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Time-on-task effect is a common consequence of long-term cognitive demand work, which reflects reduced behavioral performance and increases the risk of accidents. Neurofeedback is a neuromodulation method that can guide individuals to regulate their brain activity and manifest as changes in related symptoms and cognitive behaviors. This study aimed to examine the effects of functional near-infrared spectroscopy-based neurofeedback training on time-on-task effects and sustained cognitive performance. A randomized, single-blind, sham-controlled study was performed: 17 participants received feedback signals of their own dorsolateral prefrontal cortex activity (neurofeedback group), and 16 participants received feedback signals of dorsolateral prefrontal cortex activity from the neurofeedback group (sham-neurofeedback group). All participants received 5 neurofeedback training sessions and completed 2 sustained cognitive tasks, including a 2-back task and a psychomotor vigilance task, to evaluate behavioral performance changes following neurofeedback training. Results showed that neurofeedback relative to the sham-neurofeedback group exhibited increased dorsolateral prefrontal cortex activation, increased accuracy in the 2-back task, and decreased mean response time in the psychomotor vigilance task after neurofeedback training. In addition, the neurofeedback group showed slower decline performance during the sustained 2-back task after neurofeedback training compared with sham-neurofeedback group. These findings demonstrate that neurofeedback training could regulate time-on-task effects on difficult task and enhance performance on sustained cognitive tasks by increasing dorsolateral prefrontal cortex activity.
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Cognición , Neurorretroalimentación , Desempeño Psicomotor , Espectroscopía Infrarroja Corta , Humanos , Neurorretroalimentación/métodos , Neurorretroalimentación/fisiología , Espectroscopía Infrarroja Corta/métodos , Masculino , Femenino , Adulto Joven , Método Simple Ciego , Cognición/fisiología , Adulto , Desempeño Psicomotor/fisiología , Corteza Prefontal Dorsolateral/fisiología , Tiempo de Reacción/fisiología , Corteza Prefrontal/fisiologíaRESUMEN
The accomplishment of interpersonal sensorimotor synchronization is a challenging endeavor because it requires the achievement of a balance between accurate temporal control within individuals and smooth communication between them. This raises a critical question: How does the brain comprehend and process the perceptual information of others to guarantee accurate temporal control of action goals in a social context? A joint synchronization - continuation tapping task was conducted together with varying relative phases (0°/180°) and intervals of tempos (400 ms/800 ms/1600 ms) while neural data was collected using fNIRS (functional near-infrared spectroscopy). Individuals showed better behavioral performance and greater interpersonal brain synchronization(IBS) in the left dorsolateral prefrontal cortex at alternated condition (180° relative phase) compared to symmetric condition (0° relative phase), suggesting that the individual can better maintain behavioral performance and show improved IBS when the partner taps between the individual's gaps. Meanwhile, in most levels of alternated condition, IBS is inversely proportional to interference from partner, implying the counteraction of IBS against interference from others. In addition, when the interval of tempo was 1600 ms, behavioral performance showed a sharp decline, accompanied by a decrease in IBS, reflecting that IBS in SMS reflects effective information exchange between individuals rather than ineffective interference with each other. This study provides insight into the mechanisms underlying sensorimotor synchronization between individuals.
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The present study provides a facile one-pot pyrolysis strategy to prepare serial nitrogen-doped (N-doped) metal/carbon composites derived from six types of metal ethylenediaminetetraacetic acid (EDTA-M, M = Co, Cu, Mn, Fe, Mg, and Ca). N-doped Co/C composite integrated carbonaceous with magnetic components to attain dielectric-magnetic double loss mechanisms. The minimum reflection loss and effective absorption bandwidth reached -57.6 dB at 1.75 mm and 4.64 GHz at 1.52 mm, respectively. The electromagnetic simulation further confirms that the dissipation ability increases with the improvement of carbonization temperature. Results show that altering the metal species of precursors can significantly improve the electrochemical performance of the composites using the identical strategy. N-doped Cu/C composite performed a maximum specific capacitance of 2383.3 F g-1 at 0.5 A g-1 -1, and maintained 86.3% cycling stability at 20 A g-1 after 5000 cycles. The energy density of a symmetrical two-electrode configuration achieved 350.13 Wh kg-1 at a power density of 4000.04 W kg-1. Density functional theory calculations indicate that nitrogen dopants cause faster ion transport and stronger adsorption capacity. Moreover, the bifunctionality of other composites types are also systematically characterized.
