Search Results (78)

Introduction: Scattering of kernels due to angular dehiscence is a key bottleneck in mechanized harvesting of oilseed rape. Materials and Methods: In this study, a dual-track “genotype–phenotype” screening strategy was established by innovatively integrating high-throughput KASP molecular marker technology and a standardized random collision phenotyping system for the complex quantitative trait of angular resistance. Results: Through the systematic evaluation of 634 oilseed rape hybrid progenies, it was found that the KASP marker S12.68, targeting the cleavage resistance locus (BnSHP1) on chromosome C9, achieved a 73.34% introgression rate (465/634), which was significantly higher than the traditional breeding efficiency (<40%). Phenotypic characterization screened seven excellent resources with cracking resistance index (SRI) > 0.6, of which four reached the high resistance standard (SRI > 0.8), including the core materials NR21/KL01 (SRI = 1.0) and YuYou342/KL01 (SRI = 0.97). Six breeding intermediate materials (44.7–48.7% oil content, mycosphaerella resistance MR grade or above) were created, combining high resistance to chipping and excellent agronomic traits. For the first time, it was found that local germplasm YuYou342 (non-KL01-derived line) was purely susceptible at the S12.68 locus (SRI = 0.86), but its angiosperm vascular bundles density was significantly increased by 37% compared with that of the susceptible material 0911 (p < 0.01); and the material 187308 (SRI = 0.78), although purely susceptible at S12.68, had a 2.8-fold downregulation in expression of the angiosperm-related gene, BnIND1, and a 2.8-fold downregulation of expression of the angiosperm-related gene, BnIND1. expression was significantly downregulated 2.8-fold (q < 0.05), indicating the existence of a novel resistance mechanism independent of the primary effector locus. Conclusions: The results of this research provide an efficient technical platform and breakthrough germplasm resources for oilseed rape crack angle resistance breeding, which is of great practical significance for promoting the whole mechanized production. Full article

Background/Objectives: This Phase 3, randomised, double-blind, multicentre trial evaluated the efficacy and safety of a novel hyaluronic acid hydrogel cross-linked with hexamethylenediamine (HMDA-HA) compared to a conventional 1,4-butanediol diglycidyl ether cross-linked HA (BDDE-HA) in patients with mild-to-moderate knee osteoarthritis (OA). Methods: A total of 223 adults (mean age 63.5 years; 167 women) with Kellgren–Lawrence (KL) grade I–III knee OA were randomised 1:1 to receive two intra-articular injections of HMDA-HA or BDDE-HA at baseline and at 24 weeks. The primary endpoint was changes from baseline in weight-bearing pain (WBP) on a 100 mm visual analogue scale (VAS) at Week 12, assessed in the per-protocol population. A non-inferiority margin of 10 mm was predefined. Secondary outcomes included global assessments, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index scores, responder rates, and rescue medication use [ClinicalTrials.gov: NCT06307847]. Results: At Week 12, least squares mean change (standard error [SE]) in WBP was −23.72 (1.88) mm in the HMDA-HA group (n = 83) and −25.99 (1.76) mm in the BDDE-HA group (n = 95), yielding a difference of 2.26 mm (95% confidence interval [CI]: −2.83 to 7.34; p = 0.3825), thus demonstrating the non-inferiority of HMDA-HA to BDDE-HA. Secondary outcomes were comparable between groups. A total of 136 adverse events were reported: 44 (41.1%) in the HMDA-HA group and 32 (28.1%) in the BDDE-HA group, with no treatment-related adverse drug reactions. Conclusions: A single-injection intra-articular regimen of HMDA-HA was effective and safe for the treatment of adult patients with mild-to-moderate knee OA. Full article

