A "Bandwidth" in cortical representations of multiple faces.

The human ability to process multiple items simultaneously can be constrained by the extent to which those items are represented by distinct neural populations. In the current study, we used fMRI to investigate the cortical representation of multiple faces. We found that the addition of a second face to occupy both visual hemifields led to an increased response, whereas a further addition of faces within the same visual hemifield resulted in a decreased response. This pattern was widely observed in the occipital visual cortex, the intraparietal sulcus, and extended to the posterior inferotemporal cortex. A parallel trend was found in a behavioral change-detection task, revealing a perceptual "bandwidth" of multiface processing. The sensitivity to face clutter gradually decreased along the ventral pathway, supporting the notion of a buildup of clutter-tolerance representation. These cortical response patterns to face clutters suggest that adding signals with nonoverlapping cortical representation enhanced perception, while adding signals that competed for representation resources impaired perception.

Context-dependent attentional spotlight in pulvinar-V1 interaction.

Spatial attention is often described as a mental spotlight that enhances information processing at the attended location. Using fMRI, we investigated background connectivity between the pulvinar and V1 in relation to focused versus diffused attention allocation, in weak and strong crowding contexts. Our findings revealed that focused attention led to enhanced correlations between the pulvinar and V1. Notably, this modulation was initiated by the pulvinar, and the strength of the modulation was dependent on the saliency of the target. These findings suggest that the pulvinar initiates information reweighting to V1, which underlies attentional selection in cluttered scenes.

FLAIR vascular hyperintensity predicts early neurological deterioration in patients with acute ischemic stroke receiving endovascular thrombectomy.

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently observed in patients with acute ischemic stroke (AIS). FVH is associated with functional outcome at 3 months in AIS patients receiving endovascular thrombectomy. In the present study, we assessed whether FVH predicted early neurological deterioration (END) and hemorrhagic transformation (HT) within 72 h in AIS patients receiving endovascular thrombectomy. We retrospectively analyzed 104 patients with acute internal-carotid-artery or proximal middle-cerebral-artery occlusion within 16 h after symptom onset. Before thrombectomy, all patients underwent brain magnetic resonance imaging. END was defined as an increase of 4 points or more from baseline National Institutes of Health Stroke Scale (NIHSS) during 72 h following onset. HT was assessed by brain computed tomography. Statistical analyses were performed to predict END and HT. The proportion of high FVH score, high American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grade in non-END group was higher than that in END group (p < 0.001, p < 0.001, respectively). FVH score was positively correlated with ASITN/SIR grade (r = 0.461, p < 0.001). FVH score was a predictor factor for END (adjusted OR, 13.552; 95% CI, 2.408-76.260; p = 0.003), while FVH score was not a predictor factor for HT. Furthermore, NIHSS at admission (adjusted OR, 1.112; 95% CI, 1.006-1.228; p = 0.038) and high-density lipoprotein cholesterol (adjusted OR, 18.865; 95% CI, 2.998-118.683; p = 0.002) were predictor factors for HT. To assess FVH score before thrombectomy might be useful for predicting END in AIS patients receiving endovascular thrombectomy.

Hypersensitive C-reactive protein-albumin ratio predicts symptomatic intracranial hemorrhage after endovascular therapy in acute ischemic stroke patients.

BACKGROUND: Approximately 10% of patients would develop symptomatic intracranial hemorrhage (sICH) after endovascular therapy. The aim of our study was to explore the ability of hypersensitive C-reactive protein-albumin ratio (HAR) in predicting sICH after endovascular therapy. METHODS: From April 2016 to December 2018, 334 consecutive patients with anterior circulation infarction undergoing endovascular therapy were enrolled in our study. sICH was defined using Heidelberg bleeding classification after endovascular therapy. Multiple regression analysis was used to investigate the potential risk factors of sICH after endovascular therapy. We used receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the HAR in predicting sICH after endovascular therapy. RESULTS: Among these 334 patients enrolled, 37 (11.1%) patients with anterior circulation infarction were identified with sICH after endovascular therapy. Univariate logistic regression analysis demonstrated that patients with higher levels of HAR may be inclined to develop sICH (odds ratio, 10.994; 95% confidence interval, 4.567-26.463; P = 0.001). This association remained significant even after adjustment for potential confounders. Also, a cutoff value of 0.526× 10- 3 for HAR was detected in predicting sICH (area under curve, 0.763). Furthermore, nomogram analysis also suggested that HAR was an indicator of sICH (c-index was 0.890, P< 0.001). CONCLUSIONS: This study showed that high levels of HAR could predict sICH after endovascular therapy.

Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with endovascular therapy.

Stroke-associated infection (SAI) is a major medical complication in acute ischemic stroke patients (AIS) treated with endovascular therapy (EVT). Three hundred thirty-three consecutive patients with AIS caused by a large vessel occlusion in the anterior circulation who received EVT (142 (42.6%) of them were given IV tPA as bridging therapy) and 337 AIS patients who received IV tPA only (non-EVT) were enrolled in the study and evaluated to determine the association of inflammatory factors on admission with SAI. Among the 333 AIS patients undergoing EVT, SAI occurred in 219 (65.8%) patients. Patients with SAI had higher baseline National Institutes of Health Stroke Scale (NIHSS) total scores, white blood cell (WBC) and neutrophil counts, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) than those without SAI (P < 0.05). The multivariable logistic regression analyses showed that older age in addition to higher diastolic blood pressure (DBP), NIHSS score, fasting blood glucose, WBC and neutrophil counts, NLR, and PLR were significantly associated with SAI (P < 0.05). However, these associations were not revealed in 337 non-EVT AIS patients. Furthermore, based on the inflammatory markers, we developed a nomogram that provided the opportunity for more accurate predictions (compared with conventional factors) and appeared a better prognostic tool for SAI according to the decision curve analysis. In summary, if proven externally valid, our nomogram that included WBC count, NLR, and PLR may be a useful tool for SAI prediction in clinical practice.

Effects of daily training amount on visual motion perceptual learning.

Perceptual learning has been widely used to study the plasticity of the visual system in adults. Owing to the belief that practice makes perfect, perceptual learning protocols usually require subjects to practice a task thousands of times over days, even weeks. However, we know very little about the relationship between training amount and behavioral improvement. Here, four groups of subjects underwent motion direction discrimination training over 8 days with 40, 120, 360, or 1080 trials per day. Surprisingly, different daily training amounts induced similar improvement across the four groups, and the similarity lasted for at least 2 weeks. Moreover, the group with 40 training trials per day showed more learning transfer from the trained direction to the untrained directions than the group with 1080 training trials per day immediately after training and 2 weeks later. These findings suggest that perceptual learning of motion direction discrimination is not always dependent on the daily training amount and less training leads to more transfer.

Cortical Reorganization of Peripheral Vision Induced by Simulated Central Vision Loss.

When one's central vision is deprived, a spared part of the peripheral retina acts as a pseudofovea for fixation. The neural mechanisms underlying this compensatory adjustment remain unclear. Here we report cortical reorganization induced by simulated central vision loss. Human subjects of both sexes learned to place the target at an eccentric retinal locus outside their blocked visual field for object tracking. Before and after training, we measured visual crowding-a bottleneck of object identification in peripheral vision, using psychophysics and fMRI. We found that training led to an axis-specific reduction of crowding. The change of the crowding effect was reflected in the change of BOLD signal, as a release of cortical suppression in multiple visual areas starting as early as V1. Our findings suggest that the adult visual system is capable of reshaping its oculomotor control and sensory coding to adapt to impoverished visual input.SIGNIFICANCE STATEMENT By simulating central vision loss in normally sighted adults, we found that oculomotor training not only induces PRL, but also facilitates form processing in peripheral vision. As subjects learned to place the target at an eccentric retinal locus, "visual crowding"-the detrimental effect of clutter on peripheral object identification-was reduced. The reduction of the crowding effect was accompanied by a release of response suppression in the visual cortex. These findings indicate that the adult visual system is capable of reshaping the peripheral vision to adapt to central vision loss.

Functional specialization in human dorsal pathway for stereoscopic depth processing.

