Follicular neoplasms with nuclear atypia versus other types of atypia: Should follicular neoplasms be stratified according to the presence of nuclear atypia?

BACKGROUND: The third edition of The Bethesda System (TBS) subclassifies the atypia of undetermined significance (AUS) category on the basis of the presence of nuclear atypia (AUS-Nuclear). This approach is supported by studies showing significant differences in the risk of malignancy (ROM) between AUS-Nuclear and those without (AUS-Other). Although aspirates of follicular neoplasms (FNs) are characterized by marked architectural atypia, TBS recognizes the infrequent occurrence of FNs with mild nuclear atypia (FN-Nuclear). Furthermore, limited studies have shown significant differences in ROM between FN-Nuclear and those without (FN-Other). This study explored potential differences in ROM, molecular-derived risk of malignancy (MDROM), and molecular alterations between FN-Nuclear and FN-Other. METHODS: A retrospective database search identified 93 FN aspirates. Cytology slides, molecular reports, and histologic follow-ups were reviewed. Both groups' benign call rate (BCR), positive call rate (PCR), MDROM, and ROM were computed and compared. RESULTS: Eighty-six percent of aspirates (80 of 93) comprised FN-Other, whereas 14% (13 of 93) were FN-Nuclear. The BCR and PCR for FN-Other were 51% and 49%, respectively. In contrast, they were 23% and 77% for FN-Nuclear, respectively. The MDROM significantly differed between FN-Other (30%) and FN-Nuclear (56%) (p < .05). HRAS mutation was the most common molecular alteration in FN-Nuclear, whereas mutations in NRAS/KRAS and copy number alterations were more common in FN-Other. The ROM1/ROM2 in FN-Other and FN-Nuclear were 16%/31% and 54%/88%, respectively. CONCLUSIONS: These results reveal that FN-Nuclear exhibits significantly higher MDROM and ROM than FN-Other, which provides support for a subclassification scheme for FNs based on the presence of nuclear atypia.

Exploration, Distributed Attention, and Development of Category Learning.

Category learning is a crucial aspect of cognition that involves organizing entities into equivalence classes. Whereas adults tend to focus on category-relevant features, young children often distribute attention between relevant and irrelevant ones. The reasons for children's distributed attention are not fully understood. In two category-learning experiments with adults and with children aged 4, 5, and 6 (N = 201), we examined potential drivers of distributed attention, including (a) immature filtering of distractors and (b) the general tendency for exploration or broad information sampling. By eliminating distractor competition, we reduced filtering demands. Despite identifying the features critical for accurate categorization, children, regardless of their categorization performance, continued sampling more information than was necessary. These results indicate that the tendency to sample information extensively contributes to distributed attention in young children. We identify candidate drivers of this tendency that need to be examined in future research.

Psychometric Properties of Fine Motor Function Measure in Children With Cerebral Palsy: A Rasch Analysis.

Our study utilized Rasch Analysis to examine the psychometric properties of 61-items fine motor function measure (FMFM) in children with cerebral palsy (CP). Partial credit model (PCM) was utilized to test the reliability and validity of FMFM. The response pattern of this samples displayed acceptable fitness to PCM. The analysis results supported the assumption of 1-dimensionality of FMFM. Disordered category thresholds were found in 30 items. Differential item functioning (DIF) was detected in 23 items. Participants with different CP subtypes in different age groups may perform in differently responses patterns. The Rasch analysis produces reliable evidence to support the clinical application of FMFM. Some items may produce inaccurate measurements originated from category structures. Difference in age groups and symptom topography may be associated with variation in fine motor ability among children with CP and leading to unnecessary assessment bias. Hence, FMFM items need modifications to calibrate the former item formulation.

Exploring the effectiveness of reward-based learning strategies for second-language speech sounds.

