RNA-seq-based comparative transcriptome analysis reveals the role of CsPrx73 in waterlogging-triggered adventitious root formation in cucumber.

Abiotic stressors like waterlogging are detrimental to cucumber development and growth. However, comprehension of the highly complex molecular mechanism underlying waterlogging can provide an opportunity to enhance cucumber tolerance under waterlogging stress. We examined the hypocotyl and stage-specific transcriptomes of the waterlogging-tolerant YZ026A and the waterlogging-sensitive YZ106A, which had different adventitious rooting ability under waterlogging. YZ026A performed better under waterlogging stress by altering its antioxidative machinery and demonstrated a greater superoxide ion (O 2-) scavenging ability. KEGG pathway enrichment analysis showed that a high number of differentially expressed genes (DEGs) were enriched in phenylpropanoid biosynthesis. By pairwise comparison and weighted gene co-expression network analysis analysis, 2616 DEGs were obtained which were categorized into 11 gene co-expression modules. Amongst the 11 modules, black was identified as the common module and yielded a novel key regulatory gene, CsPrx73. Transgenic cucumber plants overexpressing CsPrx73 enhance adventitious root (AR) formation under waterlogging conditions and increase reactive oxygen species (ROS) scavenging. Silencing of CsPrx73 expression by virus-induced gene silencing adversely affects AR formation under the waterlogging condition. Our results also indicated that CsERF7-3, a waterlogging-responsive ERF transcription factor, can directly bind to the ATCTA-box motif in the CsPrx73 promoter to initiate its expression. Overexpression of CsERF7-3 enhanced CsPrx73 expression and AR formation. On the contrary, CsERF7-3-silenced plants decreased CsPrx73 expression and rooting ability. In conclusion , our study demonstrates a novel CsERF7-3-CsPrx73 module that allows cucumbers to adapt more efficiently to waterlogging stress by promoting AR production and ROS scavenging.

Tailoring tokamak error fields to control plasma instabilities and transport.

A tokamak relies on the axisymmetric magnetic fields to confine fusion plasmas and aims to deliver sustainable and clean energy. However, misalignments arise inevitably in the tokamak construction, leading to small asymmetries in the magnetic field known as error fields (EFs). The EFs have been a major concern in the tokamak approaches because small EFs, even less than 0.1%, can drive a plasma disruption. Meanwhile, the EFs in the tokamak can be favorably used for controlling plasma instabilities, such as edge-localized modes (ELMs). Here we show an optimization that tailors the EFs to maintain an edge 3D response for ELM control with a minimized core 3D response to avoid plasma disruption and unnecessary confinement degradation. We design and demonstrate such an edge-localized 3D response in the KSTAR facility, benefiting from its unique flexibility to change many degrees of freedom in the 3D coil space for the various fusion plasma regimes. This favorable control of the tokamak EF represents a notable advance for designing intrinsically 3D tokamaks to optimize stability and confinement for next-step fusion reactors.

Investigation into white matter microstructure differences in visual training by using an automated fiber tract subclassification segmentation quantification method.

Visual training has emerged as a useful framework for investigating training-related brain plasticity, a highly complex task involving the interaction of visual orientation, attention, reasoning, and cognitive functions. However, the effects of long-term visual training on microstructural changes within white matter (WM) is poorly understood. Therefore, a set of visual training programs was designed, and automated fiber tract subclassification segmentation quantification based on diffusion magnetic resonance imaging was performed to obtain the anatomical changes in the brains of visual trainees. First, 40 healthy matched participants were randomly assigned to the training group or the control group. The training group underwent 10 consecutive weeks of visual training. Then, the fiber tracts of the subjects were automatically identified and further classified into fiber clusters to determine the differences between the two groups on a detailed scale. Next, each fiber cluster was divided into segments that can analyze specific areas of a fiber cluster. Lastly, the diffusion metrics of the two groups were comparatively analyzed to delineate the effects of visual training on WM microstructure. Our results showed that there were significant differences in the fiber clusters of the cingulate bundle, thalamus frontal, uncinate fasciculus, and corpus callosum between the training group compared and the control group. In addition, the training group exhibited lower mean fractional anisotropy, higher mean diffusivity and radial diffusivity than the control group. Therefore, the long-term cognitive activities, such as visual training, may systematically influence the WM properties of cognition, attention, memory, and processing speed.

Industrial-scale extraction of high value-added kaolin from excavation waste: Demonstration from Xiamen, China.

