Morphological Classification Research Articles

Congenital three generation wide familial non-syndromic polydactyly.

Polydactyly is typically observed as isolated and sporadic occurrences, although familial cases do exist, albeit with lower frequency, manifesting in various inheritance patterns. In around 30% of polydactyly cases, there exists a familial history, suggesting the probable involvement of a single gene. Given its potential for hereditary transmission, thorough investigation of the patients' parents, first-degree relatives, grandparents, and even great-grandparents for similar disorders becomes imperative. In our clinic, we conducted an analysis focusing on patients presenting with foot polydactyly, along with occurrences of polydactyly among their first- and second-degree relatives spanning two to three generations of family history. The study encompassed three patients and their respective families, including a pair of siblings. We speculate that the inheritance type in our cases was autosomal dominant. Among our patients, one presented with central polydactyly, while the remaining patients and all familial cases displayed postaxial polydactyly. In terms of morphologic classification, one patient had a Y-shaped metatarsal, another had a T-shaped metatarsal, and the third patient exhibited a duplicated ray-shaped anomaly. In our review of the literature, we haven't come across a case spanning three generations like the ones we encountered. Additionally, the presence of a transverse accessory extensor tendon between both extensor tendons in cases with T- and Y-shaped metatarsals intrigued us from an anatomical perspective. Our goal is to present these rare cases of congenital familial polydactyly spanning three generations, highlighting the anatomical variations observed and aiming to contribute to the existing body of literature on the subject.

The shell formation mechanism of Turbo argyrostomus based on ultrastructure and transcriptome analysis

The gold inner shell of Turbo argyrostomus is an important morphological classification characteristic in Gastropoda. However, the gene sets responsible for shell formation in gastropods remain poorly explored. In this study, we investigated the microstructure using scanning electron microscopy (SEM), hematoxylin-eosin (HE) and Alcian blue staining-periodic acid-Schiff (AB-PAS) staining. The SEM results illustrated that the T. argyrostomus shell exhibited a special “sandwich” microstructure. The results of histological observation demonstrated two major cell types: adipocytes and mucin cells. A total of 318 differentially expressed genes were identified between edge mantle and central mantle, among which whey acidic protein, N66, and nacre-like proteins, and Lam G and EGF domains may be related to shell microstructure. 22.39% − 25.20% of the mucin genes had biomineralization related domains, which supported for the relationship between mucins and shell formation. Moreover, this study revealed energy distribution differences between the edge mantle and central mantle. These results provide insights for further understanding of the biomineralization mechanism in Gastropoda.

P-123 Comparison of the performance of 3 models (iDAScore v1.0, KIDScore D5 v3, and NEQsi score) for predicting pregnancy after single blastocyst transfer

Abstract Study question What is the respective performance of an AI model, a morphokinetic model and an embryo morphology model for the prediction pregnancy after single blastocyst transfer? Summary answer KIDScore™ D5 v3, NEQsi score, and iDAScore™ v1.0 demonstrated similar performance in predicting biochemical pregnancy, clinical pregnancy, and live birth. What is known already Blastocyst selection for transfer currently mostly relies on Gardner’s morphological classification, which suffers from relatively limited predictive performance and interoperator variability. Both morphokinetic scores and the development of AI tools raised hope for improved embryo quality assessment in IVF. The NEQsi score is a very recently published digital transcription of the Gardner classification, allowing easier data categorization and comparison with other scores / models. The respective performance of these models / scores has hardly been reported up to now. Studying this in a setting with systematic single blastocyst policy allows avoiding biases related to patients’ selection. Study design, size, duration This is a retrospective monocentric study conducted in 2020-2022 on single blastocyst transfers after culture in a time-lapse incubator (Embryoscope©). All embryos with a known clinical outcome after fresh or frozen transfer and with KIDScore™ D5 v3, NEQsi score, and iDAScore™ v1.0 were included, regardless of the ART technique. Participants/materials, setting, methods All patients gave their consent for anonymous analysis of their clinical data. All scores were compared by conducting a One-way ANOVA test followed by a non-parametric Kruskal-Wallis test. A ROC curve was calculated for the prediction of both biochemical, clinical pregnancy and live birth. Main results and the role of chance 1888 single blastocyst transfers were performed in 1223 patients, 907 resulting in a biochemical pregnancy, 626 in a clinical pregnancy, and 495 in a live birth. The mean values were 7.00 (± 1.64) for the KIDscore, 7.99 (± 1.30) for the NEQsi, and 8.50 (± 1.00) for the iDAscore. The mean score values were significantly different between groups according to positive or negative clinical outcome (p < 0.0001 for all). The ROC curves showed that all 3 scores are predictive of a biochemical pregnancy (AUC KIDScore = 0.62; AUC NEQsi = 0.63; AUC iDAScore = 0.60), clinical pregnancy (AUC KIDScore = 0.64; AUC NEQsi = 0.65; AUC iDAScore = 0.61), and a live birth (AUC KIDScore = 0.62; AUC NEQsi = 0.63; AUC iDAScore = 0.60). These AUCs were not significantly different, and none of these scores appeared to be superior to the others in predicting live birth after single blastocyst transfer. Limitations, reasons for caution The retrospective and monocentric design calls for caution when generalizing these results. Wider implications of the findings The respective relevance of these scores in shortening time to pregnancy by ranking usable embryos within a cohort should be considered in further studies. Trial registration number not applicable