Adults struggle to learn non-native speech categories in many experimental settings (Goto, Neuropsychologia, 9(3), 317-323 1971), but learn efficiently in a video game paradigm where non-native speech sounds have functional significance (Lim & Holt, Cognitive Science, 35(7), 1390-1405 2011). Behavioral and neural evidence from this and other paradigms point toward the involvement of reinforcement learning mechanisms in speech category learning (Harmon, Idemaru, & Kapatsinski, Cognition, 189, 76-88 2019; Lim, Fiez, & Holt, Proceedings of the National Academy of Sciences, 116, 201811992 2019). We formalize this hypothesis computationally and implement a deep reinforcement learning network to map between environmental input and actions. Comparing to a supervised model of learning, we show that the reinforcement network closely matches aspects of human behavior in two experiments - learning of synthesized auditory noise tokens and improvement in speech sound discrimination. Both models perform comparably and the similarity in the output of each model leads us to believe that there is little inherent computational benefit to a reward-based learning mechanism. We suggest that the specific neural circuitry engaged by the paradigm and links between striatum and superior temporal areas play a critical role in effective learning.

A single-item Expectancy Measure's Validity, Reliability, and Responsiveness to Detect Changes in Clinical Efficacy Studies of Integrative Cancer Therapies: A Methodology Study.

BACKGROUND: Expectations may modify outcomes. However, studies often fail to measure expectations. This raises the need for a brief valid and reliable expectancy measure. OBJECTIVES: To study treatment expectations in individuals entering acupuncture or rest, validity and test re-test reliability of a single-item expectancy measure graded on a category scale, a Numeric Rating Scale (NRS) and a Visual Analog Scale (VAS), and to identify psychometric differences between the scales. METHOD: In this methodology study, treatment expectations were measured in 363 participants before they received acupuncture (genuine traditional penetrating or non-penetrating telescopic sham acupuncture, n = 239, 98%, responded) or a control treatment involving just rest (n = 120, 100%, responded), aimed to improve level of relaxation. A treatment expectancy measure, graded on a five-grade category scale, an eight-grade NRS and a 100 mm VAS, was tested for test re-test reliability. Level of expectation and relaxation was measured at baseline, pre- and post-therapy (n = 729 expectancy measurements). RESULTS: The participants scheduled for acupuncture or rest believed moderately (Inter Quartile Range, IQR, moderately-much) and much (IQR moderately-much) the treatment to be effective. The Intra-Class Correlation coefficient versus Kappa coefficient between test and re-test was .868/.868 for the category scale, .820/.820 for the NRS, and .856/.854 for the VAS. The middle step "Believe moderately the treatment to be effective" was equivalent with median 4 (IQR, 3-4) on NRS and median 52 mm (IQR 42-52) on VAS. The response rates were 708 (97%) on the category scale, 707 (97%) on the NRS, and 703 (96%) on the VAS. All three scales discriminated that pre-therapy expectations were more positive in the individuals who reported an improvement in relaxation level (P < .001-.003). The VAS presented higher responsiveness to detect expectancy changes over time (71% increased expectation), compared to the NRS (52% increased) and the category scale (12% increased), P < .001. CONCLUSIONS: Individuals entering acupuncture, or a control intervention, presented positive treatment expectations, and the expectancy measure presented satisfactory reliability, validity, high response rates, sensitiveness, and responsiveness. Integrative cancer therapy researchers who want to control for expectancy-related bias in clinical trials should consider measuring expectation using the single-item expectancy measure.

EXPRESS: Hemispheric Asymmetry for Global-Local Processing: Effects of Stimulus Category and Ageing.

