The enhanced connectivity between the frontoparietal, somatomotor network and thalamus as the most significant network changes of chronic low back pain.

The prolonged duration of chronic low back pain (cLBP) inevitably leads to changes in the cognitive, attentional, sensory and emotional processing brain regions. Currently, it remains unclear how these alterations are manifested in the interplay between brain functional and structural networks. This study aimed to predict the Oswestry Disability Index (ODI) in cLBP patients using multimodal brain magnetic resonance imaging (MRI) data and identified the most significant features within the multimodal networks to aid in distinguishing patients from healthy controls (HCs). We constructed dynamic functional connectivity (dFC) and structural connectivity (SC) networks for all participants (n = 112) and employed the Connectome-based Predictive Modeling (CPM) approach to predict ODI scores, utilizing various feature selection thresholds to identify the most significant network change features in dFC and SC outcomes. Subsequently, we utilized these significant features for optimal classifier selection and the integration of multimodal features. The results revealed enhanced connectivity among the frontoparietal network (FPN), somatomotor network (SMN) and thalamus in cLBP patients compared to HCs. The thalamus transmits pain-related sensations and emotions to the cortical areas through the dorsolateral prefrontal cortex (dlPFC) and primary somatosensory cortex (SI), leading to alterations in whole-brain network functionality and structure. Regarding the model selection for the classifier, we found that Support Vector Machine (SVM) best fit these significant network features. The combined model based on dFC and SC features significantly improved classification performance between cLBP patients and HCs (AUC=0.9772). Finally, the results from an external validation set support our hypotheses and provide insights into the potential applicability of the model in real-world scenarios. Our discovery of enhanced connectivity between the thalamus and both the dlPFC (FPN) and SI (SMN) provides a valuable supplement to prior research on cLBP.

Hoffmann's sign in cervical spondylotic myelopathy patients: pathological insights from neuroimaging.

OBJECTIVE: Hoffmann's sign testing is a commonly used physical examination in clinical practice for patients with cervical spondylotic myelopathy (CSM). However, the pathophysiological mechanisms underlying its occurrence and development have not been thoroughly investigated. Therefore, the present study aimed to explore whether a positive Hoffmann's sign (PHS) in CSM patients is associated with spinal cord and brain remodeling and to identify potential neuroimaging biomarkers with diagnostic value. METHODS: Seventy-six patients with CSM and 40 sex- and age-matched healthy controls (HCs) underwent multimodal MRI. Based on the results of the Hoffmann's sign examination, patients were divided into two groups: those with a PHS (n = 38) and those with a negative Hoffmann's sign (NHS; n = 38). Quantification of spinal cord and brain structural and functional parameters of the participants was performed using various methods, including functional connectivity analysis, voxel-based morphometry, and atlas-based analysis based on functional MRI and structural MRI data. Furthermore, this study conducted a correlation analysis between neuroimaging metrics and neurological function and utilized a support vector machine (SVM) algorithm for the classification of PHS and NHS. RESULTS: In comparison with the NHS and HC groups, PHS patients exhibited significant reductions in the cross-sectional area and fractional anisotropy (FA) of the lateral corticospinal tract (CST), reticulospinal tract (RST), and fasciculus cuneatus, concomitant with bilateral reductions in the volume of the lateral pallidum. The functional connectivity analysis indicated a reduction in functional connectivity between the left lateral pallidum and the right angular gyrus in the PHS group. The correlation analysis indicated a significant positive association between the CST and RST FA and the volume of the left lateral pallidum in PHS patients. Furthermore, all three variables exhibited a positive correlation with the patients' motor function. Finally, using multimodal neuroimaging metrics in conjunction with the SVM algorithm, PHS and NHS were classified with an accuracy rate of 85.53%. CONCLUSIONS: This research revealed a correlation between structural damage to the pallidum and RST and the presence of Hoffmann's sign as well as the motor function in patients with CSM. Features based on neuroimaging indicators have the potential to serve as biomarkers for assessing the extent of neuronal damage in CSM patients.