Binocular disparity, a primary cue for stereoscopic depth perception, is widely represented in visual cortex. However, the functional specialization in the disparity processing network remains unclear. Using magnetic resonance imaging-guided transcranial magnetic stimulation, we studied the causal contributions of V3A and MT+ to stereoscopic depth perception. Subjects viewed random-dot stereograms forming transparent planes with various interplane disparities. Their smallest detectable disparity and largest detectable disparity were measured in two experiments. We found that the smallest detectable disparity was affected by V3A, but not MT+ , stimulation. On the other hand, the largest detectable disparity was affected by both V3A and MT+ stimulation. Our results suggest different roles of V3A and MT+ in stereoscopic depth processing.

Contextual-Dependent Attention Effect on Crowded Orientation Signals in Human Visual Cortex.

A target becomes hard to identify with nearby visual stimuli. This phenomenon, known as crowding, places a fundamental limit on conscious perception and object recognition. To understand the neural representation of crowded stimuli, we used fMRI and a forward encoding model to reconstruct the target-specific feature from multivoxel activation patterns evoked by orientation patches. Orientation-selective response profiles were constructed in V1-V4 for a target embedded in different contexts. Subjects of both sexes either directed their attention over all the orientation patches or selectively to the target. In the context with a weak crowding effect, attending to the target enhanced the orientation selectivity of the response profile; such effect increased along the visual pathway. In the context with a strong crowding effect, attending to the target enhanced the orientation selectivity of the response profile in the earlier visual area, but not in V4. The increase and decrease of orientation selectivity along the visual hierarchy demonstrate a contextual-dependent attention effect on crowded orientation signals: in the context with a weak crowding effect, selective attention gradually resolves the target from nearby distractors along the hierarchy; in the context with a strong crowding effect, while selective attention maintains the target feature in the earlier visual area, its effect decreases in the downstream area. Our findings reveal how the human visual system represents the target-specific feature at multiple stages under the limit of attention selection in a cluttered scene.SIGNIFICANCE STATEMENT Using fMRI and a forward encoding model, we reconstructed orientation-selective response profiles for a target embedded in crowded contexts. In the context with a weak crowding effect, attention gradually resolves the target from nearby distractors along the visual hierarchy. In the context with a strong crowding effect, while the feature of the target is preserved in the early visual cortex, it degrades in the later visual processing stage. The increase and decrease of orientation selectivity along the visual hierarchy reveal how the human visual system strikes to present the target-specific feature under the limit of attention selection in a cluttered scene.

Perceptual learning modifies the functional specializations of visual cortical areas.

Training can improve performance of perceptual tasks. This phenomenon, known as perceptual learning, is strongest for the trained task and stimulus, leading to a widely accepted assumption that the associated neuronal plasticity is restricted to brain circuits that mediate performance of the trained task. Nevertheless, learning does transfer to other tasks and stimuli, implying the presence of more widespread plasticity. Here, we trained human subjects to discriminate the direction of coherent motion stimuli. The behavioral learning effect substantially transferred to noisy motion stimuli. We used transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) to investigate the neural mechanisms underlying the transfer of learning. The TMS experiment revealed dissociable, causal contributions of V3A (one of the visual areas in the extrastriate visual cortex) and MT+ (middle temporal/medial superior temporal cortex) to coherent and noisy motion processing. Surprisingly, the contribution of MT+ to noisy motion processing was replaced by V3A after perceptual training. The fMRI experiment complemented and corroborated the TMS finding. Multivariate pattern analysis showed that, before training, among visual cortical areas, coherent and noisy motion was decoded most accurately in V3A and MT+, respectively. After training, both kinds of motion were decoded most accurately in V3A. Our findings demonstrate that the effects of perceptual learning extend far beyond the retuning of specific neural populations for the trained stimuli. Learning could dramatically modify the inherent functional specializations of visual cortical areas and dynamically reweight their contributions to perceptual decisions based on their representational qualities. These neural changes might serve as the neural substrate for the transfer of perceptual learning.

Neural mechanisms of motion perceptual learning in noise.