P-611 Quantity or quality? Comparative study on the effectiveness of recombinant, purified and mixed gonadotropins on the outcome of ICSI treatments from an embryologist perspective

Abstract Study question Are oocyte retrieval and embryo development affected by the origin of the gonadotropins used for controlled ovarian stimulation (COS), when controlling fertilization and culture conditions? Summary answer Patients stimulated with recombinant gonadotropins obtained similar number of oocytes than those using purified hormones, but more blastocysts and better embryo morphology, needing lower doses. What is known already Many authors have questioned the safety of purified urinary gonadotropins used for COS prior to an IVF treatment, and have demonstrated the presence of impurities and a high heterogeneity between batches. Another strategy involves using recombinant follicle-stimulating hormone with/without luteinizing hormone (rFSH+/-rLH) synthetized in vitro. Many studies have compared the cost-effectiveness of these drugs; however, a conclusion has not been reached. These studies have varying inclusion criteria and focus on final endpoints such as pregnancy and live birth, sometimes lacking control over the many variables introduced during the fertilization and culture procedures, which affect embryo development and potential. Study design, size, duration Preliminary retrospective observational study performed over 453 patients subjected to COS prior to autologous ICSI treatments in a private clinic over 3 years, using Time-lapse incubator. The total dose employed, the number and maturity rate of the oocytes retrieved of patients subjected to stimulation with recombinant (RH; n = 46) or mixed hormones (MH; n = 332) were compared with those using purified hormones (PH; n = 75). After ICSI, fertilization and embryo development were also compared between the three groups. Participants/materials, setting, methods The stimulation protocol was adjusted for each patient following the standard protocols of the clinic. Fertilization was performed by ICSI and embryo culture was carried out in Geri time-lapse incubators using Geri Medium (Genea Biomedx). When available (1,097 embryos), Eeva-Xtend Test was applied. Statistical analysis was performed by generalized estimating equations (significance: P≤0.05). Considered confounders include age, body mass index, days of stimulation, down-regulation protocol, and other variables relevant to embryo development. Main results and the role of chance Proper follicle stimulation was achieved with lower doses of RH (1,606.26±1,110.52 IU) than PH (2,941.73±1,011.14 IU) and MH (3,629.68±1,080.79 IU). No association was found between the use of different gonadotropins and the number of oocytes collected (Odds ratio (OR, RH vs PH)=2.51, P=0.411; OR (MH vs PH)=1.26, P=0.754) or their maturity rate (OR (RH vs PH)=2.38, P=0.328; OR (MH vs PH)=1.01, P=0.988). No significant association was found between the odds of a correct fertilization and the type of hormone used. However, the odds of reaching blastocyst stage were statistically higher for embryos from patients treated with RH: OR (RH vs PH)=1.72, P=0.006; OR (MH vs PH)=1.45, P=0.005; blastocyst rate=68.7% RH, 61.9% MH and 54.6% PH. The mean morphological classification by ASEBIR criteria of the embryos was significantly better in the RH group than in the PH group (OR = 1.55, P=0.032), but no association was found in the MH-PH comparison (OR = 1.26, P=0.092). No association was found between the type of hormone and the distribution of the Eeva-Xtend scores. Significantly lower values of the morphokinetic parameter s2 (synchrony between the second and third cell divisions) were also associated with the use of RH (OR (RH vs PH)=0.311, P=0.004). Limitations, reasons for caution The reduced sample size and the heterogeneous number of patients in the three groups limit the statistical power of the comparisons. Different hormones and brands were included in each group. Wider implications of the findings Although not altering the number of oocytes retrieved, the use of RH may improve the chances of success of ICSI cycles by increasing the number of available blastocysts. The positive outcomes paired with the lower dose needed, could make the use of recombinant hormones a cost-effective strategy. Trial registration number Not applicable

P-263 Assisted hatching, embryo quality, and re-expansion: Exploring their impact on frozen embryo transfer outcomes and predictive factors for implantation