Evaluating the implementation of the SWITCH® school wellness intervention and capacity-building process through multiple methods.

BACKGROUND: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. METHODS: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). RESULTS: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed non-significant associations between implementation group and gains in school capacity (F [2, 24] = 1.63; p = .21), class capacity (F [2, 24]=0.20 p = .82), lunchroom capacity (F [2, 24]=0.29; p = .78), and physical education (F [2, 24]=1.45; p = .25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. CONCLUSIONS: The results from this implementation study document the importance of allowing schools to adapt programming to meet their local needs, and highlight the strengths of measuring multiple implementation outcomes. Increased support is needed for schools regarding the formation and improvement of wellness policies as a means to enhance sustainability over time.

Effects of cardiorespiratory fitness and weight status on knowledge of physical activity and fitness, attitude toward physical education, and physical activity.

BACKGROUND: The purpose of this study was to examine the effects of cardiorespiratory fitness and weight status on knowledge of physical activity and fitness (PAF knowledge), attitude toward physical education (PE), and physical activity. METHODS: A total of 343 middle school students participated in the study (Age: M/SD = 12.76/.94, ranging from 11 to 14 years old). PE Metrics™ was used to measure PAF knowledge, and Attitude toward Physical Education Questionnaire and Youth Activity Profile were used to measure attitude, physical activity and sedentary behavior. Fitness and weight status were assessed using FitnessGram and converted to in Healthy Fitness Zone (HFZ) or Not in HFZ. RESULTS: Two-way multivariate analyses of covariance (MANCOVA; gender and grade as covariates) showed a significant group effect for cardiorespiratory fitness (ΛPilla = .07, F4,255 = 5.03, p = .001, [Formula: see text] = .07) but not for weight status (p = .57). PAF knowledge (F1,258 = 9.49, p < .01, [Formula: see text]= .04), attitude (F1,258 = 4.45, p < .05, [Formula: see text]= .02) and sedentary behavior (F1,258 = 6.89, p < .01, [Formula: see text]= .03) all favored the HFZ group. CONCLUSIONS: The findings reinforce the importance of promoting cardiorespiratory fitness in middle school PE as students acquire attitude, knowledge, and behaviors needed for active-living.

Feasibility study of the SWITCH implementation process for enhancing school wellness.

BACKGROUND: There is a need to identify strategies that enhance the implementation of evidence-based school wellness intervention programs in real-world settings. The present study evaluates the feasibility of empowering school wellness leaders to deliver an evidence-based, childhood obesity-prevention program called Switch ™. We specifically evaluated the feasibility of a new implementation framework, based on the robust Healthy Youth Places framework, to increase capacity of school leaders to lead school wellness programming. METHODS: The SWITCH (School Wellness Integration Targeting Child Health) implementation process was evaluated in a convenience sample of eight Iowa elementary schools. Teams of three leaders from each school attended an in-person school wellness conference followed by five online webinar sessions delivered by two SWITCH team members. The capacity-building and quality improvement process was designed to empower schools to lead wellness change using methods and concepts from the original 16-week Switch ™ program. School wellness leaders completed checklists on two occasions to assess overall school-level implementation as well as setting-level changes in physical education, classrooms, and the lunchroom. Student acceptability of SWITCH was evaluated by the degree of behavior tracking using an online SWITCH Tracker system that promoted self-monitoring. School acceptability and practicality were assessed through an exit survey completed by school leaders. RESULTS: All school staff reported satisfaction with the SWITCH implementation process. Reports of school- and setting-level implementation were relatively high (2.0 to 2.8 on a 3-point scale) but student engagement, based on use of the online tracking system, varied greatly over time and across schools. Three high implementation schools had average tracking rates exceeding 70% (range: 72-90%) while three low implementation schools had rates lower than 30% (range = 0-23%). CONCLUSIONS: This feasibility study supports the utility of the new implementation framework for promoting school and student engagement with SWITCH. Further testing regarding effectiveness and scale-up of this evidence-based school wellness intervention program is warranted.