Practice improves our perceptual ability. However, the neural mechanisms underlying this experience-dependent plasticity in adult brain remain unclear. Here, we studied the long-term neural correlates of motion perceptual learning. Subjects' behavioral performance and BOLD signals were tracked before, immediately after, and 2 weeks after practicing a motion direction discrimination task in noise over six daily sessions. Parallel to the specificity and persistency of the behavioral learning effect, we found that training sharpened the cortical tuning in MT, and enhanced the connectivity strength from MT to the intraparietal sulcus (IPS, a motion decision-making area). In addition, the decoding accuracy for the trained motion direction was improved in IPS 2 weeks after training. The dual changes in the sensory and the high-level cortical areas suggest that learning refines the neural representation of the trained stimulus and facilitates the information transmission in the decision process. Our findings are consistent with the functional specialization in the visual cortex, and provide empirical evidence to the reweighting theory of perceptual learning at a large spatial scale. Hum Brain Mapp 38:6029-6042, 2017. © 2017 Wiley Periodicals, Inc.

Sharpened cortical tuning and enhanced cortico-cortical communication contribute to the long-term neural mechanisms of visual motion perceptual learning.

Much has been debated about whether the neural plasticity mediating perceptual learning takes place at the sensory or decision-making stage in the brain. To investigate this, we trained human subjects in a visual motion direction discrimination task. Behavioral performance and BOLD signals were measured before, immediately after, and two weeks after training. Parallel to subjects' long-lasting behavioral improvement, the neural selectivity in V3A and the effective connectivity from V3A to IPS (intraparietal sulcus, a motion decision-making area) exhibited a persistent increase for the trained direction. Moreover, the improvement was well explained by a linear combination of the selectivity and connectivity increases. These findings suggest that the long-term neural mechanisms of motion perceptual learning are implemented by sharpening cortical tuning to trained stimuli at the sensory processing stage, as well as by optimizing the connections between sensory and decision-making areas in the brain.

Global versus local: double dissociation between MT+ and V3A in motion processing revealed using continuous theta burst transcranial magnetic stimulation.

The functional properties of motion selective areas in human visual cortex, including V3A, MT+, and intraparietal sulcus (IPS) are not fully understood. To examine the functional specialization of these areas for global and local motion processing, we used off-line, neuronavigated, continuous theta burst (cTBS) transcranial magnetic stimulation to temporarily alter neural activity within unilateral V3A, MT+, and IPS. A within-subjects design was employed and stimulation sessions were separated by at least 24 h. In each session, subjects were asked to discriminate the global motion directions of successively presented random dot kinematograms (RDKs) before and after cTBS. RDKs were presented at either 100 or 40 % coherence in either the left or right visual field. We found that V3A stimulation selectively impaired discrimination of 100 % coherent motion, while MT+ stimulation selectively impaired discrimination of 40 % coherent motion. IPS stimulation impaired discrimination of both motion stimuli. All cTBS effects were specific to stimuli presented contralaterally to the stimulation site and vertex stimulation had no effect. The double dissociation between the cTBS effects on MT+ and V3A indicates distinct roles for these two regions in motion processing. Judging the direction of 100 % coherent motion can rely on local motion processing because every dot moves in the same direction. However, judging the global direction of 40 % coherent motion requires global processing. Thus, our results suggest separate, parallel processing of local and global motion in V3A and MT+, respectively, with the outputs of these two areas being combined within the IPS.

Attention spotlight in V1-based cortico-cortical interactions in human visual hierarchy.

Attention is often viewed as a mental spotlight, which can be scaled like a zoom lens at specific spatial locations and features a center-surround gradient. Here, we demonstrate a neural signature of attention spotlight in signal transmission along the visual hierarchy. fMRI background connectivity analysis was performed between retinotopic V1 and downstream areas to characterize the spatial distribution of inter-areal interaction under two attentional states. We found that, compared to diffused attention, focal attention sharpened the spatial gradient in the strength of the background connectivity. Dynamic causal modeling analysis further revealed the effect of attention in both the feedback and feedforward connectivity between V1 and extrastriate cortex. In a context which induced a strong effect of crowding, the effect of attention in the background connectivity profile diminished. Our findings reveal a context-dependent attention prioritization in information transmission via modulating the recurrent processing across the early stages in human visual cortex.

Whole Transcriptome Sequencing of Peripheral Blood Identifies the Alzheimer's Disease-Related circRNA-miRNA-lncRNA Pathway.

