T1-weighted images-based radiomics for structural lesions evaluation in patients with suspected axial spondyloarthritis.

PURPOSE: The aim of this study was to investigate the feasibility of radiomics based on T1-weighted images (T1WI) for assessing sacroiliac joint (SIJ) structural lesions in patients with suspected axial spondyloarthritis (axSpA). MATERIALS AND METHODS: A total of 266 patients with clinical suspicion of axSpA between December 2016 and January 2022 were enrolled. Structural lesions were assessed on low-dose CT (ldCT) and MRI, respectively. Radiomic features, extracted from SIJ T1WI, were included to generate the radiomics model. The performance of the radiomics model was evaluated using receiver operating characteristic (ROC) curve. Furthermore, point-biserial correlation analysis was used to interpret the associations between the radiomic feature and structural lesions. RESULTS: Using ldCT as the reference standard, the radiomics model showed favorable performance for detecting positive global structural lesions in the training cohort (AUC, 0.82 [95% CI: 0.76, 0.88]) and validation cohort (AUC, 0.82 [95% CI: 0.72, 0.91]. Experienced MRI raters yielded predictive AUCs of 0.73 (95% CI: 0.67, 0.79), and 0.74 (95% CI: 0.66, 0.83) in the training and validation cohort, respectively. The seven radiomic features included in the radiomics model showed significant correlation with different kinds of structural lesions (P all < 0.05). Among them, Wavelet.LHL_firstorder_90Percentile showed the strongest association with fat lesion (r = 0.48, P < 0.05). CONCLUSION: The radiomics analysis with T1WI could effectively detect SIJ structural lesions and achieved expert-level performance. Each radiomic feature was correlated with different structural lesions significantly, which might inform radiomic-based applications for axSpA intelligent diagnosis.

A predictive clinical-radiomics nomogram for diagnosing of axial spondyloarthritis using MRI and clinical risk factors.

OBJECTIVES: Construct and validate a nomogram model integrating the radiomics features and the clinical risk factors to differentiating axial spondyloarthritis (axSpA) in low back pain patients undergone sacroiliac joint (SIJ)-MRI. METHODS: A total of 638 patients confirmed as axSpA (n = 424) or non-axSpA (n = 214) who were randomly divided into training (n = 447) and validation cohorts (n = 191). Optimal radiomics signatures were constructed from the 3.0 T SIJ-MRI using maximum relevance-minimum redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) algorithm in the training cohort. We also included six clinical risk predictors to build the clinical model. Incorporating the independent clinical factors and Rad-score, a nomogram model was constructed by multivariable logistic regression analysis. The performance of the clinical, Rad-score, and nomogram models were evaluated by ROC analysis, calibration curve and decision curve analysis (DCA). RESULTS: A total of 1316 features were extracted and reduced to 15 features to build the Rad-score. The Rad-score allowed a good discrimination in the training (AUC, 0.82; 95% CI: 0.77, 0.86) and the validation cohort (AUC, 0.82; 95% CI: 0.76, 0.88). The clinical-radiomics nomogram model also showed favourable discrimination in the training (AUC, 0.90; 95% CI: 0.86, 0.93) and the validation cohort (AUC, 0.90; 95% CI: 0.85, 0.94). Calibration curves (P >0.05) and DCA demonstrated the nomogram was useful for axSpA diagnosis in the clinical environment. CONCLUSION: The study proposed a radiomics model was able to separate axSpA and non-axSpA. The clinical-radiomics nomogram can increase the efficacy for differentiating axSpA, which might facilitate clinical decision-making process.

Initial experience of generalized intravoxel incoherent motion imaging and diffusion tensor imaging (GIVIM-DTI) in healthy subjects.