Hemispheric asymmetry has been reported for global-local processing in young and older adults, with global processing specialised in the right hemisphere (RH-global specialisation) and local processing specialised in the left hemisphere (LH-local specialisation). Questions persist regarding the extent to which hemispheric asymmetry is influenced by stimulus category (verbal stimuli processed in the left hemisphere; visuospatial stimuli processed in the right hemisphere). Some evidence suggests stimulus category does not influence hemispheric asymmetry (stimulus-independent account) while other evidence suggests it does (stimulus-dependent account). In older adults, there was evidence of a local-processing advantage, believed to result from slower and less accurate performance in right-hemisphere compared to left-hemisphere functioning-the right-hemisphere ageing hypothesis. We examined hemispheric asymmetry for global-local processing in young and older participants with three hierarchical figures (letters, verbalisable objects, nonverbalisable shapes), in a within-subjects design using a divided-attention paradigm and unilateral presentation. Our findings for letters and verbalisable objects support the stimulus-independent account-young and older participants demonstrated RH-global specialisation and LH-local specialisation regardless of stimulus category. In older participants, we also found a local-processing advantage for all three stimulus categories-an advantage best explained as faster and more accurate performance in local processing regardless of the visual field of stimulus presentation. Overall, we found hemispheric asymmetry for global-local processing in both young and older adults, and differences in global processing between young and older adults. Future investigation is suggested for the hemispheric asymmetry found in global-local processing of nonverbalisable shapes, and the mechanisms underlying age-related changes in global processing.

Genital and Subjective Sexual Arousal in Androphilic Women and Gynephilic Men in Response to the Copulatory Movements of Different Animal Species.

Research has repeatedly shown marked differences in men's and women's sexual response patterns; genital response in men tends to be elicited by cues that correspond to their sexual preference (preferred gender), while women's genital response is less sensitive to gender cues and more sensitive to the presence and intensity of other sexual cues (e.g., sexual activities). We tested whether the cue of copulatory movement in a general sexual context elicited a genital response in androphilic women but not in gynephilic men. If so, women should react to stimuli depicting not only the non-preferred gender but also other animal species differing in phylogenetic distance to humans. We studied the genital and self-reported arousal of 30 gynephilic men and 28 androphilic women to two sexual videos depicting penetrative human sexual intercourse (female-male and female-female) and nine videos depicting animal copulation. Neither women nor men showed genital or subjective sexual arousal to non-human sexual stimuli. Moreover, both sexes demonstrated a highly cue-specific pattern of arousal. Our results suggest that copulatory movement displayed in non-human species is not a sexual cue that can elicit genital or subjective sexual arousal in humans.

Derived category of weak chain U -complexes.

In this paper, we define the derived category of weak chain U -complexes, and we give a characterization of any weak chain U -complex as an object in the right bounded homotopy category of weak chain U -complexes of projective modules. Then, we show that the homology functor between the category of chain complexes and weak chain U -complexes is a natural isomorphism by constructing an adjoint pair between these two categories.

Feedback and observational learning differ in effectiveness during category learning in early school aged children and adults.

When learning new categories, do children benefit from the same types of training as adults? We compared the effects of feedback-based training with observational training in young adults (ages 18-25) and early school aged children (ages 6-7) across two different multimodal category learning tasks: conjunctive rule based and information integration. We used multimodal stimuli that varied across a visual feature (rotation speed of the "planet" stimulus) and an auditory feature (pitch frequency of a pure tone stimulus). We found an interaction between age and training type for the rule-based category task, such that adults performed better in feedback training than in observational training, whereas training type had no significant effect on children's category learning performance. Overall adults performed better than children in learning both the rule based and information integration category structures. In information integration category learning, feedback versus observational training did not have a significant effect on either adults' or children's category learning. Computational modelling revealed that children defaulted to univariate rules in both tasks. The finding that children do not benefit from feedback training and can learn successfully via observational learning has implications for the design of educational interventions appropriate for children.

Striking the Balance: Embracing Technology While Upholding Humanistic Principles in Neurorehabilitation.