Excavation waste from the construction of subways and other underground infrastructures is mainly composed of gravel, sand and clay of minimal economic value, which commonly ends up in landfills. Although the coarse sand and gravel of the excavation waste are typically recycled on site, a large amount of the fine-grained residue must be disposed of due to the prohibition of marine land reclamation in Xiamen, China, leading to an increasingly severe shortage of landfills. In this contribution, a new strategy was successfully developed for industrial-scale extraction of high value-added kaolin from the excavation waste of Xiamen. This strategy can overcome the challenges of complex and variable chemical compositions, high iron contents, low industrial grade, and organic contaminants in the raw materials. Characterization using chemical analysis, powder X-ray diffraction, scanning electron microscopy, and infrared spectroscopy showed that the Xiamen excavation waste originated from granite weathering is mainly composed of kaolinite and quartz, along with high Fe contents and other impurities. The excavation waste was subjected to an intensive process of blunging, grinding, sieving, and classifying, as well as successive iron removal by magnetic separation. Subsequently, the extracted products meet commercial requirements, including those for high-quality kaolin with whiteness and plasticity larger than 90° and 17%, respectively. Moreover, an industrial-scale green production line with an annual treatment capacity of one million tonnes of excavation waste at the utilization rate of 100% was implemented. Hence, this work presents an effective approach for exploiting similar excavation waste around the world to promote sustainable development.

A CsEIL3-CsARN6.1 module promotes waterlogging-triggered adventitious root formation in cucumber by activating the expression of CsPrx5.

The formation of adventitious roots (ARs) derived from hypocotyl is the most important morphological adaptation to waterlogging stress in Cucumis sativus (cucumber). Our previous study showed that cucumbers with the gene CsARN6.1, encoding an AAA ATPase domain-containing protein, were more tolerant to waterlogging through increased AR formation. However, the apparent function of CsARN6.1 remained unknown. Here, we showed that the CsARN6.1 signal was predominantly observed throughout the cambium of hypocotyls, where de novo AR primordia are formed upon waterlogging treatment. The silencing of CsARN6.1 expression by virus-induced gene silencing and CRISPR/Cas9 technologies adversely affects the formation of ARs under conditions of waterlogging. Waterlogging treatment significantly induced ethylene production, thus upregulating CsEIL3 expression, which encodes a putative transcription factor involved in ethylene signaling. Furthermore, yeast one-hybrid, electrophoretic mobility assay and transient expression analyses showed that CsEIL3 binds directly to the CsARN6.1 promoter to initiate its expression. CsARN6.1 was found to interact with CsPrx5, a waterlogging-responsive class-III peroxidase that enhanced H2 O2 production and increased AR formation. These data provide insights into understanding the molecular mechanisms of AAA ATPase domain-containing protein and uncover a molecular mechanism that links ethylene signaling with the formation of ARs triggered by waterlogging.

CNTSeg: A multimodal deep-learning-based network for cranial nerves tract segmentation.

The segmentation of cranial nerves (CNs) tracts based on diffusion magnetic resonance imaging (dMRI) provides a valuable quantitative tool for the analysis of the morphology and course of individual CNs. Tractography-based approaches can describe and analyze the anatomical area of CNs by selecting the reference streamlines in combination with ROIs-based (regions-of-interests) or clustering-based. However, due to the slender structure of CNs and the complex anatomical environment, single-modality data based on dMRI cannot provide a complete and accurate description, resulting in low accuracy or even failure of current algorithms in performing individualized CNs segmentation. In this work, we propose a novel multimodal deep-learning-based multi-class network for automated cranial nerves tract segmentation without using tractography, ROI placement or clustering, called CNTSeg. Specifically, we introduced T1w images, fractional anisotropy (FA) images, and fiber orientation distribution function (fODF) peaks into the training data set, and design the back-end fusion module which uses the complementary information of the interphase feature fusion to improve the segmentation performance. CNTSeg has achieved the segmentation of 5 pairs of CNs (i.e. optic nerve CN II, oculomotor nerve CN III, trigeminal nerve CN V, and facial-vestibulocochlear nerve CN VII/VIII). Extensive comparisons and ablation experiments show promising results and are anatomically convincing even for difficult tracts. The code will be openly available at https://github.com/IPIS-XieLei/CNTSeg.

A 2-bp deletion in the protein kinase domain region of the ERECTA-like receptor kinase gene in cucumber results in short internode phenotype.