PURPOSE: To evaluate the feasibility of combined generalized intravoxel incoherent imaging and diffusion tensor imaging (GIVIM-DTI) to access the renal microstructure and microcirculation with respiratory triggering. MATERIALS AND METHODS: A total of 28 young healthy volunteers with no history of renal disease were recruited into our study. GIVIM-DTI images were acquired with respiratory triggering at 3 Tesla. The following diffusion and pseudodiffusion parameters were obtained: pure tissue diffusion ( Ds), fractional anisotropy (FA), mean diffusivity (MD), mean pseudodiffusion ( D¯), perfusion volume fraction ( fp), dispersion of pseudodiffusion ( σ), and an estimate of the microcirculation flow velocity ( fp⋅D¯). The renal left-right difference was analyzed using a paired t-test. The corticomedullary difference was assessed using the one-way analysis of variance test. The reliability of individual parameters was evaluated with the coefficient of variation (CV). RESULTS: Among all parameters, only the cortical fp showed a bilateral difference (P = 0.045). The cortical fp and σ were significantly higher (P < 0.001 for both) than those in the medulla, but D¯ was significantly lower (P < 0.001) in the cortex, and the fp⋅D¯ values showed no significant corticomedullary difference (P = 0.068). The diffusion parameters Ds and MD were significantly higher (P < 0.001 for both) in the cortex than in the medulla. The cortical FA was significantly lower (P < 0.001) than the corresponding medullary value. Good consistency (CV < 20%) was obtained in the values of Ds, FA, and MD, moderate consistency (CV < 50%) in fp, and poor consistency (CV > 50%) was found in D¯, σ and fp⋅D¯. CONCLUSION: GIVIM-DTI shows promise for advancing the characterization of the renal microstructure and microcirculation. J. Magn. Reson. Imaging 2016;44:732-738.

Widespread and evolutionary analysis of a MITE family Monkey King in Brassicaceae.

BACKGROUND: Miniature inverted repeat transposable elements (MITEs) are important components of eukaryotic genomes, with hundreds of families and many copies, which may play important roles in gene regulation and genome evolution. However, few studies have investigated the molecular mechanisms involved. In our previous study, a Tourist-like MITE, Monkey King, was identified from the promoter region of a flowering time gene, BnFLC.A10, in Brassica napus. Based on this MITE, the characteristics and potential roles on gene regulation of the MITE family were analyzed in Brassicaceae. RESULTS: The characteristics of the Tourist-like MITE family Monkey King in Brassicaceae, including its distribution, copies and insertion sites in the genomes of major Brassicaceae species were analyzed in this study. Monkey King was actively amplified in Brassica after divergence from Arabidopsis, which was indicated by the prompt increase in copy number and by phylogenetic analysis. The genomic variations caused by Monkey King insertions, both intra- and inter-species in Brassica, were traced by PCR amplification. Genomic sequence analysis showed that most complete Monkey King elements are located in gene-rich regions, less than 3kb from genes, in both the B. rapa and A. thaliana genomes. Sixty-seven Brassica expressed sequence tags carrying Monkey King fragments were also identified from the NCBI database. Bisulfite sequencing identified specific DNA methylation of cytosine residues in the Monkey King sequence. A fragment containing putative TATA-box motifs in the MITE sequence could bind with nuclear protein(s) extracted from leaves of B. napus plants. A Monkey King-related microRNA, bna-miR6031, was identified in the microRNA database. In transgenic A. thaliana, when the Monkey King element was inserted upstream of 35S promoter, the promoter activity was weakened. CONCLUSION: Monkey King, a Brassicaceae Tourist-like MITE family, has amplified relatively recently and has induced intra- and inter-species genomic variations in Brassica. Monkey King elements are most abundant in the vicinity of genes and may have a substantial effect on genome-wide gene regulation in Brassicaceae. Monkey King insertions potentially regulate gene expression and genome evolution through epigenetic modification and new regulatory motif production.

Internal fixation with percutaneous kyphoplasty compared with simple percutaneous kyphoplasty for thoracolumbar burst fractures in elderly patients: a prospective randomized controlled trial.

