Depression, stress-related disorders and risk for dental caries and periodontitis: A bidirectional and multivariable Mendelian randomization study.

AIMS: Our Mendelian randomization (MR) analysis focused on investigating the bidirectional relationships between major depressive disorder (MDD), anxiety and stress-related disorder (ASRD), and dental caries as well as periodontitis. MATERIALS AND METHODS: We used summary statistics from two studies: an MDD genome-wide association study (GWAS) including 135,458 cases with 344,901 controls and a Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) GWAS based on 12,655 ASRD individuals and 19,225 controls from Denmark. GWASs on dental caries and periodontitis were based on the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) consortium. We employed different MR approaches, such as inverse-variance weighted (IVW), MR-Egger, weighted median, and MR-PRESSO, to calculate causal effects. RESULTS: Single-variable MR analysis revealed that ASRD was potentially significantly associated with decayed, missing, and filled tooth surfaces (DMFS) (ß = 0.056; 95 % CI: 0.009, 0.103; p = 0.018). Periodontitis was suggested to be causally related to increased ASRD risk (OR = 1.143, 95 % CI: 1.008, 1.298; p = 0.038). According to the multivariable MR analysis, no significant associations were detected between MDD and ASRD with dental caries and periodontitis, and vice versa. CONCLUSIONS: ASRD demonstrated a potential association with DMFS, and periodontitis was found to potentially impact ASRD according to single-variable MR analysis. Nevertheless, no significant associations were identified between MDD, ASRD, dental caries, or periodontitis after adjusting for smoking status and education level. Hence, more robust genetic instruments are required to validate and reinforce our findings.

Efficacy of Voluntary Medical Male Circumcision to Prevent HIV Infection Among Men Who Have Sex With Men : A Randomized Controlled Trial.

BACKGROUND: Observational studies suggest that voluntary medical male circumcision (VMMC) may lower HIV risk among men who have sex with men (MSM). A randomized controlled trial (RCT) is needed to confirm this. OBJECTIVE: To assess the efficacy of VMMC in preventing incident HIV infection among MSM. DESIGN: An RCT with up to 12 months of follow-up. (Chinese Clinical Trial Registry: ChiCTR2000039436). SETTING: 8 cities in China. PARTICIPANTS: Uncircumcised, HIV-seronegative men aged 18 to 49 years who self-reported predominantly practicing insertive anal intercourse and had 2 or more male sex partners in the past 6 months. INTERVENTION: VMMC. MEASUREMENTS: Rapid testing for HIV was done at baseline and at 3, 6, 9, and 12 months. Behavioral questionnaires and other tests for sexually transmitted infections were done at baseline, 6 months, and 12 months. The primary outcome was HIV seroconversion using an intention-to-treat analysis. RESULTS: The study enrolled 124 men in the intervention group and 123 in the control group, who contributed 120.7 and 123.1 person-years of observation, respectively. There were 0 seroconversions in the intervention group (0 infections [95% CI, 0.0 to 3.1 infections] per 100 person-years) and 5 seroconversions in the control group (4.1 infections [CI, 1.3 to 9.5 infections] per 100 person-years). The HIV hazard ratio was 0.09 (CI, 0.00 to 0.81; P = 0.029), and the HIV incidence was lower in the intervention group (log-rank P = 0.025). The incidence rates of syphilis, herpes simplex virus type 2, and penile human papillomavirus were not statistically significantly different between the 2 groups. There was no evidence of HIV risk compensation. LIMITATION: Few HIV seroconversions and limited follow-up period. CONCLUSION: Among MSM who predominantly practice insertive anal intercourse, VMMC is efficacious in preventing incident HIV infection; MSM should be included in VMMC guidelines. PRIMARY FUNDING SOURCE: The National Science and Technology Major Project of China.

Association between psychological resilience and body mass index in a community-based population: A cross-sectional study.