Experiment and Numerical Simulation on Gas-Liquid Annular Flow through a Cone Sensor.

The cone meter has been paid increasing attention in wet gas measurement, due to its distinct advantages. However, the cone sensor, which is an essential primary element of the cone meter, plays a role in the measurement of wet gas flow that is important, but not fully understood. In this article, we investigate the gas-liquid annular flow through a cone sensor by experiment and numerical simulation. Emphasis is put on the influences of pressure recovery characteristics and flow structure, and how they are affected by the cone sensor. The results show that the vortex length is shortened in gas-liquid annular flow, compared with that in single-phase gas flow. The pressure recovery length is closely related with the vortex length, and shorter vortex length leads to shorter pressure recovery length. The gas-liquid distribution suggests that flow around the apex of back-cone is very stable, little liquid is entrained into the vortex, and no liquid appears around the low pressure tapping, which makes a more stable pressure at the apex of cone sensor feasible. This finding highlights the importance of obtaining the low pressure from the back-cone apex, which should be recommended in the multiphase flow measurement. Our results may help to guide the optimization of the cone sensor structure in the wet gas measurement.

Development and validation of an energy-balance knowledge test for fourth- and fifth-grade students.

A valid test measuring children's energy-balance (EB) knowledge is lacking in research. This study developed and validated the energy-balance knowledge test (EBKT) for fourth and fifth grade students. The original EBKT contained 25 items but was reduced to 23 items based on pilot result and intensive expert panel discussion. De-identified data were collected from 468 fourth and fifth grade students enrolled in four schools to examine the psychometric properties of the EBKT items. The Rasch model analysis was conducted using the Winstep 3.65.0 software. Differential item functioning (DIF) analysis flagged 1 item (item #4) functioning differently between boys and girls, which was deleted. The final 22-item EBKT showed desirable model-data fit indices. The items had large variability ranging from -3.58 logit (item #10, the easiest) to 1.70 logit (item #3, the hardest). The average person ability on the test was 0.28 logit (SD = .78). Additional analyses supported known-group difference validity of the EBKT scores in capturing gender- and grade-based ability differences. The test was overall valid but could be further improved by expanding test items to discern various ability levels. For lack of a better test, researchers and practitioners may use the EBKT to assess fourth- and fifth-grade students' EB knowledge.

Investigating elementary school children's daily physical activity and sedentary behaviours during weekdays.

The purpose of the study was to quantify the contributions of physical education, exergaming (active video games that also are a type of exercise), recess, lunch break and after-school time segments to children's daily physical activity and sedentary behaviours. Participants were 138 second and third graders (71 girls) who attended 20-min recess and 75-min lunch time daily, 25-min regular physical education or exergaming-based classes being alternated daily. The after-school period was defined as 3:20-10:00pm. Physical activity was assessed via accelerometry and the dependent variables were children's time spent in moderate-to-vigorous physical activity (MVPA), light physical activity and sedentary behaviour. Children's percentages of time spent in MVPA (P < .001; except for the difference between exergaming and lunch break: P = .63), light physical activity (P < .001) and sedentary behaviour (P < .001) differed significantly across the time segments (i.e., physical education/exergaming, recess, lunch break and after-school). Additionally, children accumulated significantly more MVPA (t = 10.22, P < .001) but less light physical activity (t = -3.17, P = .002) and sedentary behaviour (t = -3.91, P < .001) in physical education than in exergaming. Overall, physical education was more effective in generating MVPA than other segments over the school day. The after-school segment holds potential as an avenue for promoting children's MVPA, as this long period could be better utilised to organise structured physical activity.

SHP2 and UGP2 are Biomarkers for Progression and Poor Prognosis of Gallbladder Cancer.

