Cherry Tomato Production in Intelligent Greenhouses-Sensors and AI for Control of Climate, Irrigation, Crop Yield, and Quality

Greenhouses and indoor farming systems play an important role in providing fresh and nutritious food for the growing global population. Farms are becoming larger and greenhouse growers need to make complex decisions to maximize production and minimize resource use while meeting market requirements. However, highly skilled labor is increasingly lacking in the greenhouse sector. Moreover, extreme events such as the COVID-19 pandemic, can make farms temporarily less accessible. This highlights the need for more autonomous and remote-control strategies for greenhouse production. This paper describes and analyzes the results of the second “Autonomous Greenhouse Challenge”. In this challenge, an experiment was conducted in six high-tech greenhouse compartments during a period of six months of cherry tomato growing. The primary goal of the greenhouse operation was to maximize net profit, by controlling the greenhouse climate and crop with AI techniques. Five international teams with backgrounds in AI and horticulture were challenged in a competition to operate their own compartment remotely. They developed intelligent algorithms and use sensor data to determine climate setpoints and crop management strategy. All AI supported teams outperformed a human-operated greenhouse that served as reference. From the results obtained by the teams and from the analysis of the different climate-crop strategies, it was possible to detect challenges and opportunities for the future implementation of remote-control systems in greenhouse production.

Patient preferences for allogeneic haematopoietic stem cell transplantation: how much benefit is worthwhile from the patient's perspective?

Oncological studies have shown that patients consider small benefits sufficient to make adjuvant chemotherapy worthwhile. We sought to determine the minimal survival benefits that patients considered enough to legitimate allogeneic haematopoietic stem cell transplantation (HCT) and the factors associated with patient preferences. One hundred eighty-four patients having previously received allogeneic HCT at our centre were included and completed a questionnaire exploring patient expectations elicited by time trade-off scenarios as well as quality of life (QoL), symptoms of graft-versus host disease (GvHD) and sociodemographic characteristics. The majority of patients considered a minimal survival benefit of at least 5 (38.6%) or 10 years (41.9%) sufficient to justify HCT, with less than 5% considering survival < 1 year sufficient to warrant HCT. In terms of minimal cure rate, a cumulative 14.8% of patients accepted cure rates below 30% and 30.6% rates below 50%. Likelihood-ratio tests were significant for the effect of age at transplant on expected minimal survival (p = 0.007) and cure rates (p = 0.0001); that is, younger patients at HCT were more likely to accept smaller survival and cure rates. Pre-transplant risk score, QoL, GvHD score and sociological factors did not seem to influence patients' expectations. In conclusion, patient expectations of treatment were much higher than what had been reported in oncological studies. Patients who experienced HCT considered a survival superior to 1 year and cure rates above 50% sufficient to make it worthwhile. Younger patients were more likely to accept smaller benefits; no other predictors for preferences could be detected.

Evaluation of Disease Risk Comorbidity Index after Allogeneic Stem Cell Transplantation in a Cohort with Patients Undergoing Transplantation with In Vitro Partially T Cell Depleted Grafts

Outcomes of hematopoietic stem cell transplantation (HSCT) are influenced by comorbidities, disease type, and status at transplantation. Several prognostic scores can be used, such as the disease risk index (DRI) or the hematopoietic cell transplantation-specific comorbidity index (HCT-CI). Recently, a new prognostic tool, the disease risk comorbidity index (DRCI), combining the DRI and the HCT-CI, was published. The DRCI determines 6 patient groups (very low risk [VLR], low risk [LR], intermediate risk 1 [IR-1], intermediate risk 2 [IR-2], high risk [HiR], and very high risk [VHR]) with a significant predictive value for overall survival (OS), disease-free survival (DFS), relapse incidence (RI), and graft-versus-host disease-free/relapse-free survival (GRFS). However, the DRCI has not been evaluated for patients allografted with partially in vitro T cell depleted (pTDEP) grafts. In our center, we offer pTDEP to reduce graft-versus-host disease for patients in complete remission at transplant time. In this retrospective study, we investigated the DRCI in 404 adult patients (including 37.6% pTDEP) undergoing a first HSCT for hematological malignancies from 2008 to 2018. Because of the small number of patients in LR, VLR and LR were combined for analysis. In the entire cohort, 2-year OS was 84.4% (95% CI, 71.6% to 97.2%) for LR, 61.6% (54.8% to 68.4%) for IR-1, 45.7% (33.3% to 58.1%) for IR-2, 31% (19.4% to 42.6%) for HiR, and 30.9% (14.5% to 47.3%) for VHR (P < .001). In addition, the DRCI was predictive of DFS, RI, and GRFS but not of nonrelapsed mortality and graft-versus-host disease. Our study confirms similar results with the original publication but gives less accurate prognosis information than the DRI and HCT-CI when used separately. In conclusion, the DRCI does not seem to offer more relevant information than the DRI and HCT-CI to help physicians and patients for the HSCT decision.

