microorganism genes. Correlation analysis shows that soil NH4+-N, T, and Eh, respectively, are significant factors for the formation of nifH, AOA-amoA, and AOB-amoA soil bacterial communities, respectively. This study suggests that to maintain the biodiversity of soil and realize the sustainable development of rice cultivation, CI is of great importance in combination with BA.

A pilot study of deep learning-based CT volumetry for traumatic hemothorax.

PURPOSE: We employ nnU-Net, a state-of-the-art self-configuring deep learning-based semantic segmentation method for quantitative visualization of hemothorax (HTX) in trauma patients, and assess performance using a combination of overlap and volume-based metrics. The accuracy of hemothorax volumes for predicting a composite of hemorrhage-related outcomes - massive transfusion (MT) and in-hospital mortality (IHM) not related to traumatic brain injury - is assessed and compared to subjective expert consensus grading by an experienced chest and emergency radiologist. MATERIALS AND METHODS: The study included manually labeled admission chest CTs from 77 consecutive adult patients with non-negligible (≥ 50 mL) traumatic HTX between 2016 and 2018 from one trauma center. DL results of ensembled nnU-Net were determined from fivefold cross-validation and compared to individual 2D, 3D, and cascaded 3D nnU-Net results using the Dice similarity coefficient (DSC) and volume similarity index. Pearson's r, intraclass correlation coefficient (ICC), and mean bias were also determined for the best performing model. Manual and automated hemothorax volumes and subjective hemothorax volume grades were analyzed as predictors of MT and IHM using AUC comparison. Volume cut-offs yielding sensitivity or specificity ≥ 90% were determined from ROC analysis. RESULTS: Ensembled nnU-Net achieved a mean DSC of 0.75 (SD: ± 0.12), and mean volume similarity of 0.91 (SD: ± 0.10), Pearson r of 0.93, and ICC of 0.92. Mean overmeasurement bias was only 1.7 mL despite a range of manual HTX volumes from 35 to 1503 mL (median: 178 mL). AUC of automated volumes for the composite outcome was 0.74 (95%CI: 0.58-0.91), compared to 0.76 (95%CI: 0.58-0.93) for manual volumes, and 0.76 (95%CI: 0.62-0.90) for consensus expert grading (p = 0.93). Automated volume cut-offs of 77 mL and 334 mL predicted the outcome with 93% sensitivity and 90% specificity respectively. CONCLUSION: Automated HTX volumetry had high method validity, yielded interpretable visual results, and had similar performance for the hemorrhage-related outcomes assessed compared to manual volumes and expert consensus grading. The results suggest promising avenues for automated HTX volumetry in research and clinical care.

Ultrasound Guidance for Full Endoscopic Spinal Surgery: A Technical Note.

BACKGROUND: The use of intraoperative ultrasound (IOU) has proven to be useful in spinal surgery. In this study, we present the techniques of applying IOU in cervical, thoracic, and lumbar full-endoscopic spine surgery (FESS). METHODS: For applying IOU in cervical FESS, first, we localize the surgical level by identifying the unique shape of C6 and C7 under ultrasound and then identify the cervical level subsequently. For the anterior approach, the endoscope passes through the cervical fascia between the carotid sheath and trachea/esophagus, which can be identified under ultrasound, and for the posterior approach, the endoscope docks on the facet joint under ultrasound. For applying IOU in thoracic FESS, we localize the surgical level by counting the ribs. The endoscope is advanced to the neural foramen under ultrasound without entering the pleural cavity. For applying IOU in lumbar FESS, we identify the surgical level by counting the interlaminar window from the sacrum. The endoscopic sheath is advanced to the neural foramen under ultrasound without entering the peritoneal cavity. RESULTS: The use of IOU in FESS has the potential to reduce radiation exposure, reach a higher successful puncture rate, and decrease the operation time. Furthermore, IOU prevents radiolucent organs from damage during FESS. CONCLUSIONS: We present the techniques of applying IOU in cervical, thoracic, and lumbar endoscopic spine surgery and hope that this will be helpful for physicians to master the IOU techniques.

Breastfeeding competency scale (BCS); development and validation of an evaluation instrument on breastfeeding competency in third trimester pregnancy.

BACKGROUND: Breastfeeding plays an important role in the early stages of humans and throughout the development process. Breastfeeding competency is a self-assessment of pregnant women's overall competency to breastfeeding which could predict the breastfeeding behaviours of pregnant women. However, a valid and reliable scale for assessing breastfeeding competency has not yet been developed and validated. This study was conducted to develop and validate an assessment scale designed to assess pregnant women's breastfeeding competency in the third trimester: the Breastfeeding Competency Scale (BCS). METHODS: The BCS was developed and validated over three phases between September 2018 and September 2019, and these phases included item statistical analysis, exploratory factor analysis (EFA), content validation, internal consistency assessment, split-half reliability assessment and confirmatory factor analysis (CFA). RESULTS: The item statistical analysis and EFA resulted in 38 items and 4 factors that explained 66.489% of the total variance. The Cronbach's α coefficients for the total scale and the 4 factors were 0.970, 0.960, 0.940, 0.822 and 0.931. The split-half reliability of the BCS was 0.894 and 0.890. CFA model showed that the 4-factor model fits the data well. CONCLUSIONS: The BCS is a new valid and reliable instrument for assessing the breastfeeding competency of pregnant women in the third trimester.

Damage spreading in the mixed spin Ising model.

We apply the damage spreading technique to study a mixed spin Ising model consisting of spin 1/2 and spin 1 with a crystal field interaction on the square lattice within a kind of Metropolis dynamics. The completely different behavior, depending on the value of the crystal field interaction, strongly suggests there may exist a dynamical tricritical point where the phase transition may change from the second order to the first order for this model.