Witnessing family violence and adolescent cyberbullying perpetration: A longitudinal moderated mediation model involving anger dysregulation and teacher support.

BACKGROUND: Family violence has been shown to be associated with traditional adolescent bullying perpetration. However, few studies have considered the association between witnessing family violence and adolescent bullying perpetration in cyberspace. OBJECTIVE: The present study aimed to reveal the mechanism explaining the association between witnessing family violence and adolescent cyberbullying perpetration by testing the mediating effect of anger dysregulation and the moderating effect of teacher support. PARTICIPANTS AND SETTING: Participants were 751 Chinese adolescents (Mage at Time 1 = 13.25) who completed the measures of witnessing family violence, anger dysregulation, cyberbullying perpetration, and teacher support at three time points over the year. METHODS: Structural equation modeling was used to assess the direct and indirect effects of witnessing family violence on adolescent cyberbullying perpetration through anger dysregulation as a mediator and perceived teacher support as a moderator. RESULTS: The results showed that witnessing family violence at baseline positively predicted adolescent cyberbullying perpetration at T3, and anger dysregulation at T2 partially mediated this association. The positive relation between witnessing family violence and later anger dysregulation was stronger for adolescents who perceived higher levels of teacher support. CONCLUSIONS: Witnessing family violence could increase the risk for adolescent cyberbullying perpetration, with anger dysregulation mediating this association. The protective effect of perceived teacher support weakens as the levels of witnessing family violence increase. These findings offer insight into the connection between witnessing family violence and adolescent bullying perpetration in the digital age, emphasizing the importance of promoting programs to prevent intrafamilial violence.

Two Hematological Markers Predicting the Efficacy and Prognosis of Neoadjuvant Chemotherapy Using Lobaplatin Against Triple-Negative Breast Cancer.

BACKGROUND: Our previous work indicated that the addition of lobaplatin to combined therapy with taxane and anthracycline can improve the pathological complete response rate of neoadjuvant therapy for triple-negative breast cancer (TNBC) and lengthen long-term survival significantly, but the therapeutic markers of this regimen are unclear. METHODS: Eighty-three patients who met the inclusion criteria were included in this post hoc analysis. We analyzed the association between platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) before neoadjuvant chemotherapy with the efficacy and prognosis after treatment with docetaxel, epirubicin, and lobaplatin neoadjuvant chemotherapy regimen. χ2 test and Cox regression were used to analyze the association between PLR and NLR with total pathologic complete response (tpCR), as well as the association between PLR and NLR with event-free survival (EFS) and overall survival (OS), respectively. RESULTS: The tpCR rate in the PLR- group was 49.0% (25/51), which was significantly higher than that in the PLR+ group (25.0% [8/32], P = .032). The tpCR rate in the NLR- group was 49.1% (26/53), which was significantly higher than that in the NLR+ group (23.3% [7/30], P = .024). The tpCR rate of the PLR-NLR- (PLR- and NLR-) group was 53.7% (22/41), which was significantly higher than that of the PLR+/NLR+ (PLR+ or/and NLR+) group (26.1% [11/42]; P = .012). EFS and OS in the NLR+ group were significantly shorter than those in the NLR- group (P = .028 for EFS; P = .047 for OS). Patients in the PLR-NLR- group had a longer EFS than those in the PLR+/NLR+ group (P = .002). CONCLUSION: PLR and NLR could be used to predict the efficacy of neoadjuvant therapy with the taxane, anthracycline, and lobaplatin regimen for patients with TNBC, as patients who had lower PLR and NLR values had a higher tpCR rate and a better long-term prognosis.

The LINC01176-miR-218-5p-IL-36G Network is Responsible for the Pathogenesis of Psoriasis by Promoting Inflammation.