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PURPOSE: PSMA/PET has been increasingly used to detect PCa, and PSMA/PET-guided biopsy has shown promising results. However, it cannot be confirmed immediately whether the tissues are the targeted area. In this study, we aimed to develop a novel probe, [123I]I-PSMA-7. First, we hope that [123I]I-PSMA-7 can provide instant confirmation for prostate biopsy. Second, we hope it will help detect PCa. METHODS: We synthesized a high-affinity probe, [123I]I-PSMA-7, and evaluated its properties. We included ten patients with suspected PCa and divided them into two groups. The injection and biopsy were approximately 24 h apart. The activity in biopsy lesions was measured as the cpm by a γ-counter. Moreover, we enrolled 3 patients to evaluate the potential of [123I]I-PSMA-7 for detecting PCa. RESULTS: Animal experiments verified the safety, targeting and effectiveness of [123I]I-PSMA-7, and the tumor-to-muscle ratio was greatest at 24 h, which confirmed the results of this study in humans. After injection of 185MBq [123I]I-PSMA-7, 18/55 cores were positive, and the cpm was significantly greater (4345 ± 3547 vs. 714 ± 547, P < 0.001), with an AUC of 0.97 and a cutoff of 1312 (sens/spec of 94.40%/91.90%). At a lower dose, 10/55 biopsy cores were cancerous, and the cpm was 2446 ± 1622 vs. 153 ± 112 (P < 0.001). The AUC was 1, with a cutoff value of 490 (sens/spec of 100%). When the radiopharmaceuticals were added to 370 MBq, we achieved better SPECT/CT imaging. CONCLUSION: With the aid of [123I]I-PSMA-7 and via cpm-based biopsy, we can reduce the number of biopsies to a minimum operation. [123I]I-PSMA-7 PSMA SPECT/CT can also provide good imaging results. TRIAL REGISTRATION: Chinese Clinical trial registry ChiCTR2300069745, Registered 24 March 2023.
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Brain injury caused by stroke has a high rate of mortality and remains a major medical challenge worldwide. In recent years, there has been significant attention given to the use of human Umbilical cord-derived Mesenchymal Stem Cells (hUC-MSCs) for the treatment of stroke in different adult and neonate animal models of stroke. However, using hUC-MSCs by systemic administration to treat ischemic stroke has not been investigated sufficiently. In this study, we conducted various experiments to explore the neuroprotection of hUC-MSCs in rats. Our findings demonstrate that an intravenous injection of a high dose of hUC-MSCs at 2 × 10^7 cells/kg markedly ameliorated brain injury resulting from ischemic stroke. This improvement was observed one day after inducing transient middle cerebral artery occlusion (MCAO) and subsequent reperfusion in rats. Notably, the efficacy of this single administration of hUC-MSCs surpassed that of edaravone, even when the latter was used continuously over three days. Mechanistically, secretory factors derived from hUC-MSCs, such as HGF, BDNF, and TNFR1, ameliorated the levels of MDA and T-SOD to regulate oxidative stress. In particular, TNFR1 also improved the expression of NQO-1 and HO-1, important proteins associated with oxidative stress. More importantly, TNFR1 played a significant role in reducing inflammation by modulating IL-6 levels in the blood. Furthermore, TNFR1 was observed to influence the permeability of the blood-brain barrier (BBB) as demonstrated in the evan's blue experiment and protein expression of ZO-1. This study represented a breakthrough in traditional methods and provided a novel strategy for clinical medication and trials.