Biomarkers for the diagnosis, prognosis, and targeting therapy of gallbladder cancers are not clinically available. This study demonstrated that the percentage of cases with positive SHP2 and UGP2 expression significantly correlated with the percentage of cases with positive vimentin, ß-catenin, MMP2, MMP9, and Ki-67 expression, large tumor size, high TNM stage, lymph node metastasis, and survival in patients with adenocarcinomas and squamous cell/adenosquamous carcinomas. Positive SHP2 and UGP2 expression are independent poor-prognostic factors in both types of tumors. Our study suggested that positive SHP2 and UGP2 expression correlated with clinicopathological and biological behaviors, and poor-prognosis of gallbladder cancer.

Relationships between County Health Rankings and child overweight and obesity prevalence: a serial cross-sectional analysis.

BACKGROUND: The County Health Rankings (CHR) system provides health rankings for U.S. counties. These factors may have utility for evaluating and predicting health outcomes. This study examined the association between CHR factors and the prevalence of child overweight/obesity (OWOB) in the state of Pennsylvania over 3 years. METHODS: The prevalence of childhood OWOB was obtained for all Pennsylvania school districts for the 2009-10 through 2011-12 school years. Correlational and inferential statistical analyses were used to examine the associations between the prevalence of OWOB in grades K-6 (OWOB1) and 7-12 (OWOB2) and z-score for the overall CHR Health Factors rank, as well as for individual predictive factors (Health Behaviors, Clinical Care, Social and Economic Factors and Physical Environment). RESULTS: Low to moderate correlations (0.29-0.43) were found between OWOB1 and CHR factors. Weaker and less consistent correlations were found for adolescents. There was a significantly higher prevalence of OWOB in counties with poorer CHR scores. CONCLUSIONS: County-level adult indicators of health are significantly associated with levels of child obesity. Future studies should examine the relationship between CHR and other health outcomes.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

Tracking energy balance in adolescents: Levels of compliance, energy flux, and learning.

BACKGROUND/OBJECTIVE: Advancing knowledge about energy balance (EB) is important for helping to reverse the obesity epidemic in many modern societies. This study examined adolescents' experience and perception of using an objective self-monitoring tool (SenseWear armband; SWA) and a portable diet journal to track EB for 7 days. METHODS: Forty-five 6th grade students in a midwestern state of the United States [Caucasian: n = 34, 76%; age: 11.7 ± 1.8 years; body mass index (BMI): 20.84 ± 3.94] participated in the study. The SWA, diet journal, and semistructured individual interview were used to measure energy expenditure (EE) and physical activity (PA), energy intake (EI), and perception of the experience, respectively. Mixed methods were used to analyze quantitative and qualitative data. RESULTS: It was found that the participants were physically active over the week (moderate-to-vigorous PA: 218.06 ± 26.50 minutes per day). Both SWA (% of wearing time: 85 ± 5%) and diet journal (days of using: 5.58 ± 2.15 days), especially the latter, were found to be under-used. A conceptual model depicting the adolescents' experience and perception was established based on the results. CONCLUSION: The study indicates that the majority of adolescents were able to effectively use the SWA and the diet journal to track EB over time. Qualitative observations revealed that tracking EI and EE with these tools provided a valuable, experiential way for youth to learn about EB. The findings support the continued exploration of self-monitoring EB for promoting knowledge and awareness about EB among adolescents.

Paxillin and carbonic anhydrase IX are prognostic markers in gallbladder squamous cell/adenosquamous carcinomas and adenocarcinomas.

AIMS: Squamous cell/adenosquamous carcinomas (SC/ASC) are rare subtypes of gallbladder cancers (GBCs). Clinical characteristics of SC/ASC have not been well documented, and no biological markers of GBC carcinogenesis, progression and prognosis are available. METHODS AND RESULTS: We measured paxillin and CAIX expression in 46 SC/ASCs and 80 adenocarcinomas (ACs) with immunohistochemistry and correlated these data with clinicopathological characteristics. Both paxillin expression and CAIX expression were associated significantly with larger tumours, a higher tumour-node-metastasis (TNM) stage, lymph node metastasis and invasiveness of SC/ASC and AC. Univariate Kaplan-Meier analysis confirmed that paxillin and CAIX expression were associated closely with decreased overall survival in SC/ASC (both P < 0.001) and AC (both P < 0.001). Multivariate Cox regression analysis confirmed that paxillin expression and CAIX expression both independently predicted poor prognosis in SC/ASC and AC patients. We also noted correlations with survival and tumour differentiation, tumour size, TNM stage, lymph node metastasis, tumour invasiveness and sample procurement methods. CONCLUSIONS: Paxillin expression and CAIX expression are both related to clinical/biological behaviour and poor prognosis of GBC.