Cucumber varieties with shortend internodes require less space than regular vining varieties, thus have great significance for germplasm improvement. Here, we found a novel spontaneous cucumber mutant si107 that exhibited short intenodes (si), smaller leaves, fruits, and seeds. The decrease in longitudinal cell length led to the shortened internodes of si107. The genetic analysis revealed a single recessive gene si-2 that was responsible for the mutation. Through multiple lines of evidence, we demonstrated that CsSI is the possible candidate gene for si-2, which encodes an ERECTA leucine-rich repeat receptor-like kinase. The shortened internode in si107 is attributed to a 2-bp deletion in the protein kinase domain region of this gene. The expression of CsSI was higher in the internodes, petioles, and fruit peels of si107 than in the wild type (WT). The transcriptome analysis between the si107 mutant and WT indicated that differentially expressed genes were significantly enriched in the plant hormone signal transduction pathway, in which auxin signal genes comprised the largest group, and all were downregulated in si107. Phytohormone quantitation confirmed that endogenous auxin levels in the stems of si107 were decreased. Our results provide new insights into the molecular mechanisms underlying the internode length control in cucumber.

Fecal Microbiota Transplantation Could Improve Chronic Diarrhea in Cynomolgus Monkey by Alleviating Inflammation and Modulating Gut Microbiota.

Chronic diarrhea is associated with enteric dysbiosis and provokes the overuse of antibiotics. Fecal microbiota transplantation (FMT) is a promising therapy, but it shows discrepant clinical efficacy. Bacterial colonization in recipients has been studied, although little is known about the role of gut fungi and Archaea after FMT. In this study, we evaluated the efficacy of human-derived FMT on spontaneous chronic diarrhea cynomolgus monkeys and revealed the effector mechanisms. We demonstrated that FMT can mitigate the appearance of diarrheal symptoms and inhibit the increase in interleukin-6, interleukin-8, interleukin-1ß, and interferon-γ and the decrease in interleukin-10 in serum. We confirmed that FMT restored the disturbance of gut bacteria by reducing the relative abundances of potential pathogens, including Cloacibacillus porcorum, Desulfovibrio desulfuricans, Erysipelotrichaceae bacterium 5_2_54FAA, and Erysipelotrichaceae bacterium 21_3, and increasing the levels of Lactobacillus fermentum and Lactobacillus ruminis CAG_367 in diarrheal monkeys. The metabolic pathways of healthy and FMT monkeys' gut bacteria were enriched in amino acid metabolism, carbohydrate metabolism, and lipid metabolism, while the metabolic pathways of pre-FMT monkeys' gut bacteria were enriched in antibiotic production. Moreover, a higher Ascomycota/Basidiomycota ratio, higher Aspergillus levels, and lower Trichosporon asahii abundance were present in intestinal fungi after FMT. Although the abundance of the Archaea Methanosphaera stastmanae did not change significantly, it was inversely correlated with the anti-inflammatory factor IL-4 after FMT. These results support the further development and application of FMT for chronic diarrhea.

Application of enhanced computed tomography-based radiomics nomogram analysis to differentiate metastatic ovarian tumors from epithelial ovarian tumors.

OBJECTIVE: To investigate the value of nomogram analysis based on conventional features and radiomics features of computed tomography (CT) venous phase to differentiate metastatic ovarian tumors (MOTs) from epithelial ovarian tumors (EOTs). METHODS: A dataset involving 286 patients pathologically confirmed with EOTs (training cohort: 133 cases, validation cohort: 68 cases) and MOTs (training cohort: 54 cases, validation cohort: 31 cases) is assembled in this study. Radiomics features are extracted from the venous phase of CT images. Logistic regression is employed to build models based on conventional features (model 1), radiomics features (model 2), and the combination of model 1 and model 2 (model 3). Diagnostic performance is assessed and compared. Additionally, a nomogram is plotted for model 3, and decision curve analysis is applied for clinical use. RESULTS: Age, abdominal metastasis, para-aortic lymph node metastasis, location, and septation are chosen to build Model 1. Ten optimal radiomics features are ultimately selected and radiomics score (rad-score) is calculated to build Model 2. Nomogram score is calculated to build model 3 that shows optimal diagnostic performance in both the training (AUC = 0.952) and validation cohorts (AUC = 0.720), followed by model 1 (AUC = 0.872 for training cohort and AUC = 0.709 for validation cohort) and model 2 (AUC = 0.833 for training cohort and AUC = 0.620 for validation cohort). Additionally, Model 3 achieves accuracy, sensitivity, and specificity of 0.893, 0.880, and 0.926 in the training cohort and 0.737, 0.853, and 0.613 in the validation cohort. CONCLUSION: Model 3 demonstrates the best diagnostic performance for preoperative differentiation of MOTs from EOTs. Thus, nomogram analysis based on Model 3 may be used as a biomarker to differentiate MOTs from EOTs.