Abstract Study question Do post-warming assisted hatching, embryo re-expansion grade and quality affect clinical pregnancy rates in frozen embryo transfer cycles? Summary answer Assisted hatching (AH) improves clinical outcomes in poor-quality embryos that struggle to hatch on their own. Embryo re-expansion grade and quality are predictive for implantation. What is known already In recent years, the use of frozen embryo transfer has grown considerably. Pre-vitrification morphological classification is a well-established method for assessing embryo quality and predicting treatment outcomes. However, there is limited evidence regarding the prognostic value of blastocyst characteristics after thawing. Embryo vitrification has revolutionized assisted reproductive technology. However, this technique can stiffen the embryo’s zona pellucida, making hatching and implantation in the uterus more challenging. To facilitate these processes, AH is performed in laboratories. While research has been conducted on AH’s efficacy, controversy remains, and it is not yet clear when it is beneficial for embryos. Study design, size, duration Retrospective observational study of 486 patients undergoing single embryo cryotransfers between January 2022 and December 2023. Patients were divided into two groups: AH-NO (n = 246) and AH-YES (n = 240). In the AH-YES group, a 1/4 opening of the zona pellucida was performed using laser shots (Octax-NaviLase®) after thawing. Images of embryos cultured for at least 4 hours (x = 5.23 hours) in a time-lapse incubator (EmbryoScope+™, Vitrolife) were analysed from the time of thawing until the time of transfer. Participants/materials, setting, methods Blastocyst morphology was assessed on two categories: good quality (GQ) embryos (expansion 4-6, inner cell mass (ICM) and trophectoderm (TE) A/B) and poor quality (BQ) embryos (expansion 3-6, ICM and TE C) according to the Gardner-Schoolcraft classification. Blastocyst re-expansion was evaluated in three categories: fully re-expanded (F), partially re-expanded, 30-70% re-expansion (P) and unre-expanded/collapsed (N) embryos following thawing before transfer. Statistical analysis was performed using the Chi-squared test. Main results and the role of chance In the comparative analysis of clinical data regarding whether or not AH was performed after thawing, there were no significant differences in implantation rates (AH-YES: 58.33%, AH-NO: 58.54%, p > 0.05) or miscarriage rates (14.39% vs 15.97%, p > 0.05) between the two groups. When comparing by embryo quality, there were no differences in implantation rates of good-quality embryos AH-YES: 60.59%(n = 216) vs AH-NO: 60.34%(n = 237). However, in poor-quality embryos, there was an improvement in the implantation rate in those in which AH had been performed, AH-YES: 41.67%(n = 24) vs AH-NO: 11,11%(n = 9), although no statistical difference was observed, likely due to the sample size. When comparing by degree of re-expansion, there were significant differences (p < 0.05) in implantation rates of completely re-expanded embryos AH-YES: 61.31% (n = 168) vs AH-NO: 62.93% (n = 205), partially re-expanded embryos AH-YES: 56.26% (n = 54) vs AH-NO 39.29% (n = 28), and unre-expanded or collapsed embryos AH-YES: 23.53% (n = 17) vs AH-NO: 33.33% (n = 12). Limitations, reasons for caution The study is limited by its retrospective nature and the low number of poor-quality embryos transferred as they are the last option for transfer. Additionally, it is common to transfer more than one poor-quality embryo to increase the chances of pregnancy, therefore losing implantation track. Wider implications of the findings Assisted hatching (AH) could benefit poor-quality embryos, and the degree of re-expansion before embryo transfer could be a predictor of implantation. Trial registration number not applicable

