RESUMO
A robust association exists between math anxiety and math achievement, with higher levels of anxiety correlating with lower achievement. Understanding this relationship is crucial due to the importance of math proficiency at individual and societal levels. In this review, we explore two prominent theories: Reduced Competency Theory, which suggests that initial low math achievement leads to math anxiety, and Processing Efficiency Theory, which suggests that math anxiety impairs performance by diverting cognitive resources. While these theories are supported by empirical evidence, they do not fully explain the mediators linking math anxiety and achievement. We propose 'math avoidance' as a critical mediator, suggesting that avoidance behaviors, formed through conditioning, create a feedback loop that exacerbates math anxiety and reduces proficiency.
RESUMO
Anoikis is programmed cell death occurring upon cell detachment from the extracellular matrix. Cancer cells need to evade anoikis to be able to metastasize to distant sites. However, the molecular features and prognostic value of anoikis-related genes (ARGs) in pancreatic cancer remain unclear. In this study, we utilized transcriptome data from the TCGA and GSE102238 databases to identify 64 ARGs significantly associated with prognosis. We used the "ConsensusClusterPlus" R package to stratify patients into high and low-risk prognostic subgroups. The KEGG and GSEA analyses revealed that the clusters with poor prognosis were enriched for the ECM receptor interaction pathway, the TP53 signaling pathway, and the galactose metabolism pathway, and that the cell cycle pathway was upregulated. A prognostic model consisting of seven ARGs (SERPINE1, EGF, E2F1, MSLN, RAB27B, ETV7, MST1) was constructed using LASSO regression and when combined with clinicopathological parameters using Cox regression, a prognostic Nomogram was created, which demonstrated high prognostic utility. Among the biomarker candidates, we report ETV7 as a novel, independent prognostic marker in pancreatic cancer. ETV7 was highly expressed in KRAS and TP53 co-occurrent mutant TCGA patients, indicating that it may be regulated by the two major driver genes of pancreatic cancer. Therefore, targeting ETV7 could be a potential focus for future therapeutic studies.
Assuntos
Anoikis , Biomarcadores Tumorais , Regulação Neoplásica da Expressão Gênica , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/mortalidade , Anoikis/genética , Prognóstico , Biomarcadores Tumorais/genética , Masculino , Transcriptoma , Feminino , Proteína Supressora de Tumor p53/genética , Perfilação da Expressão Gênica/métodos , Nomogramas , Proteínas Proto-Oncogênicas p21(ras)/genéticaRESUMO
OBJECTIVES: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. |This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries. MATERIALS AND METHODS: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients. RESULTS: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively. CONCLUSION: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary.
Assuntos
Neoplasias Pancreáticas , Guias de Prática Clínica como Assunto , Humanos , Neoplasias Pancreáticas/cirurgia , Países Escandinavos e Nórdicos , Recidiva Local de Neoplasia , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/normas , Inquéritos e Questionários , Pancreatectomia , Vigilância da PopulaçãoRESUMO
BACKGROUND/AIM: To select and stratify patients for optimal treatment plans is challenging. Identification of cancer-related biomarkers that serve as predictors for prognosis and treatment response is essential to better predict treatment outcome and find future targets for therapy. Previous data has suggested ARHGAP4 as a relevant biomarker in colorectal cancer (CRC). The purpose of this study was to assess how ARHGAP4 expression affected patients undergoing surgery for colon liver metastasis (CLM) in terms of overall survival (OS). PATIENTS AND METHODS: A total of 251 patients undergoing resection of CLM from 2006 to 2017 were included. Corresponding resected tumor specimens were examined for ARHGAP4 expression levels by immunohistochemistry (IHC). The correlation between ARHGAP4 expression and postoperative survival was analyzed. RESULTS: High expression levels of ARHGAP4 were seen in 60% of patients. High expression levels of ARHGAP4 were correlated with adverse prognosis after hepatectomy due to CLM. Survival data generated using Cox proportional hazard model showed a statistically significant difference between high and low ARHGAP4 expression groups by univariate (HR=1.5, 95% CI=1.1-2.2) and multivariate (HR=1.5, 95% CI=1.0-2.1) analysis. In multivariate Cox regression, high ARHGAP4 expression, preoperative CEA levels and presence of vascular invasion by pathological examinations were independent predictive factors of overall survival. CONCLUSION: ARHGAP4 is a novel prognostic biomarker after resection of CLM.