Remote Control of Greenhouse Vegetable Production with Artificial Intelligence-Greenhouse Climate, Irrigation, and Crop Production

The global population is increasing rapidly, together with the demand for healthy fresh food. The greenhouse industry can play an important role, but encounters difficulties finding skilled staff to manage crop production. Artificial intelligence (AI) has reached breakthroughs in several areas, however, not yet in horticulture. An international competition on "autonomous greenhouses" aimed to combine horticultural expertise with AI to make breakthroughs in fresh food production with fewer resources. Five international teams, consisting of scientists, professionals, and students with different backgrounds in horticulture and AI, participated in a greenhouse growing experiment. Each team had a 96 m² modern greenhouse compartment to grow a cucumber crop remotely during a 4-month-period. Each compartment was equipped with standard actuators (heating, ventilation, screening, lighting, fogging, CO₂ supply, water and nutrient supply). Control setpoints were remotely determined by teams using their own AI algorithms. Actuators were operated by a process computer. Different sensors continuously collected measurements. Setpoints and measurements were exchanged via a digital interface. Achievements in AI-controlled compartments were compared with a manually operated reference. Detailed results on cucumber yield, resource use, and net profit obtained by teams are explained in this paper. We can conclude that in general AI performed well in controlling a greenhouse. One team outperformed the manually-grown reference.

A comparison of body composition measurement techniques

BACKGROUND

An understanding of the reproducibility of body composition measurements is essential for effective intervention studies. Air displacement plethysmography (ADP) and bioelectrical impedance (BIA) are two easy-to-use measures of body composition. The present study aimed to assess the reproducibility of ADP and BIA and compare them with each other, as well as with skinfold measurement.

METHODS

Forty-one participants were tested on two occasions following an overnight fast. On test day 1, participants' height, weight and % body fat (BF) were measured using ADP and BIA. Measurements were replicated to assess the within-day reproducibility. On test day 2, participants were again tested using ADP and BIA and had skinfold measurements taken. Three skinfold equations for BF calculation were applied. Comparisons of within- and between-day reproducibility and between measurement techniques were completed using Pearson correlations and Bland-Altman analysis.

RESULTS

Both Pearson correlation and Bland-Altman analysis showed good within- and between-day relationships and agreement for BF from ADP and BIA measurements. The two methods had a high correlation between them; however, the mean difference between the two was 3.1% (4.1%). From the skinfold equations used, the best agreement with ADP had a mean difference of 0.3% (0.8%) and, with BIA, had mean differences of 1.9% (4.2%).

CONCLUSIONS

The data indicate that ADP and BIA cannot be used interchangeably, although both measurements had good within- and between-day agreement.

Persistent poor long-term prognosis of allogeneic hematopoietic stem cell transplant recipients surviving invasive aspergillosis

BACKGROUND

Voriconazole treatment increases early survival of allogeneic hematopoietic stem cell transplant recipients with invasive aspergillosis. We investigated whether this survival advantage translates into an increased long-term survival.

DESIGN AND METHODS

This retrospective study involved all patients with an invasive aspergillosis diagnosis transplanted between September 1997 and December 2008, at the Saint-Louis Hospital, Paris, France. The primary end point was survival up to 36 months. Survival analysis before and after 12 weeks, as well as cumulative incidence analysis in a competing risk framework, were used to assess the effect of voriconazole treatment and other factors on mortality.

RESULTS

Among 87 patients, 42 received first-line voriconazole and 45 received another antifungal agent. Median survival time was 2.6 months and survival rate at 36 months was 18%. Overall, there was a significant difference in the survival rates of the two groups. Specifically, there was a dramatic difference in survival rates up to ten months post-aspergillosis diagnosis but no significant difference after this time. Over the first 36 months as a whole, no significant difference in survival rate was observed between the two groups. First-line voriconazole significantly reduced aspergillosis-attributable mortality. However, first-line voriconazole patients experienced a significantly higher probability of death from a non-aspergillosis-attributable cause.

CONCLUSIONS

Although the prognosis for invasive aspergillosis after stem cell transplantation has dramatically improved with the use of voriconazole, this major advance in care does not translate into increased long-term survival for these severely immunocompromised patients.

Long-term follow up after allogeneic stem cell transplantation in patients with severe aplastic anemia after cyclophosphamide plus antithymocyte globulin conditioning

BACKGROUND

Due to increased rates of secondary solid organ cancer in patients with severe aplastic anemia who received an irradiation-based conditioning regimen, we decided some years ago to use the combination of cyclophosphamide and antithymocyte globulin. We report the long-term follow up of patients who underwent hematopoietic stem cell transplantation from an HLA-matched sibling donor after this conditioning regimen.

