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1.
Cell ; 185(2): 299-310.e18, 2022 01 20.
Artículo en Inglés | MEDLINE | ID: mdl-35063072

RESUMEN

Ductal carcinoma in situ (DCIS) is a pre-invasive lesion that is thought to be a precursor to invasive breast cancer (IBC). To understand the changes in the tumor microenvironment (TME) accompanying transition to IBC, we used multiplexed ion beam imaging by time of flight (MIBI-TOF) and a 37-plex antibody staining panel to interrogate 79 clinically annotated surgical resections using machine learning tools for cell segmentation, pixel-based clustering, and object morphometrics. Comparison of normal breast with patient-matched DCIS and IBC revealed coordinated transitions between four TME states that were delineated based on the location and function of myoepithelium, fibroblasts, and immune cells. Surprisingly, myoepithelial disruption was more advanced in DCIS patients that did not develop IBC, suggesting this process could be protective against recurrence. Taken together, this HTAN Breast PreCancer Atlas study offers insight into drivers of IBC relapse and emphasizes the importance of the TME in regulating these processes.


Asunto(s)
Neoplasias de la Mama/patología , Carcinoma Intraductal no Infiltrante/patología , Diferenciación Celular , Estudios de Cohortes , Progresión de la Enfermedad , Células Epiteliales/patología , Epitelio/patología , Matriz Extracelular/metabolismo , Femenino , Fibroblastos/metabolismo , Fibroblastos/patología , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/patología , Fenotipo , Análisis de la Célula Individual , Células del Estroma/patología , Microambiente Tumoral
2.
Cell ; 181(2): 236-249, 2020 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-32302568

RESUMEN

Crucial transitions in cancer-including tumor initiation, local expansion, metastasis, and therapeutic resistance-involve complex interactions between cells within the dynamic tumor ecosystem. Transformative single-cell genomics technologies and spatial multiplex in situ methods now provide an opportunity to interrogate this complexity at unprecedented resolution. The Human Tumor Atlas Network (HTAN), part of the National Cancer Institute (NCI) Cancer Moonshot Initiative, will establish a clinical, experimental, computational, and organizational framework to generate informative and accessible three-dimensional atlases of cancer transitions for a diverse set of tumor types. This effort complements both ongoing efforts to map healthy organs and previous large-scale cancer genomics approaches focused on bulk sequencing at a single point in time. Generating single-cell, multiparametric, longitudinal atlases and integrating them with clinical outcomes should help identify novel predictive biomarkers and features as well as therapeutically relevant cell types, cell states, and cellular interactions across transitions. The resulting tumor atlases should have a profound impact on our understanding of cancer biology and have the potential to improve cancer detection, prevention, and therapeutic discovery for better precision-medicine treatments of cancer patients and those at risk for cancer.


Asunto(s)
Transformación Celular Neoplásica/metabolismo , Neoplasias/metabolismo , Microambiente Tumoral/fisiología , Atlas como Asunto , Transformación Celular Neoplásica/patología , Genómica/métodos , Humanos , Medicina de Precisión/métodos , Análisis de la Célula Individual/métodos
3.
Cell ; 174(6): 1373-1387.e19, 2018 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-30193111

RESUMEN

The immune system is critical in modulating cancer progression, but knowledge of immune composition, phenotype, and interactions with tumor is limited. We used multiplexed ion beam imaging by time-of-flight (MIBI-TOF) to simultaneously quantify in situ expression of 36 proteins covering identity, function, and immune regulation at sub-cellular resolution in 41 triple-negative breast cancer patients. Multi-step processing, including deep-learning-based segmentation, revealed variability in the composition of tumor-immune populations across individuals, reconciled by overall immune infiltration and enriched co-occurrence of immune subpopulations and checkpoint expression. Spatial enrichment analysis showed immune mixed and compartmentalized tumors, coinciding with expression of PD1, PD-L1, and IDO in a cell-type- and location-specific manner. Ordered immune structures along the tumor-immune border were associated with compartmentalization and linked to survival. These data demonstrate organization in the tumor-immune microenvironment that is structured in cellular composition, spatial arrangement, and regulatory-protein expression and provide a framework to apply multiplexed imaging to immune oncology.