Assuntos
Biomarcadores Tumorais , Neoplasias do Colo , Proteínas Ativadoras de GTPase , Hepatectomia , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/mortalidade , Masculino , Feminino , Biomarcadores Tumorais/metabolismo , Pessoa de Meia-Idade , Prognóstico , Idoso , Proteínas Ativadoras de GTPase/metabolismo , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Neoplasias do Colo/metabolismo , Neoplasias do Colo/mortalidade , Adulto , Idoso de 80 Anos ou maisRESUMO
Metabolic rewiring is a key feature of cancer cells to support the demands of growth and proliferation. The metabolism of amino acids is altered in many cancers, including pancreatic cancer. The cellular uptake of amino acids is regulated by amino acid transporters, such as L-type amino acid transporter 1 (LAT1). Accumulating evidence suggests that LAT1 is overexpressed in pancreatic cancer and confers a poor prognosis. Here we discuss the prospects of utilizing LAT1 as a novel target for pancreatic cancer therapy.
Assuntos
Transportador 1 de Aminoácidos Neutros Grandes , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/patologia , Transportador 1 de Aminoácidos Neutros Grandes/metabolismo , Terapia de Alvo Molecular/métodosRESUMO
BACKGROUND AND OBJECTIVE: Surveillance following resection with curative intent of pancreatic cancer varies widely, and supporting evidence is limited. Recurrence is although frequent, not at least during the first 2 years. Surveillance may be costly, but evidence on how this influences overall survival is not fully elucidated. METHODS, RESULTS: There are reports implying that signs of biological recurrence (increasing CA 19-9) precede radiologically demonstrated recurrence by months. CONCLUSIONS: The possibility of initiating salvage therapy earlier is discussed, potentially based on improved future biomarker panels.
Assuntos
Carcinoma Ductal Pancreático , Recidiva Local de Neoplasia , Neoplasias Pancreáticas , Humanos , Carcinoma Ductal Pancreático/cirurgia , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/patologia , Recidiva Local de Neoplasia/epidemiologia , Pancreatectomia/métodos , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/mortalidadeRESUMO
Children with dyslexia frequently also struggle with math. However, studies of reading disability (RD) rarely assess math skill, and the neurocognitive mechanisms underlying co-occurring reading and math disability (RD+MD) are not clear. The current study aimed to identify behavioral and neurocognitive factors associated with co-occurring MD among 86 children with RD. Within this sample, 43% had co-occurring RD+MD and 22% demonstrated a possible vulnerability in math, while 35% had no math difficulties (RD-Only). We investigated whether RD-Only and RD+MD students differed behaviorally in their phonological awareness, reading skills, or executive functions, as well as in the brain mechanisms underlying word reading and visuospatial working memory using functional magnetic resonance imaging (fMRI). The RD+MD group did not differ from RD-Only on behavioral or brain measures of phonological awareness related to speech or print. However, the RD+MD group demonstrated significantly worse working memory and processing speed performance than the RD-Only group. The RD+MD group also exhibited reduced brain activations for visuospatial working memory relative to RD-Only. Exploratory brain-behavior correlations along a broad spectrum of math ability revealed that stronger math skills were associated with greater activation in bilateral visual cortex. These converging neuro-behavioral findings suggest that poor executive functions in general, including differences in visuospatial working memory, are specifically associated with co-occurring MD in the context of RD. RESEARCH HIGHLIGHTS: Children with reading disabilities (RD) frequently have a co-occurring math disability (MD), but the mechanisms behind this high comorbidity are not well understood. We examined differences in phonological awareness, reading skills, and executive function between children with RD only versus co-occurring RD+MD using behavioral and fMRI measures. Children with RD only versus RD+MD did not differ in their phonological processing, either behaviorally or in the brain. RD+MD was associated with additional behavioral difficulties in working memory, and reduced visual cortex activation during a visuospatial working memory task.
