Spaced Digital Education for Health Professionals: Systematic Review and Meta-Analysis.

BACKGROUND: Spaced digital education applies digital tools to deliver educational content via multiple, repeated learning sessions separated by prespecified time intervals. Spaced digital education appears to promote acquisition and long-term retention of knowledge, skills, and change in clinical behavior. OBJECTIVE: The aim of this review was to assess the effectiveness of spaced digital education in improving pre- and postregistration health care professionals' knowledge, skills, attitudes, satisfaction, and change in clinical behavior. METHODS: This review followed Cochrane's methodology and PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) reporting guidelines. We searched MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses databases from January 1990 to February 2023. We included randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs comparing spaced digital education with nonspaced education, spaced nondigital education, traditional learning, or no intervention for pre- or postregistration health care professionals. Study selection, data extraction, study quality, and certainty of evidence were assessed by 2 independent reviewers. Meta-analyses were conducted using random effect models. RESULTS: We included 23 studies evaluating spaced online education (n=17, 74%) or spaced digital simulation (n=6, 26%) interventions. Most studies assessed 1 or 2 outcomes, including knowledge (n=15, 65%), skills (n=9, 39%), attitudes (n=8, 35%), clinical behavior change (n=8, 35%), and satisfaction (n=7, 30%). Most studies had an unclear or a high risk of bias (n=19, 83%). Spaced online education was superior to massed online education for postintervention knowledge (n=9, 39%; standardized mean difference [SMD] 0.32, 95% CI 0.13-0.51, I2=66%, moderate certainty of evidence). Spaced online education (n=3, 13%) was superior to massed online education (n=2, 9%) and no intervention (n=1, 4%; SMD 0.67, 95% CI 0.43-0.91, I2=5%, moderate certainty of evidence) for postintervention clinical behavior change. Spaced digital simulation was superior to massed simulation for postintervention surgical skills (n=2, 9%; SMD 1.15, 95% CI 0.34-1.96, I2=74%, low certainty of evidence). Spaced digital education positively impacted confidence and satisfaction with the intervention. CONCLUSIONS: Spaced digital education is effective in improving knowledge, particularly in substantially improving surgical skills and promoting clinical behavior change in pre- and postregistration health care professionals. Our findings support the use of spaced digital education interventions in undergraduate and postgraduate health profession education. Trial Registration: PROSPERO CRD42021241969. TRIAL REGISTRATION: PROSPERO CRD42021241969; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=241969.

Automated Classification of Coronary Plaque on Intravascular Ultrasound by Deep Classifier Cascades.

Intravascular ultrasound (IVUS) is the gold standard modality for in vivo visualization of coronary arteries and atherosclerotic plaques. Classification of coronary plaques helps to characterize heterogeneous components and evaluate the risk of plaque rupture. Manual classification is time-consuming and labor-intensive. Several machine learning-based classification approaches have been proposed and evaluated in recent years. In the current study, we develop a novel pipeline composed of serial classifiers for distinguishing IVUS images into five categories: normal, calcified plaque, attenuated plaque, fibrous plaque, and echolucent plaque. The cascades comprise densely connected classification models and machine learning classifiers at different stages. Over 100,000 IVUS frames of five different lesion types were collected and labeled from 471 patients for model training and evaluation. The overall accuracy of the proposed classifier is 0.877, indicating that the proposed framework has the capacity to identify the nature and category of coronary plaques in IVUS images. Further, it may provide real-time assistance on plaque identification and facilitate clinical decision-making in routine practice.

Characteristics of Patients with Spontaneous Coronary Artery Dissection Presenting with Sudden Cardiac Arrest in the United States and the Potential Role of Implantable Cardioverter Defibrillator Therapy.

