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Glyphosate (GLY) is among the most widely used pesticides in the world. However, there are a lot of unknowns about chronic exposure to GLY's effects on Honeybee (HB) behavior and physiology. To address this, we carried out five experiments to study the impact of chronic exposure to 5 mg/kg GLY on sugar consumption, survival, gene expression, gut microbiota, and metabolites of HB workers. Our results find a significant decrease in sugar consumption and survival probability of HB after chronic exposure to GLY. Further, genes associated with immune response, energy metabolism, and longevity were conspicuously altered. In addition, a total of seven metabolites were found to be differentially expressed in the metabolomic profiles, mainly related the sucrose metabolism. There was no significant difference in the gut microbiota. Results suggest that chronic exposure to field-level GLY altered the health of HB and the intricate toxic mechanisms. Our data provided insights into the chronic effects of GLY on HB behavior in food intake and health, which represents the field conditions where HB are exposed to pesticides over extended periods.
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Microbioma Gastrointestinal , Glicina , Glifosato , Herbicidas , Abelhas/efeitos dos fármacos , Abelhas/microbiologia , Animais , Glicina/análogos & derivados , Glicina/toxicidade , Microbioma Gastrointestinal/efeitos dos fármacos , Herbicidas/toxicidade , Expressão Gênica/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Metaboloma/efeitos dos fármacos , MetabolômicaRESUMO
Imidacloprid, chlorpyrifos, and glyphosate rank among the most extensively employed pesticides worldwide. The effects of these pesticides and their combined on the flight capability of Apis cerana, and the potential underlying mechanisms remain uncertain. To investigate these effects, we carried out flight mill, transcriptome, and metabolome experiments. Our findings reveal that individual acute oral treatments with pesticides, specifically 20 µL of 10 ng/g imidacloprid (0.2 ng per bee), 30 ng/g chlorpyrifos (0.6 ng per bee), and 60 ng/g glyphosate (1.2 ng per bee), did not impact the flight capability of the bees. However, when bees were exposed to a combination of two or three pesticides, a notable reduction in flight duration and distance was observed. In the transcriptomic and metabolomic analyses, we identified 307 transcripts and 17 metabolites that exhibited differential expression following exposure to combined pesticides, primarily associated with metabolic pathways involved in energy regulation. Our results illuminate the intricate effects and potential hazards posed by combined pesticide exposures on bee behavior. These findings offer valuable insights into the synergistic potential of pesticide combinations and their capacity to impair bee behavior. Understanding these complex interactions is essential for comprehending the broader consequences of pesticide formulations on honey bee populations.
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Clorpirifos , Voo Animal , Glicina , Glifosato , Metabolômica , Neonicotinoides , Nitrocompostos , Praguicidas , Transcriptoma , Animais , Abelhas/efeitos dos fármacos , Abelhas/genética , Abelhas/metabolismo , Nitrocompostos/toxicidade , Clorpirifos/toxicidade , Neonicotinoides/toxicidade , Voo Animal/efeitos dos fármacos , Transcriptoma/efeitos dos fármacos , Glicina/análogos & derivados , Glicina/toxicidade , Praguicidas/toxicidade , Inseticidas/toxicidade , Metaboloma/efeitos dos fármacosRESUMO