PURPOSE: The impact of percutaneous internal fixation as a supplement to percutaneous kyphoplasty (PKP) for the management of thoracolumbar burst fractures in elderly patients is unclear. We conducted a clinical controlled trial to investigate the effect and outcomes of this technique in such patients. METHODS: Forty-three patients over 65 years old with thoracolumbar burst fractures without nerve injuries were enrolled. They were randomly assigned to treatment with simple PKP (control group, n = 22) or percutaneous short-segment pedicle screw internal fixation with PKP (treatment group, n = 21). The patients were followed for at least 2 years postoperatively and were assessed with regard to clinical and radiological outcomes. Clinical outcomes were evaluated mainly with use of visual analog scale (VAS) for pain and the Oswestry Disability Index (ODI) questionnaire. Radiological outcomes were assessed mainly on the basis of Cobb kyphosis angle and loss of kyphosis correction. RESULTS: There were no significant differences between the two groups with regard to preoperative indices. The treatment group had better VAS scores and greater postoperative improvement on the ODI compared with the control group (P < 0.05). Postoperative kyphosis angle correction in the treatment group was superior to that in the control group, and loss of correction postoperatively was significantly less (P < 0.05). In the control group, two patients suffered refractures of the injured vertebra postoperatively and one had a fracture in the adjacent vertebra. No postoperative complications needing management were noted in either group. CONCLUSIONS: Compared with simple PKP, percutaneous internal fixation with PKP is a valuable surgical option for the treatment of selected elderly patients with thoracolumbar burst fractures.

Infant death prediction using machine learning: A population-based retrospective study.

BACKGROUND: Despite declines in infant death rates in recent decades in the United States, the national goal of reducing infant death has not been reached. This study aims to predict infant death using machine-learning approaches. METHODS: A population-based retrospective study of live births in the United States between 2016 and 2021 was conducted. Thirty-three factors related to birth facility, prenatal care and pregnancy history, labor and delivery, and newborn characteristics were used to predict infant death. RESULTS: XGBoost demonstrated superior performance compared to the other four compared machine learning models. The original imbalanced dataset yielded better results than the balanced datasets created through oversampling procedures. The cross-validation of the XGBoost-based model consistently achieved high performance during both the pre-pandemic (2016-2019) and pandemic (2020-2021) periods. Specifically, the XGBoost-based model performed exceptionally well in predicting neonatal death (AUC: 0.98). The key predictors of infant death were identified as gestational age, birth weight, 5-min APGAR score, and prenatal visits. A simplified model based on these four predictors resulted in slightly inferior yet comparable performance to the all-predictor model (AUC: 0.91 vs. 0.93). Furthermore, the four-factor risk classification system effectively identified infant deaths in 2020 and 2021 for high-risk (88.7%-89.0%), medium-risk (4.6%-5.4%), and low-risk groups (0.1), outperforming the risk screening tool based on accumulated risk factors. CONCLUSIONS: XGBoost-based models excel in predicting infant death, providing valuable prognostic information for perinatal care education and counselling. The simplified four-predictor classification system could serve as a practical alternative for infant death risk prediction.

HAR2bot: a human-centered augmented reality robot programming method with the awareness of cognitive load.

In the era of Industry 4.0, manufacturing enterprises are actively adopting collaborative robots (Cobots) in their productions. Current online and offline robot programming methods are difficult to use and require extensive experience or skills. On the other hand, the manufacturing industries are experiencing a labor shortage. An essential question, therefore, is: how would a new robot programming method help novice users complete complex tasks effectively, efficiently, and intuitively? To answer this question, we proposed HAR2bot, a novel human-centered augmented reality programming interface with awareness of cognitive load. Using NASA's system design theory and the cognitive load theory, a set of guidelines for designing an AR-based human-robot interaction system is obtained through a human-centered design process. Based on these guidelines, we designed and implemented a human-in-the-loop workflow with features for cognitive load management. The effectiveness and efficiency of HAR2bot are verified in two complex tasks compared with existing online programming methods. We also evaluated HAR2bot quantitatively and qualitatively through a user study with 16 participants. According to the user study, compared with existing methods, HAR2bot has higher efficiency, a lower overall cognitive load, lower cognitive loads for each type, and higher safety.

Highly Hydrophilic and Defective Carbon Nitride for Enhanced Photocatalytic Hydrogen Evolution.

Graphitic carbon nitride (g-C3N4), as a kind of nonmetallic low-cost photocatalyst, has great potential in photocatalytic hydrogen (H2) evolution, but its poor hydrophilicity and nonwetting extremely limit its H2 evolution efficiency. Herein, highly hydrophilic and defective g-C3N4 photocatalysts (NH3-CN-P as a representative example) have been fabricated on the basis of the strategy of joint phosphorus doping and ammonia stripping. The dopant of phosphorus prefers to occupy the C atoms bonded to -NH2 groups in the g-C3N4 skeleton, which is conducive to the formation of N defects caused by the effects of electronegativity and charge balance. Moreover, ammonia stripping plays a dual role in exposing plentiful two-dimensional defective planar structure and implanting the hydrophilic groups on the surface. As expected, the photocatalytic H2 evolution property of NH3-CN-P reaches 11.31 mmol g-1 h-1, with an apparent quantum yield of 17.9% at 420 nm, outperforming the majority of the reported g-C3N4-based photocatalysts.