P-037 Deep learning for morphology classification of live stain-free human sperm

Abstract Study question Can a deep-learning algorithm classify live, stain-free human sperm cells based on the whole cell morphology in real-time? Summary answer Our model predicts sperm morphology with 94% precision and accuracy, maintaining performance despite over six-fold image quality reduction, demonstrating less than a 12% accuracy drop. What is known already Sperm morphology analysis plays a crucial role in infertility diagnosis and treatment. However, current clinical methods either use diagnostic staining, rendering sperm cells unsuitable for treatment or depend on subjective manual examination. While deep learning has presented new opportunities for morphology analysis, previous studies only evaluate sperm head morphology, neglecting other important morphological characteristics of sperm midpiece and tail. Additionally, these algorithms rely on fixed and stained images of sperm, preventing their applicability for the classification of live, unstained sperm cells for use in treatment cycles. Study design, size, duration Donor human semen samples (with a concentration range of 30-80 million/mL) comprising 8 technical replicates sourced from 6 biological replicates, were used to generate a dataset of 2254 stain-free single sperm images. Subsequently, three expert clinicians from two different fertility clinics labelled the images according to their morphological status (assessing head, midpiece, and tail morphology) as the ground truth for training our deep-learning model. Model development, training, testing, and analysis were then performed. Participants/materials, setting, methods Using the YOLOv3 algorithm, 2254 single sperm images were automatically extracted from 1000× magnification microscopy images. Three expert andrology scientists from Monash IVF classified and labelled these images based on the WHO morphological characteristics of the sperm head, midpiece, and tail. Then our optimized ensemble structure was trained using 80% of the images for morphology classification of the whole cell. Testing on the remaining unseen images was conducted to assess accuracy, precision, and processing time. Main results and the role of chance While our clinical labelling results highlighted the subjective nature of current manual morphology analysis practices in clinics, with only 16% agreement between experts, our model classifies human sperm images based on their whole morphology status with an accuracy and precision of 94% in real-time (less than a second per image). Testing our model across multiple image resolutions (800 × 800, 224 × 224, 192 × 192, and 128 × 128 pixels) revealed consistent performance, with less than a 12% variation. This underscores the robustness and compatibility of our model across various clinical imaging settings. Importantly, for more challenging images with 2-out-of-3 experts’ agreement (53% of the images) or images without an agreement between experts (25% of the images), our model consistently classified 96% and 97% of the images with at least 75% confidence, respectively. This demonstrates the performance of the model in classifying sperm images that pose difficulties for the experts to label. Consistency in operation and informing sperm selection with quantitative metrics through this platform offers promising opportunities to reduce day-to-day variability in fertility clinics when analysing or selecting sperm. Limitations, reasons for caution This study is confined to samples and clinics exclusively located in Australia, while a larger number of samples across multiple clinics could enhance the generalizability of findings. Additionally, real-time clinical implications and long-term performance evaluation are still needed. Wider implications of the findings This platform not only provides automated evaluation of live sperm as part of infertility diagnostics but also facilitates selection of the most morphologically normal sperm for treatment cycles, particularly in the context of Intracytoplasmic Sperm Injection (ICSI). Therefore, it can enhance positive long-term treatment outcomes by prioritizing normal sperm selection. Trial registration number 2017370

First complete mitochondrial genome of Pselliophora (Diptera, Tipulidae): genome description and phylogenetic implications

Pselliophora is widely distributed in Eurasia and China. To explore the characteristics of the mitogenome of Pselliophora and reveal phylogenetic relationships, the mitogenome of Pselliophora bifascipennis Brunetti, 1911 was sequenced and annotated. This is the first complete mitochondrial genome in this genus. Its mitogenome is 15821 bp in length, containing 13 protein-coding genes, 22 tRNA and 2 rRNA genes. Nucleotide compositions of its whole mitogenome are 39.09% for A, 38.49% for T, 13.42% for C, and 9.01% for G. Consistent with previous observations of Tipulidae species, the mitogenome of Pselliophora bifascipennis is highly conserved in gene size, organization and codon usage, and secondary structures of tRNAs. Most tRNAs have the typical clover-leaf structure. The control region is 1006 bp long with an A + T content of 92.7%. Phylogenetic tree analysis using the sequences of the mitochondrial genomes of Pselliophora bifascipennis and other Tipulidae species showed that Pselliophora bifascipennis is closely related to Tanyptera hebeiensis. These two species are grouped on the same branch, which is in accordance with the traditional morphological classification. The results of this study lay a foundation for screening molecular markers of mitochondrion for molecular identification and genetic structure research in Tipulidae species.

PHANGS-HST Catalogs for ∼100,000 Star Clusters and Compact Associations in 38 Galaxies. I. Observed Properties

We present the largest catalog to date of star clusters and compact associations in nearby galaxies. We have performed a V-band-selected census of clusters across the 38 spiral galaxies of the PHANGS–Hubble Space Telescope (HST) Treasury Survey, and measured integrated, aperture-corrected near-ultraviolet-U-B-V-I photometry. This work has resulted in uniform catalogs that contain ∼20,000 clusters and compact associations, which have passed human inspection and morphological classification, and a larger sample of ∼100,000 classified by neural network models. Here, we report on the observed properties of these samples, and demonstrate that tremendous insight can be gained from just the observed properties of clusters, even in the absence of their transformation into physical quantities. In particular, we show the utility of the UBVI color–color diagram, and the three principal features revealed by the PHANGS-HST cluster sample: the young cluster locus, the middle-age plume, and the old globular cluster clump. We present an atlas of maps of the 2D spatial distribution of clusters and compact associations in the context of the molecular clouds from PHANGS–Atacama Large Millimeter/submillimeter Array. We explore new ways of understanding this large data set in a multiscale context by bringing together once-separate techniques for the characterization of clusters (color–color diagrams and spatial distributions) and their parent galaxies (galaxy morphology and location relative to the galaxy main sequence). A companion paper presents the physical properties: ages, masses, and dust reddenings derived using improved spectral energy distribution fitting techniques.