Asunto(s)
Linfocitos/inmunología , Espectrometría de Masas , Neoplasias de la Mama Triple Negativas/patología , Microambiente Tumoral/inmunología , Antígenos CD/metabolismo , Antígeno B7-H1/metabolismo , Análisis por Conglomerados , Femenino , Humanos , Indolamina-Pirrol 2,3,-Dioxigenasa/metabolismo , Estimación de Kaplan-Meier , Linfocitos/citología , Linfocitos/metabolismo , Aprendizaje Automático , Análisis de Componente Principal , Receptor de Muerte Celular Programada 1/metabolismo , Análisis Espacial , Neoplasias de la Mama Triple Negativas/diagnóstico por imagen , Neoplasias de la Mama Triple Negativas/inmunología , Neoplasias de la Mama Triple Negativas/mortalidad , Proteína del Gen 3 de Activación de Linfocitos
4.
Nature ; 597(7878): 715-719, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34526722

RESUMEN

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer deaths worldwide1. Studies in human tissues and in mouse models have suggested that for many cancers, stem cells sustain early mutations driving tumour development2,3. For the pancreas, however, mechanisms underlying cellular renewal and initiation of PDAC remain unresolved. Here, using lineage tracing from the endogenous telomerase reverse transcriptase (Tert) locus, we identify a rare TERT-positive subpopulation of pancreatic acinar cells dispersed throughout the exocrine compartment. During homeostasis, these TERThigh acinar cells renew the pancreas by forming expanding clones of acinar cells, whereas randomly marked acinar cells do not form these clones. Specific expression of mutant Kras in TERThigh acinar cells accelerates acinar clone formation and causes transdifferentiation to ductal pre-invasive pancreatic intraepithelial neoplasms by upregulating Ras-MAPK signalling and activating the downstream kinase ERK (phospho-ERK). In resected human pancreatic neoplasms, we find that foci of phospho-ERK-positive acinar cells are common and frequently contain activating KRAS mutations, suggesting that these acinar regions represent an early cancer precursor lesion. These data support a model in which rare TERThigh acinar cells may sustain KRAS mutations, driving acinar cell expansion and creating a field of aberrant cells initiating pancreatic tumorigenesis.


Asunto(s)
Células Acinares/citología , Carcinogénesis , Páncreas/citología , Animales , Carcinoma Ductal Pancreático/patología , Transdiferenciación Celular , Transformación Celular Neoplásica/genética , Homeostasis , Humanos , Sistema de Señalización de MAP Quinasas , Ratones , Mutación , Páncreas/patología , Páncreas/fisiología , Neoplasias Pancreáticas/patología , Proteínas Proto-Oncogénicas p21(ras)/genética , Telomerasa/genética
5.
Proc Natl Acad Sci U S A ; 121(8): e2313377121, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38349876

RESUMEN

In recent years, critics of online platforms have raised concerns about the ability of recommendation algorithms to amplify problematic content, with potentially radicalizing consequences. However, attempts to evaluate the effect of recommenders have suffered from a lack of appropriate counterfactuals-what a user would have viewed in the absence of algorithmic recommendations-and hence cannot disentangle the effects of the algorithm from a user's intentions. Here we propose a method that we call "counterfactual bots" to causally estimate the role of algorithmic recommendations on the consumption of highly partisan content on YouTube. By comparing bots that replicate real users' consumption patterns with "counterfactual" bots that follow rule-based trajectories, we show that, on average, relying exclusively on the YouTube recommender results in less partisan consumption, where the effect is most pronounced for heavy partisan consumers. Following a similar method, we also show that if partisan consumers switch to moderate content, YouTube's sidebar recommender "forgets" their partisan preference within roughly 30 videos regardless of their prior history, while homepage recommendations shift more gradually toward moderate content. Overall, our findings indicate that, at least since the algorithm changes that YouTube implemented in 2019, individual consumption patterns mostly reflect individual preferences, where algorithmic recommendations play, if anything, a moderating role.

