CSANet: a lightweight channel and spatial attention neural network for grading diabetic retinopathy with optical coherence tomography angiography.

Background: Diabetic retinopathy (DR) is one of the most common eye diseases. Convolutional neural networks (CNNs) have proven to be a powerful tool for learning DR features; however, accurate DR grading remains challenging due to the small lesions in optical coherence tomography angiography (OCTA) images and the small number of samples. Methods: In this article, we developed a novel deep-learning framework to achieve the fine-grained classification of DR; that is, the lightweight channel and spatial attention network (CSANet). Our CSANet comprises two modules: the baseline model, and the hybrid attention module (HAM) based on spatial attention and channel attention. The spatial attention module is used to mine small lesions and obtain a set of spatial position weights to address the problem of small lesions being ignored during the convolution process. The channel attention module uses a set of channel weights to focus on useful features and suppress irrelevant features. Results: The extensive experimental results for the OCTA-DR and diabetic retinopathy analysis challenge (DRAC) 2022 data sets showed that the CSANet achieved state-of-the-art DR grading results, showing the effectiveness of the proposed model. The CSANet had an accuracy rate of 97.41% for the OCTA-DR data set and 85.71% for the DRAC 2022 data set. Conclusions: Extensive experiments using the OCTA-DR and DRAC 2022 data sets showed that the proposed model effectively mitigated the problems of mutual confusion between DRs of different severity and small lesions being neglected in the convolution process, and thus improved the accuracy of DR classification.

Diversifying crop rotation increases food production, reduces net greenhouse gas emissions and improves soil health.

Global food production faces challenges in balancing the need for increased yields with environmental sustainability. This study presents a six-year field experiment in the North China Plain, demonstrating the benefits of diversifying traditional cereal monoculture (wheat-maize) with cash crops (sweet potato) and legumes (peanut and soybean). The diversified rotations increase equivalent yield by up to 38%, reduce N2O emissions by 39%, and improve the system's greenhouse gas balance by 88%. Furthermore, including legumes in crop rotations stimulates soil microbial activities, increases soil organic carbon stocks by 8%, and enhances soil health (indexed with the selected soil physiochemical and biological properties) by 45%. The large-scale adoption of diversified cropping systems in the North China Plain could increase cereal production by 32% when wheat-maize follows alternative crops in rotation and farmer income by 20% while benefiting the environment. This study provides an example of sustainable food production practices, emphasizing the significance of crop diversification for long-term agricultural resilience and soil health.

Deep-learning segmentation method for optical coherence tomography angiography in ophthalmology.

PURPOSE: The optic disc and the macular are two major anatomical structures in the human eye. Optic discs are associated with the optic nerve. Macular mainly involves degeneration and impaired function of the macular region. Reliable optic disc and macular segmentation are necessary for the automated screening of retinal diseases. METHODS: A swept-source OCTA system was designed to capture OCTA images of human eyes. To address these segmentation tasks, first, we constructed a new Optic Disc and Macula in fundus Image with optical coherence tomography angiography (OCTA) dataset (ODMI). Second, we proposed a Coarse and Fine Attention-Based Network (CFANet). RESULTS: The five metrics of our methods on ODMI are 98.91 % , 98.47 % , 89.77 % , 98.49 % , and 89.77 % , respectively. CONCLUSIONS: Experimental results show that our CFANet has achieved good performance on segmentation for the optic disc and macula in OCTA.

Research on the Health Literacy Status and Compliance Behavior of Patients with Acute Coronary Syndrome.

This study is aimed at assessing the current status of ACS patients' health literacy and medication compliance, analyzing the relationship between the two, and providing ideas for clinically improving the medication compliance of ACS patients and preventing the recurrence of cardiovascular events. ACS patients need long-term medication to prevent vascular restenosis after surgery, and bad living habits and mood swings will affect postoperative recovery, so clinical interventions are needed to help patients establish a healthy lifestyle. The effect of conventional care is not ideal. Therefore, this paper uses regression analysis to analyze the correlation between the health literacy status of ACS patients and the compliance behavior, combines the investigation and experiment to perform regression analysis and uses mathematical statistics to process data. The connection between health literacy level and compliance behavior is discovered via a study, providing a point of reference for future research.

Compound α-keto acid tablet supplementation alleviates chronic kidney disease progression via inhibition of the NF-kB and MAPK pathways.

BACKGROUND: Keto-analogues administration plays an important role in clinical chronic kidney disease (CKD) adjunctive therapy, however previous studies on their reno-protective effect mainly focused on kidney pathological changes induced by nephrectomy. This study was designed to explore the currently understudied alternative mechanisms by which compound α-ketoacid tablets (KA) influenced ischemia-reperfusion (IR) induced murine renal injury, and to probe the current status of KA administration on staving CKD progression in Chinese CKD patients at different stages. METHODS: In animal experiment, IR surgery was performed to mimic progressive chronic kidney injury, while KA was administrated orally. For clinical research, a retrospective cohort study was conducted to delineate the usage and effects of KA on attenuating CKD exacerbation. End-point CKD event was defined as 50% reduction of initial estimated glomerular filtration rate (eGFR). Kaplan-Meier analysis and COX proportional hazard regression model were adopted to calculate the cumulative probability to reach the end-point and hazard ratio of renal function deterioration. RESULTS: In animal study, KA presented a protective effect on IR induced renal injury and fibrosis by attenuating inflammatory infiltration and apoptosis via inhibition of nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. In clinical research, after adjusting basic demographic factors, patients at stages 4 and 5 in KA group presented a much delayed and slower incidence of eGFR decrease compared to those in No-KA group (hazard ratio (HR) = 0.115, 95% confidence interval (CI) 0.021-0.639, p = 0.0134), demonstrating a positive effect of KA on staving CKD progression. CONCLUSION: KA improved IR induced chronic renal injury and fibrosis, and seemed to be a prospective protective factor in end stage renal disease.

Putative endothelial progenitor cells do not promote vascular repair but attenuate pericyte-myofibroblast transition in UUO-induced renal fibrosis.

BACKGROUND: Putative endothelial progenitor cells (pEPCs) have been confirmed to participate in alleviation of renal fibrosis in several ischaemic diseases. However, their mechanistic effect on renal fibrosis, which is characterized by vascular regression and further rarefaction-related pathology, remains unknown. METHODS: To explore the effect and molecular mechanisms by which pEPCs act on unilateral ureteral obstruction (UUO)-induced renal fibrosis, we isolated pEPCs from murine bone marrow. In vivo, pEPCs (2 × 105 cells/day) and pEPC-MVs (microvesicles) were injected into UUO mice via the tail vein. In vitro, pEPCs were co-cultured with renal-derived pericytes. Pericyte-myofibroblast transition was evaluated using the myofibroblast marker α-smooth muscle actin (α-SMA) and pericyte marker platelet-derived growth factor receptor ß (PDGFR-ß). RESULTS: Exogenous supply of bone marrow-derived pEPCs attenuated renal fibrosis by decreasing pericyte-myofibroblast transition without significant vascular repair in the UUO model. Our results indicated that pEPCs regulated pericytes and their transition into myofibroblasts via pEPC-MVs. Co-culture of pericytes with pEPCs in vitro suggested that pEPCs inhibit transforming growth factor-ß (TGF-ß)-induced pericyte-myofibroblast transition via a paracrine pathway. CONCLUSION: pEPCs effectively attenuated UUO-induced renal fibrosis by inhibiting pericyte-myofibroblast transition via a paracrine pathway, without promoting vascular repair.