Can radiomics replace the SPARCC scoring system in evaluating bone marrow edema of sacroiliac joints in patients with axial spondyloarthritis?

OBJECTIVES: To develop an objective and efficient method based on radiomics to evaluate bone marrow edema (BMO) of sacroiliac joints (SIJs) by magnetic resonance imaging (MRI) in patients with axial spondyloarthritis (axSpA) and to compare with the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system. METHODS: From September 2013 to March 2022, patients with axSpA who underwent 3.0T SIJ-MRI were included and were randomly divided into training and validation cohorts at a ratio of 7:3. The optimal radiomics features selected from the SIJ-MRI in the training cohort were included to generate the radiomics model. The performance of the model was evaluated by ROC analysis and decision curve analysis (DCA). Rad scores were calculated using the radiomics model. The responsiveness was compared for Rad scores and SPARCC scores. We also assessed the correlation between the Rad score and SPARCC score. RESULTS: A total of 558 patients were finally included. The radiomics model showed favorable discrimination of a SPARCC score <2 or ≥2 both in the training (AUC, 0.90; 95% CI: 0.87-0.93) and validation cohorts (AUC, 0.90; 95% CI, 0.86-0.95). DCA confirmed that the model was clinically useful. Rad score showed higher responsiveness to treatment-related change than SPARCC score. Furthermore, a significant correlation was noted between the Rad score and SPARCC score when scoring the status of BMO (rs=0.80, P < 0.001), and a strong correlation was noted when scoring the change in BMO (r=0.70, P < 0.001). CONCLUSION: The study proposed a radiomics model to accurately quantify the BMO of SIJs in patients with axSpA, providing an alternative to the SPARCC scoring system. Key Points • The Rad score is an index with high validity for the objective and quantitative evaluation of bone marrow edema (BMO) of the sacroiliac joints in axial spondyloarthritis. • The Rad score is a promising tool to monitor the change of BMO upon treatment.

A Tourist-like MITE insertion in the upstream region of the BnFLC.A10 gene is associated with vernalization requirement in rapeseed (Brassica napus L.).

BACKGROUND: Rapeseed (Brassica napus L.) has spring and winter genotypes adapted to different growing seasons. Winter genotypes do not flower before the onset of winter, thus leading to a longer vegetative growth period that promotes the accumulation and allocation of more resources to seed production. The development of winter genotypes enabled the rapeseed to spread rapidly from southern to northern Europe and other temperate regions of the world. The molecular basis underlying the evolutionary transition from spring- to winter- type rapeseed is not known, however, and needs to be elucidated. RESULTS: We fine-mapped the spring environment specific quantitative trait locus (QTL) for flowering time, qFT10-4,in a doubled haploid (DH) mapping population of rapeseed derived from a cross between Tapidor (winter-type) and Ningyou7 (semi-winter) and delimited the qFT10-4 to an 80-kb region on chromosome A10 of B. napus. The BnFLC.A10 gene, an ortholog of FLOWERING LOCUS C (FLC) in Arabidopsis, was cloned from the QTL. We identified 12 polymorphic sites between BnFLC.A10 parental alleles of the TN-DH population in the upstream region and in intron 1. Expression of both BnFLC.A10 alleles decreased during vernalization, but decreased more slowly in the winter parent Tapidor. Haplotyping and association analysis showed that one of the polymorphic sites upstream of BnFLC.A10 is strongly associated with the vernalization requirement of rapeseed (r2 = 0.93, χ2 = 0.50). This polymorphic site is derived from a Tourist-like miniature inverted-repeat transposable element (MITE) insertion/deletion in the upstream region of BnFLC.A10. The MITE sequence was not present in the BnFLC.A10 gene in spring-type rapeseed, nor in ancestral 'A' genome species B. rapa genotypes. Our results suggest that the insertion may have occurred in winter rapeseed after B. napus speciation. CONCLUSIONS: Our findings strongly suggest that (i) BnFLC.A10 is the gene underlying qFT10-4, the QTL for phenotypic diversity of flowering time in the TN-DH population, (ii) the allelic diversity caused by MITE insertion/deletion upstream of BnFLC.A10 is one of the major causes of differentiation of winter and spring genotypes in rapeseed and (iii) winter rapeseed has evolved from spring genotypes through selection pressure at the BnFLC.A10 locus, enabling expanded cultivation of rapeseed along the route of Brassica domestication.

