Demographic bias in misdiagnosis by computational pathology models.

Despite increasing numbers of regulatory approvals, deep learning-based computational pathology systems often overlook the impact of demographic factors on performance, potentially leading to biases. This concern is all the more important as computational pathology has leveraged large public datasets that underrepresent certain demographic groups. Using publicly available data from The Cancer Genome Atlas and the EBRAINS brain tumor atlas, as well as internal patient data, we show that whole-slide image classification models display marked performance disparities across different demographic groups when used to subtype breast and lung carcinomas and to predict IDH1 mutations in gliomas. For example, when using common modeling approaches, we observed performance gaps (in area under the receiver operating characteristic curve) between white and Black patients of 3.0% for breast cancer subtyping, 10.9% for lung cancer subtyping and 16.0% for IDH1 mutation prediction in gliomas. We found that richer feature representations obtained from self-supervised vision foundation models reduce performance variations between groups. These representations provide improvements upon weaker models even when those weaker models are combined with state-of-the-art bias mitigation strategies and modeling choices. Nevertheless, self-supervised vision foundation models do not fully eliminate these discrepancies, highlighting the continuing need for bias mitigation efforts in computational pathology. Finally, we demonstrate that our results extend to other demographic factors beyond patient race. Given these findings, we encourage regulatory and policy agencies to integrate demographic-stratified evaluation into their assessment guidelines.

Profiles of Free and Bound Phenolics and Their Antioxidant Capacity in Rice Bean (Vigna umbellata).

Rice bean (Vigna umbellata) is a medicinal and dietary legume rich in polyphenols. In this study, the free and bound phenolics in rice bean were extracted by water, 80% methanol, and acid, base, and composite enzymatic hydrolysis, respectively. The polyphenol profiles of the extracted fractions were analyzed. The outcome demonstrated that base hydrolysis was the most effective way to liberate bound phenolics from rice bean (14.18 mg GAE/g DW), which was 16.68 and 56.72 folds higher than those extracted by acid and enzymatic hydrolysis, respectively. The bound polyphenols released by base hydrolysis contributed to 71.15% of the total phenolic content. A total of 35 individual phenolics was identified, of which isoquercitrin, procyanidin B1, rutin, taxifolin, and catechin were the main monomeric phenolics in the free fraction, while gallic acid, protocatechuic acid, p-hydroxybenzoic acid, catechin, and phloroglucinol were the main monomeric phenolics in the bound fraction. In comparison to the free phenolics extracted by water and 80% methanol and the bound phenolics extracted using acid and composite enzymatic hydrolysis, the bound phenolics from base hydrolysis had a superior antioxidant capacity. The antioxidant activity of rice bean is primarily attributed to individual phenolics such as catechin, abundant both in free and bound fractions, and also p-hydroxybenzoic acid, gallic acid, and protocatechuic acid in bound fractions. The bound phenolics of rice bean were first reported and showed large differences with the composition of free phenolics. This work suggests that the bound fraction of rice bean must be taken into account in assessing its potential benefits to health.

Monitoring gait at home with radio waves in Parkinson's disease: A marker of severity, progression, and medication response.

Parkinson's disease (PD) is the fastest-growing neurological disease in the world. A key challenge in PD is tracking disease severity, progression, and medication response. Existing methods are semisubjective and require visiting the clinic. In this work, we demonstrate an effective approach for assessing PD severity, progression, and medication response at home, in an objective manner. We used a radio device located in the background of the home. The device detected and analyzed the radio waves that bounce off people's bodies and inferred their movements and gait speed. We continuously monitored 50 participants, with and without PD, in their homes for up to 1 year. We collected over 200,000 gait speed measurements. Cross-sectional analysis of the data shows that at-home gait speed strongly correlates with gold-standard PD assessments, as evaluated by the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III subscore and total score. At-home gait speed also provides a more sensitive marker for tracking disease progression over time than the widely used MDS-UPDRS. Further, the monitored gait speed was able to capture symptom fluctuations in response to medications and their impact on patients' daily functioning. Our study shows the feasibility of continuous, objective, sensitive, and passive assessment of PD at home and hence has the potential of improving clinical care and drug clinical trials.

Free and Bound Phenolic Profiles of Rosa roxburghii Tratt Leaves and Their Antioxidant and Inhibitory Effects on α-Glucosidase.