Anatomic Variations of the Calcaneofibular Ligament.

The lateral ankle joint comprises the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL). The purpose of this study was to propose a classification of CFL morphology. The material comprised 120 paired lower limbs from human cadavers (30 male, 30 female), mean age 62.3 years. The morphology was carefully assessed, and morphometric measurements were performed. A 4-part method for anatomic classification can be suggested based on our study. Type 1 (48.3%), the most common type, was characterized by a bandlike morphology. Type 2 (9.2%) was characterized by a Y-shaped band, and type 3 (21.7%) by a V-shaped band. Type 4 (20.8%) was characterized by the presence of 2 or 3 bands. Type 2 and 4 were divided into further subtypes based on origin footprint. The aim of our study was to describe variations of calcaneofibular ligament. Our proposed 4-part classification may be of value in clinical practice in future recognition of CFL injuries and in its repair or reconstruction. The anatomy of the CFL plays an important role in stability of the ankle. Greater recognition of anatomical variation may help improve reconstructive options for patients with chronic lateral ankle instability.

Risk predictive score and cord morphology classification for intraoperative neuromonitoring alerts in kyphosis surgery

BACKGROUNDIntraoperative neuromonitoring (IONM) alert is one of the worrying events of kyphosis corrective surgery, which can result in a postoperative neurological deficit. To our knowledge, there is no risk prediction score to predict such events in patients undergoing kyphosis surgery. PURPOSETo develop a new preoperative MRI-based cord morphology classification (CMC) and risk prediction score for predicting IONM alerts in patients with kyphotic deformity. STUDY DESIGNRetrospective analysis of prospectively collected data. PATIENT SAMPLEAbout 114 patients undergoing surgical correction for kyphotic deformity. OUTCOME MEASURESIntraoperative neuromonitoring alerts and postoperative neurological status using AIS grading. METHODSKyphotic deformity patients undergoing posterior spinal fusion were retrospectively reviewed. Based on the morphology of the spinal cord and surrounding CSF in MRI, there are 5 types of cord. Type 1 (normal cord): circular cord with surrounding visible CSF between the cord and the apex, Type 2 (flattened cord): cord with <50% distortion at the apex with obliteration of the anterior CSF; Type 3 (deformed cord): cord with >50% distortion at the apex with complete obliteration of the surrounding CSF; Type 4 (stretched cord): the cord is stretched and atrophied over the apex of the curve. Type 5 (translated cord): horizontal translation of the cord at the apex with buckling collapse of the vertebral column. Preoperative radiographs were used to measure the preoperative sagittal cobbs angle, sagittal deformity angular ratio (S-DAR), sagittal vertical axis (SVA), apex of the curve, and type of kyphosis. Clinical data like the duration of symptoms, clinical signs of myelopathy, neurological status (AIS grade), grade of myelopathy using the mJOA score, and type of osteotomy were documented. Multivariate logistic regression was used to determine the risk factors for IONM alerts and the risk prediction score was developed which was validated with new cohort of 30 patients. RESULTSA total of 114 patients met the inclusion criteria. IONM alerts were documented in 33 patients (28.9%), with full recovery of the signal in 25 patients and a postoperative deficit in 8 patients. Rate of IONM alerts was significantly higher in Type 5 (66%), followed by Type 4 (50%), Type 3 (21.1%), Type 2 (11.1%), and Type 1 (11.1%) (p-value<.001). Based on multiple logistic regression, 7 factors, namely preoperative neurological status, mJOA score≤6, presence of signs of myelopathy, apex of the curve above T5, preoperative sagittal cobbs, S-DAR, and MRI-based CMC, were identified as risk predictors. The value for the risk factors varies from 0 to 4, and the maximum total risk score was 13. The cut-off value of 6 had good sensitivity (84.9%) and specificity (77.8%) indicating a high risk for IONM alerts. The AUC of the predictive model was 0.92, indicating excellent discriminative ability. CONCLUSIONWe developed and validated a risk predictive score that identifies patients at risk of IONM alerts during kyphosis surgery. Identification of such high-risk patients (risk score≥6) helps in proper evaluation and preoperative counselling and helps in providing a proper evidence-based reference for treatment strategies.