MRI compared with low-dose CT scanning in the diagnosis of axial spondyloarthritis.

OBJECTIVES: To compare the performance of conventional radiography, ldCT, and MRI in the diagnosis of sacroiliitis in suspected axial spondyloarthritis (axSpA). METHODS: Patients presenting with > 3 months chronic back pain were assessed by axSpA-experienced rheumatologists and diagnosed as axSpA or not; axSpA patients were then considered nr-axSpA or AS using plain radiography. Non-axSpA patients were recruited as controls, and divided into non-inflammatory and inflammatory groups on the basis of inflammatory back pain and/or CRP/ESR elevation. Clinical variables, pelvic radiography, sacroiliac joint (SIJ) ldCT, and SIJ MRI were obtained. RESULTS: A total of 121 patients were included and had SIJ radiography and ldCT, of whom 71 additionally had an SIJ MRI. These included 23 non-inflammatory controls, 21 inflammatory controls, 32 nr-axSpA cases, and 45 AS cases. Fourteen of 32 (44%) nr-axSpA patients had positive ldCT scans, 21/24 (88%) had MRI-BMO, and 11/24 (46%) had MRI-structural lesions. ldCT had high specificity with only 1/23 (4%) non-inflammatory controls being positive. MRI-BMO had the highest sensitivity for nr-axSpA, but compared with ldCT lower specificity, with 5/15 (33%) of non-inflammatory controls being positive, and similar sensitivity for AS (20/22 (91%) vs 44/44 for ldCT). CONCLUSIONS: ldCT identifies evidence of radiographic change in a significant proportion of nr-axSpA cases and is highly specific for axSpA. MRI-BMO lesions are more sensitive than either conventional radiography or MRI-structural assessment for axSpA. The relative position of these imaging modalities in screening for axSpA needs to be reconsidered, also taking into account the costs involved.Key Points• ldCT is more sensitive for erosions or sclerosis in axSpA than plain radiography, with 44% of patients with nr-axSpA having evidence of AS-related sacroiliac joint changes on ldCT.• MRI-structural lesions are no more sensitive but are less specific for AS than ldCT.• MRI-BMO is the most sensitive test for nr-axSpA of the modalities tested but is less specific for axSpA than for ldCT.

Identification of EMT-Related Gene Signatures to Predict the Prognosis of Patients With Endometrial Cancer.

BACKGROUND: Endometrial cancer (EC) is one of the most common gynecological cancers. Epithelial-mesenchymal transition (EMT) is believed to be significantly associated with the malignant progression of tumors. However, there is no relevant study on the relationship between EMT-related gene (ERG) signatures and the prognosis of EC patients. METHODS: We extracted the mRNA expression profiles of 543 tumor and 23 normal tissues from The Cancer Genome Atlas database. Then, we selected differentially expressed ERGs (DEERGs) among these mRNAs. Next, univariate and multivariate Cox regression analyses were performed to select the ERGs with predictive ability for the prognosis of EC patients. In addition, risk score models were constructed based on the selected genes to predict patients' overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS). Finally, nomograms were constructed to estimate the OS and PFS of EC patients, and pan-cancer analysis was performed to further analyze the functions of a certain gene. RESULTS: Six OS-, ten PFS-, and five DFS-related ERGs were obtained. By constructing the prognostic risk score model, we found that the OS, PFS, and DFS of the high-risk group were notably poorer. Last, we found that AQP5 appeared in all three gene signatures, and through pan-cancer analysis, it was also found to play an important role in immunity in lower grade glioma (LGG), which may contribute to the poor prognosis of LGG patients. CONCLUSIONS: We constructed ERG signatures to predict the prognosis of EC patients using bioinformatics methods. Our findings provide a thorough understanding of the effect of EMT in patients with EC and provide new targets and ideas for individualized treatment, which has important clinical significance.