Comparative Biochemical and Transcriptomic Analyses Provide New Insights into Phytoplasma Infection Responses in Cucumber.

Flat stem and witches' broom phytoplasma-like symptoms in the cucumber inbred line C17 were observed in a greenhouse at Yangzhou University, China for three consecutive planting seasons; these symptoms resulted in a decreased yield. To better understand the cause of these symptoms, 16S rRNA PCR, plant hormones, mineral elements, and RNA-seq profiling were performed using symptomatic and normal stem samples. The results showed that the causal agent was classified as the Candidatus phytoplasma asteris strain, a plant pathogenic prokaryote that could not be cultured in vitro. Measurement of plant hormones showed that auxin, salicylic acid, and jasmonic acid contents were significantly increased, whereas that of ethylene's immediate biosynthetic precursor, 1-aminocyclopropane-1-carboxylic acid, was decreased in the phytoplasma-infected stems compared with the healthy stems. Furthermore, measurement of mineral element composition showed that magnesium, calcium, sodium, iron, and zinc concentrations significantly changed in the phytoplasma-infected cucumber stems compared with the uninfected stems. Comparative RNA-seq identified 253 differentially expressed genes, including 179 upregulated and 74 downregulated genes. Further analyses suggested that genes related to phenylpropanoid biosynthesis, phenylalanine metabolism, and plant hormone signal transduction contributed to phytoplasma infection. Taken together, this study presents the first in-depth assessment of disease symptoms and biochemical content of cucumber stems known to be infected with phytoplasma.

Value of non-Gaussian diffusion imaging with a fractional order calculus model combined with conventional MRI for differentiating histological types of cervical cancer.

OBJECTIVE: This study aimed to evaluate the value of a fractional order calculus (FROC) model combined with conventional magnetic resonance imaging (MRI) for differentiating cervical adenocarcinoma (CAC) from squamous cell carcinoma (SCC). METHODS: Diffusion-weighted imaging (DWI) with 9 b values (0-2000s/mm2) was carried out in 57 cervical cancer patients. Diffusion coefficient (D), fractional order parameter (ß), and microstructural quantity (µ) together with apparent diffusion coefficient (ADC) were calculated and compared between the CAC and SCC groups. Conventional MRI features included T2WI signal intensity (SI), unenhanced-T1WI SI, enhanced-T1WI SI, and ∆T1WI SI, which were also compared between the two groups. Receiver operating characteristic (ROC) analysis was employed to assess the performance of FROC parameters, ADC, and conventional MRI features in differentiating CAC from SCC. RESULTS: ß was significantly lower in the CAC group than in the SCC group (0.682 ± 0.054 vs. 0.723 ± 0.084, P = 0.035), while D and µ were not significantly different between the two groups (D, P = 0.171; µ, P = 0.127). There was no significant difference in the ADC value between the two groups (P = 0.053). In conventional MRI features, enhanced-T1WI SI was significantly higher in the SCC group than in the CAC group (985.78 ± 130.83 vs. 853.92 ± 149.65, P = 0.002). The area under the curve (AUC) of ß, ADC, and enhanced-T1WI SI was 0.700, 0.683, and 0.799, respectively. The combination of ß, ADC, and enhanced-T1WI SI revealed optimal diagnostic performance in differentiating CAC from SCC (AUC = 0.930), followed by ß + enhanced-T1WI SI (AUC = 0.869), ADC+ enhanced-T1WI SI (AUC = 0.817), and ß + ADC (AUC = 0.761). CONCLUSION: The FROC model can serve as a noninvasive and quantitative imaging technique for differentiating CAC from SCC. ß combined with ADC and enhanced-T1WI SI had the highest diagnostic efficiency.

Mapping brain-wide excitatory projectome of primate prefrontal cortex at submicron resolution and comparison with diffusion tractography.

Resolving trajectories of axonal pathways in the primate prefrontal cortex remains crucial to gain insights into higher-order processes of cognition and emotion, which requires a comprehensive map of axonal projections linking demarcated subdivisions of prefrontal cortex and the rest of brain. Here, we report a mesoscale excitatory projectome issued from the ventrolateral prefrontal cortex (vlPFC) to the entire macaque brain by using viral-based genetic axonal tracing in tandem with high-throughput serial two-photon tomography, which demonstrated prominent monosynaptic projections to other prefrontal areas, temporal, limbic, and subcortical areas, relatively weak projections to parietal and insular regions but no projections directly to the occipital lobe. In a common 3D space, we quantitatively validated an atlas of diffusion tractography-derived vlPFC connections with correlative green fluorescent protein-labeled axonal tracing, and observed generally good agreement except a major difference in the posterior projections of inferior fronto-occipital fasciculus. These findings raise an intriguing question as to how neural information passes along long-range association fiber bundles in macaque brains, and call for the caution of using diffusion tractography to map the wiring diagram of brain circuits.

