CT coronary fractional flow reserve based on artificial intelligence using different software: a repeatability study.

OBJECTIVE: This study aims to assess the  consistency of various CT-FFR software, to determine the reliability of current CT-FFR software, and to measure relevant influence factors. The goal is to build a solid foundation of enhanced workflow and technical principles that will ultimately improve the accuracy of measurements of coronary blood flow reserve fractions. This improvement is critical for assessing the level of ischemia in patients with coronary heart disease. METHODS: 103 participants were chosen for a prospective research using coronary computed tomography angiography (CCTA) assessment. Heart rate, heart rate variability, subjective picture quality, objective image quality, vascular shifting length, and other factors were assessed. CT-FFR software including K software and S software are used for CT-FFR calculations. The consistency of the two software is assessed using paired-sample t-tests and Bland-Altman plots. The error classification effect is used to construct the receiver operating characteristic curve. RESULTS: The CT-FFR measurements differed significantly between the K and S software, with a statistical significance of P < 0.05. In the Bland-Altman plot, 6% of the points (14 out of 216) fell outside the 95% consistency level. Single-factor analysis revealed that heart rate variability, vascular dislocation offset distance, subjective image quality, and lumen diameter significantly influenced the discrepancies in CT-FFR measurements between two software programs (P < 0.05). The ROC curve shows the highest AUC for the vessel shifting length, with an optimal cut-off of 0.85 mm. CONCLUSION: CT-FFR measurements vary among software from different manufacturers, leading to potential misclassification of qualitative diagnostics. Vessel shifting length, subjective image quality score, HRv, and lumen diameter impacted the measurement stability of various software.

Molecular Traits and Functional Exploration of BES1 Gene Family in Plants.

The BES1 (BRI1-EMSSUPPRESSOR1) gene family is a unique class of transcription factors that play dynamic roles in the Brassinosteroids (BRs) signaling pathway. The published genome sequences of a large number of plants provide an opportunity to identify and perform a comprehensive functional study on the BES1 gene family for their potential roles in developmental processes and stress responses. A total of 135 BES1 genes in 27 plant species were recognized and characterized, which were divided into five well-conserved subfamilies. BES1 was not found in lower plants, such as Cyanophora paradoxa and Galdieria sulphuraria. The spatial expression profiles of BES1s in Arabidopsis, rice, and cotton, as well as their response to abiotic stresses, were analyzed. The overexpression of two rice BES1 genes, i.e., OsBES1-3 and OsBES1-5, promotes root growth under drought stress. The overexpression of GhBES1-4 from cotton enhanced the salt tolerance in Arabidopsis. Five protein interaction networks were constructed and numerous genes co-expressed with GhBES1-4 were characterized in transgenic Arabidopsis. BES1 may have evolved in the ancestors of the first land plants following its divergence from algae. Our results lay the foundation for understanding the complex mechanisms of BES1-mediated developmental processes and abiotic stress tolerance.

Therapy response assessment of non-small cell lung cancer using dual-energy computed tomography iodine map.

OBJECTIVE: To investigate feasibility of the quantitative parameters of dual-energy computed tomography (DECT) to assess therapy response in advanced non-small cell lung cancer (NSCLC) compared with the traditional enhanced CT parameters based on the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. METHODS: Forty-five patients with unresectable locally advanced NSCLC who underwent DECT before and after chemotherapy or concurrent chemoradiotherapy (cCRT) were prospectively enrolled. By comparing baseline studies with follow-up, patients were divided into two groups according to RECIST guidelines as follows: disease control (DC, including partial response and stable disease) and progressive disease (PD). The diameter (D), attenuation, iodine concentration and normalized iodine concentration of arterial and venous phases (ICA, ICv, NICA, NICv) and the percentage of these changes pre- and post-therapy were measured and calculated. The Pearson correlation was used to analyze correlation between various quantitative parameters. The receiver operating characteristic (ROC) curves were used to evaluate accuracy of therapy response prediction. RESULTS: The change percentages of Attenuation (Δ-Attenuation-A and Δ-Attenuation-V), IC (ΔICA and ΔICV) and NIC (ΔNICA and ΔNICV) pre- and post-therapy correlate with the change percentage of D (ΔD). Among these, ΔICA strongly correlates with ΔD (r = 0.793, P < 0.001). The areas under ROC curves generated using Δ-Attenuation-A, ΔICA, and ΔNICA are 0.796, 0.900, and 0.880 with the corresponding cutoff value of 9.096, -15.692, and -4.7569, respectively, which are significantly different (P < 0.001). CONCLUSIONS: The quantitative parameters of DECT iodine map, especially iodine concentration, in arterial phase provides a new quantitative image marker to predict therapy response of patients diagnosed with advanced NSCLC.