BACKGROUND: Worsening of heart failure (HF) symptoms is the leading cause of medical contact and hospitalization of patients with mildly reduced ejection fraction (HFmrEF). The prognostic value of signs and symptoms for patients with HFmrEF is currently unclear. This study investigated the prognostic impact of signs and symptoms in HFmrEF patients. METHODS: A Cox proportional risk regression model analyzed the relationship between the number of signs/symptoms and outcomes in 1691 hospitalized HFmrEF patients. Ten significant signs and symptoms were included. Patients were divided into three groups (A: ≤2, B: 3-5, C: ≥6 signs/symptoms). Stratified analysis on male and female patients was performed. The primary endpoint was all-cause mortality, and the secondary outcome was a composite of cardiovascular death and heart failure readmission (CV events) post-discharge. RESULTS: After a median follow-up of 33 months, all-cause mortality occurred in 457 patients and CV events occurred in 977 patients. Incidence of all-cause mortality was 20.7%, 32.3%* and 49.4%* in group A, B and C of male patients, (*P < 0.05 vs. A, P < 0.05 vs. B) and 18.8%, 33.6% and 55.8%* in group A, B and C of female patients. Incidence of CV events was 64.8%, 70.1%* and 87.5%* in group A, B and C of male patients, 61.9%, 75.3%, and 86.1%* in group A, B and C of female patients. Multivariate Cox regression showed older age, renal insufficiency, higher number of signs and symptoms (≥ 3, hazard ratio [HR] 1.317, 95% confidence interval [CI] 1.070-1.621, P = 0.009; ≥6, HR 1.982, 95% CI 1.402-2.801, P < 0.001), myocardial infarction, stroke, faster heart rate on admission, and diabetes were independently associated with all-cause mortality(all P < 0.05). Similarly, higher number of signs and symptoms (≥ 3, HR 1.271, 95% CI 1.119-1.443, P < 0.001; ≥6, HR 1.955, 95% CI 1.524-2.508, P < 0.001), older age, renal insufficiency, atrial fibrillation, and diabetes were independently associated with cardiovascular events (all P < 0.05). CONCLUSIONS: Higher number of symptoms and signs is associated with increased risk of all-cause mortality and CV events in HFmrEF patients. Our results highlight the prognostic importance of careful inquiry on HF symptoms and related physical examination in HFmrEF patients.
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Insuficiência Cardíaca , Alta do Paciente , Humanos , Feminino , Masculino , Assistência ao Convalescente , Hospitalização , Prognóstico , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapiaRESUMO
PURPOSE: We evaluated the impact of PET respiratory motion correction (MoCo) in a phantom and patients. Moreover, we proposed and examined a PET MoCo approach using motion vector fields (MVFs) from a deep-learning reconstructed short MRI scan. METHODS: The evaluation of PET MoCo was performed in a respiratory motion phantom study with varying lesion sizes and tumor to background ratios (TBRs) using a static scan as the ground truth. MRI-based MVFs were derived from either 2000 spokes (MoCo2000 , 5-6 min acquisition time) using a Fourier transform reconstruction or 200 spokes (MoCoP2P200 , 30-40 s acquisition time) using a deep-learning Phase2Phase (P2P) reconstruction and then incorporated into PET MoCo reconstruction. For six patients with hepatic lesions, the performance of PET MoCo was evaluated using quantitative metrics (SUVmax , SUVpeak , SUVmean , lesion volume) and a blinded radiological review on lesion conspicuity. RESULTS: MRI-assisted PET MoCo methods provided similar results to static scans across most lesions with varying TBRs in the phantom. Both MoCo2000 and MoCoP2P200 PET images had significantly higher SUVmax , SUVpeak , SUVmean and significantly lower lesion volume than non-motion-corrected (non-MoCo) PET images. There was no statistical difference between MoCo2000 and MoCoP2P200 PET images for SUVmax , SUVpeak , SUVmean or lesion volume. Both radiological reviewers found that MoCo2000 and MoCoP2P200 PET significantly improved lesion conspicuity. CONCLUSION: An MRI-assisted PET MoCo method was evaluated using the ground truth in a phantom study. In patients with hepatic lesions, PET MoCo images improved quantitative and qualitative metrics based on only 30-40 s of MRI motion modeling data.