Background and Objective: While earlier studies have focused on the relationship between stress and obesity, there was a gap in understanding the potential impact of positive psychological factors, such as resilience, on obesity. By investigating the role of psychological resilience with obesity, this study aimed to address this gap and tackle obesity through a positive psychological framework. Methods: Participants consisted of 2445 community residents from Shenzhen, China, with a mean age of 41.09 ± 13.72 years, comprising 846 males and 1599 females. Psychological resilience was measured using the Brief Resilience Scale; gender, age, marital status, education level, smoking status, alcohol consumption, frequency of physical exercise, and perceived stress were considered potential confounding factors. The relationship between psychological resilience and body mass index (BMI) was examined through multiple linear regression and logistic regression analyses. Results: The participants had an average psychological resilience score of 3.46 (standard deviation [SD] = 0.62) and an average BMI of 22.59 (SD = 3.35), with 104 individuals (4.3%) identified with obesity. In the fully adjusted multiple linear regression model, a higher psychological resilience score was associated with a higher BMI (ß = 0.507, 95% CI:0.283, 0.731). In the logistic regression model, higher psychological resilience scores were linked to increased obesity risk, with a more significant association observed among males (odds ratio [OR] = 2.169, 95% CI:1.155, 4.073), while psychological resilience acted as a protective factor against underweight among females (OR = 0.528, 95% CI:0.376, 0.816). Conclusion: The study demonstrated a significant link between higher psychological resilience and elevated BMI, emphasizing the complex relationship between psychological fortitude and weight management. Interventions targeting socioeconomic status, education, lifestyle habits, and physiological well-being might offer a promising strategy for enhancing psychological resilience and promoting healthier weight. Emphasizing self-efficacy and coping skills at the individual level could contribute to balanced weight and comprehensive health outcomes, addressing the global challenge of obesity.

Assessing and projecting the global burden of thyroid cancer, 1990-2030: Analysis of the Global Burden of Disease Study.

Background: This study aims to assess the global incidence, mortality, and disability-adjusted life years (DALYs) of thyroid cancer between 1990 and 2030. Methods: Our study analysed Global Burden of Disease (GBD) 2019 data from 204 countries, spanning 1990-2019. It focused on age-standardised thyroid cancer incidence, mortality, and disability-adjusted life years (DALYs), using the sociodemographic index (SDI) for assessing socioeconomic levels. Generalised additive models (GAMs) projected thyroid cancer trends for 2020-2030. Results: The global burden of thyroid cancer is predicted to increase significantly from 1990 to 2030. The number of thyroid cancer incidence cases is projected to rise from 233 846.64 in 2019 to 305 078.08 by 2030, representing an approximate 30.46% increase. The ASIR (age-standardised incidence rate) is expected to continue its upward trend (estimated annual percentage change (EAPC) = 0.83). The age-standardised death rate (ASDR) for thyroid cancer is projected to decline in both genders, more notably in women (EAPC = -0.34) compared to men (EAPC = -0.17). The burden of disease escalates with advancing age, with significant regional disparities. Regions with lower SDI, particularly in South Asia, are anticipated to witness substantial increases in thyroid cancer incidence from 2020 to 2030. The overall disease burden is expected to rise, especially in countries with low to middle SDI, reflecting broader socio-economic and health care shifts. Conclusions: This study highlights significant regional and gender-specific variations in thyroid cancer, with notable increases in incidence rates, particularly in areas like South Asia. These trends suggest improvements in diagnostic capabilities and the influence of socio-economic factors. Additionally, the observed decline in mortality rates across various regions reflects advancements in thyroid cancer management. The findings underline the critical importance of regionally tailored prevention strategies, robust cancer registries, and public health initiatives to address the evolving landscape of thyroid cancer and mitigate health disparities globally.

Association between sleep duration and psychological resilience in a population-based survey: A cross-sectional study.