6.
Nature ; 580(7802): 245-251, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32269342

RESUMEN

Radiologic screening of high-risk adults reduces lung-cancer-related mortality1,2; however, a small minority of eligible individuals undergo such screening in the United States3,4. The availability of blood-based tests could increase screening uptake. Here we introduce improvements to cancer personalized profiling by deep sequencing (CAPP-Seq)5, a method for the analysis of circulating tumour DNA (ctDNA), to better facilitate screening applications. We show that, although levels are very low in early-stage lung cancers, ctDNA is present prior to treatment in most patients and its presence is strongly prognostic. We also find that the majority of somatic mutations in the cell-free DNA (cfDNA) of patients with lung cancer and of risk-matched controls reflect clonal haematopoiesis and are non-recurrent. Compared with tumour-derived mutations, clonal haematopoiesis mutations occur on longer cfDNA fragments and lack mutational signatures that are associated with tobacco smoking. Integrating these findings with other molecular features, we develop and prospectively validate a machine-learning method termed 'lung cancer likelihood in plasma' (Lung-CLiP), which can robustly discriminate early-stage lung cancer patients from risk-matched controls. This approach achieves performance similar to that of tumour-informed ctDNA detection and enables tuning of assay specificity in order to facilitate distinct clinical applications. Our findings establish the potential of cfDNA for lung cancer screening and highlight the importance of risk-matching cases and controls in cfDNA-based screening studies.


Asunto(s)
ADN Tumoral Circulante/análisis , ADN Tumoral Circulante/genética , Detección Precoz del Cáncer/métodos , Genoma Humano/genética , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Mutación , Estudios de Cohortes , Femenino , Hematopoyesis/genética , Humanos , Pulmón/metabolismo , Pulmón/patología , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
7.
Nano Lett ; 24(36): 11262-11268, 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39213585

RESUMEN

Understanding optical absorption in silicon nitride is crucial for cutting-edge technologies like photonic integrated circuits, nanomechanical photothermal infrared sensing and spectroscopy, and cavity optomechanics. Yet, the origin of its strong dependence on the film deposition and fabrication process is not fully understood. This Letter leverages nanomechanical photothermal sensing to investigate optical extinction κext at a 632.8 nm wavelength in low-pressure chemical vapor deposition (LPCVD) SiN strings across a wide range of deposition-related tensile stresses (200-850 MPa). Measurements reveal a reduction in κext from 103 to 101 ppm with increasing stress, correlated to variations in Si/N content ratio. Within the band-fluctuations framework, this trend indicates an increase of the energy bandgap with the stress, ultimately reducing absorption. Overall, this study showcases the power and simplicity of nanomechanical photothermal sensing for low absorption measurements, offering a sensitive, scattering-free platform for material analysis in nanophotonics and nanomechanics.

8.
Breast Cancer Res ; 26(1): 127, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39223670

RESUMEN

BACKGROUND: Ductal carcinoma in situ (DCIS) is a non-obligate precursor to invasive breast cancer (IBC). Studies have indicated differences in DCIS outcome based on race or ethnicity, but molecular differences have not been investigated. METHODS: We examined the molecular profile of DCIS by self-reported race (SRR) and outcome groups in Black (n = 99) and White (n = 191) women in a large DCIS case-control cohort study with longitudinal follow up. RESULTS: Gene expression and pathway analyses suggested that different genes and pathways are involved in diagnosis and ipsilateral breast outcome (DCIS or IBC) after DCIS treatment in White versus Black women. We identified differences in ER and HER2 expression, tumor microenvironment composition, and copy number variations by SRR and outcome groups. CONCLUSIONS: Our results suggest that different molecular mechanisms drive initiation and subsequent ipsilateral breast events in Black versus White women.