BACKGROUND: The rapid advancement of technology-focused strategies in neurorehabilitation has brought optimism to individuals with neurological disorders, caregivers, and physicians while reshaping medical practice and training. OBJECTIVES: We critically examine the implications of technology in neurorehabilitation, drawing on discussions from the 2021 and 2024 World Congress for NeuroRehabilitation. While acknowledging the value of technology, it highlights inherent limitations and ethical concerns, particularly regarding the potential overshadowing of humanistic approaches. The integration of technologies such as robotics, artificial intelligence, neuromodulation, and brain-computer interfaces enriches neurorehabilitation by offering interdisciplinary solutions. However, ethical considerations arise regarding the balance between compensation for deficits, accessibility of technologies, and their alignment with fundamental principles of care. Additionally, the pitfalls of relying solely on neuroimaging data are discussed, stressing the necessity for a more comprehensive understanding of individual variability and clinical skills in rehabilitation. RESULTS: From a clinical perspective, the article advocates for realistic solutions that prioritize individual needs, quality of life, and social inclusion over technological allure. It underscores the importance of modesty and honesty in responding to expectations while emphasizing the uniqueness of each individual's experience. Moreover, it argues for the preservation of human-centric approaches alongside technological advancements, recognizing the invaluable role of clinical observation and human interaction in rehabilitation. CONCLUSION: Ultimately, the article calls for a balanced attitude that integrates both scientific and humanistic perspectives in neurorehabilitation. It highlights the symbiotic relationship between the sciences and humanities, advocating for philosophical questioning to guide the ethical implementation of new technologies and foster interdisciplinary dialogue.

Diagnostic performance of Node-RADS score for mesorectal lymph node metastasis in rectal cancer.

PURPOSE: To explore the diagnostic performance of the Node-RADS scoring system on preoperative assessment of mesorectal lymph node metastasis (LNM) status in rectal cancer, in comparison with the ESGAR category and size of lymph node (LN). METHODS: Preoperative clinical and MRI data of 154 rectal adenocarcinoma patients treated with radical resection surgery were retrospectively analyzed. The differences in the clinical, pathological and imaging characteristics between the pN- and pN + groups were surveyed. The correlations of Node-RADS score and ESGAR category to pN stage, LNM number and lymph node ratio (LNR) were investigated. The performances on assessing pathological LNM were compared among individual approaches. A nomogram combined the imaging and clinical features was also established and evaluated. RESULTS: Significant differences in CEA, tumor maximum diameter, tumor location, LN short-axis diameter, Node-RADS score and ESGAR category were found between the pN- and pN + groups. Node-RADS correlated significantly with pN stage, LNM number, and LNR (r = 0.665, 0.685, and 0.675, p < 0.001). Node-RADS had the highest AUC (0.862) for predicting pN + status, surpassing ESGAR (AUC = 0.797, p = 0.040) and LN size (AUC = 0.762, p = 0.015). The nomogram had the best diagnostic performance (AUC = 0.901), significantly outperforming Node-RADS alone (p = 0.037). CONCLUSIONS: The Node-RADS scoring system is comparable to the ESGAR category and surpasses short-axis diameter in preoperatively predicting LNM in rectal cancer. Integrating imaging and clinical features will lead to an enhancement in diagnostic performance. Moreover, a clear relationship was demonstrated between the Node-RADS score and the quantity-dependent pathological characteristics of LNM.

Phylogenomics resolves long-standing questions about the affinities of an endangered Corsican endemic fly.

Recent studies on oestroidean Diptera (Brachycera) are providing a comprehensive and nuanced understanding of the evolutionary history of this remarkably diverse clade of holometabolous insects. The Oestroidea, which includes formidable pests such as various blowflies, botflies, and flesh flies that infest livestock, pets and humans, are mostly composed of beneficial species that act as scavengers or parasitoids on various pest insects. In our research, we used genomic methods to elucidate the phylogenetic position of Nesodexia corsicana Villeneuve, 1911 (Diptera: Calliphoridae), a mysterious oestroid species endemic to Corsica and characterized by distinctive morphological features that have puzzled taxonomists for years. Contrary to initial hypotheses, our results place Nesodexia Villeneuve, 1911 within the Calliphoridae subfamily Rhinophorinae, a small lineage of terrestrial isopod parasitoids. Through detailed morphological analysis of adults of both sexes and eggs, we uncovered significant insights consistent with our phylogenomic reconstruction. The unique morphological features of the species, coupled with its restricted and fragmented habitat, highlight its potential conservation importance. We delineated the area of occupancy for N. corsicana and assessed its "threatened" category using specific IUCN Red List criteria. In addition, we mapped the available habitat within its range and determined potential key biodiversity areas (KBA) triggered by N. corsicana. New potential KBAs are only partially covered by the Corsican Regional Park. Finally, we mapped the distribution of habitats on the island to assess the potential distribution of the species beyond its currently known geographic range.