Purpose: Psoriasis is an incurable chronic inflammatory skin disease. The exact function and regulatory mechanism of non-coding RNA upregulation in psoriasis remains to be elucidated. The aim of this study was to analyse the role of the lncRNA-miRNA-mRNA network of psoriasis and LINC01176 in the pathogenesis of psoriasis. Patients and Methods: We performed miRNA, lncRNA, and mRNA sequencing analysis in pretreatment and treatment psoriatic tissues and normal tissues, constructed an lncRNA-miRNA-mRNA coexpression network and screened mRNA-associated pathways using bioinformatics analysis. We further validated the regulatory role of LINC01176-miR-218-5p on the proliferation and inflammation of the psoriatic model by dual-luciferase reporter assay, cell transfection, CCK-8 method, TUNEL staining and animal model construction method. An lncRNA-miRNA-mRNA coexpression network was successfully constructed by RNA-seq data analysis. Results: We obtained the relationship between LINC01176, miR-218-5p and IL36-G. Analysis of the apoptotic and proliferative capacity of the transfected cells showed that miR-218-5p up-regulation significantly inhibited cell proliferation and promoted apoptosis. A mouse model of psoriasis was successfully established. Phenotypic observations revealed that keratin-forming cells in mice coated with LINC01176-shRNA emulsifier were significantly lower than those in the model group and close to those in the normal group. HE and immunohistochemical experiments were performed, and the results showed the role and mechanism of action of LINC01176-shRNA. Suppression of LINC01176 significantly inhibited the expression of IL-36G in psoriatic tissues. LINC01176 showed a targeting and positive correlation with IL36-G expression. Conclusion: Our study shows that LINC01176 promotes the proliferation and invasion of keratinocytes and inhibits apoptosis by targeting miR-218-5p, which acts as a repressor of the psoriasis-associated IL-36G. The shRNA-LINC01176 emulsion showed potential treatment capability in alleviating symptoms of psoriasis.

Soluble urokinase plasminogen activator receptor is associated with cardiovascular calcification in peritoneal dialysis patients.

BACKGROUND: Cardiovascular disease (CVD) is an important cause of morbidity and mortality in peritoneal dialysis (PD) patients. Cardiovascular calcification (CVC) is highly prevalent in PD patients and could predict their cardiovascular mortality. Soluble urokinase plasminogen activator receptor (suPAR) is closely associated with coronary artery calcification in hemodialysis patients and is an important predictor of CVD. However, the role of suPAR in PD patients is poorly understood. We investigated the relationship between serum suPAR and CVC in PD patients. METHODS: Abdominal aortic calcification (AAC) was assessed by lateral lumbar radiography, coronary artery calcification (CAC) by multi-slice computed tomography, and cardiac valvular calcification (ValvC) by echocardiography. CVC was defined as confirmed presence of calcification in one site (AAC, CAC, or ValvC). Patients were divided into CVC group and non-CVC group. Demographic characteristics, biochemical variables, comorbidities, PD regimen, serum suPAR, and medication were compared between the two groups. Logistic regression was conducted to determine association between serum suPAR and presence of CVC. The receiver-operator curve (ROC) was plotted to calculate the area under the curve (AUC) for suPAR to identify CVC and ValvC. RESULTS: Of 226 PD patients, 111 (49.1%) had AAC, 155 (68.6%) had CAC, and 26 (11.5%) had ValvC. There were significant differences in age, BMI, diabetes, white blood cell, phosphorus, hs-CRP, suPAR, time on dialysis, total volume of dialysate, ultrafiltration, volume of urine, and Kt/V between CVC and non-CVC group. Serum suPAR was associated with CVC by multivariate logistic regression analysis in PD patients, especially in elderly patients. The levels of serum suPAR were closely related to the degree of AAC, CAC, and ValvC in PD patients. The incidence of CVC was higher in patients with higher levels of suPAR. The ROC curve showed that serum suPAR had a predictive value for CVC (AUC = 0.651), especially for ValvC (AUC = 0.828). CONCLUSION: Cardiovascular calcification is prevalent in PD patients. High levels of serum suPAR are associated with cardiovascular calcification in PD patients, especially in elderly patients.

Clinical significance and correlation of compliance to thirst in maintenance hemodialysis patients.

BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P< 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P< 0.05), and negatively correlated with self-care compliance (r=-0.35, P< 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P< 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P< 0.05). High RAAQ was associated with high VAS (b= 0.11, 95% CI: 0.05, 0.18), DTI (b= 0.28, 95% CI: 0.17, 0.38), SXI (b= 0.24, 95% CI: 0.14, 0.34) and TDS (b= 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception.

A multicenter single-arm trial of neoadjuvant pyrotinib and trastuzumab plus chemotherapy for HER2-positive breast cancer.

The objective of this multicenter, single-arm trial (ChiCTR1900022293) was to explore the efficacy and safety of neoadjuvant therapy with epirubicin, cyclophosphamide, and pyrotinib followed by docetaxel, trastuzumab, and pyrotinib (ECPy-THPy) in the treatment of patients with stage II-III HER2-positive breast cancer. The present study enrolled patients with stage II-III HER2-positive breast cancer. Epirubicin and cyclophosphamide were administrated for four 21-day cycles, followed by four cycles of docetaxel and trastuzumab. Pyrotinib was taken orally once per day throughout the treatment period. The primary endpoint was total pathological complete response (tpCR, ypT0/is ypN0) rate in the modified intention-to-treat (mITT) population. In total, 175 patients were included. The tpCR rate was 68.6% (95% CI, 60.7-75.8%), while the objective response rate was 89.1%. In the post-hoc subgroup analysis, no association between clinical characteristics and the tpCR rate was observed. The most common grade ≥3 adverse events were diarrhea (54.3%), followed by white blood cell count decreased (5.1%), and neutrophil count decreased (4.6%). In conclusion, the neoadjuvant regimen with ECPy-THPy showed promising pathological response and clinical benefits with an acceptable safety profile in patients with stage II-III HER2-positive breast cancer.

Microneedling radiofrequency enhances poly-L-lactic acid penetration that effectively improves facial skin laxity without lipolysis.

BACKGROUND: Microneedle fractional radiofrequency (MFR) is commonly used for skin laxity treatment, and poly-L-lactic acid (PLLA) can stimulate collagen synthesis in the body. However, the synergy of their combination for skin rejuvenation has not been proven. We aimed to evaluate the combined efficacy of PLLA and MRF and the potential mechanism underlying skin laxity. METHODS: This prospective, randomized study included C57BL/6 mice treated with MFR, MFR+PLLA, and CO2 laser+PLLA and 32 patients who underwent split-face treatments with MFR or MFR+PLLA twice every 2 months. The global aesthetic improvement scale, Facial Laxity Rating scale of the whole face, ECCA grading scale of acne scars, and VISIA parameters on both treated sides were evaluated. Dermatological changes were measured by ultrasonography in the submental space, and adverse events were documented. RESULTS: PLLA was delivered by channels produced by MFR but not CO2 laser in the mice model. Thirty patients were treated with split-face MFRF+PLLA or MFRF, revealing an improvement in VISIA wrinkle percentile (0.020) compared with the age-matched controls (0.000). The thickness of the dermis increased, while the fat layer did not change significantly. No adverse effects were observed. CONCLUSIONS: PLLA can be delivered via microchannels produced by MFR. PLLA enhances the efficacy of MFR for skin laxity without lipolysis.

ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi.

This study aims to investigate the impact of ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) on vascular calcification in rats. The rationale behind studying ENPP1's role in vascular calcification lies in its potential to modulate calcification processes. Understanding this relationship can offer insights into novel therapeutic avenues for addressing vascular calcification-related disorders. In this experiment, vascular smooth muscle cell (VSMC) calcification was induced using ß-glycerophosphoric acid. Subsequently, recombinant AAV9-carrying ENPP1 was introduced into VSMCs to achieve both in vitro and in vivo overexpression of ENPP1. The findings indicate that ENPP1 overexpression significantly reduces calcium and phosphorus content in the aorta (P < 0.05). Alizarin red and von Kossa staining reveal notable reductions in calcium salt deposits in VSMCs and aorta, respectively. Notably, the expression levels of BMP-2, PINP, OC, and BALP were substantially decreased in VSMCs (P < 0.05), underscoring ENPP1's role in impeding osteoblast-like transdifferentiation of VSMCs. Additionally, ENPP1 overexpression led to a significant increase in pyrophosphate (PPi) levels compared to control rats (P < 0.05). In conclusion, this study suggests that ENPP1 contributes to alleviating vascular calcification by elevating PPi levels and inhibiting the phenotypic transformation of VSMCs. These findings shed light on the potential therapeutic role of ENPP1 in mitigating vascular calcification-related complications.