In the brain is a web of interconnected nerve cells that send messages to one another via spindly projections called axons. These axons join together at junctions called synapses to create circuits of nerve cells which connect neighboring or distant brain regions. Notably, long-range neural connections underpin higher-order cognitive skills (such as planning and emotion regulation) which make humans distinct from our primate relatives. Only by untangling these far-reaching networks can researchers begin to delineate what sets the human brain apart from other species. Researchers deploy a range of imaging techniques to map neural networks: scanning entire brains using MRI machines, or imaging thin slices of fluorescently labelled brain tissue using powerful microscopes. However, tracing long-range axons at a high resolution is challenging, and has stirred up debate about whether some neural tracts, such as the inferior fronto-occipital fasciculus, are present in all primates or only humans. To address these discrepancies, Yan, Yu et al. employed a two-pronged approach to map neural circuits in the brains of macaques. First, two techniques ­ called viral tracing and two-photon microscopy ­ were used to create a three-dimensional, fine-grain map showing how the ventrolateral prefrontal cortex (vlPFC), which regulates complex behaviors, connects to the rest of the brain. This revealed prominent axons from the vlPFC projecting via a single synapse to distant brain regions involved in higher-order functions, such as encoding memories and processing emotion. However, there were no direct, monosynaptic connections between the vlPFC and the occipital lobe, the brain's visual processing center at the back of the head. Next, Yan, Yu et al. used a specialized MRI scanner to create an atlas of neural circuits connected to the vlPFC, and compared these results to a technique tracing axons stained with a fluorescent dye. In general, there was good agreement between the two methods, except for major differences in the rear-end projections that typically form the inferior fronto-occipital fasciculus. This suggests that this long-range neural pathway exists in monkeys, but it connects via multiple synapses instead of a single junction as was previously thought. The findings of Yan, Yu et al. provide new insights on the far-reaching neural pathways connecting distant parts of the macaque brain. It also suggests that atlases of neural circuits from whole brain scans should be taken with caution and validated using neural tracing experiments.

Added value of radiomics analysis in MRI invisible early-stage cervical cancers.

OBJECTIVES: To determine the diagnostic ability of cervical mucosa radiomics signature of sagittal T2WI and T1 contrast-enhanced (CE) imaging in detecting early-stage cervical cancers with negative MRI. METHODS: Preoperative images of postoperative pathology confirmed early-stage cervical cancer patients and normal cervix patients admitted to our hospital between January 2013 and December 2020 were retrospectively reviewed. Patients with cancer signals on T2WI, T1CE and DWI were deleted. Regions of interests (ROIs) were delineated on cervical mucosa (from cervical canal to cervical dome) with 5 mm width on sagittal T2WI and T1CE. The maximum-relevance and minimumredundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) methods were used for the calculation of radiomics signature scores. Diagnostic performance was assessed and compared between radiomics prediction models (model 1: T1CE; model 2: T2WI; model 3: model one combined with model 2). Differential diagnostic ability of radiomics signature in detecting lymphatic vascular space invasion (LVSI) was further explored. RESULTS: Diagnostic performance of model three was higher than model 1 and model 2 both in primary (model 3 0.874, model 1 0.857, model 2 0.816) and validation (model 3 0.853, model 1 0.847, model 2 0.634) cohorts. Model 3 showed statistical diagnostic difference compared with model 2 (primary p = 0.008, validation p = 0.000). However, the diagnostic improvement ability of model 3 showed no statistical difference compared with model 1 (primary p = 0.351, validation p = 0.739). Diagnostic efficiency of model 3 in detecting LVSI was not apparent (AUC 0.64). CONCLUSIONS: Radiomics analysis of cervical mucosa combining T1CE and T2WI is promising for predicting MRI invisible early-stage cervical cancers, however further ability in detecting LVSI was not apparent. ADVANCES IN KNOWLEDGE: Conventional MRI was originally defined as meaningless in very early-stage cervical cancers. However, whether MRI radiomics analysis of cervical mucosa can detecting tiny changes of invisible early stage cervical cancers has not been researched yet.

Percutaneous Versus Surgical Insertion of Peritoneal Dialysis Catheters: A Systematic Review and Meta-Analysis.