BACKGROUND: Previous studies on transcriptional profiles suggested dysregulation of multiple RNA species in Alzheimer's disease. However, despite recent investigations revealing various aspects of circular RNA (circRNA)-associated competing endogenous RNA (ceRNA) networks in Alzheimer's Disease (AD) pathogenesis, few genome-wide studies have explored circRNA-associated profiles in AD patients exhibiting varying degrees of cognitive loss. OBJECTIVE: To investigate the potential pathogenesis-related molecular biological changes in the various stages of AD progression. METHODS: Whole transcriptome sequencing was performed on the peripheral blood of 7 normal cognition (NC) subjects, 8 patients with mild cognitive impairment, 8 AD patients with mild dementia (miD), and 7 AD patients with moderate dementia (moD). Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted to predict the potential functions of the maternal genes of microRNAs (miRNAs), circRNAs and long non-coding RNAs (lncRNAs). The construction of ceRNA network was performed between the NC group and each diseased group based on the differently expressed RNAs. RESULTS: In total, 3568 messenger RNAs (mRNAs), 142 miRNAs, 990 lncRNAs, and 183 circRNAs were identified as significantly differentially expressed across the four groups. GO and KEGG enrichment analysis revealed the significant roles of GTPase activity and the MAPK signaling pathway in AD pathogenesis. A circRNA-miRNA-lncRNA ceRNA pathway, characterized by the downregulated hsa-miR-7-5p and upregulated hsa_circ_0001170, was identified based on the differentially expressed RNAs between the NC group and the moD group. CONCLUSION: The study suggests that circRNAs may be independent of mRNAs in AD pathogenesis and holds promise as potential biomarkers for AD clinical manifestations and pathological changes.

Seeing in crowds: Averaging first, then max.

Crowding, a fundamental limit in object recognition, is believed to result from excessive integration of nearby items in peripheral vision. To understand its pooling mechanisms, we measured subjects' internal response distributions in an orientation crowding task. Contrary to the prediction of an averaging model, we observed a pattern suggesting that the perceptual judgement is made based on choosing the largest response across the noise-perturbed items. A model featuring first-stage averaging and second-stage signed-max operation predicts the diverse errors made by human observers under various signal strength levels. These findings suggest that different rules operate to resolve the bottleneck at early and high-level stages of visual processing, implementing a combination of linear and nonlinear pooling strategies.

Visual statistical learning of naturalistic textures.

The visual system continuously adapts to the statistical properties of the environment. In this study, we demonstrated that training significantly enhanced subjects' perceptual sensitivity to co-occurrence statistics in naturalistic textures. The learning effect was specific to the statistical component and spatial location. By examining the time course of learning, we found that learning was accelerated at an untrained location. Our findings establish a link between statistical learning and visual perception, indicating multistage plasticity beyond V1 in the visual hierarchy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations of Lipoprotein(a) Level with Cerebral Small Vessel Disease in Patients with Alzheimer's Disease.

BACKGROUND: This study aimed to examine the association of lipoprotein(a) [Lp(a)] level with the burden of cerebral small vessel disease (CSVD) in patients with Alzheimer's disease (AD). METHODS: Data from 111 consecutive patients with AD admitted to Nanjing First Hospital from 2015 to 2022 were retrospectively analyzed in this study. Serum Lp(a) concentrations were grouped into tertiles (T1-T3). Brain magnetic resonance imaging (MRI) was rated for the presence of CSVD, including enlarged perivascular spaces (EPVS), lacunes, white-matter lesions, and cerebral microbleeds (CMBs). The CSVD burden was calculated by summing the scores of each MRI marker at baseline. A binary or ordinal logistic regression model was used to estimate the relationship of serum Lp(a) levels with CSVD burden and each MRI marker. RESULTS: Patients with higher tertiles of Lp(a) levels were less likely to have any CSVD (T1, 94.6%; T2, 78.4%; T3, 66.2%; p = 0.013). Multivariable analysis found that Lp(a) levels were inversely associated with the presence of CSVD (T2 vs. T1: adjusted odds ratio [aOR] 0.132, 95% confidence interval [CI] 0.018-0.946, p = 0.044; T3 vs. T1: aOR 0.109, 95% CI 0.016-0.737, p = 0.023) and CSVD burden (T3 vs. T1: aOR 0.576, 95% CI 0.362-0.915, p = 0.019). The independent relationship between Lp(a) levels and individual CSVD features was significant for moderate-to-severe EPVS in the centrum semiovale (T2 vs. T1: aOR 0.059, 95% CI 0.006-0.542, p = 0.012; T3 vs. T1: aOR 0.029, 95% CI 0.003-0.273, p = 0.002) and CMBs (T3 vs. T1: aOR 0.144, 95% CI 0.029-0.716, p = 0.018). CONCLUSIONS: In this study, serum Lp(a) level was inversely associated with CSVD in AD patients.