Background: Spontaneous coronary artery dissection (SCAD) is a disease entity that often occurs in young, healthy women and can cause life-threatening ventricular arrhythmias and sudden cardiac arrest. However, the characteristics and outcomes of SCAD with cardiac arrest are not well characterized. Methods: This study investigated the baseline characteristics of SCAD patients with cardiac arrest using the National Inpatient Sample (NIS) database between 2016 and 2020. In addition, we also sought to determine the potential impact that implantable cardioverter defibrillator (ICD) therapy had on morbidity and mortality in SCAD patients presenting with cardiac arrest. Results: Our findings showed that the SCAD with cardiac arrest population had significantly higher comorbidities, including cardiac arrhythmias, congestive heart failure, pulmonary circulation disorders, liver diseases, solid tumors, coagulopathy, fluid disorders, chronic kidney disease (CKD), anemia secondary to deficiency, psychosis, neurological disorders, carotid artery disease, atrial fibrillation, ventricular arrhythmias (ventricular tachycardia (VT), ventricular fibrillation (VF)), and acute myocardial infarction (AMI), compared to the SCAD without cardiac arrest population. Likewise, for SCAD patients who did not have an ICD in place, we found increasing age, fluid and electrolyte disorders, uncomplicated diabetes, neurological disorders, peripheral vascular disease, pulmonary circulatory disorders, cardiac arrhythmias, and congestive heart failure to be associated with greater mortality. Conclusions: SCAD patients with certain comorbidities (e.g., pulmonary diseases, liver diseases, cancers, coagulopathy, and CKD) who presented with AMI or congestive heart failure should be monitored closely for ventricular arrhythmias as they have a higher chance of progressing to cardiac arrest. ICD therapy can be considered for these patients, but data on the success of this treatment option are limited, and more research needs to be performed to determine whether the benefits of this outweigh the risks.

Temporal Trends and Outcomes of Peripheral Artery Disease and Critical Limb Ischemia in the United States.

INTRODUCTION: Peripheral arterial disease (PAD) is a progressive, systemic atherosclerotic disease that is associated with an increased risk of coronary artery disease (CAD), cerebrovascular disease (CVD), and critical limb ischemia (CLI). CLI represents the most severe stage of PAD, characterized by progressive endothelial dysfunction and arterial narrowing. We hypothesized that the incidence of CLI and PAD would increase over the study period and that the rates of in-hospital mortality and major amputations among patients admitted with CLI would rise correspondingly. METHODS: We utilized the National Inpatient Sample (NIS) database from year 2016 to 2021 using the ICD-10-CM codes. Patients with a primary or secondary diagnoses of PAD were initially selected and subsequently hospitalization with CLI were appropriately identified. Cochran Armitage test was used to describe the trend of outcomes across the years. All statistical analyses were conducted using the software Stata version 17.0. RESULTS: From 2016-2021, there were 2,930,639 admissions for critical limb ischemia. 65% of these patients were over the age of 60 and 35.8% of these patients were women. Most of these individuals were white (64.7%), followed by African Americans (15.8%) and Hispanics (12.6%). In-hospital mortality rates varied by revascularization method, with hybrid revascularization showing the highest rate at 2.6%, followed by endovascular revascularization at 1.8%, and surgical revascularization at 1.6%. Additionally, hospitalization costs were highest for patients undergoing hybrid revascularization ($46,257 ± $36,417), compared to endovascular ($36,924 ± $27,945) and surgical revascularization ($35,672 ± $27,127). Endovascular revascularization rates seemed to increase while surgical revascularization rates decreased during this time period. CONCLUSION: PAD is a progressive, systemic atherosclerotic disease that is associated with an increased risk of CAD, CVD, and CLI. Our data showed that the rates of PAD and CLI hospitalizations has remained relatively stable from 2016-2021, but there seems to be a trend towards doing more revascularization via an endovascular approach as compared to a surgical approach.

Molecular engineering and structure-property relationship based on D-A chlorophyll derivative and the application in organic solar cells.

The photoactive layer materials of organic solar cells (OSCs) play a critical role in achieving excellent performance. Chlorophyll derivatives are commonly used due to their environmental friendliness, low cost, and easy accessibility. However, the efficiency of OSCs based on chlorophyll is limited by their photoelectric properties. Here, we focused on the D-A structure of chlorophyll derivative ZnChl-1 and designed four molecules through rational molecular engineering. The photoelectric properties at the microscopic level were systematically studied using density functional theory (DFT). Our findings reveal that T-ZnChl-1 with triphenylamine donor unit has a smaller energy gap and ionization energy, as well as a larger spectral red shift and absorption range. This suggests that intramolecular charge transfer will be enhanced, leading to an improvement in short-circuit current. Furthermore, Y6 is used as the acceptor to construct the heterojunction interfaces. The results indicate that the T-ZnChl-1/Y6 interface exhibits more charge transfer states and higher exciton dissociation rate KCS, which will promote charge separation and lead to excellent photovoltaic performance. This work clarifies the structure-property relationship of chlorophyll derivatives and the photo-response mechanism of intermolecular charge transfer, providing a theoretical basis for developing valuable chlorophyll-based OSCs.