Assuntos
Dislexia , Deficiências da Aprendizagem , Criança , Humanos , Função Executiva , Encéfalo , Memória de Curto PrazoRESUMO
Functional neuroimaging serves as a tool to better understand the cerebral correlates of atypical behaviors, such as learning difficulties. While significant advances have been made in characterizing the neural correlates of reading difficulties (developmental dyslexia), comparatively little is known about the neurobiological correlates of mathematical learning difficulties, such as developmental dyscalculia (DD). Furthermore, the available neuroimaging studies of DD are characterized by small sample sizes and variable inclusion criteria, which make it problematic to compare across studies. In addition, studies to date have focused on identifying single deficits in neuronal processing among children with DD (e.g., mental arithmetic), rather than probing differences in brain function across different processing domains that are known to be affected in children with DD. Here, we seek to address the limitations of prior investigations. Specifically, we used functional magnetic resonance imaging (fMRI) to probe brain differences between children with and without persistent DD; 68 children (8-10 years old, 30 with DD) participated in an fMRI study designed to investigate group differences in the functional neuroanatomy associated with commonly reported behavioral deficits in children with DD: basic number processing, mental arithmetic and visuo-spatial working memory (VSWM). Behavioral data revealed that children with DD were less accurate than their typically achieving (TA) peers for the basic number processing and arithmetic tasks. No behavioral differences were found for the tasks measuring VSWM. A pre-registered, whole-brain, voxelwise univariate analysis of the fMRI data from the entire sample of children (DD and TA) revealed areas commonly associated with the three tasks (basic number processing, mental arithmetic, and VSWM). However, the examination of differences in brain activation between children with and without DD revealed no consistent group differences in brain activation. In view of these null results, we ran exploratory, Bayesian analyses on the data to quantify the amount of evidence for no group differences. This analysis provides supporting evidence for no group differences across all three tasks. We present the largest fMRI study comparing children with and without persistent DD to date. We found no group differences in brain activation using univariate, frequentist analyses. Moreover, Bayesian analyses revealed evidence for the null hypothesis of no group differences. These findings contradict previous literature and reveal the need to investigate the neural basis of DD using multivariate and network-based approaches to brain imaging.
Assuntos
Discalculia , Memória de Curto Prazo , Criança , Humanos , Memória de Curto Prazo/fisiologia , Imageamento por Ressonância Magnética , Discalculia/diagnóstico por imagem , Discalculia/complicações , Teorema de Bayes , Encéfalo/diagnóstico por imagemRESUMO
How did school closures affect student access to education and learning rates during the COVID-19 pandemic? How did teachers adapt to the new instructional contexts? To answer these questions, we distributed an online survey to Elementary School teachers (N = 911) in the United States and Canada at the end of the 2020-2021 school year. Around 85.8% of participants engaged in remote instruction, and nearly half had no previous experience teaching online. Overall, this transition was challenging for most teachers and more than 50% considered they were not as effective in the classroom during remote instruction and reported not being able to deliver all the curriculum expected for their grade. Despite the widespread access to digital technologies in our sample, nearly 65% of teachers observed a drop in class attendance. More than 50% of participants observed a decline in students' academic performance, a growth in the gaps between low and high-performing students, and predicted long-term adverse effects. We also observed consistent effects of SES in teachers' reports. The proportion of teachers reporting a drop in performance increases from 40% in classrooms with high-income students, to more than 70% in classrooms with low-income students. Students in lower-income households were almost twice less likely to have teachers with previous experience teaching online and almost twice less likely to receive support from adults with homeschooling. Overall, our data suggest the effects of the pandemic were not equally distributed.
RESUMO
Individual differences in reading ability are associated with characteristics of white matter microstructure in the brain. However, previous studies have largely measured reading as a single construct, resulting in difficulty characterizing the role of structural connectivity in discrete subskills of reading. The present study used diffusion tensor imaging to examine how white matter microstructure, measured by fractional anisotropy (FA), relates to individual differences in reading subskills in children aged 8 to 14 (n = 65). Findings showed positive correlations between FA of the left arcuate fasciculus and measures of single word reading and rapid naming abilities. Negative correlations were observed between FA of the right inferior longitudinal fasciculus and bilateral uncinate fasciculi, and reading subskills, particularly reading comprehension. The results suggest that although reading subskills rely to some extent on shared tracts, there are also distinct characteristics of white matter microstructure supporting different components of reading ability in children.