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Aprendizado Profundo , Tomografia por Emissão de Pósitrons , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Movimento (Física) , Tomografia por Emissão de Pósitrons/métodosRESUMO
BACKGROUND: Odor identification (OI) dysfunction is an early marker of Alzheimer's disease (AD), but it remains unclear how olfactory-related regions change from stages of subjective cognitive decline (SCD) and mild cognitive impairment (MCI) to AD dementia. METHODS: Two hundred and sixty-nine individuals were recruited in the present study. The olfactory-related regions were defined as the regions of interest, and the grey matter volume (GMV), low-frequency fluctuation, regional homogeneity (ReHo), and functional connectivity (FC) were compared for exploring the changing pattern of structural and functional abnormalities across AD, MCI, SCD, and normal controls. RESULTS: From the SCD, MCI to AD groups, the reduced GMV, increased low-frequency fluctuation, increased ReHo, and reduced FC of olfactory-related regions became increasingly severe, and only the degree of reduced GMV of hippocampus and caudate nucleus clearly distinguished the 3 groups. SCD participants exhibited reduced GMV (hippocampus, etc.), increased ReHo (caudate nucleus), and reduced FC (hippocampus-hippocampus and hippocampus-parahippocampus) in olfactory-related regions compared with normal controls. Additionally, reduced GMV of the bilateral hippocampus and increased ReHo of the right caudate nucleus were associated with OI dysfunction and global cognitive impairment, and they exhibited partially mediated effects on the relationships between OI and global cognition across all participants. CONCLUSION: Structural and functional abnormalities of olfactory-related regions present early with SCD and deepen with disease severity in the AD spectrum. The hippocampus and caudate nucleus may be the hub joining OI and cognitive function in the AD spectrum.
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Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Hipocampo , Humanos , Imageamento por Ressonância MagnéticaRESUMO
Intractable skin defects, which involve excessive inflammation and bacterial infections, caused by burns, trauma, and diabetes are a major challenge for clinicians. Compared with traditional skin transplantation, tissue-engineered skin has the advantages of a wide range of sources, prominent biological activity, and no damage to the donor area during the operation. Therefore, an effective wound-healing mat with antibacterial, anti-inflammatory, and microvascularization bioactivities is urgent to be developed. In this study, we have synthesized a poly(ester-urethane)urea/silk fibroin/magnolol nanofibrous composite mat (PSM) through electrospinning and post-hydrogen bond cross-linking. The results show that the hybrid magnolol has no adverse effect on the microstructure, porosity, wettability, and mechanical properties of PSM. Antibacterial experiments and cytocompatibility in vitro have proved that the addition of magnolol significantly improves the antibacterial ability and promotes cell adhesion and proliferation of PSM. In addition, the wound model of rat back and H&E staining, Masson trichrome staining, and CD31 and CD68 immunofluorescence staining were performed for evaluating the therapeutic efficiency of PSM. All the results show that the better wound treatment effect of magnolol hybrid nanofibrous mats in infectious skin tissue defected repair indicates their great potential for wound healing clinically.
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Nanofibras , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Anti-Inflamatórios/farmacologia , Compostos de Bifenilo , Lignanas , Nanofibras/química , Ratos , CicatrizaçãoRESUMO
We report rapid formation of three-dimensional micro optical devices by silica nanoparticle self-assembly in a face-centered cubic (fcc) structure. By controlling the hydrophobic interactions, the self-assembled products are fabricated into different morphologies, which include microsphere and hemisphere. These structures have specific applications in microsphere resonant cavities and microlens arrays. The whispering gallery mode of the formed microsphere is excited by the tapered fiber to demonstrate the optical characters of the microsphere. Moreover, the properties of the fabricated microlens and microlens array are tested through insertion in an imaging system. Ultimately, the optical devices with advanced functions are demonstrated by the secondary phase infiltrating into the interstitial space of silica nanoparticles. This report will open a new direction in manufacturing multifunctional and miniature optical devices by an ultrasimple self-assembly approach.