A study of etiological spectrum in 106 cases of pancytopenia

Introduction and aim. Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. The aim of this work was to study the etiological spectrum of pancytopenia in the National capital region of India, and evaluate the relationship of pancytopenia with serum vitamin B12 levels. Material and methods. This study is of a prospective and analytical type conducted on patients attending the outpatient and inpatient department of Santosh Medical College and the Saraswathi Institute of Medical Sciences tertiary care centers in NCR. Complete blood counts and peripheral blood smear examination was used for morphological classification and typing of anemia. Bone marrow aspiration and vitamin B12 estimation was performed where required. Results. The maximum number of pancytopenia cases were etiologically attributed to megaloblastic anemia (64.2%) followed by aplastic anemia (19.8%). Malaria was attributed to 6.6% cases of pancytopenia. Iron deficiency anemia and tuberculosis both accounted for 1.9% of cases. each. A history of drug intake and mixed nutritional anemia each contributed to 2.8% of cases. Serum vitamin B12 levels showed a significant relationship with pancytopenic cases. Conclusion. In our study, the main cause of pancytopenia is megaloblastic anemia which responds very well to treatment if diagnosed correctly in time. A detailed hematological assessment along with vitamin B12 levels should be evaluated in all cases of pancytopenia irrespective of the etiological categorization.

Pathological and imaging features of pulmonary invasive mucinous adenocarcinoma-a retrospective cohort study.

Pulmonary invasive mucinous adenocarcinoma (IMA) is a rare subtype of lung cancer which is easily misdiagnosed as inflammatory nodules, tuberculosis, pulmonary diffuse lesions, or hamartomas due to the lack of clinical specificity. This study aims to identify the pathological and imaging characteristics of IMA, which will favor to improve the diagnostic and therapeutic efficacy. A retrospective study was conducted by enrolling patients histopathologically diagnosed with pulmonary IMA in the current study between January 2014 and December 2021. The clinical pathological and radiological data were collected for analysis to evaluate the radiological patterns and pathological and molecular characteristics of IMA. A total of 136 patients were included in the study, of whom 58 were male and 78 were female. The patients had an average age of 63.0±9.7 years. The tumors were classified into the following three pathological types: pure mucinous (76 cases) featured by only mucinous cells observed under the microscope; mixed mucinous (23 cases) featured as an attached-wall, papillary, acinar, and solid tumor cells with more than 10% mucinous cells.; and mucinous-absent (29 cases) featured with the absence of mucous cells, but still can detect more than 10% of mucin expresses. In terms of the morphological classification based on the CT scans, 88 (64.7%) cases were identified as the nodular type, 31 (22.8%) as the inflammatory type, 15 (11.1%) as the mass-like type, and two (1.5%) as the diffuse type. For the molecular features, patients afflicted with IMA showed much lower levels of thyroid transcription factor-1 (15%) than those with usual adenocarcinoma (over 80%). However, cytokeratin 20 was more common in IMA (50%) than the usual adenocarcinoma (about 5%). The K-RAS mutation was prevalent in 75% of IMA, which contrasted sharply to its occurrence in a mere 15% of the usual adenocarcinoma. Epidermal growth factor receptor mutations were rarer in IMA (less than 5%) than the usual adenocarcinoma (about 50%). The pathological and imaging features enrich our understanding of the disease's heterogeneity, which will contribute to more personalized diagnostic and therapeutic strategies.

A Simplified GBR Treatment and Evaluation of Posterior Seibert Class I Ridge Defects via Bio-collagen and Platelet-Rich Fibrin: A Retrospective Study.

Classical guided bone regeneration (GBR) treatments can achieve favorable clinical results for ridge defects. However, extensive bone augmentation in the non-esthetic area in the posterior region for minor ridge defects is unnecessary. Therefore, this study used a collagen and Platelet-rich fibrin (PRF) mixture for bone augmentation on minor posterior ridge defects and evaluated the effects. 22 Seibert Class I ridge defects were treated with BC and covered with a PRF membrane (simplified guided bone regeneration, simplified GBR) and other 22 were treated with Bio-Oss and covered with Bio-Gide (classical GBR). Cone-beam computed tomography imaging was conducted 6months post-surgery to compare the ridge's horizontal width (HW) and buccal ridge's horizontal width to assess the osteogenic effect. In addition, the buccal ridge contour morphology was studied and classified. The buccal ridge contour of simplified GBR was Type A in 14 cases, Type B in 7 cases, and Type C in 1 case and it of classical GBR was Type A in 11 cases, Type B in 8 cases, and Type C in 3 cases. The mean HW significantly increased by 1.50mm of simplified GBR treatment, while it increased by 1.83mm in classical GBR treatment. The combined use of BC and PRF had a significant effect on bone augmentation and this treatment exhibited promising clinical results for correcting posterior Seibert Class I ridge defects. The morphological classification of the reconstructive effect in this study can be utilized in future clinical work.