Assuntos
Dislexia , Substância Branca , Humanos , Criança , Substância Branca/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Encéfalo/diagnóstico por imagem , Dislexia/diagnóstico por imagem , Compreensão , Anisotropia , CegueiraRESUMO
Math performance is negatively related to math anxiety (MA), though MA may impact certain math skills more than others. We investigated whether the relation between MA and math performance is affected by task features, such as number type (e.g., fractions, whole numbers, percentages), number format (symbolic vs. nonsymbolic), and ratio component size (small vs. large). Across two large-scale studies (combined n = 3,822), the MA-performance relation was strongest for large whole numbers and fractions, and stronger for symbolic than nonsymbolic fractions. The MA-performance relation was also stronger for smaller relative to larger components, and MA relating to specific number types may be a better predictor of performance than general MA for certain tasks. The relation between MA and estimation performance changes depending on task features, which suggests that MA may relate to certain math skills more than others, which may have implications for how people reason with numerical information and may inform future interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Assuntos
Ansiedade , Humanos , MatemáticaRESUMO
OBJECTIVES: To estimate the variability of the cumulative incidence of SARS-CoV-2 infections among elementary school students attributable to individual schools and/or their geographic areas, and to ascertain whether socio-economic characteristics of school populations and/or geographic areas may be predictive of this variability. DESIGN: Population-based observational study of SARS-CoV-2 infections among elementary school children. SETTING: 3994 publicly funded elementary schools in 491 forward sortation areas (designated geographic unit based on first three characters of Canadian postal code), Ontario, Canada, September 2020 to April 2021. PARTICIPANTS: All students attending publicly funded elementary schools with a positive molecular test for SARS-CoV-2 reported by the Ontario Ministry of Education. MAIN OUTCOME MEASURES: Cumulative incidence of laboratory-confirmed elementary school student SARS-CoV-2 infections in Ontario, 2020-21 school year. RESULTS: A multilevel modelling approach was used to estimate the effects of socio-economic factors at the school and area levels on the cumulative incidence of elementary school student SARS-CoV-2 infections. At the school level (level 1), the proportion of the student body from low-income households was positively associated with cumulative incidence (ß=0.083, p<0.001). At the area level (level 2), all dimensions of marginalisation were significantly related to cumulative incidence. Ethnic concentration (ß=0.454, p<0.001), residential instability (ß=0.356, p<0.001) and material deprivation (ß=0.212, p<0.001) were positively related, while dependency (ß=-0.204, p<0.001) was negatively related. Area-related marginalisation variables explained 57.6% of area variability in cumulative incidence. School-related variables explained 1.2% of school variability in cumulative incidence. CONCLUSIONS: The socio-economic characteristics of the geographic area of schools were more important in accounting for the cumulative incidence of SARS-CoV-2 elementary school student infections than individual school characteristics. Schools in marginalised areas should be prioritised for infection prevention measures and education continuity and recovery plans.
Assuntos
COVID-19 , Criança , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Estudantes , Fatores Econômicos , Ontário/epidemiologiaRESUMO
BACKGROUND: Detecting pancreatic cancer at an earlier stage may contribute to an increased survival. Patients with stage I pancreatic cancer have a 5-year survival rate of 36%, while stage IV patients have a 5-year survival rate of 1% in Sweden. Research into novel blood-based biomarkers for pancreatic cancer is highly intensive and innovative, but has yet to result in any routine screening test. The aim of this study was to evaluate the specificity and sensitivity of a hypothetical blood test for pancreatic cancer used for screening purposes and the economic aspects of testing. METHOD: A model of a screening test was created, with varying specificity and sensitivity both set at 80%, 85%, 90%, 95% or 99% and applied to selected risk groups. Excessive costs of false positive screening outcomes, QALYs, ICERs and total costs were calculated. RESULTS: Individuals with family history and genetic mutations associated with pancreatic cancer, new-onset diabetes ≥50 years of age and early symptoms had the highest positive predictive values and ICERs beneath the willingness-to-pay-level of EUR 100,000/QALY. Screening of the general population and smokers resulted in a high rate of false positive cases and extensive extra costs. CONCLUSIONS: General screening for pancreatic cancer is not cost-effective, while screening of certain high-risk groups may be economically justified given the availability of a high-performing blood-based test.