BACKGROUND: The study aimed to find out the association between sleep duration and psychological resilience in a population-based survey. MATERIALS AND METHODS: A cross-sectional survey was conducted in August 2022, employing a cluster random sampling method to recruit community residents at Futian District in Shenzhen, China. A total of 2,445 participants aged 18 years and over were included in the study. The Brief Resilience Scale (BRS) was utilized to measure psychological resilience, and sleep duration was classified according to the American Heart Association's sleep duration categories. Multivariable linear regression was used to analyze the relationship between psychological resilience and sleep duration after adjusting for gender, age, smoking status, physical exercise frequency, body mass index (BMI), and education level. RESULTS: The participants displayed moderate levels of psychological resilience, with a mean resilience score of 3.46 (standard deviation [SD] = 0.62) and a mean sleep duration of 7.04 h (SD = 1.10). After adjusting for covariates, longer sleep duration was associated with higher psychological resilience (ß = 0.047, P < 0.05), indicating that participants with a long sleep duration had higher resilience scores than those with a short sleep duration. CONCLUSION: Longer sleep duration is positively associated with higher psychological resilience in community residents. These findings suggest that improving sleep duration may be a promising approach to enhancing psychological resilience, preventing psychological problems, and promoting overall physical and mental health development.

Metabolic profiling of smoking, associations with type 2 diabetes and interaction with genetic susceptibility.

BACKGROUND: Smokers are at increased risk of type 2 diabetes (T2D), but the underlying mechanisms are unclear. We investigated if the smoking-T2D association is mediated by alterations in the metabolome and assessed potential interaction with genetic susceptibility to diabetes or insulin resistance. METHODS: In UK Biobank (n = 93,722), cross-sectional analyses identified 208 metabolites associated with smoking, of which 131 were confirmed in Mendelian Randomization analyses, including glycoprotein acetyls, fatty acids, and lipids. Elastic net regression was applied to create a smoking-related metabolic signature. We estimated hazard ratios (HR) of incident T2D in relation to baseline smoking/metabolic signature and calculated the proportion of the smoking-T2D association mediated by the signature. Additive interaction between the signature and genetic risk scores for T2D (GRS-T2D) and insulin resistance (GRS-IR) on incidence of T2D was assessed as relative excess risk due to interaction (RERI). FINDINGS: The HR of T2D was 1·73 (95% confidence interval (CI) 1·54 - 1·94) for current versus never smoking, and 38·3% of the excess risk was mediated by the metabolic signature. The metabolic signature and its mediation role were replicated in TwinGene. The metabolic signature was associated with T2D (HR: 1·61, CI 1·46 - 1·77 for values above vs. below median), with evidence of interaction with GRS-T2D (RERI: 0·81, CI: 0·23 - 1·38) and GRS-IR (RERI 0·47, CI: 0·02 - 0·92). INTERPRETATION: The increased risk of T2D in smokers may be mediated through effects on the metabolome, and the influence of such metabolic alterations on diabetes risk may be amplified in individuals with genetic susceptibility to T2D or insulin resistance.

Association between cytomegalovirus seropositivity and all-cause mortality: An original cohort study.

To examine the association between cytomegalovirus (CMV) seropositivity and all-cause mortality in a nationwide cohort of US adults. We obtained data from the National Health and Nutrition Examination Survey III (1988-1994), including 16,547 participants aged 18-90 years old with CMV serology assessments. Mortality status was ascertained until December 2019 using the National Death Index linkage data. The Cox proportional hazard model was applied to estimate the association between CMV seropositivity and mortality. During a median follow-up of 26.3 years, 6,930 deaths were recorded. CMV seropositivity was associated with a higher hazard of all-cause mortality after adjusting for attained age, sex, and ethnicity (HR: 1.22, 95% CI: 1.10, 1.36, p < 0.001). The magnitude of the association attenuated slightly after adjusting further for body mass index, family income, smoking status, diabetes, and self-reported cancer history (HR = 1.11, 95% CI: 1.00, 1.23, p = 0.04). While the association was observed for both men and women, it was only statistically significant among non-Hispanic white people (HR: 1.16, 95% CI: 1.06, 1.26, p = 0.001) but not among other ethnic populations. CMV seropositivity might be an independent risk factor for all-cause mortality among US adults. If the findings are validated in an independent population, further research is needed to unveil the biological mechanisms driving the increased mortality with CMV seropositivity.