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BACKGROUND: Construct deep learning models for colonoscopy quality control using different architectures and explore their decision-making mechanisms. METHODS: A total of 4,189 colonoscopy images were collected from two medical centers, covering different levels of bowel cleanliness, the presence of polyps, and the cecum. Using these data, eight pre-trained models based on CNN and Transformer architectures underwent transfer learning and fine-tuning. The models' performance was evaluated using metrics such as AUC, Precision, and F1 score. Perceptual hash functions were employed to detect image changes, enabling real-time monitoring of colonoscopy withdrawal speed. Model interpretability was analyzed using techniques such as Grad-CAM and SHAP. Finally, the best-performing model was converted to ONNX format and deployed on device terminals. RESULTS: The EfficientNetB2 model outperformed other architectures on the validation set, achieving an accuracy of 0.992. It surpassed models based on other CNN and Transformer architectures. The model's precision, recall, and F1 score were 0.991, 0.989, and 0.990, respectively. On the test set, the EfficientNetB2 model achieved an average AUC of 0.996, with a precision of 0.948 and a recall of 0.952. Interpretability analysis showed the specific image regions the model used for decision-making. The model was converted to ONNX format and deployed on device terminals, achieving an average inference speed of over 60 frames per second. CONCLUSIONS: The AI-assisted quality system, based on the EfficientNetB2 model, integrates four key quality control indicators for colonoscopy. This integration enables medical institutions to comprehensively manage and enhance these indicators using a single model, showcasing promising potential for clinical applications.
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Colonoscopía , Aprendizaje Profundo , Control de Calidad , Colonoscopía/normas , Humanos , Pólipos del Colon/diagnóstico por imagen , Pólipos del Colon/diagnósticoRESUMEN
BACKGROUND: Small intestinal stromal tumors (SISTs) typically require surgical treatment. However, the impact of lymphadenectomy (LA) on long-term prognosis in patients remains unclear. Therefore, we plan to analyze the effect of LA on the prognosis of patients with SISTs using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: Data on SISTs patients between 2000 and 2019 were obtained from the SEER database. Multiple imputation (MI) was employed to handle missing data, while propensity score matching (PSM) was conducted to mitigate selection bias in the comparative assessments between the LA group and the No-LA group. Kaplan-Meier analyses and multivariate Cox proportional hazards models were utilized to evaluate both overall survival (OS) and cancer-specific survival (CSS). RESULTS: A total of 2412 patients diagnosed with SISTs were included in the study, with 879 undergoing LA and 1533 not undergoing LA. There were no significant differences observed between the two cohorts concerning long-term OS (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.84-1.13, P = 0.720) and CSS (HR 1.05, 95% CI 0.86-1.29, P = 0.622). After PSM, 1596 patients (798 in the LA group and 789 in the No-LA group) were matched for comparison. There was also no difference in long-term OS and CSS between the two groups. Subgroup analysis revealed that in the age group > 60 years, the CSS in the No-LA group was superior to that in the LA group. Multivariate Cox regression analysis revealed that age, M stage, marital status, and mitotic rate are significant risk factors influencing OS and CSS. CONCLUSIONS: Conducting LA in patients with SISTs does not enhance long-term prognosis. For patients aged over 60 years, it may be more advisable to refrain from performing LA.
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Tumores del Estroma Gastrointestinal , Escisión del Ganglio Linfático , Programa de VERF , Humanos , Masculino , Femenino , Persona de Mediana Edad , Pronóstico , Anciano , Tumores del Estroma Gastrointestinal/cirugía , Tumores del Estroma Gastrointestinal/patología , Tumores del Estroma Gastrointestinal/mortalidad , Puntaje de Propensión , Intestino Delgado/patología , Intestino Delgado/cirugía , Estudios Retrospectivos , Adulto , Tasa de Supervivencia , Neoplasias Intestinales/cirugía , Neoplasias Intestinales/patología , Neoplasias Intestinales/mortalidad , Estimación de Kaplan-MeierRESUMEN
BACKGROUND: Liver metastasis (LIM) is the most common distant site of metastasis in small intestinal stromal tumors (SISTs). The aim of this study was to determine the risk and prognostic factors associated with LIM in patients with SISTs. METHODS: Patients diagnosed with gastrointestinal stromal tumors between 2010 and 2019 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression models, as well as a Cox regression model were used to explore the risk factors associated with the development and prognosis of LIM. Additionally, the overall survival (OS) of patients with LIM was analyzed using the Kaplan-Meier method. Furthermore, a predictive nomogram was constructed, and the model's performance was evaluated using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS: A total of 1582 eligible patients with SISTs were included, among whom 146 (9.2%) were diagnosed with LIM. Poor tumor grade, absence of surgery, later T-stage, and no chemotherapy were associated with an increased risk of developing LIM. The nomogram prediction model achieved an AUC of 0.810, 95% Confidence Interval (CI) 0.773-0.846, indicating good performance, and the calibration curve showed excellent accuracy in predicting LIM. The OS rate of patients with LIM was significantly lower than that of patients without LIM (p < 0.001). CONCLUSIONS: Patients with SISTs who are at high risk of developing LIM deserve more attention during follow-up, as LIM can significantly affect patient prognosis. The nomogram demonstrated good calibration and discrimination for predicting LIM.