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BACKGROUND: An atypical teratoid/rhabdoid tumor (AT/RT) is an uncommon and aggressive pediatric central nervous system neoplasm. However, a universal clinical consensus or reliable prognostic evaluation system for this malignancy is lacking. Our study aimed to develop a risk model based on comprehensive clinical data to assist in clinical decision-making. METHODS: We conducted a retrospective study by examining data from the Surveillance, Epidemiology, and End Results (SEER) repository, spanning 2000 to 2019. The external validation cohort was sourced from the Children's Hospital Affiliated to Chongqing Medical University, China. To discern independent factors affecting overall survival (OS) and cancer-specific survival (CSS), we applied Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF) regression analyses. Based on these factors, we structured nomogram survival predictions and initiated a dynamic online risk-evaluation system. To contrast survival outcomes among diverse treatments, we used propensity score matching (PSM) methodology. Molecular data with the most common mutations in AT/RT were extracted from the Catalogue of Somatic Mutations in Cancer (COSMIC) database. RESULTS: The annual incidence of AT/RT showed an increasing trend (APC, 2.86%; 95% CI:0.75-5.01). Our prognostic study included 316 SEER database participants and 27 external validation patients. The entire group had a median OS of 18 months (range 11.5 to 24 months) and median CSS of 21 months (range 11.7 to 29.2). Evaluations involving C-statistics, DCA, and ROC analysis underscored the distinctive capabilities of our prediction model. An analysis via PSM highlighted that individuals undergoing triple therapy (integrating surgery, radiotherapy, and chemotherapy) had discernibly enhanced OS and CSS. The most common mutations of AT/RT identified in the COSMIC database were SMARCB1, BRAF, SMARCA4, NF2, and NRAS. CONCLUSIONS: In this study, we devised a predictive model that effectively gauges the prognosis of AT/RT and briefly analyzed its genomic features, which might offer a valuable tool to address existing clinical challenges.
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With the technological scaling of metal-oxide-semiconductor field-effect transistors (MOSFETs) and the scarcity of circuit design margins, the characteristics of device reliability have garnered widespread attention. Traditional single-mode reliability mechanisms and modeling are less sufficient to meet the demands of resilient circuit designs. Mixed-mode reliability mechanisms and modeling have become a focal point of future designs for reliability. This paper reviews the mechanisms and compact aging models of mixed-mode reliability. The mechanism and modeling method of mixed-mode reliability are discussed, including hot carrier degradation (HCD) with self-heating effect, mixed-mode aging of HCD and Bias Temperature Instability (BTI), off-state degradation (OSD), on-state time-dependent dielectric breakdown (TDDB), and metal electromigration (EM). The impact of alternating HCD-BTI stress conditions is also discussed. The results indicate that single-mode reliability analysis is insufficient for predicting the lifetime of advanced technology and circuits and provides guidance for future mixed-mode reliability analysis and modeling.
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Aqueous zinc-ion batteries (ZIBs) have attracted enormous attention for future energy-storage devices owing to their high theoretical capacity and environmental friendliness. However, obtaining cathodes with a high specific capacity and fast reaction kinetics remains a huge challenge. Herein, Cu-VOx material with a thin sheet microsphere structure composed of nanoparticles was prepared by a simple hydrothermal reaction, which improved reaction kinetics and specific capacity. Pre-embedding Cu2+ into V2O5 to introduce abundant oxygen vacancies extended the interlayer distance to 1.16 nm, weakened the effect of the V-O bonds, and improved the electrical conductivity and structural stability. At the same time, the influence of different valence metal ions (M = K+, Cu2+, Fe3+, Sn4+, Nb5+, and W6+) pre-embedded in V2O5 was studied. Benefiting from a large interlayer spacing, high electrical conductivity, and excellent structural stability, the Cu-VOx electrode demonstrated a high specific capacity of 455.9 mA h g-1 at 0.1 A g-1. Importantly, when the current density was increased to 6 A g-1, the Cu-VOx electrode still achieved a high specific capacity of 178.8 mA h g-1 and maintained a high capacity retention of 76.5% over 2000 cycles.