Construction of a ferroptosis-based prognostic model for breast cancer helps to discriminate high/low risk groups and treatment priority.

Introduction: Breast cancer is a common malignant tumor associated with high morbidity and mortality. The role of ferroptosis, a regulated form of cell death, in breast cancer development and prognosis remains unclear. This study aims to investigate the relationship between ferroptosis-related genes and breast cancer and develop a prognostic model. Methods: RNA-seq expression datasets and clinical samples of breast cancer patients were obtained from public databases. Immunity- and drug resistance-related data were integrated. A preliminary screening was performed, resulting in the identification of 73 candidate ferroptosis factors. Univariate Cox regression analysis was conducted to select 12 genes, followed by LASSO Cox regression analysis to construct a prognostic risk prediction model consisting of 10 ferroptosis-related genes. The model was further characterized by immune cell infiltration. The expression levels of ferroptosis-related genes were validated in human breast cancer cell lines, and immunohistochemical (IHC) analysis was conducted on cancer specimens to assess ferroptosis-related protein expression. Results: The study identified 10 ferroptosis-related genes that were significantly associated with breast cancer prognosis. The constructed prognostic risk prediction model showed potential for predicting the prognostic value of these genes. In addition, the infiltration of immune cells was observed to be a characteristic of the model. The expression levels of ferroptosis-related genes were confirmed in human breast cancer cell lines, and IHC analysis provided evidence of ferroptosis-related protein expression in cancer specimens. Discussion: This study provides a novel prognostic model for breast cancer, incorporating 10 ferroptosis-related genes. The model demonstrates the potential for predicting breast cancer prognosis and highlights the involvement of immune cell infiltration. The expression levels of ferroptosis-related genes and proteins further support the association between ferroptosis and breast cancer development.

Mother phubbing and harsh mothering: Mothers' irritability and adolescents' gender as moderators.

BACKGROUND: While extant evidence supports the link between mother phubbing (Mphubbing) and harsh mothering, the current understanding of factors that may affect this relationship is limited. METHODS: Hierarchical regression analyses were conducted to examine the relation between Mphubbing and harsh mothering, as well as to explore whether mothers' irritability and adolescents' gender would moderate this relationship. The participants included 482 middle school students (51.7 % girls) and their mothers from China. RESULTS: The results revealed a significant positive association between Mphubbing as reported by adolescents and their perception of harsh mothering. However, the predictive power of Mphubbing for harsh mothering varied based on mothers' irritability and adolescents' gender. Specifically, the association between Mphubbing and harsh mothering was perceived more strongly in girls than in boys, but this gender difference was only observed among adolescents whose mothers rated themselves as high in irritability. CONCLUSIONS: The current study offers a preliminary understanding of the association between Mphubbing and harsh mothering through mothers' irritability and adolescents' gender as moderators, which has certain theoretical and practical implications for comprehending harsh mothering in the digital age.

Effect of Toll-like receptor 4 deficiency on clinical severity and expression of Th1/Th2/Th17-associated cytokines in a murine model of experimental autoimmune neuritis.