Dual Antiplatelet Therapy in Patients With Minor Stroke Receiving Intravenous Thrombolysis.

INTRODUCTION: Concern over the potential severe bleeding risk of dual antiplatelet therapy for patients with minor stroke after intravenous thrombolysis (IVT) leads to different antiplatelet strategies in the secondary prevention of stroke. Our aim was to investigate the effect of dual antiplatelet therapy on patients with minor ischemic stroke receiving IVT. METHODS: From November 2016 to April 2021, a total of 855 consecutive patients who received IVT were observed. We collected and analyzed demographic characteristics, medical history, clinical information, and important time metrics of patients with minor ischemic stroke. Comparative and multivariate logistic regression analyses were used to explore the clinical significance of single or dual antiplatelet therapy after IVT. Propensity score matching analyses (1:1 matching including baseline characteristics of patients) were also performed. RESULTS: A total of 245 patients were enrolled in the study (118 patients in the single antiplatelet therapy group and 127 patients in the dual antiplatelet group). No significant difference was found in baseline characteristics except stroke etiology (p < 0.001) for patients with minor stroke. The dual antiplatelet group showed a higher proportion of 90-day modified Rankin Scale (mRS) (0-1) than the single antiplatelet group (p = 0.030). Furthermore, patients receiving dual antiplatelet therapy had excellent outcomes (90-day mRS 0-1) after adjustment (odds ratio [OR] 2.76, 95% CI 1.27-6.01, p = 0.010). Other secondary outcomes (recurrent stroke within 90 days, symptomatic intracerebral hemorrhage, and early neurological deterioration) were not significantly different between the two groups. These findings were generally consistent in propensity score analyses. CONCLUSIONS: Dual antiplatelet therapy may be a potential therapeutic approach in patients with minor stroke receiving IVT. Further randomized controlled trials are required to confirm this finding.

Dynamic Prediction of Mechanical Thrombectomy Outcome for Acute Ischemic Stroke Patients Using Machine Learning.

The unfavorable outcome of acute ischemic stroke (AIS) with large vessel occlusion (LVO) is related to clinical factors at multiple time points. However, predictive models used for dynamically predicting unfavorable outcomes using clinically relevant preoperative and postoperative time point variables have not been developed. Our goal was to develop a machine learning (ML) model for the dynamic prediction of unfavorable outcomes. We retrospectively reviewed patients with AIS who underwent a consecutive mechanical thrombectomy (MT) from three centers in China between January 2014 and December 2018. Based on the eXtreme gradient boosting (XGBoost) algorithm, we used clinical characteristics on admission ("Admission" Model) and additional variables regarding intraoperative management and the postoperative National Institute of Health stroke scale (NIHSS) score ("24-Hour" Model, "3-Day" Model and "Discharge" Model). The outcome was an unfavorable outcome at the three-month mark (modified Rankin scale, mRS 3-6: unfavorable). The area under the receiver operating characteristic curve and Brier scores were the main evaluating indexes. The unfavorable outcome at the three-month mark was observed in 156 (62.0%) of 238 patients. These four models had a high accuracy in the range of 75.0% to 87.5% and had a good discrimination with AUC in the range of 0.824 to 0.945 on the testing set. The Brier scores of the four models ranged from 0.122 to 0.083 and showed a good predictive ability on the testing set. This is the first dynamic, preoperative and postoperative predictive model constructed for AIS patients who underwent MT, which is more accurate than the previous prediction model. The preoperative model could be used to predict the clinical outcome before MT and support the decision to perform MT, and the postoperative models would further improve the predictive accuracy of the clinical outcome after MT and timely adjust therapeutic strategies.