Assessment of Acute Pulmonary Embolism by Computer-Aided Technique: A Reliability Study.

BACKGROUND Acute pulmonary embolism is one of the most common cardiovascular diseases. Computer-aided technique is widely used in chest imaging, especially for assessing pulmonary embolism. The reliability and quantitative analyses of computer-aided technique are necessary. This study aimed to evaluate the reliability of geometry-based computer-aided detection and quantification for emboli morphology and severity of acute pulmonary embolism. MATERIAL AND METHODS Thirty patients suspected of acute pulmonary embolism were analyzed by both manual and computer-aided interpretation of vascular obstruction index and computer-aided measurements of emboli quantitative parameters. The reliability of Qanadli and Mastora scores was analyzed using computer-aided and manual interpretation. RESULTS The time costs of manual and computer-aided interpretation were statistically different (374.90±150.16 versus 121.07±51.76, P<0.001). The difference between the computer-aided and manual interpretation of Qanadli score was 1.83±2.19, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (intraclass correlation coefficient, ICC=0.998). The difference between the computer-aided and manual interpretation of Mastora score was 1.46±1.62, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (ICC=0.997). The emboli quantitative parameters were moderately correlated with the Qanadli and Mastora scores (all P<0.001). CONCLUSIONS Computer-aided technique could reduce the time costs, improve the and reliability of vascular obstruction index and provided additional quantitative parameters for disease assessment.

Right coronary artery-right ventricular fistula complicated with infective endocarditis.

Coronary artery fistula (CAF) is a congenital disease in which a communication forms between one or more coronary arteries and a cardiac chamber or great vessel. We describe an infrequent case of right coronary artery (RCA) fistula into the right ventricle (RV) complicated by infective endocarditis in a child. The patient received echocardiography and contrast-enhanced multidetector computed tomography (MDCT). Surgical treatment was performed after management of the infection. Unfortunately, a residual fistula formed after surgery. However, interestingly, the residual fistula spontaneously resolved at one year after surgery. He is now in good condition and totally asymptomatic.

Right atrial appendage aneurysm complicated with atrial septal defect: A rare case report.

Right atrial appendage aneurysms (RAAAs) are rare heart malformations, presenting as isolated anomalies or co-existing with other structural heart diseases. We describe a rare case of RAAA complicated with an atrial septal defect (ASD). The diagnosis was established using transthoracic echocardiography and confirmed using cardiac magnetic resonance imaging. To treat the ASD and reduced right atrium volume load, ASD transcatheter closure was performed. On echocardiography performed 3 months post discharge, the RAAA was observed to have reduced in size compared to that presurgery. Six years later, she was in good condition without any adverse events.

Molecular Traits and Functional Analysis of the CLAVATA3/Endosperm Surrounding Region-Related Small Signaling Peptides in Three Species of Gossypium Genus.

The CLAVATA3/endosperm surrounding region-related (CLE) small peptides are a group of C-terminally encoded and post-translationally modified signal molecules involved in regulating the growth and development of various plants. However, the function and evolution of these peptides have so far remained elusive in cotton. In this study, 55, 56, and 86 CLE genes were identified in the Gossypium raimondii, Gossypium arboreum, and Gossypium hirsutum genomes, respectively, and all members were divided into seven groups. These groups were distinctly different in their protein characteristics, gene structures, conserved motifs, and multiple sequence alignment. Whole genome or segmental duplications played a significant role in the expansion of the CLE family in cotton, and experienced purifying selection during the long evolutionary process in cotton. Cis-acting regulatory elements and transcript profiling revealed that the CLE genes of cotton exist in different tissues, developmental stages, and respond to abiotic stresses. Protein properties, structure prediction, protein interaction network prediction of GhCLE2, GhCLE33.2, and GhCLE28.1 peptides were, respectively, analyzed. In addition, the overexpression of GhCLE2, GhCLE33.2, or GhCLE28.1 in Arabidopsis, respectively, resulted in a distinctive shrub-like dwarf plant, slightly purple leaves, large rosettes with large malformed leaves, and lack of reproductive growth. This study provides important insights into the evolution of cotton CLEs and delineates the functional conservatism and divergence of CLE genes in the growth and development of cotton.