Introduction: The aim was to observe the effect of Toll-like receptor 4 (TLR4) deficiency on clinical severity and expression of Th1/Th2/Th17-associated cytokines in experimental autoimmune neuritis (EAN). Material and methods: We selected C57BL/10 wild type (WT) mice and TLR4 knockout (KO) mice with the C57BL/10 background for induction of the EAN model by immunizing mice twice (days 0 and 8) via subcutaneous injection of 180 µg P0 peptide 180-199 emulsion in 25 µl of PBS and 0.5 mg Mycobacterium tuberculosis (Difco, USA) in 25 µl of Freund's incomplete adjuvant into the back of mice. The concentrations of serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ and TNF) were determined using the Ms Th1/Th2/Th17 CBA kit. Results: We found that TLR4 deficiency could attenuate the clinical severity and delay the onset of EAN. Moreover, our data showed that the sera levels of IFN-γ, TNF, IL-6 and IL-17A were elevated in the WT mice with EAN when compared with the naive WT mice, but only the production of IL-17A was significantly lower in the TLR4 KO mice with EAN than in their WT counterparts. Conclusions: Based on these findings, TLR4 may contribute to the pathogenesis of EAN by regulating Th17 cells and the production of Th17-associated factors. However, the exact mechanism remains unclear and more evidence is needed to elucidate its role in EAN.

Risk Factors and Prediction Methods for Endometriosis Combined with Ureteral Stricture Based on Logistic-Regression Analysis.

OBJECTIVE: This study aimed to explore the risk factors of patients with endometriosis (EMS) and ureteral stricture and to establish a prediction model based on logistic-regression analysis. METHODS: The clinical data of 228 EMS patients in Jiaozhou Central Hospital of Qingdao from May 2019 to May 2022 were selected for a retrospective study. According to the results of ureteroscopic biopsy, they were divided into concurrent (n = 32) and nonconcurrent (n = 196) groups. Univariate analysis was performed on the general data and situations of clinical treatment in both groups. Single factor with statistically significant differences was included in unconditional logistic-regression analysis with multiple factors to explore the risk factors of such patients and establish a prediction model. RESULTS: Overt differences were found in previous history of ureter operation (odds ratio (OR) = 3.711, p = 0.006), course of EMS (OR = 3.987, p = 0.007), presence or absence of haematuria (OR = 3.586, p = 0.009) and lateral abdominal pain (OR = 4.451, p = 0.002), and invasion depth of lesion (OR = 7.271, p < 0.001) between the two groups (p < 0.05), without distinct difference in age, menstrual duration, BMI values, history of dysmenorrhea, previous history of drug therapy, smoking history, and drinking history (p > 0.05). Logistic-regression analysis showed that previous history of ureter operation (a1), course of EMS (b2), occurrence of haematuria (c3) and lateral abdominal pain (d4), and invasion depth of lesion ≥5 mm (e5) were risk factors for EMS combined with ureteral stricture (p < 0.05), taking logit (p) = -4.990 + 1.311a1 + 1.383b2 + 1.277c3 + 1.493d4 + 1.984e5 as regression model. The receiver operating characteristic (ROC) curve analysis based on this model showed that the area under the curve (AUC), standard error, and 95% confidence interval (CI) were 0.813, 0.062, and 0.692-0.934, respectively. One hundred EMS patients were re-included, whose values for predictive sensitivity, specificity, and kappa coefficient were 71.40%, 91.10% and 0.615. CONCLUSIONS: Previous history of ureter operation, course of EMS, occurrence of haematuria and lateral abdominal pain, and invasion depth of lesion ≥5 mm were risk factors for EMS combined with ureteral stricture. Therefore, the use of this model has a certain clinical value.

Current status of Guillain-Barré syndrome (GBS) in China: a 10-year comprehensive overview.

Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy; a disease involving the peripheral nervous system which is the most common cause of acute flaccid paralysis worldwide. So far, it is still lack of a comprehensive overview and understanding of the national epidemiological, clinical characteristics, and the risk factors of GBS in China, as well as differences between China and other countries and regions in these respects. With the global outbreak of the coronavirus disease 2019 (COVID-19), an epidemiological or phenotypic association between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and GBS has attracted great attention. In this review, we outlined the current clinical data of GBS in China by retrieving literature, extracting and synthesizing the data of GBS in China from 2010 to 2021. Besides, we compared the characteristics of epidemiology, preceding events and clinical profiles of GBS between China and other countries and regions. Furthermore, in addition to conventional intravenous immunoglobulin (IVIG) and plasma exchange (PE) therapy, the potential therapeutic effects with novel medications in GBS, such as complement inhibitors, etc., have become the research focus in treatments. We found that epidemiological and clinical findings of GBS in China are approximately consistent with those in the International GBS Outcome Study (IGOS) cohort. We provided an overall picture of the present clinical status of GBS in China and summarized the global research progress of GBS, aiming to further understand the characteristics of GBS and improve the future work of GBS worldwide, especially in countries with the middle and low incomes.