Integrating phylogenetic, phylogeographic, and morphometric analyses to reveal cryptic lineages within the genus Asaccus (Reptilia: Squamata: Phyllodactylidae) in Iran

The Middle Eastern endemic genus Asaccus comprises Southwest Asian leaf-toed geckos. To date, this genus includes 19 species of leaf-toed geckos (seven in Arabia and 12 in the Zagros Mountains). Despite a recent study on the taxonomy and phylogeny of Asaccus species in Iran, controversies still remain surrounding the phylogeny and phylogeography of the genus. Here, we used an integrative approach to determine the phylogeny and phylogeography of Asaccus species using two mitochondrial genes (12 S and Cyt b), and one nuclear gene (c-mos). Our results uncovered 22 distinct lineages, demonstrating a significant cryptic diversity that challenges the current morphological classifications of these species. Phylogenetic analyses reinforce the monophyly of the Asaccus group, positioning A. montanus as a basal lineage, which supports a deep evolutionary divergence dating back to the Late Oligocene, approximately 27.94 million years ago. This genetic diversity also highlights the impact of historical climatic and geographical changes on species diversification. The findings advocate for an integrative approach combining both molecular and morphological data to resolve species identities accurately, thereby enhancing conservation strategies to protect these genetically distinct lineages.

A MORPHOLOGICAL REVIEW OF MEDIAL MALLEOLAR FRACTURES: ARE THERE ANY FACTORS WHICH MAY PREDISPOSE TO NONUNION AND MALUNION?

BackgroundMany approaches to management of medial malleolar fractures are described in the literature however, their morphology is under investigated. The aim of this study was to analyse the morphology of medial malleolar fractures to identify any association with medial malleolar fracture non-union or malunion.MethodsPatients who had undergone surgical fixation of their MMF were identified from 2012 to 2022, using electronic patient records in a single centre. Analysis of their preoperative, intraoperative, and postoperative radiographs was performed to determine their morphology and prevalence of non-union and malunion. Lauge-Hansen classification was used to characterise ankle fracture morphology and Herscovici classification to characterise MMF morphology.ResultsA total of 650 patients were identified across a 10-year period which could be included in the study. The overall non-union rate for our cohort was 18.77% (122/650). The overall malunion rate was 6.92% (45/650). There was no significant difference in union rates across the Herscovici classification groups. Herscovici type A fractures were significantly more frequently malreduced at time of surgery as compared to other fracture types (p=.003). Medial wall blowout combined with Hercovici type B fractures showed a significant increase in malunion rate. There is a higher rate of bone union in patients who have been anatomically reduced.ConclusionThe morphology of medial malleolar fractures does have an impact of the radiological outcome following surgical management. Medial wall blowout fractures were most prevalent in adduction-type injuries; however, it should not be ruled out in rotational injuries with medial wall blowouts combined with and Herscovici type B fractures showing a significant increase in malunions. Herscovici type A fractures had significantly higher malreductions however the clinical implications of mal reducing small avulsions is unknown.

Facial morphological analysis for the development of a representative atlas of the brazilian population

The objective of this study was to propose categories of morphological classification for the face and its anatomical structures, as well as to propose illustrations to support the development of an atlas that facilitates facial morphological analysis of adult Brazilians. It was a descriptive study based on the analysis of the frequency and distribution of 13 photoanthropometric facial ratios (RFAs) obtained from a representative sample of the Brazilian population. RFAs related to facial height and width, eye width, intercanthal distance, nose length and width, philtrum ridge height and width, mouth thickness and width, upper and lower lip thickness, and chin height were analyzed. The study included a sample of 5.000 individuals aged between 18 and 22 years, evenly distributed between genders. Data normality was assessed using the Shapiro-Wilk test, considering them as parametric when p > 0.05. For the RFAs that showed normal distribution, mean ± 1.5 standard deviations (SD) were used to categorize facial measurements as regular, below average, or above average. Non-parametric RFAs were analyzed based on the median and 10th and 90th percentiles of the data. Based on the established average iris diameter, which is considered the most stable facial measurement, the values of the described RFAs were converted to a numerical scale in centimeters, allowing for the illustration of female and male faces. In this way, it was possible to categorize the facial anatomical structures and, consequently, visualize the facial morphological pattern of the adult Brazilian population.