Osteoarthritis (OA) is the most prevalent degenerative joint disorder worldwide, causing significant declines in quality of life. The osteochondral junction (OCJ), a critical structural interface between deep cartilage and subchondral bone, plays an essential role in OA progression but is challenging to assess using conventional magnetic resonance imaging (MRI) due to its short T2 relaxation times. This study aimed to evaluate the utility of ultrashort echo time (UTE) MRI biomarkers, including macromolecular fraction (MMF), magnetization transfer ratio (MTR), and T2*, for in vivo quantification of OCJ changes in knee OA for the first time. Forty-five patients (mean age: 53.8 ± 17.0 years, 50% female) were imaged using 3D UTE-MRI sequences on a 3T clinical MRI scanner. Patients were stratified into two OA groups based on radiographic Kellgren–Lawrence (KL) scores: normal/subtle (KL = 0–1) (n = 21) and mild to moderate (KL = 2–3) (n = 24). Quantitative analysis revealed significantly lower MMF (15.8  ±  1.4% vs. 13.6 ± 1.2%, p < 0.001) and MTR (42.5 ± 2.5% vs. 38.2  ±  2.3%, p < 0.001) in the higher KL 2–3 group, alongside a higher trend in T2* values (19.7  ±  2.6 ms vs. 21.6  ±  3.8 ms, p = 0.06). Moreover, MMF and MTR were significantly negatively correlated with KL grades (r = −0.66 and −0.59; p < 0.001, respectively), while T2* showed a weaker positive correlation (r = 0.26, p = 0.08). Receiver operating characteristic (ROC) analysis demonstrated superior diagnostic accuracy for MMF (AUC = 0.88) and MTR (AUC = 0.86) compared to T2* (AUC = 0.64). These findings highlight UTE-MT techniques (i.e., MMF and MTR) as promising imaging tools for detecting OCJ degeneration in knee OA, with potential implications for earlier and more accurate diagnosis and disease monitoring. Full article

Background: Knee Osteoarthritis (KOA) is a prevalent and debilitating joint disorder that significantly impacts quality of life, particularly in aging populations. Accurate and consistent classification of KOA severity, typically using the Kellgren-Lawrence (KL) grading system, is crucial for effective diagnosis, treatment planning, and monitoring disease progression. However, traditional KL grading is known for its inherent subjectivity and inter-rater variability, which underscores the pressing need for objective, automated, and reliable classification methods. Methods: This study investigates the performance of an EfficientNetB5 deep learning model, enhanced with transfer learning from the ImageNet dataset, for the task of classifying KOA severity into five distinct KL grades (0–4). We utilized a publicly available Kaggle dataset comprising 9786 knee X-ray images. A key aspect of our methodology was a comprehensive data-centric preprocessing pipeline, which involved an initial phase of outlier removal to reduce noise, followed by systematic label correction using the Cleanlab framework to identify and rectify potential inconsistencies within the original dataset labels. Results: The final EfficientNetB5 model, trained on the preprocessed and Cleanlab-remediated data, achieved an overall accuracy of 82.07% on the test set. This performance represents a significant improvement over previously reported benchmarks for five-class KOA classification on this dataset, such as ResNet-101 which achieved 69% accuracy. The substantial enhancement in model performance is primarily attributed to Cleanlab’s robust ability to detect and correct mislabeled instances, thereby improving the overall quality and reliability of the training data and enabling the model to better learn and capture complex radiographic patterns associated with KOA. Class-wise performance analysis indicated strong differentiation between healthy (KL Grade 0) and severe (KL Grade 4) cases. However, the “Doubtful” (KL Grade 1) class presented ongoing challenges, exhibiting lower recall and precision compared to other grades. When evaluated against other architectures like MobileNetV3 and Xception for multi-class tasks, our EfficientNetB5 demonstrated highly competitive results. Conclusions: The integration of an EfficientNetB5 model with a rigorous data-centric preprocessing approach, particularly Cleanlab-based label correction and outlier removal, provides a robust and significantly more accurate method for five-class KOA severity classification. While limitations in handling inherently ambiguous cases (such as KL Grade 1) and the small sample size for severe KOA warrant further investigation, this study demonstrates a promising pathway to enhance diagnostic precision. The developed pipeline shows considerable potential for future clinical applications, aiding in more objective and reliable KOA assessment. Full article