Task imprinting: Another mechanism of representational change?

Research from several areas suggests that mental representations adapt to the specific tasks we carry out in our environment. In this study, we propose a mechanism of adaptive representational change, task imprinting. Thereby, we introduce a computational model, which portrays task imprinting as an adaptation to specific task goals via selective storage of helpful representations in long-term memory. We test the main qualitative prediction of the model in four behavioral experiments using healthy young adults as participants. In each experiment, we assess participants' baseline representations in the beginning of the experiment, then expose participants to one of two tasks intended to shape representations differently according to our model, and finally assess any potential change in representations. Crucially, the tasks used to measure representations differ in the amount that strategic, judgmental processes play a role. The results of Experiments 1 and 2 allow us to exclude the option that representations used in more perceptual tasks become biased categorically. The results of Experiment 4 make it likely that people strategically decide given the specific task context whether they use categorical information or not. One signature of representational change was however observed: category learning practice increased the perceptual sensitivity over and above mere exposure to the same stimuli.

Trends in amorphous solid dispersion drug products approved by the U.S. Food and Drug Administration between 2012 and 2023.

Forty-eight (48) drug products (DPs) containing amorphous solid dispersions (ASDs) have been approved by the U.S. Food and Drug Administration in the 12-year period between 2012 and 2023. These DPs comprise 36 unique amorphous drugs. Ten (10) therapeutic categories are represented, with most DPs containing antiviral and antineoplastic agents. The most common ASD polymers are copovidone (49%) and hypromellose acetate succinate (30%), while spray drying (54%) and hot melt extrusion (35%) are the most utilized manufacturing processes to prepare the ASD drug product intermediate (DPI). Tablet dosage forms are the most common, with several capsule products available. Line extensions of several DPs based on flexible oral solids and powders for oral suspension have been approved which provide patient-centric dosing to pediatric and other patient populations. The trends in the use of common excipients and film coating types are discussed. Eighteen (18) DPs are fixed-dose combinations, and some contain a mixture of amorphous and crystalline drugs. The DPs have dose/unit of amorphous drug ranging from <5 mg up to 300 mg, with the majority being ≤100 mg/unit. This review details several aspects of DPI and DP formulation and manufacturing of ASDs, as well as trends related to therapeutic category, dose, and patient-centricity.

Distractor similarity and category variability effects in search.

Categorical search involves looking for objects based on category information from long-term memory. Previous research has shown that search efficiency in categorical search is influenced by target/distractor similarity and category variability (i.e., heterogeneity). However, the interaction between these factors and their impact on different subprocesses of search remains unclear. This study examined the effects of target/distractor similarity and category variability on processes of categorical search. Using multidimensional scaling, we manipulated target/distractor similarity and measured category variability for target categories that participants searched for. Eye-tracking data were collected to examine attentional guidance and target verification. The results demonstrated that the effect of category variability on response times (RTs) was dependent on the level of target/distractor similarity. Specifically, when distractors were highly similar to target categories, there was a negative relation between RTs and variability, with low variability categories producing longer RTs than higher variability categories. Surprisingly, this trend was only present in the eye-tracking measures of target verification but not attentional guidance. Our results suggest that searchers more effectively guide attention to low-variability categories compared to high-variability categories, regardless of the degree of similarity between targets and distractors. However, low category variability interferes with target match decisions when distractors are highly similar to the category, thus the advantage that low category variability provides to searchers is not equal across processes of search.

Exploring developmental MeHg impact on extraembryonic and cardiac vessels and its effect on cardiomyocyte contractility.