Assuntos
Detecção Precoce de Câncer , Neoplasias Pancreáticas , Humanos , Detecção Precoce de Câncer/métodos , Suécia/epidemiologia , Análise Custo-Benefício , Valor Preditivo dos Testes , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Anos de Vida Ajustados por Qualidade de Vida , Programas de RastreamentoRESUMO
INTRODUCTION: Novel therapeutic options have improved prognosis for patients with colonic liver metastases (CLM) over the last decades. Despite this, the challenge to select and stratify patients for optimal treatment regimen persists. This study aimed to evaluate established and novel histopathological features and investigate the impact on overall survival (OS) and recurrence in patients undergoing surgery for CLM. METHODS: Two hundred and sixty patients who underwent resection of CLM with curative intent 2006-2017 were included in the study. Clinicopathological characteristics were retrieved from patient medical records. The following histopathological parameters were investigated: vascular/lymphatic invasion, perineural invasion, tumor regression grade (TRG), tumor growth pattern, pseudocapsule and acellular mucin. Histopathological traits were correlated to OS. RESULTS: Vascular and lymphatic invasion, as well as perineural invasion, significantly correlated with an adverse prognosis hazard ratio (HR) = 1.7, 95% confidence interval (CI) 1.23-2.40 and HR = 1.7, 95% CI 1.20-2.51, respectively. Results retrieved from the study could not propose any novel explorative histopathological features (TRG, tumor growth pattern, pseudocapsule and acellular mucin) to be of significant value as comes correlation with patient OS. DISCUSSION: Classical histopathological characteristics of previously reported influence on survival were confirmed, while more novel factors that has been proposed, like tumor growth pattern, tumor regression and grade and presence of a pseudocapsule, were not. Further studies are thus needed to identify better ways of understanding the impact of tumor microenvironment and tumor biology on patient outcome and not at least for stratification and improved treatment response.
Assuntos
Neoplasias do Colo , Neoplasias Colorretais , Neoplasias Hepáticas , Neoplasias Retais , Humanos , Hepatectomia/métodos , Estadiamento de Neoplasias , Neoplasias do Colo/cirurgia , Neoplasias do Colo/patologia , Prognóstico , Neoplasias Hepáticas/patologia , Neoplasias Retais/cirurgia , Mucinas , Neoplasias Colorretais/patologia , Taxa de Sobrevida , Estudos Retrospectivos , Microambiente TumoralRESUMO
Very large numbers words such as "hundred," "thousand," "million," "billion," and "trillion" pose a learning problem for children because they are sparse in everyday speech and children's experience with extremely large quantities is scarce. In this study, we examine when children acquire the relative ordering of very large number words as a first step toward understanding their acquisition. In Study 1, a hundred and twenty-five 5-8-year-olds participated in a verbal number comparison task involving very large number words. We found that children can judge which of two very large numbers is more as early as age 6, prior to entering first grade. In Study 2, we provided a descriptive analysis on the usage of very large number words using the CHILDES database. We found that the relative frequency of large number words does not change across the years, with "hundred" uttered more frequently than others by an order of magnitude. We also found that adults were more likely to use large number words to reference units of quantification for money, weight, and time, than for discrete, physical entities. Together, these results show that children construct a numerical scale for large number words prior to learning their precise cardinal meanings, and highlight how frequency and context may support their acquisition. Our results have pedagogical implications and highlight a need to investigate how children acquire meanings for number words that reference quantities beyond our everyday experience.
Assuntos
Aprendizagem , Fala , Criança , Adulto , HumanosRESUMO
Mental arithmetic is a complex skill of great importance for later academic and life success. Many neuroimaging studies and several meta-analyses have aimed to identify the neural correlates of mental arithmetic. Previous meta-analyses of arithmetic grouped all problem types into a single meta-analytic map, despite evidence suggesting that different types of arithmetic problems are solved using different strategies. We used activation likelihood estimation (ALE) to conduct quantitative meta-analyses of mental arithmetic neuroimaging (n = 31) studies, and subsequently grouped contrasts from the 31 studies into problems that are typically solved using retrieval strategies (retrieval problems) (n = 18) and problems that are typically solved using procedural strategies (procedural problems) (n = 19). Foci were compiled to generate probabilistic maps of activation for mental arithmetic (i.e., all problem types), retrieval problems, and procedural problems. Conjunction and contrast analyses were conducted to examine overlapping and distinct activation for retrieval and procedural problems. The conjunction analysis revealed overlapping activation for retrieval and procedural problems in the bilateral inferior parietal lobules, regions typically associated with magnitude processing. Contrast analyses revealed specific activation in the left angular gyrus for retrieval problems and specific activation in the inferior frontal gyrus and cingulate gyrus for procedural problems. These findings indicate that the neural bases of arithmetic systematically differs according to problem type, providing new insights into the dynamic and task-dependent neural underpinnings of the calculating brain.