Background: Knee osteoarthritis (KOA) affects 37% of individuals aged ≥ 60 years in the national health survey, causing pain, discomfort, and reduced functional independence. Methods: This study aims to automate the assessment of KOA severity by training deep learning models using the Kellgren–Lawrence grading system (class 0~4). A total of 15,000 images were used, with 3000 images collected for each grade. The learning models utilized were DenseNet201, ResNet101, and EfficientNetV2, and their performance in lesion classification was evaluated and compared. Statistical metrics, including accuracy, precision, recall, and F1-score, were employed to assess the feasibility of applying deep learning models for KOA classification. Results: Among these four metrics, DenseNet201 achieved the highest performance, while the ResNet101 model recorded the lowest. DenseNet201 demonstrated the best performance with an overall accuracy of 73%. The model’s accuracy by K-L grade was 80.7% for K-L Grade 0, 53.7% for K-L Grade 1, 72.7% for K-L Grade 2, 75.3% for K-L Grade 3, and 82.7% for K-L Grade 4. The model achieved a precision of 73.2%, a recall of 73%, and an F1-score of 72.7%. Conclusions: These results highlight the potential of deep learning models for assisting specialists in diagnosing the severity of KOA by automatically assigning K-L grades to patient data. Full article

Knee osteoarthritis (KOA) is a highly prevalent muscoloskeletal joint disorder affecting a significant portion of the population worldwide. Accurate predictions of KOA progression can assist clinicians in drawing preventive strategies for patients. In this paper, we present an integrated approach based on hypergraph convolutional networks (HGCNs) for longitudinal predictions of KOA grades and progressions from MRI images. We propose two novel models, namely, the C_Shape.Net and the predictor network. The C_Shape.Net operates on a hypergraph of volumetric nodes, especially designed to represent the surface and volumetric features of the cartilage. It encompasses deep HGCN convolutions, graph pooling, and readout operations in a hierarchy of layers, providing, at the output, expressive 3D shape descriptors of the cartilage volume. The predictor is a spatio-temporal HGCN network (ST_HGCN), following the sequence-to-sequence learning scheme. Concretely, it transforms sequences of knee representations at the historical stage into sequences of KOA predictions at the prediction stage. The predictor includes spatial HGCN convolutions, attention-based temporal fusion of feature embeddings at multiple layers, and a transformer module that generates longitudinal predictions at follow-up times. We present comprehensive experiments on the Osteoarthritis Initiative (OAI) cohort to evaluate the performance of our methodology for various tasks, including node classification, longitudinal KL grading, and progression. The basic finding of the experiments is that the larger the depth of the historical stage, the higher the accuracy of the obtained predictions in all tasks. For the maximum historic depth of four years, our method yielded an average balanced accuracy (BA) of 85.94% in KOA grading, and accuracies of 91.89% (+1), 88.11% (+2), 84.35% (+3), and 79.41% (+4) for the four consecutive follow-up visits. Under the same setting, we also achieved an average value of Area Under Curve (AUC) of 0.94 for the prediction of progression incidence, and follow-up AUC values of 0.81 (+1), 0.77 (+2), 0.73 (+3), and 0.68 (+4), respectively. Full article

Background/Objectives: In 2020, 595 million world citizens had osteoarthritis, and the largest growth in OA morbidity refers to the hip joint. Effective OA therapies have been sought for years. Assessing the treatment effectiveness and QoL improvement in hip OA after intra-articular administration of fresh peripheral blood hematopoietic CD34+ stem cells. Methods: The study comprised 49 adults (median age: 63). The SCs were injected into hip joints and straight to the bone. Hip manipulation was conducted. Patients were subjected to a standardized rehabilitation protocol. Hip degeneration was graded by Kellgren–Lawrence. Multi-factor statistical analyses, with replications, were performed. The study was an R&D project, co-financed by the E.U. Results: Patient-reported outcomes (HOOS, SF-36) ameliorated remarkably over 24 months (p < 0.0001). Ranges of movement improved significantly (p < 0.0001). The most noticeable improvement manifested 6 months after the SC administration. Its furtherance was maintained. Conclusions: Intra-articular administration of CD34+ cells significantly reduces pain and improves hip joint function, regardless of the severity of OA, according to K-L, over a 24-month follow-up period. The combination of CD34+ cell therapy with joint mobilization and rehabilitation allows for the postponement of hip arthroplasty by significantly improving patients’ QoL over the 24-month follow-up period. Full article