Rosa roxburghii Tratt (R. roxburghii) tea is a traditional Chinese beverage. This study aims to investigate and compare the phenolics in free and bound forms of two cultivars of R. roxburghii leaves, and their bioactivities. The total phenolic content of free and bound fractions was 72.71 and 17.75 mg GAE/g DW in Gui Nong No. 5 (GNN5) and 94.28 and 11.19 mg GAE/g DW in Seedless Cili (SC). A total of 37 phenolic compounds were characterized and quantified by UPLC-Q-Exactive Orbitrap/MS with ellagic acid, quercitrin, isoquercitrin, and quininic acid in free fraction, while gallic acid, ellagic acid, and hyperoside were main compounds in bound fraction. The free fraction with higher phenolic contents also showed excellent performances on antioxidant activities and α-glucosidase inhibitory potency than bound phenolics. Therefore, the results highlight that R. roxburghii leaves are a promising source enriched in phenolic constituents for functional beverages and nutritional foods.

Phenolic Compounds Profile and Antioxidant Capacity of Pitahaya Fruit Peel from Two Red-Skinned Species (Hylocereus polyrhizus and Hylocereus undatus).

Pitahaya peel is a good source of bioactive polyphenols. However, the bound phenolics and their antioxidant activity remain unclear. The bound phenolics of pitahaya peel from two red-skinned species with red pulp (RP) and white pulp (WP) were released with different methods (acid, base, and composite enzymes hydrolysis). The results revealed that base hydrolysis was the most efficient method for releasing the bound phenolics from RP (11.6 mg GAE/g DW) and WP (10.5 mg GAE/g DW), which was 13.04-fold and 8.18-fold for RP and 75.07-fold and 10.94-fold for WP compared with acid hydrolysis and enzymatic hydrolysis, respectively. A total of 37 phenolic compounds were identified by UPLC-TOF/MS with most chlorogenic acid, caffeic acid, ferulic acid and p-coumaric acid in RP, whereas chlorogenic acid, caffeic acid, ferulic acid, rutin and isoquercitrin were the main compounds in WP. Regardless of the hydrolysis method, the extracts having the highest phenolic content showed the strongest antioxidant activities. The work shows that hydrolysis methods have a significant effect on the release of phenolics, and the contents of major characteristic bound phenolic compounds are related to the ecological type of pitahaya.

Structural characterization of an active polysaccharide of longan and evaluation of immunological activity.

An active polysaccharide (LPD2) was isolated from longan pulp by comparing the effects of polysaccharides on the phagocytosis of macrophages. LPD2 was composed of arabinose, mannose, glucose, and galactose in a molar ratio of 0.25:0.49:1:0.5 with average molecular weight of 9.64 × 106 Da. The main linkages of the sugar residues of LPD2 were (1→4)-ß-Glc and (1→6)-ß-Man. LPD2 significantly enhanced the lymphocytes proliferation, phagocytosis and NO and IL-6 secretion by macrophage. The anti-TLR2 and anti-TLR4 mAbs markedly suppressed LPD2-mediated NO and IL-6 production. Furthermore, anti-TLR4 or anti-TLR2 plus anti-TLR4 treatment significantly decreased LPD2-induced increase of MyD88, IRAK4, TRAF6 and INOS mRNA expression. Moreover, western blotting analysis showed that LPD2 enhanced the expression of target proteins in MyD88/IRAK4-TRAF6- INOS pathways. These results suggested that LPD2 induced macrophage activation partly via the TLR2- and TLR4-mediated MyD88/IRAK4-TRAF6 signaling pathways. Knowing the structural features and activities of active polysaccharide of longan gives the insights into longan polysaccharide application as an immunomodulatory agent.

Insulin Receptor Substrate Suppression by the Tyrphostin NT157 Inhibits Responses to Insulin-Like Growth Factor-I and Insulin in Breast Cancer Cells.