Optimized H2-evolving dye-sensitized LaFeO3 photocathodes prepared via the layer-by-layer assembly of dyes and catalysts.

A molecular dye and a molecular catalyst were loaded onto the surface of a mesoporous LaFeO3 (LFO) film via layer-by-layer assembly relying on the coordination of phosphates and Zr4+. After assembling six layers of the dye and four layers of the catalyst, the (NiP-4 + PQA-6)@LFO photocathode exhibited a significant photocurrent for light-driven H2 generation.

Molecular landscape and emerging therapeutic strategies in breast cancer brain metastasis.

Breast cancer (BC) is the most commonly diagnosed cancer worldwide. Advanced BC with brain metastasis (BM) is a major cause of mortality with no specific or effective treatment. Therefore, better knowledge of the cellular and molecular mechanisms underlying breast cancer brain metastasis (BCBM) is crucial for developing novel therapeutic strategies and improving clinical outcomes. In this review, we focused on the latest advances and discuss the contribution of the molecular subtype of BC, the brain microenvironment, exosomes, miRNAs/lncRNAs, and genetic background in BCBM. The blood-brain barrier and blood-tumor barrier create challenges to brain drug delivery, and we specifically review novel approaches to bypass these barriers. Furthermore, we discuss the potential application of immunotherapies and genetic editing techniques based on CRISPR/Cas9 technology in treating BCBM. Emerging techniques and research findings continuously shape our views of BCBM and contribute to improvements in precision therapies and clinical outcomes.

hiPSC-derived GRN-deficient astrocytes delay spiking activity of developing neurons.

Frontotemporal dementia (FTD) refers to a group of neurodegenerative disorders that are characterized by pathology predominantly localized to the frontal and temporal lobes. Approximately 40% of FTD cases are familial, and up to 20% of these are caused by heterozygous loss of function mutations in the gene encoding for progranulin (PGRN), GRN. The mechanisms by which loss of PGRN leads to FTD remain incompletely understood. While astrocytes and microglia have long been linked to the neuropathology of FTD due to mutations in GRN (FTD-GRN), a primary mechanistic role of these supporting cells have not been thoroughly addressed. In contrast, mutations in MAPT, another leading cause of familial FTD, greatly alters astrocyte gene expression leading to subsequent non-cell autonomous effects on neurons, suggesting similar mechanisms may be present in FTD-GRN. Here, we utilized human induced pluripotent stem cell (hiPSC)-derived neural tissue carrying a homozygous GRN R493X-/- knock-in mutation to investigate in vitro whether GRN mutant astrocytes have a non-cell autonomous effect on neurons. Using microelectrode array (MEA) analysis, we demonstrate that the development of spiking activity of neurons cultured with GRN R493X-/- astrocytes was significantly delayed compared to cultures with WT astrocytes. Histological analysis of synaptic markers in these cultures showed an increase in GABAergic synaptic markers and a decrease in glutamatergic synaptic markers during this period when activity was delayed. We also demonstrate that this effect may be due in-part to soluble factors. Overall, this work represents one of the first studies investigating astrocyte-induced neuronal pathology in GRN mutant hiPSCs, and supports the hypothesis of astrocyte involvement in the early pathophysiology of FTD.

Prediction of the sarcopenia in peritoneal dialysis using simple clinical information: A machine learning-based model.