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. The Spearman correlation test was used to analyze the relationship between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the PainDetect Questionnaire (PDQ), Central Sensitization Inventory (CSI), and Pain Catastrophizing Scale (PCS). The Kruskal–Wallis test was employed to compare WOMAC scores according to CSI categories. A multivariate analysis was conducted to identify predictors of functional ability, with the WOMAC score as the dependent variable and the independent variables including pain-related indices such as PCS, PDQ, and CSI, along with Kellgren–Lawrence (K-L) grading and demographic characteristics. Results. This study included 149 patients (76.5% female; mean age 71.5 years; mean duration of pain 8.1 years). In total, 23.5% exhibited NP, 30.9% showed PC, and 33.6% had CS. Higher mean values of WOMAC were correlated with CSI categories (p < 0.0001). WOMAC showed a significant relationship with CSI (rho = 0.791; p < 0.0001), PDQ (rho = 0.766; p < 0.0001), and PCS (rho = 0.536; p < 0.0001). In the multiple regression analysis, WOMAC was independently associated with CSI (p < 0.0001), PDQ (p < 0.0001), and PC (p = 0.0001). No association was observed between the K-L grading and the other variables. Conclusions. A reduced functional capacity in patients with knee OA is correlated with the presence of NP, PC and CS, without being significantly associated with radiological damage. Full article

Gliomas are the most common and lethal forms of malignant brain tumors. We attempted to identify the role of the aging-suppressor Klotho gene and Klotho protein in the immunopathogenesis of gliomas. We examined Klotho genetic variants by PCR-RFLP and measured serum Klotho levels using the ELISA method. We found a statistically significantly increased frequency of rs1207568A allele and rs1207568 GA genotypes in co-dominant, dominant and over-dominant models in grade IV as compared to grade II and III glioma patients. The levels of soluble α Klotho (sαKL) were significantly lower in grade III and IV glioma patients than in healthy controls (p = 0.034; 0.0083). Patients with sαKL levels above 2500 pg/mL survived significantly longer than patients with sαKL below 2500 pg/mL (p = 0.038). We also found a positive correlation of the serum levels of sαKL with seven biomarkers, like angiogenic vascular endothelial growth factor (p = 0.0008), chemokine fractalkine (p = 0.0009), interferon γ (p = 0.003), glial derived neurotrophic factor (p = 0.0268), pro-inflammatory and pro-Th1 cytokine IL-6 (p = 0.0347), anti-inflammatory, pro-Th2 cytokines IL-4 (p = 0.0037) and IL-13 (p = 0.0004). Our results suggest the impact of Klotho genetic variants and Klotho levels on advanced-grade glioma. Full article

One of the most common diseases afflicting humans is knee osteoarthritis (KOA). KOA occurs when the knee joint cartilage breaks down, and knee bones start rubbing together. The diagnosis of KOA is a lengthy process, and missed diagnosis can have serious consequences. Therefore, the diagnosis of KOA at an initial stage is crucial which prevents the patients from Severe complications. KOA identification using deep learning (DL) algorithms has gained popularity during the past few years. By applying knee X-ray images and the Kellgren–Lawrence (KL) grading system, the objective of this study was to develop a DL model for detecting KOA. This study proposes a novel model based on CNN called knee osteoarthritis classification network (KOC_Net). The KOC_Net model contains 05 convolutional blocks, and each convolutional block has three components such as Convlotuioanl2D, ReLU, and MaxPooling 2D. The KOC_Net model is evaluated on two publicly available benchmark datasets which consist of X-ray images of KOA based on the KL grading system. Additionally, we applied contrast-limited adaptive histogram equalization (CLAHE) methods to enhance the contrast of the images and utilized SMOTE Tomek to deal with the problem of minority classes. For the diagnosis of KOA, the classification performance of the proposed KOC_Net model is compared with baseline deep networks, namely Dense Net-169, Vgg-19, Xception, and Inception-V3. The proposed KOC_Net was able to classify KOA into 5 distinct groups (including Moderate, Minimal, Severe, Doubtful, and Healthy), with an AUC of 96.71%, accuracy of 96.51%, recall of 91.95%, precision of 90.25%, and F1-Score of 96.70%. Dense Net-169, Vgg-19, Xception, and Inception-V3 have relative accuracy rates of 84.97%, 81.08%, 87.06%, and 83.62%. As demonstrated by the results, the KOC_Net model provides great assistance to orthopedics in making diagnoses of KOA. Full article