A comparative study of clinicopathological significance, FGFBP1, and WISP-2 expression between squamous cell/adenosquamous carcinomas and adenocarcinoma of the gallbladder.

BACKGROUND: The differences in clinical, pathological, and biological characteristics between adenocarcinoma (AC) and squamous cell/adenosquamous carcinoma (SC/ASC) of gallbladder cancer have not been well documented. This study is to compare the clinicopathological characteristics and FGFBP1 and WISP-2 expression between AC and SC/ASC patients. METHODS: We examined FGFBP1 and WISP-2 expression in 46 SC/ASC and 80 AC samples using immunohistochemistry and analyzed their correlations with clinicopathological characteristics. RESULTS: SC/ASCs occur more frequently in older patients and often correspond to larger tumor masses than ACs. Positive FGFBP1 and negative WISP-2 expression were significantly associated with lymph node metastasis and invasion of SC/ASCs and ACs. In addition, positive FGFBP1 and negative WISP-2 expression were significantly associated with differentiation and TMN stage in ACs. Univariate Kaplan-Meier analysis showed that either elevated FGFBP1 (p < 0.001) or lowered WISP-2 (p < 0.001) expression was closely associated with decreased overall survival in both SC/ASC and AC patients. Multivariate Cox regression analysis showed that positive FGFBP1 expression (p = 0.001) or negative WISP-2 expression (p = 0.035 for SC/ASC and p = 0.009 for AC) is an independent predictor of poor prognosis in both SC/ASC and AC patients. We also revealed that differentiation, tumor size, TNM stage, lymph node metastasis, invasion, and surgical procedure were associated with survival of both SC/ASC and AC patients. CONCLUSION: Our study suggested that the overexpression of FGFBP1 or loss of WISP-2 expression is closely related to the metastasis, invasion and poor prognosis of gallbladder cancer.

The contributing role of physical education in youth's daily physical activity and sedentary behavior.

BACKGROUND: School physical education (PE) is considered as an effective channel for youth to accumulate moderate-to-vigorous physical activity (MVPA) and reduce sedentary time. The purpose of this study was to determine the contributing role of PE in daily MVPA and sedentary time among youth. METHODS: The study recruited 67 sixth grade children (29 boys; Mean age = 11.75) from two suburban schools at a U.S. Midwest state, 48 of whom contributed ≥10 hours of physical activity (PA) data per day were included for analysis. An objective monitoring tool (i.e., Sensewear armband monitor) was used to capture the participants' MVPA and sedentary time for 7-14 days. Pearson product-moment correlation analysis (r), multi-level regression analyses, and analysis of variance were conducted for data analysis. RESULTS: MVPA and sedentary time in PE showed significant positive associations with daily MVPA and sedentary time, respectively (r = 0.35, p < 0.01; r = 0.55, p < 0.01). Regression analyses revealed that one minute increase in MVPA and sedentary behavior in PE was associated with 2.04 minutes and 5.30 minutes increases in daily MVPA and sedentary behavior, respectively, after controlling for sex and BMI. The participants demonstrated a significantly higher level of MVPA (p = .05) but similar sedentary time (p = 0.61) on PE days than on non-PE days. Boys had significantly more daily MVPA (p < .01) and less sedentary time (p < .01) than girls; while higher BMI was associated with more sedentary time (p < .01). CONCLUSIONS: PE displayed a positive contribution to increasing daily MVPA and decreasing daily sedentary time among youth. Active participation in PE classes increases the chance to be more active and less sedentary beyond PE among youth.