Asunto(s)
Neoplasias de la Mama , Carcinoma Intraductal no Infiltrante , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Biomarcadores de Tumor/genética , Negro o Afroamericano/genética , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Neoplasias de la Mama/etnología , Carcinoma Intraductal no Infiltrante/genética , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/etnología , Estudios de Casos y Controles , Variaciones en el Número de Copia de ADN , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Pronóstico , Receptor ErbB-2/metabolismo , Receptor ErbB-2/genética , Receptores de Estrógenos/metabolismo , Autoinforme , Microambiente Tumoral/genética , Blanco/genética
9.
Artículo en Inglés | MEDLINE | ID: mdl-38876193

RESUMEN

BACKGROUND & AIMS: Current classification systems for irritable bowel syndrome (IBS) based on bowel habit do not consider psychological impact. We validated a classification model in a UK population with confirmed IBS, using latent class analysis, incorporating psychological factors. We applied this model in the Rome Foundation Global Epidemiological Survey (RFGES), assessing impact of IBS on the individual and the health care system, and examining reproducibility. METHODS: We applied our model to 2195 individuals in the RFGES with Rome IV-defined IBS. As described previously, we identified 7 clusters, based on gastrointestinal symptom severity and psychological burden. We assessed demographics, health care-seeking, symptom severity, and quality of life in each. We also used the RFGES to derive a new model, examining whether the broader concepts of our original model were replicated, in terms of breakdown and characteristics of identified clusters. RESULTS: All 7 clusters were identified. Those in clusters with highest psychological burden, and particularly cluster 6 with high overall gastrointestinal symptom severity, were more often female, exhibited higher levels of health care-seeking, were more likely to have undergone previous abdominal surgeries, and had higher symptom severity and lower quality of life (P < .001 for trend for all). When deriving a new model, the best solution consisted of 10 clusters, although at least 2 seemed to be duplicates, and almost all mapped on to the previous clusters. CONCLUSIONS: Even in the community, our original clusters derived from patients with physician-confirmed IBS identified groups of individuals with significantly higher rates of health care-seeking and abdominal surgery, more severe symptoms, and impairments in quality of life.

10.
Artículo en Inglés | MEDLINE | ID: mdl-39248146

RESUMEN

BACKGROUND: Procalcitonin (PCT) is a blood marker used to help diagnose bacterial infections and guide antibiotic treatment. PCT testing was widely used/adopted during the COVID-19 pandemic in the UK. OBJECTIVES: Primary: to measure the difference in length of early (during first 7 days) antibiotic prescribing between patients with COVID-19 who did/did not have baseline PCT testing during the first wave of the pandemic. Secondary: to measure differences in length of hospital/ICU stay, mortality, total days of antibiotic prescribing and resistant bacterial infections between these groups. METHODS: Multi-centre, retrospective, observational, cohort study using patient-level clinical data from acute hospital Trusts/Health Boards in England/Wales. Inclusion: patients ≥16 years, admitted to participating Trusts/Health Boards and with a confirmed positive COVID-19 test between 1 February 2020 and 30 June 2020. RESULTS: Data from 5960 patients were analysed: 1548 (26.0%) had a baseline PCT test and 4412 (74.0%) did not. Using propensity-score matching, baseline PCT testing was associated with an average reduction in early antibiotic prescribing of 0.43 days [95% confidence interval (CI): 0.22-0.64 days, P < 0.001) and of 0.72 days (95% CI: 0.06-1.38 days, P = 0.03] in total antibiotic prescribing. Baseline PCT testing was not associated with increased mortality or hospital/ICU length of stay or with the rate of antimicrobial-resistant secondary bacterial infections. CONCLUSIONS: Baseline PCT testing appears to have been an effective antimicrobial stewardship tool early in the pandemic: it reduced antibiotic prescribing without evidence of harm. Our study highlights the need for embedded, rapid evaluations of infection diagnostics in the National Health Service so that even in challenging circumstances, introduction into clinical practice is supported by evidence for clinical utility. STUDY REGISTRATION NUMBER: ISRCTN66682918.