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by inflammation and cartilage degradation. The infrapatellar fat pad (IFP), located beneath the patella within the knee joint, serves as a key anatomical structure involved in cushioning and supporting the knee. It is also an active endocrine organ that secretes various bioactive substances, potentially influencing the local inflammatory environment and contributing to KOA pathogenesis. Netrin-4 (NTN4), a protein primarily known for its role in neuronal guidance, has been implicated in various non-neuronal functions, including inflammatory processes and tissue remodeling. This study aims to explore the involvement of NTN4 in KOA, focusing on its expression in the IFP and its potential impact on disease progression. This study involved 82 patients with radiographically confirmed KOA undergoing total knee arthroplasty (TKA). The correlation between NTN4 expression and OA pathology, including Kellgren–Lawrence (K/L) grades, was investigated. NTN4-expressing cells were identified in the stromal vascular fraction, including fibroblastic, hematopoietic, and endothelial cells of the IFP. To elucidate the molecular effects of NTN4, RNA sequencing (RNA-seq) was performed on fibroblastic cells treated with recombinant NTN4. Subsequent quantitative PCR (qPCR) was used to validate the RNA-seq findings. NTN4 expression was significantly elevated in the IFP of patients with advanced KOA (K/L grades 3 and 4) compared to those with early-stage disease (K/L grade 2). Higher NTN4 expression was found in fibroblastic cells, and RNA-seq analysis revealed upregulation of genes associated with pro-inflammatory pathways, including IL-17 and TNF-α signaling, and matrix degradation. Notably, genes including IL6, MMP1, CXCL1, and CXCL8 were significantly elevated, as confirmed by qPCR, indicating NTN4’s role in promoting an inflammatory and catabolic environment. Our findings suggest that NTN4 plays a significant role in the pathogenesis of KOA by promoting inflammation and matrix degradation within the IFP. Although NTN4 expression was not directly correlated with clinical symptoms, its elevated expression in fibroblastic cells and influence on inflammatory and degradative pathways suggest a potential mechanism for exacerbating joint damage. Targeting NTN4 could offer a novel therapeutic approach to mitigating inflammation and slowing disease progression in KOA, ultimately improving patient outcomes. Further research is needed to clarify NTN4’s specific roles and therapeutic potential in OA management. Full article

Introduction: Knee osteoarthritis (OA) is a highly prevalent and debilitating condition with significant emotional and economic impacts. Current treatment options may only provide temporary pain relief and are not regenerative, thus the progression of knee OA is not deterred and total knee arthroplasty is inevitable. Injection therapies with orthobiologics possess regenerative potential and are an emerging treatment option. We present a prospective study aimed at examining patients with knee OA who had received an autologous platelet concentrate fluid (APCF) injection produced through a fluid volume reducer. Methods: This was an observational review of the results following an APCF injection in a cohort of patients at a single site. Patients were included in the study if they were diagnosed with K/L grade 2–3 knee OA and treated with an APCF knee injection. Patients were excluded if they had obtained an orthobiologic injection in the three months prior to study enrollment or if baseline data were unavailable. Knee score and function score were used to assess patients at the baseline and post-injection follow-ups. Results: Improvements for knee score were statistically significant for the follow-ups at three months, six months, one year, and three years. Function score improved, with statistically significant changes for the three month and three year follow-ups. Conclusions: Our study demonstrates that there is some utility in using APCF injection for knee OA, with improvements that may be sustained up to three years in some patients. Full article