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BACKGROUND: Schizophrenia remains a major public health challenge, and designing efforts to manage it requires understanding its prevalence over time at different geographic scales and population groups. METHODS: Drawing on data from the Global Burden of Disease study 2019, annual percentage change of schizophrenia was assessed across different age, period and cohort groups at different geographic scales from 1990 to 2019. We examined associations of prevalence with the sociodemographic index. RESULTS: Global prevalence of schizophrenia in 2019 was 23.60 million (95â¯% uncertainty interval: 20.23-27.15), with China, India, the USA and Indonesia accounting for 50.72â¯% of it. Global prevalence increased slightly from 1990 to 2019, with an annual percentage change of 0.03â¯% (95â¯% confidence interval 0.01-0.05). Regions with intermediate sociodemographic index accounted for greater proportion of prevalence increasing than regions with high index. Prevalence decreased among those born after 1979 in regions with intermediate sociodemographic index, whereas it consistently improved among all birth cohorts in regions with low index. Regardless of sociodemographic index, prevalence was highest among individuals 30-59 years old than younger or older groups. CONCLUSIONS: Prevalence of schizophrenia has shown small increases globally over the last three decades. The burden of disease is heavier in relatively less affluent regions, and it disproportionately affects individuals 30-59 years in all regions. Meanwhile, for regions with lower sociodemographic indices, the recent increasing burden among birth cohorts is more pronounced. These findings may help guide futural design of measures to manage or prevent schizophrenia in communities at higher risk.
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Desmoplastic small round cell tumor (DSRCT) is a rare undifferentiated malignant soft tissue tumor with a poor prognosis and a lack of consensus on treatment. This study's objective was to build a nomogram based on clinicopathologic factors and an online survival risk calculator to predict patient prognosis and support therapeutic decision-making. A retrospective cohort analysis of the Surveillance, Epidemiology and End Results (SEER) database was performed for patients diagnosed with DSRCT between 2000 and 2019. The least absolute shrinkage and selection operator (LASSO) Cox regression analysis was applied to identify the individual variables related to overall survival (OS) and cancer-specific survival (CSS), as well as to construct online survival risk calculators and nomogram survival models. The nomogram was employed to categorize patients into different risk groups, and the Kaplan-Meier method was utilized to determine the survival rate of each risk category. Propensity score matching (PSM) was used to assess survival with different therapeutic approaches. A total of 374 patients were included, and the median OS and CSS were 25 (interquartile range 21.9-28.1) months and 27 (interquartile range 23.6-30.3) months, respectively. The nomogram models demonstrated high predictive accuracy. PSM found that patients with triple-therapy had better CSS and OS than those who received surgery plus chemotherapy (median survival times: 49 vs 34 months and 49 vs 35 months, respectively). The nomogram successfully predicted the DSRCT patients survival rate. This approach could assist doctors in evaluating prognoses, identifying high-risk populations, and implementing personalized therapy.
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Tumor Desmoplásico de Pequenas Células Redondas , Nomogramas , Humanos , Pontuação de Propensão , Estudos Retrospectivos , InternetRESUMO
Urbanization has dramatically altered Earth's landscapes and changed a multitude of environmental factors. This has resulted in intense land-use change, and adverse consequences such as the urban heat island effect (UHI), noise pollution, and artificial light at night (ALAN). However, there is a lack of research on the combined effects of these environmental factors on life-history traits and fitness, and on how these interactions shape food resources and drive patterns of species persistence. Here, we systematically reviewed the literature and created a comprehensive framework of the mechanistic pathways by which urbanization affects fitness and thus favors certain species. We found that urbanization-induced changes in urban vegetation, habitat quality, spring temperature, resource availability, acoustic environment, nighttime light, and species behaviors (e.g., laying, foraging, and communicating) influence breeding choices, optimal time windows that reduce phenological mismatch, and breeding success. Insectivorous and omnivorous species that are especially sensitive to temperature often experience advanced laying behaviors and smaller clutch sizes in urban areas. By contrast, some granivorous and omnivorous species experience little difference in clutch size and number of fledglings because urban areas make it easier to access anthropogenic food resources and to avoid predation. Furthermore, the interactive effect of land-use change and UHI on species could be synergistic in locations where habitat loss and fragmentation are greatest and when extreme-hot weather events take place in urban areas. However, in some instances, UHI may mitigate the impact of land-use changes at local scales and provide suitable breeding conditions by shifting the environment to be more favorable for species' thermal limits and by extending the time window in which food resources are available in urban areas. As a result, we determined five broad directions for further research to highlight that urbanization provides a great opportunity to study environmental filtering processes and population dynamics.