11.
J Antimicrob Chemother ; 79(8): 1831-1842, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38842487

RESUMEN

BACKGROUND: Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK. OBJECTIVES: Evaluating cost-effectiveness of using PCT to guide antibiotic decisions in individuals hospitalized with COVID-19, as part of a wider research programme. METHODS: Retrospective individual-level data on patients hospitalized with COVID-19 were collected from 11 NHS acute hospital Trusts and Health Boards from England and Wales, which varied in their use of baseline PCT testing during the first COVID-19 pandemic wave. A matched analysis (part of a wider analysis reported elsewhere) created groups of patients whose PCT was/was not tested at baseline. A model was created with combined decision tree/Markov phases, parameterized with quality-of-life/unit cost estimates from the literature, and used to estimate costs and quality-adjusted life years (QALYs). Cost-effectiveness was judged at a £20 000/QALY threshold. Uncertainty was characterized using bootstrapping. RESULTS: People who had baseline PCT testing had shorter general ward/ICU stays and spent less time on antibiotics, though with overlap between the groups' 95% CIs. Those with baseline PCT testing accrued more QALYs (8.76 versus 8.62) and lower costs (£9830 versus £10 700). The point estimate was baseline PCT testing being dominant over no baseline testing, though with uncertainty: the probability of cost-effectiveness was 0.579 with a 1 year horizon and 0.872 with a lifetime horizon. CONCLUSIONS: Using PCT to guide antibiotic therapy in individuals hospitalized with COVID-19 is more likely to be cost-effective than not, albeit with uncertainty.


Asunto(s)
Antibacterianos , COVID-19 , Análisis Costo-Beneficio , Polipéptido alfa Relacionado con Calcitonina , Humanos , Polipéptido alfa Relacionado con Calcitonina/sangre , Antibacterianos/uso terapéutico , Antibacterianos/economía , Masculino , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Anciano , Hospitalización/economía , SARS-CoV-2 , Años de Vida Ajustados por Calidad de Vida , Adulto , Tratamiento Farmacológico de COVID-19 , Reino Unido , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/economía
12.
Nat Mater ; 2023 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-37957268

RESUMEN

Breast cancer becomes invasive when carcinoma cells invade through the basement membrane (BM)-a nanoporous layer of matrix that physically separates the primary tumour from the stroma. Single cells can invade through nanoporous three-dimensional matrices due to protease-mediated degradation or force-mediated widening of pores via invadopodial protrusions. However, how multiple cells collectively invade through the physiological BM, as they do during breast cancer progression, remains unclear. Here we developed a three-dimensional in vitro model of collective invasion of the BM during breast cancer. We show that cells utilize both proteases and forces-but not invadopodia-to breach the BM. Forces are generated from a combination of global cell volume expansion, which stretches the BM, and local contractile forces that act in the plane of the BM to breach it, allowing invasion. These results uncover a mechanism by which cells collectively interact to overcome a critical barrier to metastasis.

13.
BMC Cancer ; 24(1): 533, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38671382

RESUMEN

BACKGROUND: In Saudi Arabia, approximately one-third of colorectal cancer (CRC) patients are diagnosed at an advanced stage. Late diagnosis is often associated with a worse prognosis. Understanding the risk factors for late-stage presentation of CRC is crucial for developing targeted interventions enabling earlier detection and improved patient outcomes. METHODS: We conducted a retrospective cohort study on 17,541 CRC patients from the Saudi Cancer Registry (1997-2017). We defined distant CRCs as late-stage and localized and regional CRCs as early-stage. To assess risk factors for late-stage CRC, we first used multivariable logistic regression, then developed a decision tree to segment regions by late-stage CRC risk, and finally used stratified logistic regression models to examine geographical and sex variations in risk factors. RESULTS: Of all cases, 29% had a late-stage diagnosis, and 71% had early-stage CRC. Young (< 50 years) and unmarried women had an increased risk of late-stage CRC, overall and in some regions. Regional risk variations by sex were observed. Sex-related differences in late-stage rectosigmoid cancer risk were observed in specific regions but not in the overall population. Patients diagnosed after 2001 had increased risks of late-stage presentation. CONCLUSION: Our study identified risk factors for late-stage CRC that can guide targeted early detection efforts. Further research is warranted to fully understand these relationships and develop and evaluate effective prevention strategies.