Fitness promotion in college: the relationships among students' perceived physical literacy, knowledge, and physical fitness.

Purpose: The purpose of this study was to examine the relationships among perceived physical literacy (PPL), knowledge of physical activity and fitness (PAF knowledge), and physical fitness. Methods: Undergraduates (N = 968, female = 414; Mage = 18.64) from a public university in central China completed a simplified Chinese version of the PPL instrument, an online test for PAF knowledge, and seven health-related physical fitness tests. The PPL includes three dimensions: (a) confidence and physical competence, (b) motivation, and (c) interaction with the environment. The fitness tests measured lung capacity, body mass index (BMI), and performances in 800 (female)/1000 (male) meters run, 50 meters dash (50 M), sit-up (female) / pull-up (male), standing long jump (SLJ), and sit-and-reach. Results: PPL and its dimensions significantly predicted six fitness test performances both in male (ß: -0.42 - 0.37; p < 0.01-0.05; R2: 0.01-0.13) and female (ß: -0.59 - 0.49; p < 0.01-0.05; R2: 0.03-0.13) students. PAF knowledge (ß: -0.17 - 0.18; p < 0.01-0.05; R2: 0.01-0.05) significantly predicted BMI (males) and performances in 50 M (females) and SLJ (females) tests. Conclusion: To support college students' fitness development and maintenance, tailored physical activity and fitness promotion programs are needed to strengthen students' PPL and PAF knowledge.

Contribution of changes in the spinal cord and brain to the onset and progression of hand clumsiness symptoms in cervical spondylotic myelopathy.

OBJECTIVE: Cervical spondylotic myelopathy (CSM) stands as the most prevalent form of spinal cord injury, frequently prompting various changes in both the brain and spinal cord. However, the precise nature of these changes within the brains and spinal cords of CSM patients experiencing hand clumsiness (HCL) symptoms has remained elusive. The authors aimed to scrutinize these alterations and explore potential links between these changes and the onset of HCL symptoms. METHODS: Using the modified Japanese Orthopaedic Association (mJOA) scale, the authors classified CSM patients into two groups: those without HCL and those with HCL. The authors performed voxel-wise z-score transformation amplitude of low-frequency fluctuations (zALFF) and resting-state functional connectivity (FC) evaluations in the brain. Additionally, they used the Spinal Cord Toolbox to calculate the fractional anisotropy (FA) of spinal cord tracts. The analysis also encompassed an examination of the correlation of these measures with improvements in mJOA scores. RESULTS: Significant disparities in zALFF values surfaced in the right calcarine, right cuneus, right precuneus, right middle occipital gyrus (MOG), right superior occipital gyrus (SOG), and right superior parietal gyrus (SPG) between healthy controls (HC), patients without HCL, and patients with HCL, primarily within the visual cortex. In the patient group, patients with HCL displayed reduced FC between the right calcarine, right MOG, right SOG, right SPG, right SFG, bilateral MFG, and left median cingulate and paracingulate gyri when compared with patients without HCL. Moreover, significant differences in FA values of the corticospinal tract (CST) and reticulospinal tract (REST) at the C2 level emerged among HC, patients without HCL, and patients with HCL. Notably, zALFF, FC, and FA values in specific brain regions and spinal cord tracts exhibited correlations with mJOA upper-extremity scores. Additionally, FA values of the CST and REST correlated with zALFF values in the right calcarine, right MOG, right SOG, and right SPG. CONCLUSIONS: Alterations within brain regions associated with the visual cortex, the fronto-parietal-occipital attention network, and spinal cord pathways appear to play a substantial role in the emergence and progression of HCL symptoms. Furthermore, the existence of a potential connection between the spinal cord and the brain suggests that this link might be related to the clinical symptoms of CSM.

ILK and PRDX1 are prognostic markers in squamous cell/adenosquamous carcinomas and adenocarcinoma of gallbladder.