AstroCLIP: a cross-modal foundation model for galaxies

ABSTRACT We present AstroCLIP, a single, versatile model that can embed both galaxy images and spectra into a shared, physically meaningful latent space. These embeddings can then be used – without any model fine-tuning – for a variety of downstream tasks including (1) accurate in-modality and cross-modality semantic similarity search, (2) photometric redshift estimation, (3) galaxy property estimation from both images and spectra, and (4) morphology classification. Our approach to implementing AstroCLIP consists of two parts. First, we embed galaxy images and spectra separately by pre-training separate transformer-based image and spectrum encoders in self-supervised settings. We then align the encoders using a contrastive loss. We apply our method to spectra from the Dark Energy Spectroscopic Instrument and images from its corresponding Legacy Imaging Survey. Overall, we find remarkable performance on all downstream tasks, even relative to supervised baselines. For example, for a task like photometric redshift prediction, we find similar performance to a specifically trained ResNet18, and for additional tasks like physical property estimation (stellar mass, age, metallicity, and specific-star-formation rate), we beat this supervised baseline by 19 per cent in terms of R2. We also compare our results with a state-of-the-art self-supervised single-modal model for galaxy images, and find that our approach outperforms this benchmark by roughly a factor of two on photometric redshift estimation and physical property prediction in terms of R2, while remaining roughly in-line in terms of morphology classification. Ultimately, our approach represents the first cross-modal self-supervised model for galaxies, and the first self-supervised transformer-based architectures for galaxy images and spectra.

A nomenclatural review of family-group names in the Tettigoniidae (Orthoptera: Ensifera)

The Tettigoniidae is the largest and most complex family within the Orthoptera, and perhaps expectedly, its systematic arrangement is largely unsatisfactory. Recent phylogenetic studies within the group have been almost wholly at odds with traditional morphological classification, and it is clear that a great number of changes will be made to the family in the near future. To remove the element of nomenclatural uncertainty that will inevitably arise with such dramatic changes, I here provide a complete annotated list of all family-group names proposed within the Tettigoniidae in explicit order of priority. I provide details of the authorship, availability, current validity, current rank(s) and name(s), type genus, stem, and parent taxon of each of the 182 proposed family-group names, of which 171 represent available names. I also make several nomenclatural changes, the most significant of which is the replacement of available but informal groupings (e.g. species groups) with formal tribes, subtribes, and infratribes. Other major changes are the replacement of Nedubini syn. nov. with Apteropedetini stat. nov., the replacement of Eumegalodontina (unavailable name) with Lesinina stat. nov., and the designation of Acanthodidae as nomen oblitum with respect to Pleminiae (nomen protectum). To reduce confusion in future, I recommend that all new family-group names be clearly proposed as new, with a correct rank, stem, suffix, and diagnosis, that informal groupings are explicitly proposed as informal, and that formal names are used and proposed in place of informal names wherever possible. I additionally propose that the suffixes -iti and -ita be used for all supertribe and infratribe rankings within the Tettigoniidae. Finally, I discuss the various names that have been used for taxa between the ranks of family and subfamily, with the recommendation that informal ‘group’ and ‘clade’ names with unambiguous suffixes are formed from available subfamily names.

Artificial intelligence-based morphologic classification and molecular characterization of neuroblastic tumors from digital histopathology.

A deep learning model using attention-based multiple instance learning (aMIL) and self-supervised learning (SSL) was developed to perform pathologic classification of neuroblastic tumors and assess MYCN-amplification status using H&E-stained whole slide digital images. The model demonstrated strong performance in identifying diagnostic category, grade, mitosis-karyorrhexis index (MKI), and MYCN-amplification on an external test dataset. This AI-based approach establishes a valuable tool for automating diagnosis and precise classification of neuroblastoma tumors.

Assessment of phylogenetic relationships and genetic diversity of Sagittaria trifolia using phenotypic traits and SNP markers.

The aquatic perennial herb Sagittaria trifolia L. commonly known as arrowhead, has been utilized in China both as a culinary vegetable and in traditional medicines. Characterizing the phylogenetic relationships and genetic diversity of arrowheads is crucial for improved management, conservation, and efficient utilization of the germplasm resources associated with this species. Herein, we presented the phenotypic traits and genome-wide DNA marker-based analyses of 111 arrowhead accessions, most of which were from China. Cluster analysis revealed that arrowhead could be categorized into two clusters based on 11 phenotypic traits, with Cluster 1 comprising two subclusters. All accessions were clustered into three sub-clusters based primarily on leaf shape and tuber weight. A set of 759,237 high-quality single-nucleotide polymorphisms was identified and used to assess the phylogenetic relationships. Population structure and phylogenetic tree analyses suggested that the accessions could be classified into two major groups, Group I was further subdivided into two subgroups, aligning with the clusters identified through morphological classification. By employing Sagittaria lichuanensis as an outgroup, the rooted tree revealed that the evolutionary relationships within the three groups followed a progression from Group I-1 to Group I-2 and finally to Group II. The landraces were clustered into one group along with the remaining wild accessions. The level of genetic diversity for Group I (π = 0.26) was slightly lower than that which was estimated for Group II (π = 0.29). The lowest pairwise differentiation levels (Fst, 0.008) were obtained from the comparison between groups I-2 and II, indicating that the two groups were the most closely related. This study provides novel insights into germplasm classification, evolutionary relationships, genomics and arrowhead breeding.