The toxicity of methylmercury (MeHg) during embryonic development is a relevant issue that remains unclear and deserves investigation. In this sense, there is evidence that links the intake of contaminated food with cardiovascular pathologies in human adults and children. Thus, this study aimed to verify the impact of MeHg on the structure and integrity of extraembryonic and cardiac blood vessels and the contractile function of cardiomyocytes, also evaluating embryonic weight and the cardiosomatic index (CSI). Thus, chicken embryos, used as an experimental model, were exposed to a single dose of 0.1 µg MeHg/50 µl saline at E1.5 and analyzed at E10. After exposure, an increase in the number of extraembryonic blood vessels and the veins of the cardiac tissue was observed. These increases were accompanied by a reduction in the content of VEGF and VCAM proteins related to vessel growth and adhesiveness. Together, these results were related to reduced nitrite (NOx) levels. Furthermore, MeHg reduces the number of sarcomeres and increases the content of cardiac troponin I (cTnI), a protein that regulates contraction. In general, exposure to MeHg affected the integrity of extraembryonic and cardiac vessels and the contractile function of cardiomyocytes, which had a systemic impact evidenced by the reduction in embryonic weight gain and CSI.

Dissociable Roles of the Dorsolateral and Ventromedial Prefrontal Cortex in Human Categorization.

Models of human categorization predict the prefrontal cortex (PFC) serves a central role in category learning. The dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) have been implicated in categorization; however, it is unclear whether both are critical for categorization and whether they support unique functions. We administered three categorization tasks to patients with PFC lesions (mean age, 69.6 years; 5 men, 5 women) to examine how the prefrontal subregions contribute to categorization. These included a rule-based (RB) task that was solved via a unidimensional rule, an information integration (II) task that was solved by combining information from two stimulus dimensions, and a deterministic/probabilistic (DP) task with stimulus features that had varying amounts of category-predictive information. Compared with healthy comparison participants, both patient groups had impaired performance. Impairments in the dlPFC patients were largest during the RB task, whereas impairments in the vmPFC patients were largest during the DP task. A hierarchical model was fit to the participants' data to assess learning deficits in the patient groups. PFC damage was correlated with a regularization term that limited updates to attention after each trial. Our results suggest that the PFC, as a whole, is important for learning to orient attention to relevant stimulus information. The dlPFC may be especially important for rule-based learning, whereas the vmPFC may be important for focusing attention on deterministic (highly diagnostic) features and ignoring less predictive features. These results support overarching functions of the dlPFC in executive functioning and the vmPFC in value-based decision-making.

Characterization and ecological risk assessment of microplastics accumulated in sea water, sand, sediment, shell water and selected tissues of hermit crab of Sundarban Biosphere Reserve.

Sundarban, a Ramsar site of India, has been encountering an ecological threat due to the presence of microplastic (MP) wastes generated from different anthropogenic sources. Clibanarius longitarsus, an intertidal hermit crab of Sundarban Biosphere Reserve, resides within the abandoned shell of a gastropod mollusc, Telescopium telescopium. We characterized and estimated the MP in the gills and gut of hermit crab, as well as in the water present in its occupied gastropod shell. The average microplastic abundance in sea water, sand and sediment were 0.175 ± 0.145 MP L-1, 42 ± 15.03 MP kg-1 and 67.63 ± 24.13 MP kg-1 respectively. The average microplastic load in hermit crab was 1.94 ± 0.59 MP crab-1, with 33.89 % and 66.11 % in gills and gut respectively. Gastropod shell water exhibited accumulation of 1.69 ± 1.43 MP L-1. Transparent and fibrous microplastics were documented as the dominant polymers of water, sand and sediment. Shell water exhibited the prevalence of green microplastics followed by transparent ones. Microscopic examination revealed microplastics with 100-300 µm size categories were dominant across all abiotic compartments. ATR-FTIR and Raman spectroscopy confirmed polyethylene and polypropylene as the prevalent polymers among the five identified polymers of biotic and abiotic components. The target group index indicated green and black as the preferable microplastics of crab. The ecological risk analysis indicated a considerable level of environmental pollution risk in Sundarban and its inhabiting organisms. This important information base may facilitate in developing a strategy of mitigation to limit the MP induced ecological risk at Sundarban Biosphere Reserve.