Although the incidence of gallbladder cancers is low, they are highly aggressive tumors. Squamous cell/adenosquamous carcinoma (SC/ASC) is a rare subtype of gallbladder cancer. The clinical characteristics of SC/ASC have not been well documented, and no prognosis marker has been identified. In this study, we examined integrin-linked kinase (ILK) and peroxiredoxin-1 (PRDX1) expression in 46 SC/ASCs and 80 adenocarcinomas (ACs) by using immunohistochemistry and analyzed their correlations with clinicopathological characteristics. We demonstrated that positive ILK and PRDX1 expressions were significantly associated with large tumor size, high TNM stage, lymph node metastasis, and invasion of SC/ASC and AC. Univariate Kaplan-Meier analysis showed that positive ILK and PRDX1 expressions were closely associated with decreased overall survival in both SC/ASC (p < 0.001 and p = 0.005, respectively) and AC (p < 0.001) patients. Multivariate Cox regression analysis showed that positive ILK and PRDX1 expressions were an independent poor prognostic predictor in both SC/ASC and AC patients. We also revealed a similar significance of differentiation, tumor size, TNM stage, lymph node metastasis, invasion, and surgical curability with survival in SC/ASC and AC patients. Our study suggested that positive ILK and PRDX1 expressions are closely related to the progression and poor prognosis of gallbladder cancer.

CFL1 and Arp3 are biomarkers for metastasis and poor prognosis of squamous cell/adenosquamous carcinomas and adenocarcinomas of gallbladder.

Cofilin-1 (CFL1) and Arp3 expression in 46 squamous cell and adenosquamous carcinomas (SC/ASCs) and 80 adenocarcinomas (ACs) were measured by using immunohistochemistry. Positive CFL1 and Arp3 expression were significantly associated with large tumor size, high TNM stage, lymph node metastasis, and decreased overall survival in both SC/ASC and AC patients (p < .001). Multivariate Cox regression analysis showed that positive CFL1 and Arp3 expression are independent poor-prognostic factors for both SC/ASC and AC patients. Our study suggested that positive CFL1 and Arp3 expression are closely related to tumor progression, metastasis, and poor prognosis of gallbladder cancer.

Clinicopathological features and CCT2 and PDIA2 expression in gallbladder squamous/adenosquamous carcinoma and gallbladder adenocarcinoma.

BACKGROUND: Gallbladder cancer (GBC) is a relatively uncommon carcinoma among gastrointestinal cancers and usually has a rather poor prognosis. The most common subtype of GBC is adenocarcinoma (AC), which accounts for about 90% of GBC. Squamous carcinoma/adenosquamous carcinoma (SC/ASC) are comparatively rare histopathological subtypes of GBC. The clinicopathological features and biological behaviors of SC/ASC have not been well-characterized. No molecular biomarkers are currently available for predicting the progression, metastasis, and prognosis of the SC/ASC subtype of GBC. METHODS: We examined the expression levels of CCT2 and PDIA3 by immunohistochemistry (IHC) staining in human GBC tissue samples collected from 46 patients with SC/ASC and evaluated the clinicopathological significance of both CCT2 and PDIA3 expression in the SC/ASC subtypes of GBC by Kaplan-Meier analysis and multivariate Cox regression analysis. For comparison, we included specimens from 80 AC patients in our study to investigate the specificity of CCT2 and PDIA3 expression in GBC subtypes. RESULTS: We found that the positive expression of CCT2 and PDIA3 was significantly associated with clinicopathological features of both SC/ASC and AC specimens, including high TNM stage and lymph node metastasis. Univariate analysis revealed that the two-year survival rate was significantly lower for patients with positive expression of CCT2 and PDIA3 than for those with negative expression. Multivariate analysis also indicated that the positive expression of CCT2 and PDIA3 was negatively correlated with poor postoperative patient survival and positively correlated with high mortality. CONCLUSIONS: Our study suggests that positive expression of CCT2 or PDIA3 is associated with tumor progression and the clinical behavior of gallbladder carcinoma. Therefore, CCT2 and PDIA3 could be potentially important diagnostic and prognostic biomarkers for both SC/ASC and AC subtypes of GBC.