INTRODUCTION: Sarcopenia is associated with significant cardiovascular risk, and death in patients undergoing peritoneal dialysis (PD). Three tools are used for diagnosing sarcopenia. The evaluation of muscle mass requires dual energy X-ray absorptiometry (DXA) or computed tomography (CT), which is labor-intensive and relatively expensive. This study aimed to use simple clinical information to develop a machine learning (ML)-based prediction model of PD sarcopenia. METHODS: According to the newly revised Asian Working Group for Sarcopenia (AWGS2019), patients were subjected to complete sarcopenia screening, including appendicular skeletal muscle mass, grip strength, and five-time chair stand time test. Simple clinical information such as general information, dialysis-related indices, irisin and other laboratory indices, and bioelectrical impedance analysis (BIA) data were collected. All data were randomly split into training (70%) and testing (30%) sets. Difference, correlation, univariate, and multivariate analyses were used to identify core features significantly associated with PD sarcopenia. RESULT: 12 core features (C), namely, grip strength, body mass index (BMI), total body water value, irisin, extracellular water/total body water, fat-free mass index, phase angle, albumin/globulin, blood phosphorus, total cholesterol, triglyceride, and prealbumin were excavated for model construction. Two ML models, the neural network (NN), and support vector machine (SVM) were selected with tenfold cross-validation to determine the optimal parameter. The C-SVM model showed a higher area under the curve (AUC) of 0.82 (95% confidence interval [CI]: 0.67-1.00), with a highest specificity of 0.96, sensitivity of 0.91, positive predictive value (PPV) of 0.96, and negative predictive value (NPV) of 0.91. CONCLUSION: The ML model effectively predicted PD sarcopenia and has clinical potential to be used as a convenient sarcopenia screening tool.

Prediction of sarcopenia among peritoneal dialysis patients using a combination of irisin and phase angle

Background: Sarcopenia is associated with significant morbidity and mortality in patients undergoing peritoneal dialysis (PD). Three different tools must be applied to measure the three indices for diagnosing sarcopenia. Considering the cumbersome diagnostic steps and multi-layered mechanisms underlying sarcopenia, we combined new biomarker with bioelectrical impedance analysis (BIA) data to predict PD sarcopenia. Methods: Patients underwent regular PD were asked to complete sarcopenia screening, including appendicular skeletal muscle mass, handgrip strength, and the 5-time chair stand time test according to the newly revised diagnosis consensus of Asian Working Group for Sarcopenia (AWGS2019). Serum was collected for centralized detection of the irisin levels. BIA data, especially the phase angle (PhA), as well as patient's general clinical information, dialysis related indices, laboratory data and body composition data were recorded. Results: Among 105 enrolled PD patients (41.0% men, mean age 54.2 ± 8.89 years), the sarcopenia prevalence was 31.4% and the sarcopenic obesity was 8.6%. Binary regression analysis showed that serum irisin concentrations (OR = 0.98; 95% CI,0.97-0.99; p = 0.002), PhA (OR = 0.43; 95% CI, 0.21-0.90; p = 0.025) and body mass index (BMI) (OR = 0.64; 95% CI, 0.49-0.83; p = 0.001) were independently associated with PD sarcopenia. The AUC of the combination use of serum irisin concentrations and PhA for predicting PD sarcopenia was 0.925 with a sensitivity of 100% and specificity of 84.0% in male and was 0.880 with a sensitivity of 92.0% and specificity of 81.5% in female. PD sarcopenia score=1533.48+-0.75*Handgrip strength+4.63*BMI+-18.07*Total body water +-11.87*Extra-cellular water / total body water +9.26*Fat free mass index+-83.41*PhA+22.42*Albumin/Globulin+-26.38*blood phosphorus+-17.04*Total cholesterol+-29.02*Triglyceride+-0.29*Prealbumin+-0.17*Irisin. Conclusions: Sarcopenia is relatively common among PD patients. The combination of serum irisin concentrations and PhA facilitated the rapid prediction of PD sarcopenia and could serve as an optimal screening tool for PD sarcopenia in clinical settings.