Insulin and insulin-like growth factor (IGF) signaling systems regulate breast cancer growth, progression, and metastasis. The insulin receptor substrates 1 and 2 (IRS1/2) transduce signaling from the type I IGF receptor (IGF-IR) and insulin receptor (InR) to mediate the biological effects of receptor activation. In breast cancer, IRS-1 plays a critical role in cancer cell proliferation while IRS-2 is associated with motility and metastasis. NT157, a small-molecule tyrphostin, downregulates IRS proteins in several model systems. In breast cancer cells, NT157 treatment suppressed IRS protein expression in a dose-dependent manner. Exposure to NT157 inhibited the activation of downstream signaling mediated by the IRS proteins. NT157 induced a MAPK-dependent serine phosphorylation of IRS proteins which resulted in disassociation between IRS proteins and their receptors resulting in IRS degradation. In estrogen receptor-α-positive (ERα+) breast cancer cells (MCF-7 and T47D), NT157 also resulted in cytoplasmic ERα downregulation likely because of disruption of an IRS-1-IGF-IR/InR/ERα complex. NT157 decreased S phase fraction, monolayer, and anchorage-independent growth after IGF/insulin treatment in ERα+ breast cancer cells. NT157 downregulation of IRS protein expression also sensitized ERα+ breast cancer cells to rapamycin. Moreover, NT157 inhibited the growth of tamoxifen-resistant ERα+ breast cancer cells. Given that both IGF-IR and InR play a role in cancer biology, targeting of IRS adaptor proteins may be a more effective strategy to inhibit the function of these receptors.

IGF-I regulates redox status in breast cancer cells by activating the amino acid transport molecule xC-.

Insulin-like growth factors (IGF) stimulate cell growth in part by increasing amino acid uptake. xCT (SLC7A11) encodes the functional subunit of the cell surface transport system xC(-), which mediates cystine uptake, a pivotal step in glutathione synthesis and cellular redox control. In this study, we show that IGF-I regulates cystine uptake and cellular redox status by activating the expression and function of xCT in estrogen receptor-positive (ER(+)) breast cancer cells by a mechanism that relies on the IGF receptor substrate-1 (IRS-1). Breast cancer cell proliferation mediated by IGF-I was suppressed by attenuating xCT expression or blocking xCT activity with the pharmacologic inhibitor sulfasalazine (SASP). Notably, SASP sensitized breast cancer cells to inhibitors of the type I IGF receptor (IGF-IR) in a manner reversed by the reactive oxygen species (ROS) scavenger N-acetyl-L-cysteine. Thus, IGF-I promoted the proliferation of ER(+) breast cancer cells by regulating xC(-) transporter function to protect cancer cells from ROS in an IRS-1-dependent manner. Our findings suggest that inhibiting xC(-) transporter function may synergize with modalities that target the IGF-IR to heighten their therapeutic effects.

Targeting insulin and insulin-like growth factor signaling in breast cancer.

The insulin and insulin like growth factor (IGF) signaling systems are implicated in breast cancer biology. Thus, disrupting IGF/insulin signaling has been shown to have promise in a number of preclinical models. However, human clinical trials have been less promising. Despite evidence of some activity in early phase trials, randomized phase III studies have thus far been unable to show a benefit of blocking IGF signaling in combination with conventional strategies. In breast cancer, combination anti IGF/insulin signaling agents with hormone therapy has not yet proven to have benefit. This inability to translate the preclinical findings into useful clinical strategies calls attention to the need for a deeper understanding of this complex pathway. Development of predictive biomarkers and optimal inhibitory strategies of the IGF/insulin system should yield better clinical strategies. Furthermore, unraveling the interaction between the IGF/insulin pathway and other critical signaling pathways in breast cancer biology, namely estrogen receptor-α (ERα) and epidermal growth factor receptor (EGFR) pathways, provides additional new concepts in designing combination therapies. In this review, we will briefly summarize the current strategies targeting the IGF/insulin system, discuss the possible reasons of success or failure of the existing therapies, and provide potential future directions for research and clinical trials.

Mast cell-derived mediators protect against oxygen-glucose deprivation-induced injury in PC12 cells and neurons.

Recent reports and our previous study suggest that mast cells play a crucial role in the pathological processes that follow cerebral ischemia. In this study, the effect of mast cells on neuron injury after cerebral ischemia was determined by adding in vitro ischemia-induced supernatant from mast cells to neurons and PC12 cells under the same conditions (oxygen-glucose deprivation, OGD). The degree of cell injury was evaluated by the 3-[4,5-dimethylthiazol-2-yl]-2,5-dipheny-ltetrazolium bromide (MTT) assay. Mast cell-derived supernatant protected against OGD-induced injury of PC12 cells and neurons, and this protection was reversed by a histamine H1 antagonist and by anti-histamine serum, but not by an H2 antagonist. However, histamine and nerve growth factor (NGF) added separately or together did not have protective effects against OGD-induced injury. These results indicate that mast cell-derived protection during in vitro ischemia is histamine-dependent, and involves cooperation with other mediators, but not NGF.