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The low patency rate after artificial blood vessel replacement is mainly due to the ineffective use of anticoagulant factors and the mismatch of mechanical compliance after transplantation. Electrospun nanofibers with biomimetic extracellular matrix three-dimensional structure and tunable mechanical strength are excellent carriers for heparin. In this work, we have designed and synthesized a series of biodegradable poly(ester-ether-urethane)ureas (BEPU), following compound with optimized constant concentration of heparin by homogeneous emulsion blending, then spun into the hybrid BEPU/heparin nanofibers tubular graft for replacing rats' abdominal aorta in situ for comprehensive performance evaluation. The results in vitro demonstrated that the electrospun L-PEUUH (LDI-based PEUU with heparin) vascular graft was of regular microstructure, optimum surface wettability, matched mechanical properties, reliable cytocompatibility, and strongest endothelialization in situ. Replacement of resected abdominal artery with the L-PEUUH vascular graft in rat showed that the graft was capable of homogeneous hybrid heparin and significantly promoted the stabilization of vascular endothelial cells (VECs) and vascular smooth muscle cells (VSMCs), as well as stabilizing the blood microenvironment. This research demonstrates the L-PEUUH vascular graft with substantial patency, indicating their potential for injured vascular healing.
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Prótese Vascular , Células Endoteliais , Ratos , Animais , Heparina/química , Anticoagulantes , Biomimética , Poliésteres/químicaRESUMO
Small-diameter blood vascular transplantation failure is mainly caused by the vascular materials' unreliable hemocompatibility and histocompatibility and the unmatched mechanical properties, which will cause unstable blood flow. How to solve the problems of coagulation and intimal hyperplasia caused by the above factors is formidable in vascular replacement. In this work, we have synthesized poly(ferulic acid) (PFA) and prepared poly(ester-urethane)urea (PEUU)/silk fibroin (SF)/poly(ferulic acid) (PFA) hybrid nanofibers vascular graft (PSPG) by random electrospinning and post-double network bond crosslinking for process optimization. The results in vitro demonstrated that the graft is of significant anti-oxidation, matched mechanical properties, reliable cytocompatibility, and blood compatibility. Replacing resected rat abdominal aorta and rabbit carotid artery models with PSPG vascular grafts indicated that the grafts are capable of homogeneous hybrid PFA significantly promoted the stabilization of endothelial cells and the ingrowth of smooth muscle cells, meanwhile stabilizing the immune microenvironment. This research demonstrates the PSPG vascular graft with substantial patency, indicating their potential for injured vascular healing.
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Nanofibras , Trombose , Ratos , Animais , Coelhos , Engenharia Tecidual , Células Endoteliais , Hiperplasia , Nanofibras/uso terapêutico , Teste de MateriaisRESUMO
The management of chronic wounds remains a challenging clinical problem worldwide, mainly because of secondary infections, excessive oxidative stress, and blocked angiogenesis. Aerogel is a novel material with high porosity and specific surface area that allows gas exchange and rapid absorption of a large amount of exudate as well as loading bioactive molecules. Therefore, functional aerogel can be an ideal material for chronic wound treatment. The multifunctional aerogel (CG-DA-VEGF) was prepared by a simple and eco-friendly freeze-drying process combined with harmless EDC/NHS as crosslinking agents using chitosan and dopamine-grafted gelatin as raw materials. The physicochemical characterization revealed that the CG-DA-VEGF aerogel had excellent water absorption, water retention, and mechanical properties, and could release VEGF continuously and stably. In vitro experiments demonstrated that the CG-DA-VEGF aerogel exhibited effective antioxidant and antibacterial properties, as well as superb cytocompatibility. In vivo experiments further confirmed that the CG-DA-VEGF aerogel could significantly improve angiogenesis and re-epithelialization, and promote collagen deposition, thus accelerating wound healing with excellent biosafety. These results suggest that the as-prepared CG-DA-VEGF aerogel may be adopted as a promising multifunctional graft for the treatment of chronic wounds.