Associations between psychological resilience and epigenetic clocks in the health and retirement study.

The aim of this study was to evaluate the associations between psychological resilience and epigenetic clocks assessed by DNA methylation age predictions. We used data from 4018 participants in the Health and Retirement Study. Multivariable linear regression models were used to estimate the association between psychological resilience and epigenetic clocks adjusted for age, sex, race, body mass index, smoking status, and years of education. Thirteen epigenetic clocks were used in our analysis and were highly correlated with one another. A higher psychological resilience score was associated with slower DNA methylation age acceleration for the majority of epigenetic clocks after multivariable adjustment. These findings imply that people with a higher level of psychological resilience may experience slower DNA methylation age acceleration and biological aging.

Interplay of body mass index and metabolic syndrome: association with physiological age from midlife to late-life.

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65-85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65-85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging.

Association between cytomegalovirus infection and cancer­related mortality in the US adults.

PURPOSE: In a nationwide cohort of US adults, an exploration of the association between cytomegalovirus (CMV) infection and cancer­related mortality was conducted. MATERIALS AND METHODS: We acquired data from the National Health and Nutrition Examination Survey III (1988-1994), including 11,138 individuals who were aged 18-90 years at enrollment and underwent CMV serology assessments. CMV infection was determined by CMV antibody testing. Cancer­related mortality status was ascertained until December 2019 utilizing the National Death Index linkage data and determined by neoplasms. The Cox proportional hazard model was applied to estimate the potential association between CMV infection and the risk of cancer-related mortality. RESULTS: During a median follow-up of 26.1 years, 1514 cancer­related deaths were identified in the study cohort. After adjusting for age, sex, and ethnicity, CMV infection was associated with a higher hazard of cancer­related mortality (hazard ratio [HR]: 1.39, 95 % CI: 1.13, 1.70). Further adjustments for body mass index, family income, and smoking status slightly attenuated the magnitude of the association (HR: 1.24, 95 % CI: 1.00, 1.53). However, no significant interaction was observed among gender by subgroup analysis. CONCLUSIONS: CMV infection might be an independent risk factor for cancer­related mortality among US adults. Future studies could focus on the mechanisms through which CMV infection influences mortality induced by neoplasms and develop targeted interventions to reduce the risk.

Fast and low-dose medical imaging generation empowered by hybrid deep-learning and iterative reconstruction.

Fast and low-dose reconstructions of medical images are highly desired in clinical routines. We propose a hybrid deep-learning and iterative reconstruction (hybrid DL-IR) framework and apply it for fast magnetic resonance imaging (MRI), fast positron emission tomography (PET), and low-dose computed tomography (CT) image generation tasks. First, in a retrospective MRI study (6,066 cases), we demonstrate its capability of handling 3- to 10-fold under-sampled MR data, enabling organ-level coverage with only 10- to 100-s scan time; second, a low-dose CT study (142 cases) shows that our framework can successfully alleviate the noise and streak artifacts in scans performed with only 10% radiation dose (0.61 mGy); and last, a fast whole-body PET study (131 cases) allows us to faithfully reconstruct tumor-induced lesions, including small ones (<4 mm), from 2- to 4-fold-accelerated PET acquisition (30-60 s/bp). This study offers a promising avenue for accurate and high-quality image reconstruction with broad clinical value.

Sex-specific non-linear associations between body mass index and impaired pulmonary ventilation function in a community-based population: Longgang COPD study.