Fabrication of core-shell-like bimetallic SERS substrates with inter-coordination effect for catalysis of p-mercaptoaniline.

The present study discusses the core-shell structures of Au@Ag prepared by a seed-growth method. The morphology and composition of Au@Ag nanoparticles were analyzed, indicating that they were successfully prepared. By studying the surface-enhanced Raman scattering spectra (SERS) of p-mercaptoaniline (PATP) molecules adsorbed on Au@Ag substrates, it was found that PATP molecules could be oxidized to form p-mercaptoazobenzene (DMAB) on Au@Ag substrates, indicating that the gold-silver bimetallic nanomaterials could catalyze the PATP molecules with excellent enhancement effect and stability. In order to further study the enhancement effect of the Au@Ag substrate, the electric field strength of Au nanoparticles and Au@Ag nanoparticles was simulated by using the finite difference time domain (FDTD) method, which showed that the SERS enhancement effect of Au@Ag nanoparticles was more significant as well as consistent with the experimental results. This work provides a reference for further preparation of efficient and stable bimetallic SERS substrates.

Natural Products and Derivatives Targeting Metabolic Reprogramming in Colorectal Cancer: A Comprehensive Review.

Metabolic reprogramming is a critical pathogenesis of colorectal cancer (CRC), referring to metabolic disorders that cancer cells make in response to the stimulating pressure. Metabolic reprogramming induces changes in genetic material and promotes CRC progression and has been proven to be an efficient target of CRC. As natural products have garnered interest due to notable pharmacological effects and potential in counteracting chemoresistance, an increasing body of research is delving into the impact of these natural products on the metabolic reprogramming associated with CRC. In this review, we collected published data from the Web of Science and PubMed, covering the period from January 1980 to October 2023. This article focuses on five central facets of metabolic alterations in cancer cells, glucose metabolism, mitochondrial oxidative phosphorylation (OXPHOS), amino acid metabolism, fatty acid synthesis, and nucleotide metabolism, to provide an overview of recent advancements in natural product interventions targeting metabolic reprogramming in CRC. Our analysis underscores the potential of natural products in disrupting the metabolic pathways of CRC, suggesting promising therapeutic targets for CRC and expanding treatment options for metabolic-associated ailments.

Optical absorption spectroscopy and electronic properties of D-A dyes and chlorophyll derivatives for co-sensitization in DSSCs.

The photophysical and photochemical processes of the experimental dyes ZS11 and ZS12 containing phenyl-cyanoacrylic acid (PCA) and ethynyl-PCA (EPCA) group were studied by DFT and TD-DFT systems to develop their applications in solar cells. First, their geometry, absorption spectra, chemical reaction parameters, electron transfer and dye activity were systematically studied. The photoelectric conversion efficiency (PCE) was predicted, and it was found that the PCE of ZS12 (9.974 %) was higher than ZS11 (7.171 %), which was consistent with the experimental trend (the PCE of ZS12 is 10.4 ± 0.3 % and the PCE of ZS11 is 9.0 ± 0.3 %). Secondly, the dye was co-sensitized with the chlorophyll derivative CHL-1c, and the co-sensitization system's interaction force, excited state characteristics, electron transfer mechanism and electron transfer rates were studied. The results show that the JSC of all co-sensitive systems (the JSC of ZS12-CHL is 22.363 mA/cm2 and the JSC of ZS11-CHL is 23.978 mA/cm2) is significantly higher than that of monomers (the JSC of ZS12 is 16.112 mA/cm2 and the JSC of ZS11 is 11.051 mA/cm2). It can be inferred that the optoelectronic performance of co-sensitizing systems is better than that of monomers. This study demonstrates that the use of dye molecules co-sensitized with chlorophyll derivatives can enhance DSSC performance from multiple perspectives, providing insights for further improvements.

Qualitative insights into the effectiveness of a targeted nursing research support program: Understanding and experiences of support recipients and providers.