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Quitosana , Quitosana/farmacologia , Fator A de Crescimento do Endotélio Vascular , Cicatrização , Reepitelização , Antibacterianos/farmacologiaRESUMO
Tissue engineered skin and its substitutes have a promising future in wound healing. However, enabling fast formation of blood vessels during the wound healing process is still a huge challenge to the currently available wound substitutes. In this work, active mesoporous bioglass nanoparticles with a high specific surface area and doped with strontium (Sr) were fabricated for rapid microvascularization and wound healing. The as-prepared bioglass nanoparticles with Sr ions significantly promoted the proliferation of fibroblasts and microvascularization of human umbilical vein endothelial cells in vitro. Silk fibroin sponges encapsulating the nanoparticles accelerated wound healing by promoting the formation of blood vessels and epithelium in vivo. This work provides a strategy for the design and development of active biomaterials for enhancing wound healing by rapid vascularization and epithelial reconstruction.
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Nanopartículas , Estrôncio , Humanos , Estrôncio/farmacologia , Neovascularização Fisiológica , Cicatrização , Células Endoteliais da Veia Umbilical Humana , Neovascularização PatológicaRESUMO
Understanding the clinical features and accurately predicting the prognosis of patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) is important for patient centered decision-making. This study aimed to create a multi-factor nomogram predictive model and a web-based calculator to predict post-therapy survival for patients with LA-HPSCC. A retrospective cohort study analyzing Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 for patients diagnosed with LA-HPSCC was conducted and randomly divided into a training and a validation group (7:3 ratio). The external validation cohort included 276 patients from Sichuan Cancer Hospital, China. The Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression analysis was used to identify independent factors associated with overall survival (OS) and cancer-specific survival (CSS), and nomogram models and web-based survival calculators were constructed. Propensity score matching (PSM) was used to compare survival with different treatment options. A total of 2526 patients were included in the prognostic model. The median OS and CSS for the entire cohort were 20 (18.6-21.3) months and 24 (21.7-26.2) months, respectively. Nomogram models integrating the seven factors demonstrated high predictive accuracy for 3-year and 5-year survival. PSM found that patients who received surgery-based curative therapy had better OS and CSS than those who received radiotherapy-based treatment (median survival times: 33 months vs 18 months and 40 months vs 22 months, respectively). The nomogram model accurately predicted patient survival from LA-HPSCC. Surgery with adjuvant therapy yielded significantly better survival than definitive radiotherapy. and should be prioritized over definitive radiotherapy.