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Neoplasias Intestinales , Neoplasias Hepáticas , Humanos , Pronóstico , Estudios Retrospectivos , Neoplasias Hepáticas/cirugía , Neoplasias Intestinales/cirugía , Bases de Datos Factuales , Nomogramas , Programa de VERFRESUMEN
BACKGROUND: To investigate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) semi-quantitative parameters, including the lesion diameter, maximum standardized uptake value (SUVmax), maximum standardized uptake value corrected for lean body mass (SULmax), metabolic lesion volume (MLV), and total lesion glycolysis (TLG), for classifying hepatic echinococcosis. METHODS: In total, 20 patients with 36 hepatic echinococcosis lesions were included in the study. Overall, these lesions were categorized as hepatic cystic echinococcosis (HCE) or hepatic alveolar echinococcosis (HAE) according to the pathological results. Multiple semi-parameters including the maximum diameter, SUVmax, SULmax, MLV, and TLG were measured to classify HCE and HAE compared with the pathological results. The receiver operator characteristic curve and area under the curve (AUC) of each quantitative parameter were calculated. The Mann-Whitney U test was used to compare data between the two groups. RESULTS: In total, 12 cystic lesions and 24 alveolar lesions were identified after surgery. There were significant differences in SUV max, SUL max, MLV, and TLG between the HAE and HCE groups (Z = - 4.70, - 4.77, - 3.36, and - 4.23, respectively, all P < 0.05). There was no significant difference in the maximum lesion diameter between the two groups (Z = - 0.77, P > 0.05). The best cutoffs of SUV max, SUL max, MLV, and TLG for the differential diagnosis of HAE and HCE were 2.09, 2.67, 27.12, and 18.79, respectively. The AUCs of the four parameters were 0.99, 0.99, 0.85, and 0.94, respectively. The sensitivities were 91.7%, 87.5%, 66.7%, and 85.6%, respectively, and the specificities were 90.1%, 91.7%, 83.3%, and 90.9%, respectively. CONCLUSION: 18F-FDG PET/CT semi-quantitative parameters had significant clinical value in the diagnosis and pathological classification of hepatic echinococcosis and evaluation of clinical treatment.
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Equinococosis Hepática , Fluorodesoxiglucosa F18 , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Masculino , Equinococosis Hepática/diagnóstico por imagen , Femenino , Adulto , Persona de Mediana Edad , Tibet , Anciano , Adulto Joven , Curva ROC , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: To assess the viability and efficiency of performing arthroscopic meniscoplasty in treating discoid meniscus (DM) in the knee joint. METHODS: A total of 29 patients diagnosed with symptomatic lateral DM between October 2014 and December 2019 were included in the study. Among them, 7 patients with intact DM underwent arthroscopic discoid meniscoplasty (group A), while 22 patients with torn DM received arthroscopic DM plasty along with repair and suturing (group B). Both Visual Analog Scale (VAS) score and Lysholm score assessments were conducted preoperatively and postoperatively. RESULT: The favorable and acceptable outcome rate was 85.71% in group A and 95.45% in group B (P > 0.05). The VAS scores post-operatively at each follow-up time point were consistently lower compared to pre-operative values, while the Lysholm knee function scores showed improvement. There were no significant differences in VAS score and Lysholm score between group A and group B at different stages (P > 0.05). Both surgical techniques (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) showed significant improvement in postoperative VAS score and Lysholm score, but there was no difference in outcomes between the two groups. CONCLUSION: Overall, the two surgical techniques studied in this study (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) produced similar results in terms of pain reduction and improved knee function.
