RESUMEN
Effective screening and early detection are critical to improve the prognosis of gastric cancer (GC). Our study aims to explore noninvasive multianalytical biomarkers and construct integrative models for preliminary risk assessment and GC detection. Whole genomewide methylation marker discovery was conducted with CpG tandems target amplification (CTTA) in cfDNA from large asymptomatic screening participants in a high-risk area of GC. The methylation and mutation candidates were validated simultaneously using one plasma from patients at various gastric lesion stages by multiplex profiling with Mutation Capsule Plus (MCP). Helicobacter pylori specific antibodies were detected with a recomLine assay. Integrated models were constructed and validated by the combination of multianalytical biomarkers. A total of 146 and 120 novel methylation markers were found in CpG islands and promoter regions across the genome with CTTA. The methylation markers together with the candidate mutations were validated with MCP and used to establish a 133-methylation-marker panel for risk assessment of suspicious precancerous lesions and GC cases and a 49-methylation-marker panel as well as a 144-amplicon-mutation panel for GC detection. An integrated model comprising both methylation and specific antibody panels performed better for risk assessment than a traditional model (AUC, 0.83 and 0.63, P < .001). A second model for GC detection integrating methylation and mutation panels also outperformed the traditional model (AUC, 0.82 and 0.68, P = .005). Our study established methylation, mutation and H. pylori-specific antibody panels and constructed two integrated models for risk assessment and GC screening. Our findings provide new insights for a more precise GC screening strategy in the future.
Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología , Metilación de ADN , Detección Precoz del Cáncer , Biomarcadores , Medición de Riesgo , Helicobacter pylori/genética , Biomarcadores de Tumor/genética , Islas de CpG , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/genética , Infecciones por Helicobacter/patologíaRESUMEN
BACKGROUND: The early diagnosis and intervention of mild cognitive impairment (MCI) patients is expected to delay the progression of AD. Delayed treatment will lead to MCI patients missing the best intervention expectation. At present, the medical help-seeking behavior of this group is not optimistic. This study aimed to explore influencing factors of help-seeking behavior among patients with MCI in China based on the help-seeking behavior model. METHODS: Twenty-two patients with MCI were recruited to participate in semi-structured interviews via purposeful sampling with a qualitative, descriptive design. Data were analyzed by qualitative content analysis. RESULTS: The study revealed the main influencing factors of help-seeking behavior among MCI patients in China included perceived disease threat, symptom attribution, disease knowledge, use of cognitive compensation strategies, sense of foreseeable burden, social support, economic condition, and accessibility of medical service. CONCLUSIONS: The help-seeking behavior of patients with MCI is affected by multiple factors. There are some key factors in different stages of the help-seeking process. Healthcare providers can utilize these factors to design targeted interventions for promoting early help-seeking of patients with MCI.
Asunto(s)
Disfunción Cognitiva , Conducta de Búsqueda de Ayuda , Humanos , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/terapia , Investigación Cualitativa , ChinaRESUMEN
Building on attribution theory, this study applied regression analysis and explored the double-edged sword effect of leader self-sacrifice behavior on employee work outcomes, thus revealing the potential negative impacts of such behavior. Specifically, when leadership self-sacrifice was met with low employee authenticity attribution, we found that employees tended to perceive leadership as hypocritical, thus reducing their organizational citizenship behavior. By contrast, when leaders' self-sacrifice behavior was met with high employee authenticity attribution, employees tended to trust the leader and improve their task performance. Given these findings, we challenge the general scholarly consensus on leadership self-sacrifice behavior, enrich the current literature on leadership self-sacrifice, and emphasize the important role of employee attribution in the relevant leadership process.