DESIGN AND METHODS

We analyzed 61 consecutive patients transplanted from June 1991 to February 2010, following conditioning with cyclophosphamide (200 mg/kg) and antithymocyte globulin (2.5 mg/kg/day × 5 days).

RESULTS

Median age was 21 years (range 4-43); 41 of the 61 patients were adults. Median duration of the disease before hematopoietic stem cell transplantation was 93 days. All but 2 patients received bone marrow as the source of stem cells and all but 2 engrafted. Cumulative incidence of acute grade II-IV graft-versus-host disease was 23% (95%CI 13-34) and 18 developed chronic graft-versus-host disease (cumulative incidence 32% at 72 months, 95% CI 20-46). In multivariate analysis, a higher number of infused CD3 cells was associated with an increased risk of developing chronic graft-versus-host disease (P = 0.017). With a median follow up of 73 months (range 8-233), the estimated 6-year overall survival was 87% (95% CI 78-97). At 72 months, the cumulative incidence of avascular necrosis was 21% and 12 patients presented with endocrine dysfunction (cumulative incidence of 19%). Only one patient developed a secondary malignancy (Hodgkin's lymphoma) during follow up.

CONCLUSIONS

Cyclophosphamide and antithymocyte globulin is an effective conditioning regimen for patients with severe aplastic anemia and is associated with low treatment-related mortality. Long-term complications include avascular necrosis and endocrine dysfunction.

Steroid-refractory acute GVHD: lack of long-term improved survival using new generation anticytokine treatment

There is no consensus on the optimal treatment of steroid-refractory acute graft-versus-host disease (SR-aGVHD) after allogeneic hematopoietic stem cell transplantation. In our center, the treatment policy has changed over time with mycophenolate mofetil (MMF) being used from 1999 to 2003, and etanercept or inolimomab after 2004. An observational study compared survival and infection rates in all consecutive patients receiving 1 of these 3 treatments. Ninety-three patients were included. The main end point was overall survival (OS). Median age was 37 years. Acute GVHD developed at a median of 15 days after transplantation. Second-line treatment was initiated a median of 12 days after aGVHD diagnosis. Therapies were MMF in 56%, inolimomab in 22%, and etanercept in 23% of the patients. Overall, second-line treatment response rate was 45% (complete response: 28%), MMF: 55%, inolimomab: 35%, and etanercept: 28%. With 74 months median follow-up, the 2-year survival was 30% (95% confidence interval: 22-41). Risk factors significantly associated with OS in multivariate analysis were disease status at transplantation; grade III-IV aGVHD at second-line treatment institution; and liver involvement. None of the second-line therapy influenced this poor outcome. Viral and fungal infections were not statistically different among the 3 treatment options; however, bacterial infections were more frequent in patients treated with anticytokines. Over an 11-year period, 3 treatment strategies, including 2 anticytokines, give similar results in patients with SR-aGVHD.

Circulating platelet-leukocyte aggregates: a marker of microvascular injury in diabetic patients

Diabetes is associated with multiple disorders including metabolic, cellular and blood disturbances leading to vascular complications. Increased circulating levels of platelet-leukocyte aggregates (PLA) have been described in several thrombotic diseases. In this study, we have evaluated circulating PLA in diabetic patients and we have investigated whether they may be a marker of vascular complications. Using flow cytometry assay, we have quantified PLA percentages in 65 diabetics including 20 patients with type I and 45 with type II diabetes, and 25 healthy subjects. Specific labelling identified platelet-polymorphonuclear aggregates (PPA) and platelet-monocyte aggregates (PMA). We have observed a significant increase of PPA and PMA levels in diabetics (22+/-12% and 45+/-18%, respectively) compared to controls (7+/-4% and 19+/-10%, respectively) (p<0.01). However, both PPA and PMA values were similar in the two diabetes types. Circulating PPA and PMA were significantly enhanced in diabetics with vascular lesions (PPA: 24+/-13%; PMA: 50+/-18%) than in diabetics without vascular lesions (PPA: 18+/-8%; PMA: 38+/-15%) (p<0.05 and p<0.01). Patients with PPA>18% and/or PMA>38% showed a more important vascular injury (OR: 6; 95% CI: 1.6-23). Increased PMA circulating rate is particularly correlated to retinopathic injury (OR: 19; 95% CI: 2.3-154). Our findings established a relationship between increased circulating PLA levels, particularly PMA, and the incidence of microvascular complications in diabetes. They reinforce the concept of pro-inflammatory cells involvement in diabetic retinopathy pathogenesis and their link with thrombotic process.