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Artroscopía , Articulación de la Rodilla , Meniscos Tibiales , Humanos , Masculino , Femenino , Estudios Retrospectivos , Artroscopía/métodos , Adulto , Resultado del Tratamiento , Articulación de la Rodilla/cirugía , Articulación de la Rodilla/fisiopatología , Estudios de Seguimiento , Meniscos Tibiales/cirugía , Persona de Mediana Edad , Dimensión del Dolor , Lesiones de Menisco Tibial/cirugía , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: Acute kidney injury (AKI) represents a frequent and grave complication associated with acute pancreatitis (AP), substantially elevating both mortality rates and the financial burden of hospitalization. The aim of our study is to construct a predictive model utilizing automated machine learning (AutoML) algorithms for the early prediction of AKI in patients with AP. METHODS: We retrospectively analyzed patients who were diagnosed with AP in our hospital from January 2017 to December 2021. These patients were randomly allocated into a training set and a validation set at a ratio of 7:3. To develop predictive models for each set, we employed the least absolute shrinkage and selection operator (LASSO) algorithm along with AutoML. A nomogram was developed based on multivariate logistic regression analysis outcomes. The model's efficacy was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Additionally, the performance of the model constructed via AutoML was evaluated using decision curve analysis (DCA), feature importance, SHapley Additive exPlanations (SHAP) plots, and locally interpretable model-agnostic explanations (LIME). RESULTS: This study incorporated a total of 437 patients who met the inclusion criteria. Out of these, 313 were assigned to the training cohort and 124 to the validation cohort. In the training and validation cohorts, AKI occurred in 68 (21.7%) and 29(23.4%) patients, respectively. Comparative analysis revealed that the AutoML models exhibited enhanced performance over traditional logistic regression (LR). Furthermore, the deep learning (DL) model demonstrated superior predictive accuracy, evidenced by an area under the ROC curve of 0.963 in the training set and 0.830 in the validation set, surpassing other comparative models. The key variables identified as significant in the DL model within the training dataset included creatinine (Cr), urea (Urea), international normalized ratio (INR), etiology, smoking, alanine aminotransferase (ALT), hypertension, prothrombin time (PT), lactate dehydrogenase (LDH), and diabetes. CONCLUSION: The AutoML model, utilizing DL algorithm, offers considerable clinical significance in the early detection of AKI among patients with AP.
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Lesión Renal Aguda , Pancreatitis , Humanos , Enfermedad Aguda , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Aprendizaje Automático , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Estudios Retrospectivos , UreaRESUMEN
PURPOSE: This study systematically reviewed our team's research on the mechanism and assessment of liver fibrosis in BA, summarized our experience, and discussed the future development direction. METHODS: In this study, Pubmed and Wanfang databases were searched to collect the literature published by our team on the mechanisms of liver fibrosis in BA and the assessment of liver fibrosis in BA, and the above research results were systematically reviewed. RESULTS: A total of 58 articles were retrieved. Among the included articles, 25 articles related to the mechanism of liver fibrosis in BA, and five articles evaluated liver fibrosis in BA. This article introduces the key pathways and molecules of liver fibrosis in BA and proposes a new grading system for liver fibrosis in BA. CONCLUSIONS: The new BA liver fibrosis grading method is expected to assess children's conditions, guide treatment, and improve prognosis more accurately. In addition, we believe that the TGF-ß1 signaling pathway is the most important in the study of liver fibrosis in BA, and at the same time, the study of EMT occurrence in BA should also be deepened to resolve the controversy on this issue.