Aim: To investigate the prevalence of pulmonary airflow limitation and its association with body mass index (BMI) in a community-based population in Shenzhen, China. Methods: Study participants were recruited from Nanlian Community in Shenzhen, China, and spirometry was performed to assess lung function including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, and FEV1 divided by predicted value. Pulmonary airflow limitation was determined by the Chinese Guideline of Pulmonary Function Examination. Multivariable logistic regression models were used to examine the association between BMI and pulmonary airflow limitation. Age, sex, educational attainment, occupation, and current cigarette smoking were used as potential confounders. Results: Of the 1206 participants, 612 (50.7%) were men and 594 (49.3%) were women with the average age being 53.7 years old. After adjusting for age, sex, educational attainment, occupation, and current cigarette smoking, higher BMI was associated with lower odds (odds ratio: 0.98, 95% confidence interval: 0.97, 0.99) of pulmonary airflow limitation by assuming a linear relationship. Further investigation of the interaction terms, we found that the magnitudes of the associations differed in men and women. A U-shaped relationship was observed in women, while the association was almost linear in men. Conclusion: The relationship between BMI and pulmonary airflow limitation was U-shaped in women and linear in men.

3D deep learning versus the current methods for predicting tumor invasiveness of lung adenocarcinoma based on high-resolution computed tomography images.

Background: Different pathological subtypes of lung adenocarcinoma lead to different treatment decisions and prognoses, and it is clinically important to distinguish invasive lung adenocarcinoma from preinvasive adenocarcinoma (adenocarcinoma in situ and minimally invasive adenocarcinoma). This study aims to investigate the performance of the deep learning approach based on high-resolution computed tomography (HRCT) images in the classification of tumor invasiveness and compare it with the performances of currently available approaches. Methods: In this study, we used a deep learning approach based on 3D conventional networks to automatically predict the invasiveness of pulmonary nodules. A total of 901 early-stage non-small cell lung cancer patients who underwent surgical treatment at Shanghai Chest Hospital between November 2015 and March 2017 were retrospectively included and randomly assigned to a training set (n=814) or testing set 1 (n=87). We subsequently included 116 patients who underwent surgical treatment and intraoperative frozen section between April 2019 and January 2020 to form testing set 2. We compared the performance of our deep learning approach in predicting tumor invasiveness with that of intraoperative frozen section analysis and human experts (radiologists and surgeons). Results: The deep learning approach yielded an area under the receiver operating characteristic curve (AUC) of 0.946 for distinguishing preinvasive adenocarcinoma from invasive lung adenocarcinoma in the testing set 1, which is significantly higher than the AUCs of human experts (P<0.05). In testing set 2, the deep learning approach distinguished invasive adenocarcinoma from preinvasive adenocarcinoma with an AUC of 0.862, which is higher than that of frozen section analysis (0.755, P=0.043), senior thoracic surgeons (0.720, P=0.006), radiologists (0.766, P>0.05) and junior thoracic surgeons (0.768, P>0.05). Conclusions: We developed a deep learning model that achieved comparable performance to intraoperative frozen section analysis in determining tumor invasiveness. The proposed method may contribute to clinical decisions related to the extent of surgical resection.

Deep learning empowered volume delineation of whole-body organs-at-risk for accelerated radiotherapy.

In radiotherapy for cancer patients, an indispensable process is to delineate organs-at-risk (OARs) and tumors. However, it is the most time-consuming step as manual delineation is always required from radiation oncologists. Herein, we propose a lightweight deep learning framework for radiotherapy treatment planning (RTP), named RTP-Net, to promote an automatic, rapid, and precise initialization of whole-body OARs and tumors. Briefly, the framework implements a cascade coarse-to-fine segmentation, with adaptive module for both small and large organs, and attention mechanisms for organs and boundaries. Our experiments show three merits: 1) Extensively evaluates on 67 delineation tasks on a large-scale dataset of 28,581 cases; 2) Demonstrates comparable or superior accuracy with an average Dice of 0.95; 3) Achieves near real-time delineation in most tasks with <2 s. This framework could be utilized to accelerate the contouring process in the All-in-One radiotherapy scheme, and thus greatly shorten the turnaround time of patients.

The Spectrum-Beamformer for Conventional B-Mode Ultrasound Imaging System: Principle, Validation, and Robustness.