AIM: The aims of this study were to examine the effectiveness of a targeted nursing research support program for clinical nurses. BACKGROUND: Nursing research capacity is increasingly essential to clinical nurses and currently relatively low. Therefore, effective and systematic nursing research training programs are urgently needed to improve the scientific research abilities of nurses. METHODS: Qualitative research was conducted to investigate the effectiveness of a targeted nursing research support program. The program was formulated by considering the research training requirements of nurses and standard nursing research procedures, through literature review and group deliberations. The program was implemented for 973 nurses using a "plan-action-observation-reflection" learning cycle. The research outcomes achieved by nurses were evaluated and thematic analysis conducted to assess the perspectives of nurses and teachers regarding the research support program. RESULTS: Nurses participating in the targeted nursing research support program collectively accomplished 195 research proposals and authored 332 original research articles. Nurses shared their rich experience as "understanding my needs and achieving my potential", including: (1) systematic procedures and coherence; (2) easy to learn, easy to use; (3) a sense of belonging and mutual support; (4) self-confidence growth; and (5) high expectations. Further, the experiences of teachers were summarized as "helping others is helping myself", including: (1) teaching is learning; (2) the happiness of being needed; and (3) the importance of scientific teaching. CONCLUSION: This study evaluated the experiences of nurses and educators involved in a targeted nursing research support program and assessed its preliminary effectiveness. The findings revealed that the program, grounded in scientific and systematic research principles, was beneficial to both nurses and teachers. Based on our findings, we recommend that nursing educators should prioritize comprehensive, practice-integrated research training programs and create supportive environments, to effectively enhance the research capacity of nurses.

Regulation of organic solar cells performance through external electric field: From charge transfer mechanisms to photovoltaic properties.

In organic solar cells (OSCs), comprehending the charge transfer mechanism at D/A interfaces is crucial for photoinduced charge generation and enhancing power conversion efficiency (PCE). The charge transfer mechanism and photovoltaic performance of the parallel stacking interface configuration of the PTQ10 polymer donor and T2EH non-fullerene acceptor (NFA) are systematically studied at the microscopic scale. The analysis of the electron-hole distribution of the PTQ10/T2EH excited states revealed the presence of multiple charge excitation modes and charge transfer pathways. Using Marcus theory, we examine the charge separation rate (KCS) of PTQ10/T2EH under external electric field (Fext) modulation, and it is clarified that reorganization energy (λ) is the main factor that affects the KCS. Our results show that Fext has a positive impact on the photovoltaic properties of PTQ10/T2EH thin films, as evidenced by the modulation of the open circuit voltage (VOC), voltage loss (VLOSS) and fill factor (FF). Overall, this study provides valuable theoretical insights for Fext to accelerate the charge separation process and enhance photovoltaic efficiency.

TESMIN is a Prognostic Biomarker Associated with Immunosuppression and Activated Cell Cycle in Lung Adenocarcinoma.

BACKGROUND: The Testis Expressed Metallothionein Like Protein (TESMIN) gene encodes highly conserved, cysteine-rich, low-molecular proteins that are activated by and have an affinity for heavy metal ions. Previous literature has shown its association with cancer. Nevertheless, no thorough bioinformatics analysis of TESMIN has been done yet in lung adenocarcinoma (LUAD). METHODS: Differential expression of TESMIN between cancer and normal tissues was confirmed by analyzing databases and immunohistochemistry staining. Enrichment analysis was adopted to explore biological functions. The relationship of TESMIN with immune infiltration was evaluated by ssGSVA, with immunotherapy response predicted by TCIA and TIDE tools, with mutational traits analyzed by R software. Drug sensitivity analysis was implemented via GSCA tool, pRRophetic algorithms, and CellMiner database. RESULTS: The results demonstrated that TESMIN expression was upregulated in tumor tissue and related to Ki67. TESMIN was associated with poor survival and significantly related to age, gender, N stage, M stage, pathological stage, and survival status. TESMIN- related genes (TRGs) were primarily involved in cell division and cancer-related enrichment pathways. TESMIN was associated with high frequencies of somatic mutations and an immunosuppressive tumor microenvironment. Interestingly, patients with elevated levels of TESMIN expression benefited more from commonly used chemotherapy drugs such as cisplatin, paclitaxel, vinorelbine, and docetaxel, whereas those with low levels of TESMIN expression showed favorable clinical responses to immunotherapy. CONCLUSION: As a prognostic biomarker associated with the cell cycle and immune infiltration, TESMIN may serve as an effective target for predicting the sensitivity to immunotherapy and chemotherapy.