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Atresia Biliar , Cirrosis Hepática , Humanos , Atresia Biliar/complicaciones , Cirrosis Hepática/diagnóstico , Factor de Crecimiento Transformador beta1/metabolismo , PronósticoRESUMEN
Although family and school experiences play an important role in adolescents' adjustment during the transition to high school, most prior studies investigated the effects of these experiences in isolation; their joint implications for both adolescents' concurrent and long-term adjustment outcomes are less clear, and the potential role of individual characteristics within such associations remains understudied. Based on 525 10th graders (Mage = 15.48, SDage = 0.71, 43.6% boys) who participated in a longitudinal study, the present research aimed to identify distinct family and school experience profiles among first-year high school students and examine their associations with adolescents' internalizing problems and externalizing problems, both concurrently and 18 months later. Latent profile analysis revealed four distinctive profiles: thriving, low resources-moderate family risk, developmental stress-high parental conflicts, and developmental stress-high peer victimization profiles. The other three profiles (vs. the thriving profile) reported significantly higher levels of concurrent internalizing problems; while these differences diminished after 18 months. However, the enduring impacts of these profiles on internalizing problems persisted among adolescents with higher levels of environmental sensitivity. Additionally, adolescents characterized by two developmental stress profiles (vs. the thriving profile) exhibited significantly higher levels of externalizing problems both currently and longitudinally. Findings underscore the importance of identifying at-risk populations among adolescents during the transition to high school by including both family and school experiences when examining environmental influence on their adjustment, as well as the necessity to take individual environmental sensitivity into account when examining these associations.
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Conducta del Adolescente , Instituciones Académicas , Estudiantes , Humanos , Adolescente , Masculino , Femenino , Estudios Longitudinales , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Conducta del Adolescente/psicología , Adaptación Psicológica , Ajuste Social , Estrés Psicológico/psicología , Grupo Paritario , Acoso Escolar/psicología , Acoso Escolar/estadística & datos numéricos , Familia/psicologíaRESUMEN
PURPOSE: To determine the prevalent microbiological profile of biliary atresia (BA) patients at the time of its occurrence by studying their intestinal flora. METHODS: A total of 118 gut microbiota samples from three groups of 43 BA patients, 33 disease controls (DC) with other cholestatic diseases and 42 healthy controls (HC), were analyzed by deep mining of public data. Subsequently, a total of 23 fecal samples from three groups of clinically collected patients (11 BA, 6 DC and 6 HC) were sequenced for 16S rRNA gene amplification and analyzed for serum butyrate (BU) level by liquid chromatography. RESULTS: Taxonomic analysis revealed significant differences in the composition of the intestinal microbiota between BA patients and controls, with a reduction in diversity and a higher abundance of Proteobacteria, Streptococcus and Lactobacillus in the BA group. Database and clinical data analyses concluded that Streptococcus/Bacteroides (AUC = 0.9035, 95% CI 0.8347-0.9722, P < 0.0001) or Streptococcus/Eggerthella (AUC = 0.8333, 95% CI 0.6340-1.000, P = 0.027) was the best microbiota to differentiate between BA and DC. Serum butyrate levels were low in the BA and DC groups and differed from the HC group (P = 0.01, P = 0.04). Butyrate levels in BA were negatively correlated with jaundice clearance and cholangitis, but not statistically significant. CONCLUSIONS: Our study reveals changes in the composition of the gut microbiota in BA, especially the butyrate-producing microbiota, and suggests the potential for using gut microbiota as a noninvasive diagnostic benefit for BA. Low levels of serum butyrate in BA may indicate a poor prognosis.
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Atresia Biliar , Microbioma Gastrointestinal , Niño , Humanos , Microbioma Gastrointestinal/genética , Butiratos , Pronóstico , ARN Ribosómico 16SRESUMEN
BACKGROUND: Controversy surrounds the indications for endoscopic treatment (ET) versus surgery in addressing gastrointestinal neuroendocrine neoplasms (GI-NENs). This paper aims to compare the long-term survival prognosis between ET and surgery for patients with GI-NENs. METHODS: A retrospective analysis of GI-NEN patients diagnosed between 2000 and 2020 was conducted using the SEER database. Overall survival (OS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Prognostic factors were assessed through univariate and multivariate Cox regression analyses. Propensity score matching (PSM) was employed to adjust for clinical variables. RESULTS: This study encompassed 12,016 patients with GI-NENs, with 3732 patients (31.1%) undergoing ET and 8284 patients (68.9%) opting for surgery. The rectum was the most frequent location for ET, while the small bowel was the predominant site for surgery. Both the ET and surgical groups exhibited similar overall survival risk and cancer-specific survival risk before and after matching. No significant differences in the 1-year, 3-year, 5-year, and 10-year OS and CSS rates were observed between the ET and surgery groups after PSM. Nevertheless, subgroup analysis revealed a significantly better CSS in the ET group than the surgery group, particularly in stage I and tumors sized <10mm ( P <0.01). In the colon subgroup, the OS and CSS of the ET group were superior to those of the surgery group ( P <0.05). CONCLUSION: Endoscopic treatment and surgery demonstrate comparable long-term survival prognoses for treating GI-NENs. ET emerges as a viable option for patients averse to surgical interventions.
