Dissecting the Contributing Role of Divergent Adipose Tissue to Multidimensional Frailty in Cirrhosis

Background and Aims:Emerging evidence has demonstrated that abnormal body composition may potentiate the development of frailty,whereas little work focuses on the role of divergent adipose tissue.Therefore,we aimed to determine the potential contribution of adipose tissue distribution to multidimensional frailty in decompensated cirrhosis.Methods:We conducted a retrospective cohort study.Divergent adipose tissues were assessed by computed tomography-derived subcutaneous adipose tissue index(SATI),visceral adipose tissue index(VATI)and total adipose tissue index(TATI),respectively.Frailty was identified by our validated self-reported Frailty Index.Multiple binary logistic models incorporating different covariates were established to assess the relationship between adipose tissue distribution and frailty.Results:The study cohort comprised 245 cirrhotic patients with 45.3%being male.The median Frailty Index,body mass index(BMI)and model for end-stage liver disease(MELD)score were 0.11,24.3 kg/m2 and 8.9 points,respectively.In both men and women,patients who were frail exhibited lower levels of SATI in comparison with nonfrail patients.SATI inversely correlated with Frailty Index in the entire cohort(rs=−0.1361,p=0.0332).Furthermore,SATI or TATI was independently associated with frail phenotype in several multiple logistic regression models adjusting for age,BMI,presence of ascites,sodium,Child-Pugh class or MELD score in isolation.Conclusions:In the context of decompensated cirrhosis,low SATI and concomitant TATI were associated with higher risk of being frail.These findings highlight the importance to further apply tissue-specific tools of body composition in place of crude metric like BMI.

Multispectral Drone Imagery and SRGAN for Rapid Phenotypic Mapping of Individual Chinese Cabbage Plants

The phenotypic parameters of crop plants can be evaluated accurately and quickly using an unmanned aerial vehicle(UAV)equipped with imaging equipment.In this study,hundreds of images of Chinese cabbage(Brassica rapa L.ssp.pekinensis)germplasm resources were collected with a low-cost UAV system and used to estimate cabbage width,length,and relative chlorophyll content(soil plant analysis development[SPAD]value).The super-resolution generative adversarial network(SRGAN)was used to improve the resolution of the original image,and the semantic segmentation network Unity Networking(UNet)was used to process images for the segmentation of each individual Chinese cabbage.Finally,the actual length and width were calculated on the basis of the pixel value of the individual cabbage and the ground sampling distance.The SPAD value of Chinese cabbage was also analyzed on the basis of an RGB image of a single cabbage after background removal.After comparison of various models,the model in which visible images were enhanced with SRGAN showed the best performance.With the validation set and the UNet model,the segmentation accuracy was 94.43%.For Chinese cabbage dimensions,the model was better at estimating length than width.The R2 of the visible-band model with images enhanced using SRGAN was greater than 0.84.For SPAD prediction,the R2 of the model with images enhanced with SRGAN was greater than 0.78.The root mean square errors of the 3 semantic segmentation network models were all less than 2.18.The results showed that the width,length,and SPAD value of Chinese cabbage predicted using UAV imaging were comparable to those obtained from manual measurements in the field.Overall,this research demonstrates not only that UAVs are useful for acquiring quantitative phenotypic data on Chinese cabbage but also that a regression model can provide reliable SPAD predictions.This approach offers a reliable and convenient phenotyping tool for the investigation of Chinese cabbage breeding traits.

The relationship between sarcopenia,multidimensional frailty,and malnutrition cluster and long-term mortality in hospitalized patients with cirrhosis

Aim:Sarcopenia,multidimensional frailty,and malnutrition represent common debilitating conditions in the context of cirrhosis,linked to a variety of dismal outcomes.We aimed to clarify their overlap and cumulative impact on long-term mortality in hospitalized patients with cirrhosis.Methods:Consecutive patients with cirrhosis were prospectively recruited from January 2018 to December 2020.The diagnosis of sarcopenia,multidimensional frailty,and malnutrition was standardized according to the consensus definition and our well-documented criteria.The prevalence of the respective debilitating condition and the concurrence of this comorbidity were calculated.Results:In total,253 patients with cirrhosis aged 64 years with a female predominance(52.4%)were recruited.Sarcopenia was present in 20.9%(53/253),multidimensional frailty in 12.6%(32/253),and malnutrition in 44.7%(113/253)of the entire cohort.Approximately half of the patients had at least one debilitating condition(127/253).Sarcopenia and malnutrition co-existed in 33 nonfrail patients(13.0%)and multidimensional frailty and malnutrition in eight nonsarcopenic patients(3.2%).Fifteen(5.9%)subjects had all three debilitating conditions,namely malnutrition,sarcopenia,and frailty(MSF)group.The proportions of males,infections,and ascites were significantly higher in the MSF group.Patients in the MSF group had the highest levels of neutrophil-to-lymphocyte ratio and creatinine.The 2-year mortality rates in patients with three debilitating conditions,two conditions,one condition,and no conditions were 60.0%,23.8%,21.4%,and 13.5%,respectively.Multivariate Cox regression indicated the long-term mortality risk was approximately four-fold higher among patients in the MSF group compared to those with no conditions.Conclusions:A fraction of patients with cirrhosis exhibited comorbidities of sarcopenia,multidimensional frailty,and malnutrition,linked to a higher risk of long-term mortality.

Multispectral Drone Imagery and SRGAN for Rapid Phenotypic Mapping of Individual Chinese Cabbage Plants

The phenotypic parameters of crop plants can be evaluated accurately and quickly using an unmanned aerial vehicle(UAV)equipped with imaging equipment.In this study,hundreds of images of Chinese cabbage(Brassica rapa L.ssp.pekinensis)germplasm resources were collected with a low-cost UAV system and used to estimate cabbage width,length,and relative chlorophyll content(soil plant analysis development[SPAD]value).The super-resolution generative adversarial network(SRGAN)was used to improve the resolution of the original image,and the semantic segmentation network Unity Networking(UNet)was used to process images for the segmentation of each individual Chinese cabbage.

Sarcopenic obesity in liver disease: Handling both sides of the penny

Skeletal muscle and fat tissue show distinct pathophysiological roles and pivotal functions.The culmination of muscle wasting and fat accumulation represents an opposite terminal of each state.Specifically,this situation has been designated as sarcopenic obesity.However,sarcopenic obesity still lacks a unanimous definition,diagnostic criteria,and generalized modalities for assessment in the context of versatile liver diseases.Moreover,the underpinning mechanisms by which a combination of abnormal skeletal muscle and fat tissue leads to the progression of liver disease and impairs health‐related consequences are still elusive.Additionally,the interplay between skeletal muscle and fat,and the driving factors that shift different body compositions are not well understood.Therefore,in this review,we discuss skeletal muscle and fat components,with the purpose of conceptualization,as well as interpret their roles in liver diseases.We focus on the definitions,diagnostic criteria,and currently available measurements for sarcopenic obesity in the literature.We comprehensively discuss recent data and evidence regarding the potential role of sarcopenic obesity in the development and progression of numerous liver diseases and associated conditions,including nonalcoholic fatty liver disease,chronic viral hepatitis,cirrhosis,and liver transplantation.Furthermore,explicit information related to the pathogenesis of sarcopenic obesity from basic research is also provided in this narrative review.Finally,we discuss,from the clinical perspective of view,how to manage sarcopenic obesity using nutritional,physical,and pharmacological methods.