Asunto(s)
Neoplasias Colorrectales , Estadificación de Neoplasias , Sistema de Registros , Humanos , Arabia Saudita/epidemiología , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/patología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Factores de Riesgo , Adulto , Diagnóstico Tardío/estadística & datos numéricos , Factores Sexuales , Detección Precoz del Cáncer
14.
Age Ageing ; 53(3)2024 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-38520142

RESUMEN

BACKGROUND: Falls are common in older adults and can devastate personal independence through injury such as fracture and fear of future falls. Methods to identify people for falls prevention interventions are currently limited, with high risks of bias in published prediction models. We have developed and externally validated the eFalls prediction model using routinely collected primary care electronic health records (EHR) to predict risk of emergency department attendance/hospitalisation with fall or fracture within 1 year. METHODS: Data comprised two independent, retrospective cohorts of adults aged ≥65 years: the population of Wales, from the Secure Anonymised Information Linkage Databank (model development); the population of Bradford and Airedale, England, from Connected Bradford (external validation). Predictors included electronic frailty index components, supplemented with variables informed by literature reviews and clinical expertise. Fall/fracture risk was modelled using multivariable logistic regression with a Least Absolute Shrinkage and Selection Operator penalty. Predictive performance was assessed through calibration, discrimination and clinical utility. Apparent, internal-external cross-validation and external validation performance were assessed across general practices and in clinically relevant subgroups. RESULTS: The model's discrimination performance (c-statistic) was 0.72 (95% confidence interval, CI: 0.68 to 0.76) on internal-external cross-validation and 0.82 (95% CI: 0.80 to 0.83) on external validation. Calibration was variable across practices, with some over-prediction in the validation population (calibration-in-the-large, -0.87; 95% CI: -0.96 to -0.78). Clinical utility on external validation was improved after recalibration. CONCLUSION: The eFalls prediction model shows good performance and could support proactive stratification for falls prevention services if appropriately embedded into primary care EHR systems.


Asunto(s)
Fracturas Óseas , Hospitalización , Humanos , Anciano , Estudios Retrospectivos , Fracturas Óseas/diagnóstico , Fracturas Óseas/epidemiología , Fracturas Óseas/prevención & control , Modelos Logísticos
15.
Qual Life Res ; 2024 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-39400690

RESUMEN

PURPOSE: The relationship between quality of life (QoL) and frailty has previously been investigated cross-sectionally and longitudinally as unidirectional where QoL depends upon frailty and where frailty depends on QoL. Here a bidirectional relationship is examined. METHODS: This work uses a latent curve model with structured residuals to address the bidirectional association between QoL and frailty in older English people considering within-person and group levels. The study measures frailty using a functional frailty measure and quality of life using CASP-12. The sample size is 17,529. RESULTS: There is a strong relationship between QoL (Quality of Life) and frailty, which is almost linear and inversely proportional over time. Although the cross-lagged coefficients from QoL to frailty and vice versa showed statistical significance, the impact was found to be minimal. The time between assessments (which are two years apart) and/or the few observations available per individual may have impacted the effect of this relationship. When accounting for gender, age, net wealth, and multimorbidity, some variations in the results were observed at the group level but not at the within-person level. CONCLUSION: The study provides empirical evidence that supports a bidirectional association between QoL and frailty in older individuals who reside at home. These results offer valuable insights for healthcare providers, as participants did not exhibit an advanced need for health services. Additionally, involving participants in evaluating and assessing these services enhances their effectiveness and overall benefit.


There's growing evidence suggesting a two-way relationship between frailty and quality of life, meaning they can each affect the other. Understanding this dynamic requires sophisticated statistical methods, like the ones used in this study. Our research aims to shed light on a crucial question: when caring for older individuals, should our healthcare system prioritize improving quality of life or addressing frailty? Pinpointing which factor has a greater influence can guide healthcare institutions in allocating resources effectively and supporting elderly individuals in leading fulfilling lives as they age. Surprisingly, our findings reveal a minimal, yet significant, impact of frailty and quality of life on each other over time. This remained consistent across various demographic factors such as gender, age groups, socioeconomic status, and health conditions. One possible explanation for this minimal impact is the lengthy time gap between our measurements, spanning two years for each participant. These insights help us better understand how to care for our aging population by involving them in sharing their needs and thoughts. This input informs healthcare policies and practices, allowing us to better meet the diverse needs of older individuals who are raised at home.