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Neoplasias Gastrointestinales , Tumores Neuroendocrinos , Humanos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Tumores Neuroendocrinos/cirugía , Tumores Neuroendocrinos/mortalidad , Neoplasias Gastrointestinales/cirugía , Neoplasias Gastrointestinales/mortalidad , Anciano , Endoscopía Gastrointestinal/métodos , Puntaje de Propensión , Adulto , Tasa de Supervivencia , Pronóstico , Programa de VERF , Resultado del TratamientoRESUMEN
Background: Liver metastases from cancer of unknown primary (CUPL) constitute a rare disease, particularly among individuals younger than 50 years old. This paper aims to investigate the clinical characteristics of patients with CUPL and analyze prognostic differences across distinct age groups. Methods: Data pertaining to patients with CUPL were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was employed to adjust for clinical variables. Cox regression analysis identified risk factors influencing overall survival (OS), while competing-risk analyses were conducted to determine prognostic factors for cancer-specific survival (CSS). Survival differences were compared using the Kaplan-Meier method and cumulative incidence function (CIF). Results: The study encompassed 4,691 patients, with 319 (6.8%) in the age <50 years group and 4,372 (93.2%) in the age ≥50 years group. Individuals with unexplained liver metastases exhibited a 1-year OS rate of 14.7% and a 1-year CSS rate of 23%. Following matching, age, histology, brain metastases, and chemotherapy were identified as independent prognostic factors affecting OS. Additionally, race, grade, histology, brain metastases, and chemotherapy were recognized as independent prognostic factors influencing CSS. Notably, the age <50 years group demonstrated superior OS and CSS compared to the age ≥50 years group before and after PSM. Among patients undergoing chemotherapy, the age <50 years group exhibited enhanced OS and CSS compared to their age ≥50 years counterparts. Furthermore, in individuals subjected to radiotherapy, the age <50 years group demonstrated superior OS, although no significant difference in CSS was observed. Conclusions: The survival prognosis of patients with CUPL was found to be poor. However, both OS and CSS were more favorable in the age <50 years group compared to the age ≥50 years group. Additionally, radiotherapy and chemotherapy were associated with an OS benefit for patients in the age <50 years group.
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There is a robust association between friendship quality and victimization in adolescence; yet, it remains unclear whether friendship quality may be linked causally with different forms of victimization in middle adolescence. To fill this gap, this study examines the bidirectional associations of friendship quality and relational/verbal victimization with data collected at two time points, 6 months apart, in a sample of 671 middle Chinese adolescents (Mage = 15.63, SDage = 0.73, 49% males). Cross-lagged panel analyses revealed a two-way relationship between friendship quality and victimization, which existed in both verbal and relational victimization. Multi-group panel analyses observed that the cross-lagged associations between friendship quality and relational/verbal victimization were only found for males, but not for females. This result suggests that adolescent males' victimization is both affected by and a predictor of friendship quality, with implications for youth prevention programs.