BACKGROUND: Home-based peritoneal dialysis (PD) is an alternative to facility-based hemodialysis and has lower costs and greater freedom for patients with kidney failure. For a patient to undergo PD, a safe and reliable method of accessing the peritoneum is needed. However, different catheter insertion techniques may affect patient health outcomes. OBJECTIVE: To compare the risk of infectious and mechanical complications between surgical (open and laparoscopic) PD catheter insertion and percutaneous catheter insertion. DESIGN: Systematic review and meta-analysis. SETTING: We searched for observational studies and randomized controlled trials (RCTs) in CENTRAL, EMBASE, MEDLINE, PubMed, and SCOPUS from inception until June 2018. Data were extracted by 2 independent reviewers based on a preformed template. PATIENTS: Adult (aged 18+) patients with kidney failure who underwent a PD catheter insertion procedure. MEASUREMENTS: We analyzed leak, malfunction, and bleed as early complications (occurring within 1 month of catheter insertion). Infectious complications (exit-site infections, tunnel infections, and peritonitis) were presented as both early complications and with the longest duration of follow-up. METHODS: Random effects meta-analyses with the generic inverse variance method to estimate pooled rate ratios and 95% confidence intervals. We quantified heterogeneity by using the I2 statistic for inconsistency and assessed heterogeneity using the χ2 test. Sensitivity analysis was performed by removing studies at high risk of bias as measured with the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. RESULTS: Twenty-four studies (22 observational, 2 RCTs) with 3108 patients and 3777 catheter insertions were selected. Data from 2 studies were unable to be extracted and were qualitatively assessed. In the remaining 22 studies, percutaneous insertion was associated with a lower risk of both exit-site infections (risk ratio [RR] = 0.36, 95% confidence interval [CI] = 0.24-0.53, I2 = 0%) and peritonitis (RR = 0.52, 95% CI = 0.36-0.77, I2 = 3%) within 1 month of the procedure. There was no difference in mechanical complication rates between the 2 techniques. LIMITATIONS: Lack of consistency in the time periods for the various outcomes reported, risk of bias concerns with respect to population comparability, and the inability to analyze individual component causes of primary nonfunction (catheter obstruction, catheter migration, and leak). CONCLUSIONS: Our meta-analysis suggests differences in early infectious complications in favor of percutaneous insertion and no significant differences in mechanical complications compared with surgical insertion. These findings have implications on the direction of PD programs in terms of maximizing operating room resources.

CONTEXTE: La dialyse péritonéale à domicile (DPD) est une alternative plus économique à l'hémodialyse en centre et offre une plus grande liberté aux patients atteints d'insuffisance rénale. Or, pour qu'un patient soit traité par DPD, il est essentiel de recourir à une méthode d'accès au péritoine qui soit fiable et sûre. Les techniques existantes pour l'insertion du cathéter sont toutefois susceptibles d'affecter les résultats de santé du patient. OBJECTIFS: Comparer le risque de complications mécaniques et infectieuses entre l'insertion chirurgicale (incision et laparoscopie) et percutanée d'un cathéter de DP. TYPE D'ÉTUDE: Revue systématique et méta-analyse. CADRE: Nous avons consulté les bases de données CENTRAL, EMBASE, MEDLINE, PubMed et SCOPUS à la recherche d'études observationnelles et d'essais contrôlés à répartition aléatoire (ECRA) de la création à juin 2018. Deux réviseurs indépendants ont procédé à l'extraction des données en suivant un modèle préformé. SUJETS: Des adultes atteints d'insuffisance rénale ayant subi une procédure d'insertion d'un cathéter de DP. MESURES: Nous avons analysé les fuites, le dysfonctionnement et les saignements comme des complications précoces (survenant dans le mois suivant l'insertion du cathéter). Les complications infectieuses (infections au point de sortie, infections des tunnels, péritonite) ont été présentées comme complications précoces et avec la plus longue durée de suivi. MÉTHODOLOGIE: Nous avons procédé à des méta-analyses selon la méthode générique de l'inverse de la variance avec effets aléatoires pour estimer les rapports des taux combinés et les intervalles de confiance à 95 %. L'hétérogénéité a été quantifiée en utilisant la statistique I2 pour l'incohérence et a été évaluée par le test du Chi-Deux. L'analyse de sensibilité a été réalisée en retirant les études présentant un risque élevé de biais, lesquelles ont été définies à l'aide de l'échelle Newcastle-Ottawa et de l'outil Cochrane sur le risque de biais. RÉSULTATS: En tout, 24 études (22 études observationnelles, 2 ECRA) ont été sélectionnées, ce qui représente 3 108 patients et 3 777 insertions de cathéters. Les données de deux études n'ont pu être extraites et ont été évaluées qualitativement. Dans les 22 autres études, l'insertion percutanée a été associée, dans le mois suivant la procédure, à un risque plus faible d'infections au site de sortie (RR = 0,36; IC à 95 %: 0,24-0,53; I2 = 0 %) et de péritonite (RR = 0,52; IC à 95 %: 0,36-0,77; I2 = 3 %). Aucune différence dans les taux de complications mécaniques n'a été observée entre les deux techniques. LIMITES: Les résultats sont limités par le manque de cohérence dans les périodes associées aux divers résultats signalés, le risque de biais quant à la comparabilité des populations et l'incapacité d'analyser les causes individuelles du non-fonctionnement primaire (obstruction du cathéter, migration du cathéter, fuite). CONCLUSION: Notre méta-analyse suggère des différences en faveur de l'insertion percutanée par rapport à l'insertion chirurgicale pour les complications infectieuses précoces, mais aucune différence significative en ce qui concerne les complications mécaniques. Ces résultats ont des implications sur l'orientation des programmes de DP relativement à l'optimisation des ressources du bloc opératoire.