Multiomics analyses decipher intricate changes in the cellular and metabolic landscape of steatotic livers upon dietary restriction and sleeve gastrectomy.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic, progressive liver disease that encompasses a spectrum of steatosis, steatohepatitis (or MASH), and fibrosis. Evidence suggests that dietary restriction (DR) and sleeve gastrectomy (SG) can lead to remission of hepatic steatosis and inflammation through weight loss, but it is unclear whether these procedures induce distinct metabolic or immunological changes in MASLD livers. This study aims to elucidate the intricate hepatic changes following DR, SG or sham surgery in rats fed a high-fat diet as a model of obesity-related MASLD, in comparison to a clinical cohort of patients undergoing SG. Single-cell and single-nuclei transcriptome analysis, spatial metabolomics, and immunohistochemistry revealed the liver landscape, while circulating biomarkers were measured in serum samples. Artificial intelligence (AI)-assisted image analysis characterized the spatial distribution of hepatocytes, myeloid cells and lymphocytes. In patients and experimental MASLD rats, SG improved body mass index, circulating liver injury biomarkers and triglyceride levels. Both DR and SG attenuated liver steatosis and fibrosis in rats. Metabolism-related genes (Ppara, Cyp2e1 and Cyp7a1) were upregulated in hepatocytes upon DR and SG, while SG broadly upregulated lipid metabolism on cholangiocytes, monocytes, macrophages, and neutrophils. Furthermore, SG promoted restorative myeloid cell accumulation in the liver not only ameliorating inflammation but activating liver repair processes. Regions with potent myeloid infiltration were marked with enhanced metabolic capacities upon SG. Additionally, a disruption of periportal hepatocyte functions was observed upon DR. In conclusion, this study indicates a dynamic cellular crosstalk in steatotic livers of patients undergoing SG. Notably, PPARα- and gut-liver axis-related processes, and metabolically active myeloid cell infiltration indicate intervention-related mechanisms supporting the indication of SG for the treatment of MASLD.

Racial disparities in trend, clinical characteristics and outcomes in Takotsubo syndrome.

INTRODUCTION: Takotsubo syndrome (TTS) is an acute transient nonischemic cardiomyopathy often characterized by its hallmark feature of left ventricular apical ballooning. The correlation between racial backgrounds and the prognosis of individuals with TTS remains poorly defined. Our study aimed to explore the influence of race on the trends, clinical presentations, and outcomes in patients diagnosed with TTS. METHODS: We queried the National Inpatient Sample (NIS) database from 2016 to 2020 and identified hospitalizations with TTS. We compared the clinical features and outcomes across three different races - non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic population. The primary outcome was in-hospital mortality. RESULTS: 76,505 weighted hospitalizations for TTS were identified, of which 65,495 (85.6%) were non-Hispanic White, 5,830 (7.6%) were non-Hispanic Black, and 5,180 (6.8%) were Hispanics. After propensity-score matching, NHB patients had higher odds of acute kidney injury (OR: 1.49, 95% CI: 1.21-1.84, p < 0.001) and mechanical ventilation (OR: 1.33, 95% CI: 1.04-1.68, p = 0.02). Hispanic patients had a higher incidence of acute kidney injury requiring dialysis when compared to NHW patients (OR: 2.53, 95% CI: 1.11-5.77, p = 0.027). There was no significant difference in terms of in-hospital mortality between NHB and Hispanic patients when compared to NHW patients. Notably, Hispanic populations experienced a higher mortality rate during the COVID-19 period. CONCLUSION: Our study suggested significant differences in the outcomes of TTS across different racial groups. Hispanic populations experienced a higher mortality rate with TTS during the COVID-19 era. Further research should emphasize discovering the factors contributing to the observed disparities.

Mechanical Properties and Cooperation Mechanism of Corroded Steel Plates Retrofitted by Laser Cladding Additive Manufacturing under Tension.