16.
Proc Natl Acad Sci U S A ; 118(38)2021 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-34526401

RESUMEN

Deceased public figures are often said to live on in collective memory. We quantify this phenomenon by tracking mentions of 2,362 public figures in English-language online news and social media (Twitter) 1 y before and after death. We measure the sharp spike and rapid decay of attention following death and model collective memory as a composition of communicative and cultural memory. Clustering reveals four patterns of postmortem memory, and regression analysis shows that boosts in media attention are largest for premortem popular anglophones who died a young, unnatural death; that long-term boosts are smallest for leaders and largest for artists; and that, while both the news and Twitter are triggered by young and unnatural deaths, the news additionally curates collective memory when old persons or leaders die. Overall, we illuminate the age-old question of who is remembered by society, and the distinct roles of news and social media in collective memory formation.


Asunto(s)
Medios de Comunicación de Masas/tendencias , Identificación Social , Medios de Comunicación Sociales/tendencias , Comunicación , Humanos , Reuniones Masivas , Memoria , Factores Sociológicos
17.
J Arthroplasty ; 39(1): 269-275, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37343648

RESUMEN

BACKGROUND: We compared the incidence of postoperative periprosthetic femoral fractures (POPFF) following hip arthroplasty with either a cemented polished taper slip (PTS) stem or a cemented composite beam (CB) stem in comparative studies. METHODS: A systematic review of comparative studies, written in English and published in peer-reviewed journals since the year 2000, was conducted. Study quality was assessed using the Newcastle-Ottawa scale.The overall study qualities were good. There were 913,021 patients from 18 cohorts included in the meta-analysis. There were 294,540 patients who received a CB stem and 618,481 received a PTS stem. Cohorts were classified as high- or low-risk for POPFF based on patient risk factors. A metanalysis was performed using a random effects model, and the relative incidence with 95% confidence intervals (CIs) was reported. RESULTS: The patients at low risk of POPFF had an incidence rate ratio of 3.14 (CI: 2.48, 3.98) for the PTS group versus the CB group. Whereas, the patients at high risk of POPFF had an incidence rate ratio of 9.87 (CI: 3.63, 26.80) for the PTS group versus the CB group. CONCLUSIONS: The risk of POPFF is lower when hip arthroplasty was performed using a CB stem versus a PTS stem. This protective effect was greatest in patients who had a higher risk of POPFF. Surgeons should consider the effect of cemented stem choice on the risk of subsequent periprosthetic femur fracture, particularly in frail or elderly patients who are at a higher risk of postoperative periprosthetic femoral fracture.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Fracturas del Fémur , Prótesis de Cadera , Fracturas Periprotésicas , Humanos , Anciano , Fracturas Periprotésicas/epidemiología , Fracturas Periprotésicas/etiología , Fracturas Periprotésicas/cirugía , Artroplastia de Reemplazo de Cadera/efectos adversos , Prótesis de Cadera/efectos adversos , Estudios Retrospectivos , Factores de Riesgo , Reoperación/efectos adversos , Fracturas del Fémur/epidemiología , Fracturas del Fémur/etiología , Fracturas del Fémur/cirugía , Diseño de Prótesis
18.
Toxicol Ind Health ; 40(8): 441-464, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38748851

RESUMEN

The water extractability and acute aquatic toxicity of seven aliphatic diisocyanate-based prepolymer substances were investigated to determine if lesser reactivity of the aliphatic isocyanate groups, as well as increased ionization potential of the expected (aliphatic amine-terminated) polymeric hydrolysis products, would influence their aquatic behavior compared to that of previously investigated aromatic diisocyanate-based prepolymers. At loading rates of 100 and 1,000 mg/L, only the substances having log Kow ≤9 exhibited more than 1% extractability in water, and a maximum of 66% water extractability was determined for a prepolymer having log Kow = 2.2. For the more hydrophobic prepolymer substances (log Kow values from 18-37), water extractability was negligible. High-resolution mass spectrometric analyses were performed on the water-accommodated fractions (WAF) of the prepolymers, which indicated the occurrence of primary aliphatic amine-terminated polymer species having backbones and functional group equivalent weights aligned to those of the parent prepolymers. Measurements of reduced surface tension and presence of suspended micelles in the WAFs further supported the occurrence of these surface-active cationic polymer species as hydrolysis products of the prepolymers. Despite these characteristics, the water-extractable hydrolysis products were practically non-toxic to Daphnia magna. All of the substances tested exhibited 48-h EL50 values of >1,000 mg/L, with one exception of EL50 = 157 mg/L. The results from this investigation support a grouping of the aliphatic diisocyanate-based prepolymers as a class of water-reactive polymer substances having predictable aquatic exposure and a uniformly low hazard potential, consistent with that previously demonstrated for the aromatic diisocyanate-based prepolymers.