Introduction: La sarcopénie est associée à une morbidité et une mortalité importantes chez les patients sous dialyse péritonéale (DP). Trois outils différents doivent être appliqués pour mesurer les trois indices de diagnostic de la sarcopénie. Compte tenu des étapes de diagnostic fastidieuses et des mécanismes multicouches sous-jacents à la sarcopénie, nous avons combiné un nouveau biomarqueur avec des données d'analyse d'impédance bioélectrique (BIA) pour prédire la sarcopénie. Méthodes: Les patients ayant subi une DP régulière ont été invités à compléter le dépistage de la sarcopénie, y compris la qualité du muscle squelettique des membres, la force de préhension et le test de temps debout sur chaise à cinq reprises, conformément au consensus de diagnostic nouvellement révisé du Groupe de travail asiatique sur la sarcopénie (AWGS2019). Le sérum a été recueilli pour la détection centralisée des niveaux d'irisine. Les données BIA, en particulier l'angle de phase (PhA), ainsi que les informations cliniques générales du patient, les indices liés à la dialyse, les données de laboratoire et les données de composition corporelle ont été enregistrés. Résultats. Parmi les 105 patients sous DP inscrits (41,0 % d'hommes, âge moyen de 54,2 ± 8,89 ans), la prévalence de la sarcopénie était de 31,4 % et l'obésité sarcopénique de 8,6 %. L'analyse de régression binaire a montré que les concentrations sériques d'irisine (OR = 0,98 ; IC à 95 % : 0,97-0,99 ; p = 0,002), PhA (OR = 0,43 ; IC à 95 % : 0,21-0,90 ; p = 0,025) et l'indice de masse corporelle (IMC) (OR = 0,64 ; IC à 95 % : 0,49-0,83 ; p = 0,001) étaient indépendamment associées à la sarcopénie DP. L'ASC de l'utilisation combinée des concentrations sériques d'irisine et du PhA pour prédire la sarcopénie était de 0,925 avec une sensibilité de 100 % et une spécificité de 84,0 % chez les hommes et était de 0,880 avec une sensibilité de 92,0 % et une spécificité de 81,5 % chez les femmes. Le score de sarcopénie DP était = 1 533,48 + -0,75 * Force de préhension + 4,63 * IMC + -18,07 * Eau corporelle totale + -11,87 * Eau extracellulaire / eau corporelle totale + 9,26 * Indice de masse sans graisse + -83,41 * PhA + 22,42 * Albumine / Globuline + -26,38 * Phosphore sanguin + -17,04 * Cholestérol total + -29,02 * Triglycérides + -0,29 * Préalbumine + -0,17 * Irisine. Conclusion: La sarcopénie est relativement fréquente chez les patients sous DP. La combinaison des concentrations sériques d'irisine et de PhA a facilité la prédiction rapide de la sarcopénie DP et pourrait servir d'outil de dépistage optimal de la sarcopénie DP en milieu clinique.

In the presence and absence of conflicting testimony, children's selective trust in the in-group informant in moral judgment and knowledge access.

In this study, we assessed whether the trust model formed by children in a moral judgment context with an inaccurate in-group informant affected their corresponding trust model in the knowledge access context and whether conditions (the presence of conflicting testimony: an inaccurate in-group informant paired with an accurate out-group informant; the absence of conflicting testimony: only an inaccurate in-group informant) influenced the trust model. Children aged 3 to 6 years (N = 215; 108 girls) in blue T-shirts as in-group members completed selective trust tasks in the moral judgment and knowledge access contexts. Results for moral judgment showed that children under both conditions were more likely to trust informants based on accurate judgments and gave less consideration to group identity. Results for knowledge access showed that in the presence of conflicting testimony, 3- and 4-year-olds trusted the in-group informant at chance, but 5- and 6-year-olds trusted the accurate informant. In the absence of conflicting testimony, 3- and 4-year-olds agreed more with the inaccurate in-group informant, but 5- and 6-year-olds trusted the in-group informant at chance. The results indicated that older children considered the accuracy of the informant's previous moral judgment for selective trust in the context of knowledge access while ignoring group identity, but that younger children were affected by in-group identity. The study found that 3- to 6-year-olds' trust in inaccurate in-group informants was conditional and that their trust choices appeared to be experimentally conditioned, domain specific, and age differentiated.