As a metal additive manufacturing process, laser cladding (LC) is employed as a novel and beneficial repair technology for damaged steel structures. This study employed LC technology with 316 L stainless steel powder to repair locally corroded steel plates. The influences of interface slope and scanning pattern on the mechanical properties of repaired specimens were investigated through tensile tests and finite element analysis. By comparing the tensile properties of the repaired specimens with those of the intact and corroded specimens, the effectiveness of LC repair technology was assessed. An analysis of strain variations in the LC sheet and substrate during the load was carried out to obtain the cooperation mechanism between the LC sheet and substrate. The experimental results showed that the decrease in interface slope slightly improved the mechanical properties of repaired specimens. The repaired specimens have similar yield strength and ultimate strength to the intact specimens and better ductility as compared to the corroded specimen. The stress-strain curve of repaired specimens can be divided into four stages: elastic stage, substrate yield-LC sheet elastic stage, substrate hardening-LC sheet elastic stage, and plastic stage. These findings suggest that the LC technology with 316 L stainless steel powder is effective in repairing damaged steel plates in civil engineering structures and that an interface slope of 1:2.5 with the transverse scanning pattern is suitable for the repair process.

Efficacy and prognostic factors of COVID-19 vaccine in patients with hepatocellular carcinoma: Analysis of data from a prospective cohort study.

BACKGROUND: The efficacy of coronavirus disease 2019 (COVID-19) vaccines in preventing SARS-CoV-2 infection in patients with hepatocellular carcinoma (HCC) is not clear. METHODS: From January 2022 to October 2022, patients diagnosed with HCC in a prospective, multicenter, observational cohort were analyzed. RESULTS: One hundred and forty-one patients with (n = 107) or without COVID-19 vaccination (n = 34) were included. The number of patients with severe or very severe infection was relatively lower in the vaccinated group (3.7% vs. 11.8%, p = 0.096). Median infection-free survival in the vaccinated group (14.0 vs. 8.3 months, p = 0.010) was significantly longer than that in the unvaccinated group. COVID-19 vaccination (hazard ratio (HR) HR = 0.47), European Cooperative Oncology Group performance score = 0 (HR = 2.06), and extrahepatic spread (HR = 0.28) were found to be the independent predictive factors for infection-free survival. CONCLUSION: COVID-19 vaccines could effectively reduce the SARS-Cov-2 infection in patients with HCC.

Bioenzymatic detoxification of mycotoxins.

Mycotoxins are secondary metabolites produced during the growth, storage, and transportation of crops contaminated by fungi and are physiologically toxic to humans and animals. Aflatoxin, zearalenone, deoxynivalenol, ochratoxin, patulin, and fumonisin are the most common mycotoxins and can cause liver and nervous system damage, immune system suppression, and produce carcinogenic effects in humans and animals that have consumed contaminated food. Physical, chemical, and biological methods are generally used to detoxify mycotoxins. Although physical methods, such as heat treatment, irradiation, and adsorption, are fast and simple, they have associated problems including incomplete detoxification, limited applicability, and cause changes in food characteristics (e.g., nutritive value, organoleptic properties, and palatability). Chemical detoxification methods, such as ammonification, ozonation, and peroxidation, pollute the environment and produce food safety risks. In contrast, bioenzymatic methods are advantageous as they achieve selective detoxification and are environmentally friendly and reusable; thus, these methods are the most promising options for the detoxification of mycotoxins. This paper reviews recent research progress on common mycotoxins and the enzymatic principles and mechanisms for their detoxification, analyzes the toxicity of the degradation products and describes the challenges faced by researchers in carrying out enzymatic detoxification. In addition, the application of enzymatic detoxification in food and feed is discussed and future directions for the development of enzymatic detoxification methods are proposed for future in-depth study of enzymatic detoxification methods.

A High-Throughput Method for Accurate Extraction of Intact Rice Panicle Traits.

