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Introduction: The Steinberg classification system is commonly used by orthopedic surgeons to stage the severity of patients with osteonecrosis of the femoral head (ONFH), and it includes mild, moderate, and severe grading of each stage based on the area of the femoral head affected. However, clinicians mostly grade approximately by visual assessment or not at all. To accurately distinguish the mild, moderate, or severe grade of early stage ONFH, we propose a convolutional neural network (CNN) based on magnetic resonance imaging (MRI) of the hip joint of patients to accurately grade and aid diagnosis of ONFH. Materials and Methods: T1-MRI images of patients diagnosed with early stage ONFH were collected. Three orthopedic surgeons selected 261 slices containing images of the femoral head and labeled each case with the femoral head necrosis classification. Our CNN model learned, trained, and segmented the regions of femoral head necrosis in all the data. Results: The accuracy of the proposed CNN for femoral head segmentation is 97.73%, sensitivity is 91.17%, specificity is 99.40%, and positive predictive value is 96.98%. The diagnostic accuracy of the overall framework is 90.80%. Conclusions: Our proposed CNN model can effectively segment the region where the femoral head is in MRI and can identify the region of early stage femoral head necrosis for the purpose of aiding diagnosis. [ABSTRACT FROM AUTHOR]

Idiopathic pulmonary fibrosis (IPF) poses significant challenges due to limited treatment options despite its complex pathogenesis involving cellular and molecular mechanisms. This study investigated the role of transient receptor potential ankyrin 1 (TRPA1) channels in regulating M2 macrophage polarization in IPF progression, potentially offering novel therapeutic targets. Using a bleomycin-induced pulmonary fibrosis model in C57BL/6J mice, we assessed the therapeutic potential of the TRPA1 inhibitor HC-030031. TRPA1 upregulation was observed in fibrotic lungs, correlating with worsened lung function and reduced survival. TRPA1 inhibition mitigated fibrosis severity, evidenced by decreased collagen deposition and restored lung tissue stiffness. Furthermore, TRPA1 blockade reversed aberrant M2 macrophage polarization induced by bleomycin, associated with reduced Smad2 phosphorylation in the TGF-β1-Smad2 pathway. In vitro studies with THP-1 cells treated with bleomycin and HC-030031 corroborated these findings, highlighting TRPA1's involvement in fibrotic modulation and macrophage polarization control. Overall, targeting TRPA1 channels presents promising therapeutic potential in managing pulmonary fibrosis by reducing pro-fibrotic marker expression, inhibiting M2 macrophage polarization, and diminishing collagen deposition. This study sheds light on a novel avenue for therapeutic intervention in IPF, addressing a critical need in the management of this challenging disease. [ABSTRACT FROM AUTHOR]