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Neoplasias de Cabeça e Pescoço , Neoplasias Hipofaríngeas , Humanos , Nomogramas , Pontuação de Propensão , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço , InternetRESUMO
BACKGROUND: MRI has a rapidly growing role in radiation therapy (RT) for treatment planning, real-time image guidance, and beam gating (e.g., MRI-Linac). Free-breathing 4D-MRI is desirable in respiratory motion management for therapy. Moreover, high-quality 3D-MRIs without motion artifacts are needed to delineate lesions. Existing MRI methods require multiple scans with lengthy acquisition times or are limited by low spatial resolution, contrast, and signal-to-noise ratio. PURPOSE: We developed a novel method to obtain motion-resolved 4D-MRIs and motion-integrated 3D-MRI reconstruction using a single rapid (35-45 s scan on a 0.35 T MRI-Linac. METHODS: Golden-angle radial stack-of-stars MRI scans were acquired from a respiratory motion phantom and 12 healthy volunteers (n = 12) on a 0.35 T MRI-Linac. A self-navigated method was employed to detect respiratory motion using 2000 (acquisition time = 5-7 min) and the first 200 spokes (acquisition time = 35-45 s). Multi-coil non-uniform fast Fourier transform (MCNUFFT), compressed sensing (CS), and deep-learning Phase2Phase (P2P) methods were employed to reconstruct motion-resolved 4D-MRI using 2000 spokes (MCNUFFT2000) and 200 spokes (CS200 and P2P200). Deformable motion vector fields (MVFs) were computed from the 4D-MRIs and used to reconstruct motion-corrected 3D-MRIs with the MOtion Transformation Integrated forward-Fourier (MOTIF) method. Image quality was evaluated quantitatively using the structural similarity index measure (SSIM) and the root mean square error (RMSE), and qualitatively in a blinded radiological review. RESULTS: Evaluation using the respiratory motion phantom experiment showed that the proposed method reversed the effects of motion blurring and restored edge sharpness. In the human study, P2P200 had smaller inaccuracy in MVFs estimation than CS200. P2P200 had significantly greater SSIMs (p < 0.0001) and smaller RMSEs (p < 0.001) than CS200 in motion-resolved 4D-MRI and motion-corrected 3D-MRI. The radiological review found that MOTIF 3D-MRIs using MCNUFFT2000 exhibited the highest image quality (scoring > 8 out of 10), followed by P2P200 (scoring > 5 out of 10), and then motion-uncorrected (scoring < 3 out of 10) in sharpness, contrast, and artifact-freeness. CONCLUSIONS: We have successfully demonstrated a method for respiratory motion management for MRI-guided RT. The method integrated self-navigated respiratory motion detection, deep-learning P2P 4D-MRI reconstruction, and a motion integrated reconstruction (MOTIF) for 3D-MRI using a single rapid MRI scan (35-45 s) on a 0.35 T MRI-Linac system.
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Imageamento Tridimensional , Imageamento por Ressonância Magnética , Humanos , Imageamento Tridimensional/métodos , Movimento (Física) , Imageamento por Ressonância Magnética/métodos , Respiração , Imagens de FantasmasRESUMO
AIMS: Atrial fibrillation (AF) and heart failure (HF) often co-exist and are closely intertwined. The impact of AF on the outcome of patients with heart failure with mildly-reduced ejection fraction (HFmrEF) is not fully clear. This study aimed to investigate the impact of AF on the outcomes of hospitalized HFmrEF patients. METHODS AND RESULTS: The study included 1691 consecutive patients with HFmrEF (mean 68.2 years, 64.8% male) including 296 AF patients. Patients completed 1 year and mean of 33 month clinical follow-up after discharge by telephone interview, clinical visit, or community visit. The primary endpoint was cerebro-cardiovascular events (CCE, composite of HF rehospitalization, stroke, or cardiovascular death). After propensity score matching, 296 patients were included into the AF group (mean 71.5 years) and 592 patients into the non-AF group (mean 70.6 years). After propensity score matching, CCE at 1 year (59.1% vs. 48.5%, P = 0.003) and at a mean of 33 month (77.0% vs. 70.6%, P = 0.043). AF was independently associated with increased CCE within 1 year (HR = 1.31, 95% CI 1.07 to 1.61, P = 0.010) and at 33 months (HR = 1.20, 95% CI 1.00 to 1.43, P = 0.050) post-discharge after adjusted for other clinical confounders including discharge heart rate, NT-proBNP, haemoglobin, and uric acid. CONCLUSIONS: AF is independently associated with an increased risk of CCE in HFmrEF patients within 1 year and at a mean of 33 months after discharge.