Radiomics-Based Machine Learning Classification Strategy for Characterization of Hepatocellular Carcinoma on Contrast-Enhanced Ultrasound in High-Risk Patients with LI-RADS Category M Nodules.

Objective Accurate differentiation within the LI-RADS category M (LR-M) between hepatocellular carcinoma (HCC) and non-HCC malignancies (mainly intrahepatic cholangiocarcinoma [CCA] and combined hepatocellular and cholangiocarcinoma [cHCC-CCA]) is an area of active investigation. We aimed to use radiomics-based machine learning classification strategy for differentiating HCC from CCA and cHCC-CCA on contrast-enhanced ultrasound (CEUS) images in high-risk patients with LR-M nodules. Methods A total of 159 high-risk patients with LR-M nodules (69 HCC and 90 CCA/cHCC-CCA) who underwent CEUS within 1 month before pathologic confirmation from January 2006 to December 2019 were retrospectively included (111 patients for training set and 48 for test set). The training set was used to build models, while the test set was used to compare models. For each observation, six CEUS images captured at predetermined time points (T1, peak enhancement after contrast injection; T2, 30 seconds; T3, 45 seconds; T4, 60 seconds; T5, 1-2 minutes; and T6, 2-3 minutes) were collected for tumor segmentation and selection of radiomics features, which included seven types of features: first-order statistics, shape (2D), gray-level co-occurrence matrix, gray-level size zone matrix, gray-level run length matrix, neighboring gray tone difference matrix, and gray-level dependence matrix. Clinical data and key radiomics features were employed to develop the clinical model, radiomics signature (RS), and combined RS-clinical (RS-C) model. The RS and RS-C model were built using the machine learning framework. The diagnostic performance of these three models was calculated and compared. Results Alpha-fetoprotein (AFP), CA19-9, enhancement pattern, and time of washout were included as independent factors for clinical model (all p < 0.05). Both the RS and RS-C model performed better than the clinical model in the test set (area under the curve [AUC] of 0.698 [0.571-0.812] for clinical model, 0.903 [0.830-0.970] for RS, and 0.912 [0.838-0.977] for the RS-C model; both p < 0.05). Conclusions Radiomics-based machine learning classifiers may be competent for differentiating HCC from CCA and cHCC-CCA in high-risk patients with LR-M nodules.

Analysis of factors influencing the trajectory of fatigue in maintenance haemodialysis patients: a longitudinal study.

OBJECTIVE: To explore the potential categories and influencing factors of fatigue trajectory in maintenance haemodialysis patients. METHODS: Between June 2023 and December 2023, a convenience sample of 306 maintenance haemodialysis patients in a tertiary hospital haemodialysis centre in Zhenjiang City was selected as the study population, and patient information was collected monthly after the baseline survey using the General Information Questionnaire, Pittsburgh Sleep Quality Scale, Piper Fatigue Revision Scale, Collaborative Social Support Scale, Patient Health Questionnaire Depression Scale, Comprehensive Economic Toxicity Rating Scale, and Fear of Disease Progression Simplified Scale, for a total of six follow-up visits. In addition, the potential category growth model was used to identify the developmental trajectory of fatigue, and univariate analysis and binary logistic regression were used to analyse its determinants. RESULTS: The 6 month fatigue trajectory of maintenance haemodialysis patients could be divided into two categories: persistent low-fatigue group (59.8%) and fluctuating high-fatigue group (40.2%). Age, surgical history, level of social support, sleep, economic toxicity, and changes in ultrafiltration volume during dialysis were the influencing factors for repeated fatigue in maintenance haemodialysis patients (p < 0.05). CONCLUSION: The fatigue trajectory of maintenance haemodialysis patients is heterogeneous, suggesting that clinical workers should focus on the haemodialysis patients with repeated fatigue and make targeted interventions to improve their fatigue status and reduce the occurrence of adverse events in patients.