Effects of Family Intervention on Physical Activity and Sedentary Behavior in Children Aged 2.5-12 Years: A Meta-Analysis.

Introduction: To use a quantitative approach to examine the effects of family interventions on physical activity (PA) and sedentary behavior (SB) in children aged 2. 5-12 years. Methods: PubMed, OVID, Web of Science, and others were searched from their inception to May 2020. Intervention studies that examined the effects of family interventions on PA among children aged 2.5-12 years were included in this meta-analysis. Lastly, subgroup analyses were conducted to examine the potential modifying effects of family intervention's characteristics and study quality. Results: Eleven articles met the inclusion criteria for this review. Studies investigated a range of PA outcomes, including moderate-to-vigorous PA (MVPA), total PA (TPA), daily steps, and SB levels. Meta-analysis showed that family intervention had a significant effect on PA [standardized mean difference (SMD) = 0.10; 95% CI = 0.01-0.19], especially for daily steps [weight means difference (WMD) = 1,006; 95% CI = 209-1,803], but not for SB (WMD = -0.38; 95% CI = -7.21-6.46). Subgroup analyses indicated the improvements in PA occurred when children were 6-12 years old, intervention focused on PA only, intervention duration ≤ 10 weeks, and "low risk of bias" study performed. Conclusions: Family intervention may be a promising way to promote children's PA levels, especially for daily steps. Trial Registration: Meta-analysis protocol was registered on PROSPERO: CRD42020193667.

The Distribution Pattern of Traditional Chinese Medicine Syndromes in 549 Patients with Type 2 Diabetes.

OBJECTIVE: This study aimed to summarize the distribution pattern of traditional Chinese medicine (TCM) syndromes in patients with type 2 diabetes mellitus (T2DM). METHODS: The frequency, characteristics and distribution of all TCM syndromes of 549 patients with T2DM were analyzed. RESULTS: The average age of T2DM onset was higher in women than in men (ie, men experienced earlier onset). The distribution of TCM syndromes, in order of frequency, was as follows: damp-heat trapping spleen (including spleen deficiency and dampness, damp heat due to spleen deficiency, and qi weakness due to spleen deficiency) (58.29%), qi-yin deficiency (16.03%), deficiency of yin and excessive heat (12.93%), blood stasis in collaterals (9.41%), and yin-yang deficiency (3.21%). The physical intensity of patients' occupational activity was mainly light (49.6%), followed by heavy (31.4%) and moderate (19.0%). CONCLUSION: Damp-heat trapping spleen is the most common TCM syndrome in patients with T2DM, with damp heat due to spleen deficiency the most significant subtype. This syndrome tends to occur in people over the age of 60 and those undertaking too much or too little physical activity in their occupational activities. The traditional "three more and one less" symptoms do not adequately describe the clinical symptoms of T2DM.

Feasibility of T2WI-MRI-based radiomics nomogram for predicting normal-sized pelvic lymph node metastasis in cervical cancer patients.