Asunto(s)
Isocianatos , Contaminantes Químicos del Agua , Animales , Contaminantes Químicos del Agua/toxicidad , Contaminantes Químicos del Agua/química , Contaminantes Químicos del Agua/análisis , Isocianatos/química , Isocianatos/toxicidad , Polímeros/química , Polímeros/toxicidad , Daphnia/efectos de los fármacos , Relación Estructura-Actividad , Poliuretanos/química , Poliuretanos/toxicidad
19.
Nano Lett ; 23(10): 4344-4350, 2023 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-37167540

RESUMEN

One of the challenges of nanoelectromechanical systems (NEMS) is the effective transduction of the tiny resonators. Vertical structures, such as nanomechanical pillar resonators, which are exploited in optomechanics, acoustic metamaterials, and nanomechanical sensing, are particularly challenging to transduce. Existing electromechanical transduction methods are ill-suited as they put constraints on the pillars' material and do not enable a transduction of freestanding pillars. Here, we present an electromechanical transduction method for single nanomechanical pillar resonators based on surface acoustic waves (SAWs). We demonstrate the transduction of freestanding nanomechanical platinum-carbon pillars in the first-order bending and compression mode. Since the principle of the transduction method is based on resonant scattering of a SAW by a nanomechanical resonator, our transduction method is independent of the pillar's material and not limited to pillar-shaped geometries. It represents a general method to transduce vertical mechanical resonators with nanoscale lateral dimensions.

20.
Int J Mol Sci ; 25(12)2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38928454

RESUMEN

Ductal carcinoma in situ (DCIS) is a heterogeneous breast disease that remains challenging to treat due to its unpredictable progression to invasive breast cancer (IBC). Contemporary literature has become increasingly focused on extracellular matrix (ECM) alterations with breast cancer progression. However, the spatial regulation of the ECM proteome in DCIS has yet to be investigated in relation to IBC. We hypothesized that DCIS and IBC present distinct ECM proteomes that could discriminate between these pathologies. Tissue sections of pure DCIS, mixed DCIS-IBC, or pure IBC (n = 22) with detailed pathological annotations were investigated by multiplexed spatial proteomics. Across tissues, 1,005 ECM peptides were detected in pathologically annotated regions and their surrounding extracellular microenvironments. A comparison of DCIS to IBC pathologies demonstrated 43 significantly altered ECM peptides. Notably, eight fibrillar collagen peptides could distinguish with high specificity and sensitivity between DCIS and IBC. Lesion-targeted proteomic imaging revealed heterogeneity of the ECM proteome surrounding individual DCIS lesions. Multiplexed spatial proteomics reported an invasive cancer field effect, in which DCIS lesions in closer proximity to IBC shared a more similar ECM profile to IBC than distal counterparts. Defining the ECM proteomic microenvironment provides novel molecular insights relating to DCIS and IBC.


Asunto(s)
Neoplasias de la Mama , Carcinoma Intraductal no Infiltrante , Matriz Extracelular , Proteómica , Microambiente Tumoral , Humanos , Femenino , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Carcinoma Intraductal no Infiltrante/metabolismo , Carcinoma Intraductal no Infiltrante/patología , Proteómica/métodos , Matriz Extracelular/metabolismo , Matriz Extracelular/patología , Proteoma/metabolismo , Proteoma/análisis , Invasividad Neoplásica , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patología , Persona de Mediana Edad
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