Background/Objectives: 3′-Sialyllactose (3′-SL), a human milk oligosaccharide, has anti-inflammatory effects and is demonstrated to have protective effects against osteoarthritis (OA) in vitro and in vivo. However, this hypothesis remains to be investigated in a clinical setting. Herein, we investigated the effects of 3′-SL on pain and physical function in patients with knee OA. Methods: Sixty patients with knee OA with Kellgren and Lawrence grades (KL-grades) 1–4 and Korean Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC) scores ≥30 were randomly assigned to the placebo (n = 20), 3′-SL 200 mg (n = 20), and 3′-SL 600 mg (n = 20) groups. For 12 weeks, 3′-SL or placebo was administered to patients once a day. Clinical efficacy was evaluated using a visual analog scale (VAS) for pain and KWOMAC for physical function at baseline and at 6 and 12 weeks. Adverse effects were assessed for 12 weeks. Results: Significant reductions in VAS and KWOMAC scores were observed at 12 weeks compared with the baseline in the 3′-SL group. No severe adverse effects were observed over 12 weeks. Conclusions: 3′-SL reduced pain in patients with knee OA, improved daily life movements, and was safe, suggesting that 3′-SL might be an effective treatment for knee OA without severe side effects. Full article

Background/Objective: This study aimed to compare the functional outcomes, such as knee muscle strength, dynamic postural stability, pain scores, and physical activity, in patients with knee osteoarthritis (OA) on stair climbing training with and without interferential electrotherapy (IFE) for 12 weeks. Methods: A total of 40 knee OA patients with Kellgren–Lawrence (K–L) grade ≤ 2 were enrolled (20 stair-climbing training with IFE vs. 20 stair-climbing training without IFE). The knee quadriceps and hamstring muscle strengths were measured using an isokinetic device. The dynamic postural stability was assessed using postural stabilometry. The pain score was evaluated using the visual analog scale (VAS). Physical activity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The WOMAC score was significantly different (p < 0.019) between stair-climbing training with and without IFE in patients with knee OA, while knee muscle strength, dynamic postural stability, or pain score were not (all p > 0.05). Conclusion: Stair-climbing training with IFE was more beneficial for physical activity recovery than stair-climbing training without IFE. Therefore, clinicians and therapists should be aware that stair climbing, which can be practiced in daily life for the management of patients with knee OA, and the addition of IFE may improve physical activity. Full article

Background/Objectives: There is a gap between the very positive opinion of patients and doctors regarding knee viscosupplementation (VS) and the contrasting results of controlled studies. The objective of this study was to evaluate the overall satisfaction and predictors of satisfaction with VS in patients with knee osteoarthritis treated with VS. Methods: Post-hoc analysis of a cross-sectional study in patients with knee OA treated with one injection of a mannitol-modified cross-linked HA (HANOX-M-XL). The primary outcome was satisfaction, self-assessed semi-quantitatively by the patients. Demographics, radiological features, comorbidities, OA and comorbidities treatments, and lifestyle associated with satisfaction were studied in bivariate and multivariate analysis. Results: 89 patients (124 knees) were analyzed. A total of 88.7% were satisfied with the treatment. Satisfaction was correlated with duration of effectiveness (DoE) and negatively correlated with BMI. Satisfaction was higher in active versus sedentary patients, in tibiofemoral involvement, in Kellgren-Lawrence grade 1–3 versus 4, and in subjects not requiring intraarticular corticosteroid (IACS) concomitantly to VS. Satisfied subjects were older than dissatisfied ones. In multivariate analysis, older age, K–L grade < 4, absence of IACS, and longer DoE were associated with higher rates of satisfaction. Conclusions: We identified several predictive factors of patient satisfaction after VS of the knee. Alongside these objective factors, there are probably subjective factors linked to patient beliefs, fears, and expectations impacting satisfaction. Full article