OBJECTIVE: To investigate the feasibility of T2WI-based radiomics nomogram analysis to non-invasively predict normal-sized pelvic lymph node (LN) metastasis (LNM) in cervical cancer patients. METHODS: Preoperative images of 219 normal-sized pathologically confirmed LNs from 132 cervical cancer patients admitted to our hospital between January 2013 and March 2020 were retrospectively reviewed. Regions of interests (ROIs) were separately delineated on whole LNs and tumors. The maximum-relevance and minimum-redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) methods were used for the construction of radiomics signature. Logistic regression modeling was employed to build models based on clinical features on LN T2WI (model 1), model 1 combined with LN radiomics features (model 2), and model 2 combined with tumor score (model 3). Diagnostic performance was assessed and compared. RESULTS: Both model 2 and model 3 showed higher diagnostic accuracy (training: model 2 0.75, model 3 0.78, model 1 0.72; validation: model 2 0.77, model 3 0.69, model 1 0.66) and AUC (training: model 2 0.77, model 3 0.82, model 1 0.74; validation: model 2 0.75, model 3 0.74, model 1 0.70) than clinical model 1. Diagnostic performance of model 3 was improved compared with model 2 in primary cohort, but reduced in validation cohort. However, the differences did not show obvious statistical difference (p = 0.05 and p = 0.15). CONCLUSIONS: T2WI-based radiomics nomogram incorporating the LN radiomics signature with the clinical morphological LN features is promising for predicting the normal-sized pelvic LNM in cervical cancer patients. The original tumor radiomics analysis did not significantly improve the differential diagnosis of LNM. KEY POINTS: • The combination of LN radiomics signature with LN clinical morphological features on T2WI could discriminate LNM relatively well. • The tumor radiomics analysis did not significantly improve the differential diagnosis of LNM.

Value of diffusion-weighted and dynamic contrast-enhanced MR in predicting parametrial invasion in cervical stromal ring focally disrupted stage IB-IIA cervical cancers.

OBJECTIVES: To compare the effectiveness of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging in detecting parametrial invasion (PMI) in cervical stromal ring focally disrupted stage IB-IIA cervical cancers. METHODS: Eighty-one patients with cervical stromal ring focally disrupted stage IB-IIA cervical cancers (PMI positive, n = 35; PMI negative, n = 46) who underwent preoperative MRI and radical hysterectomy were included in this study. Preoperative clinical variables and MRI variables were analyzed and compared. RESULTS: The Ktrans (min, mean, 10%, 25%, 50%, 75%, 90%), Kep (min, 10%, 25%, 50%, 75%, 90%), and Ve (min, 10%, 25%, 50%, 75%, 90%) values of patients with PMI were significantly higher than patients without PMI. The apparent diffusion coefficient (ADC) value did not show statistical difference between the two groups (1.01 ± 0.21 vs. 0.97 ± 0.20 10-3 mm2/s, p = 0.360). Tumor craniocaudal planes were higher in PMI-positive group than PMI-negative group (35.84 ± 15.39 vs. 29.70 ± 11.78 mm, p = 0.048). Tumor craniocaudal planes combined with Kepmin value showed the highest area under the curve (AUCs) of 0.775, with a sensitivity of 72.7% and a specificity of 71.1% (p = 0.000). CONCLUSIONS: DCE parameters combined tumor craniocaudal planes may represent a prognostic indicator for PMI in cervical stromal ring focally disrupted IB-IIA cervical cancers.

Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers.

BACKGROUND: Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. PURPOSE: To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. MATERIAL AND METHODS: Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5-10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. RESULTS: LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10-3 vs. 1.00 ± 0.18 × 10-3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10-3 vs. 1.07 ± 0.21 × 10-3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. CONCLUSIONS: Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.

Investigation of the eddy current effect on the high frequency response of the Mirnov probe on J-TEXT.

This paper investigates the high frequency response of the Mirnov probe based on a test platform, which is capable of generating a uniform AC magnetic field within the frequency range of 1-300 kHz. The eddy current effect is quantitatively reflected by the phase shift ϕc and normalized amplitude δ of the measured magnetic field between cases with and without a conducting plate located near the Mirnov probe. This method compensates the resonant effect in the Mirnov probe circuit and hence reflects purely the eddy current effect. The eddy current effect increases with the decrease in the distance between the probe and the conducting plate. With the increase in frequency, the magnitude of δ decreases to a saturated value at 10 kHz but increases significantly above 100 kHz for 304-stainless steel, while the eddy current effect with graphite appears at around 10 kHz and the magnitude of δ decreases to the minimum at 125 kHz, followed by a significant increase above 125 kHz. With the increase in f, the magnitude of ϕc increased until 2.5 kHz and 40 kHz for steel and graphite, respectively, then decreased with a further increase in f. The phasor expression is introduced to describe the AC magnetic field and allows an easy expression of the eddy current field. The phase of the eddy current field decreases toward -180° with f. The amplitude of the eddy current field increases with f and reaches its maximum when the skin depth reduces to a critical value. The eddy current field decreases with a further increase in the frequency.