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Conducta del Adolescente , Acoso Escolar , Víctimas de Crimen , Masculino , Femenino , Humanos , Adolescente , Lactante , Amigos , Grupo Paritario , Estudios LongitudinalesRESUMEN
Gastrointestinal stromal tumors (GISTs) are a rare type of tumor that can develop liver metastasis (LIM), significantly impacting the patient's prognosis. This study aimed to predict LIM in GIST patients by constructing machine learning (ML) algorithms to assist clinicians in the decision-making process for treatment. Retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database, and cases from 2010 to 2015 were assigned to the developing sets, while cases from 2016 to 2017 were assigned to the testing set. Missing values were addressed using the multiple imputation technique. Four algorithms were utilized to construct the models, comprising traditional logistic regression (LR) and automated machine learning (AutoML) analysis such as gradient boost machine (GBM), deep neural net (DL), and generalized linear model (GLM). We evaluated the models' performance using LR-based metrics, including the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA), as well as AutoML-based metrics, such as feature importance, SHapley Additive exPlanation (SHAP) Plots, and Local Interpretable Model Agnostic Explanation (LIME). A total of 6207 patients were included in this study, with 2683, 1780, and 1744 patients allocated to the training, validation, and test sets, respectively. Among the different models evaluated, the GBM model demonstrated the highest performance in the training, validation, and test cohorts, with respective AUC values of 0.805, 0.780, and 0.795. Furthermore, the GBM model outperformed other AutoML models in terms of accuracy, achieving 0.747, 0.700, and 0.706 in the training, validation, and test cohorts, respectively. Additionally, the study revealed that tumor size and tumor location were the most significant predictors influencing the AutoML model's ability to accurately predict LIM. The AutoML model utilizing the GBM algorithm for GIST patients can effectively predict the risk of LIM and provide clinicians with a reference for developing individualized treatment plans.
Asunto(s)
Tumores del Estroma Gastrointestinal , Neoplasias Hepáticas , Aprendizaje Automático , Programa de VERF , Humanos , Tumores del Estroma Gastrointestinal/patología , Neoplasias Hepáticas/secundario , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Pronóstico , Adulto , Algoritmos , Curva ROC , Neoplasias Gastrointestinales/patologíaRESUMEN
The progression of atherosclerosis (AS), the pathological foundation of coronary artery disease (CAD), is featured by massive lipid deposition in the vessel wall. LncRNAs are implicated in lipid disorder and AS, whereas the specific role of lncRNA DANCR in atherogenesis remains unknown. Here, we demonstrated that DANCR promotes macrophage lipid accumulation by regulating the expression of membrane cholesterol transport proteins. qPCR showed that compared to control groups, CAD patients and atherosclerotic mice had higher DANCR levels. Treating human THP-1 macrophages and mouse RAW264.7 macrophages with ox-LDL significantly upregulated the expression levels of DANCR. Oil Red O staining showed that the silence of DANCR robustly reduced, while overexpression of DANCR significantly increased the numbers and size of lipid droplets in ox-LDL-treated THP-1 macrophages. In contrast, the opposite phenomena were observed in DANCR overexpressing cells. The expression of ABCA1, ABCG1, SR-BI, and NBD-cholesterol efflux was increased obviously by DANCR inhibition and decreased by DANCR overexpression, respectively. Furthermore, transfection with DANCR siRNA induced a robust decrease in the levels of CD36, SR-A, and Dil-ox-LDL uptake, while DANCR overexpression amplified the expression of CD36, SR-A and the uptake of Dil-ox-LDL in lipid-laden macrophages. Lastly, we found that the effects of DANCR on macrophage lipid accumulation and the expression of membrane cholesterol transport proteins were not likely related to miR-33a. The present study unraveled the adverse role of DANCR in foam cell formation and its relationship with cholesterol transport proteins. However, the competing endogenous RNA network underlying these phenomena warrants further exploration.
RESUMEN
Triple-negative breast cancer (TNBC) stands out as the most aggressive subtype within the spectrum of breast cancer. The current clinical guidelines propose treatment strategies involving cytotoxic agents like epirubicin or paclitaxel. However, the emergence of acquired resistance frequently precipitates secondary tumor recurrence or the spread of metastasis. In recent times, significant attention has been directed toward the transcription factor RUNX2, due to its pivotal role in both tumorigenesis and the progression of cancer. Previous researches suggest that RUNX2 might be intricately linked to the development of resistance against chemotherapy, with its mechanism of action possibly intertwined with the signaling of TGF-ß. Nevertheless, the precise interplay between their effects and the exact molecular mechanisms underpinning chemoresistance in TNBC remain elusive. Therefore, we have taken a multifaceted approach from in vitro and in vivo experiments to validate the relationship between RUNX2 and TGF-ß and to search for their pathogenic mechanisms in chemoresistance. In conclusion, we found that RUNX2 affects chemoresistance by regulating cancer cell stemness through direct binding to TGF-ß, and that TGF-ß dually regulates RUNX2 expression. The important finding will provide a new reference for clinical reversal of the development of chemoresistance in breast cancer.