Rice panicle traits serve as critical indicators of both yield potential and germplasm resource quality. However, traditional manual measurements of these traits, which typically involve threshing, are not only laborious and time-consuming but also prone to introducing measurement errors. This study introduces a high-throughput and nondestructive method, termed extraction of panicle traits (EOPT), along with the software Panicle Analyzer, which is designed to assess unshaped intact rice panicle traits, including the panicle grain number, grain length, grain width, and panicle length. To address the challenge of grain occlusion within an intact panicle, we define a panicle morphology index to quantify the occlusion levels among the rice grains within the panicle. By calibrating the grain number obtained directly from rice panicle images based on the panicle morphology index, we substantially improve the grain number detection accuracy. For measuring grain length and width, the EOPT selects rice grains using an intersection over union threshold of 0.8 and a confidence threshold of 0.7 during the grain detection process. The mean values of these grains were calculated to represent all the panicle grain lengths and widths. In addition, EOPT extracted the main path of the skeleton of the rice panicle using the Astar algorithm to determine panicle lengths. Validation on a dataset of 1,554 panicle images demonstrated the effectiveness of the proposed method, achieving 93.57% accuracy in panicle grain counting with a mean absolute percentage error of 6.62%. High accuracy rates were also recorded for grain length (96.83%) and panicle length (97.13%). Moreover, the utility of EOPT was confirmed across different years and scenes, both indoors and outdoors. A genome-wide association study was conducted, leveraging the phenotypic traits obtained via EOPT and genotypic data. This study identified single-nucleotide polymorphisms associated with grain length, width, number per panicle, and panicle length, further emphasizing the utility and potential of this method in advancing rice breeding.

Analysis of risk factors for liver metastasis in patients with gastric cancer and construction of prediction model: A multicenter study.

BACKGROUND: To retrospectively analyze the risk factors of liver metastases in patients with gastric cancer in a single center, and to establish a Nomogram prediction model to predict the occurrence of liver metastases. METHODS: A total of 96 patients with gastric cancer who were also diagnosed with liver metastasis (GCLM) and treated in our center from January 1, 2010 to December 31, 2020 were included. The clinical data of 1095 patients with gastric cancer who were diagnosed without liver metastases (GC) in our hospital from January 1, 2014 to December 31, 2017 were retrospectively compared by univariate and multivariate logistic regression. 309 patients diagnosed with gastric cancer in another medical center from January 1, 2014 to December 31, 2018 were introduced as external validation cohorts. RESULTS: Based on the training cohort, multivariate analysis revealed that tumor site (OR = 0.55, P = 0.046), N stage (OR = 4.95, P = 0.004), gender (OR = 0.04, P = 0.001), OPNI (OR = 0.95, P = 0.041), CEA (OR = 1.01, P = 0.018), CA724 (OR = 1.01, P = 0.006), CA242 (OR = 1.01, P = 0.006), WBC (OR = 1.13, P = 0.024), Hb (OR = 0.98, P < 0.001) were independent risk factors for liver metastasis in patients with gastric cancer, and Nomogram was established based on this analysis (C-statistics = 0.911, 95%CI 0.880-0.958), and the C-statistics of the external validation cohorts achieved 0.926. ROC analysis and decision curve analysis (DCA) revealed that the nomogram provided superior diagnostic value than single variety. CONCLUSIONS: By innovatively introducing a new tumor location classification method, systemic inflammatory response indicators such as NLR and PLR, and nutritional index OPNI, the risk factors of gastric cancer liver metastasis were determined and a predictive Nomogram model was established, which can provide clinical prediction for patients with gastric cancer liver metastasis.

Gene Mutations in Gastrointestinal Stromal Tumors: Advances in Treatment and Mechanism Research.

Although gastrointestinal stromal tumors (GISTs) has been reported in patients of all ages, its diagnosis is more common in elders. The two most common types of mutation, receptor tyrosine kinase (KIT) and platelet-derived growth factor receptor a (PDGFRA) mutations, hold about 75 and 15% of GISTs cases, respectively. Tumors without KIT or PDGFRA mutations are known as wild type (WT)-GISTs, which takes up for 15% of all cases. WT-GISTs have other genetic alterations, including mutations of the succinate dehydrogenase and serine-threonine protein kinase BRAF and neurofibromatosis type 1. Other GISTs without any of the above genetic mutations are named "quadruple WT" GISTs. More types of rare mutations are being reported. These mutations or gene fusions were initially thought to be mutually exclusive in primary GISTs, but recently it has been reported that some of these rare mutations coexist with KIT or PDGFRA mutations. The treatment and management differ according to molecular subtypes of GISTs. Especially for patients with late-stage tumors, developing a personalized chemotherapy regimen based on mutation status is of great help to improve patient survival and quality of life. At present, imatinib mesylate is an effective first-line drug for the treatment of unresectable or metastatic recurrent GISTs, but how to overcome drug resistance is still an important clinical problem. The effectiveness of other drugs is being further evaluated. The progress in the study of relevant mechanisms also provides the possibility to develop new targets or new drugs.