Fast and efficient imaging techniques are important for real-time ultrasound imaging. The delay and sum (DAS) beamformer is the most widely-used strategy in focused ultrasound imaging (FUI) modality. However, calculating the time delays and coherently summing the amplitude response in DAS is computationally expensive and generally require a high-performance processor to realize real-time processing. In this study, an efficient spectrum beamformer, namely full-matrix capture (FMC)-stolt, is proposed in FUI system with a linear phased array. The imaging performance of FMC-stolt was validated with the point-scatter simulation and in vitro point and cyst phantoms, and then compared with that of five beamformers, that is, Multiline acquisition (MLA), retrospective transmit beamforming (RTB) in the FUI modality, as well as DAS, Garcia's frequency-wavenumber (f-k), Lu's f-k in the coherent plane wave compounding imaging (CPWCI) modality, under specific conditions. We show that the imaging performance of FMC-stolt is better than MLA-DAS in non-transmit-focal regions, and comparable with RTB-DAS at all imaging depths. FMC-stolt also shows better discontinuity alleviation than MLA and RTB. In addition, FMC-stolt has similar imaging characteristics (e.g., off-axis resolution, computational cost) as the f-k beamformers. The computational complexity and actual computational time indicate that FMC-stolt is comparable to Garcia's f-k, Lu's f-k, and faster than RTB and CPWCI-DAS if the transmitting numbers are close for FUI and CPWCI. The study demonstrates that the proposed FMC-stolt could achieve good reconstruction speed while preserving high-quality images and thus provide a choice for software beamforming for conventional B-mode ultrasound imaging, especially for hand-held devices with limited performance processors.

Advanced nanoengineered-customized point-of-care tools for prostate-specific antigen.

Change in the level of human prostate-specific antigen (PSA) is a major element in the development and progression of prostate cancer (PCa). Most of the methodologies are currently restricted to their application in routine clinical screening due to the scarcity of adequate screening tools, false reading, long assay time, and cost. Innovative techniques and the integration of knowledge from a variety of domains, such as materials science and engineering, are needed to provide sustainable solutions. The convergence of precision point-of-care (POC) diagnostic techniques, which allow patients to respond in real time to changes in PSA levels, provides promising possibilities for quantitative and quantitative detection of PSA. This solution could be interesting and relevant for use in PCa diagnosis at the POC. The approaches enable low-cost real-time detection and are simple to integrate into user-friendly sensor devices. This review focuses on the investigations, prospects, and challenges associated with integrating engineering sciences with cancer biology to develop nanotechnology-based tools for PCa diagnosis. This article intends to encourage the development of new nanomaterials to construct high-performance POC devices for PCa detection. Finally, the review concludes with closing remarks and a perspective forecast.

Neuroticism, Smoking, and the Risk of Parkinson's Disease.

BACKGROUND: The relationship among neuroticism, smoking, and Parkinson's disease (PD) is less examined. OBJECTIVE: To examine the causal associations between neuroticism, smoking initiation, and the risk of PD. METHODS: We performed a two-sample Mendelian randomization (MR) design in a network framework. Summary statistics from meta-analyses of genome-wide association studies (GWAS) were based on large cohorts of European ancestry. Study participants were from various cohort studies for neuroticism and smoking initiation, and case-control studies or cohort studies of PD from previously published GWAS meta-analyses. Patients with PD were ascertained from either clinical visit or self-reported. RESULTS: The two-sample MR analysis showed no evidence for a causal association between neuroticism and PD risk (odds ratio [OR] 0.86, 95%confidence intervals [CIs] 0.67 to 1.12). While we did not find a significant association between neuroticism and PD, one SNP, rs58879558 (located in MAPT region), was associated with both neuroticism and PD. We found a significant association of neuroticism on smoking initiation (OR: 1.10, 95%CI: 1.05 to 1.14). Further, our results provided evidence for a protective effect of smoking initiation on the risk of PD (OR: 0.75, 95%CI: 0.62 to 0.91). CONCLUSION: These findings do not support a causal association of neuroticism on PD risk. However, they provide evidence for a causal relationship between neuroticism and smoking initiation and a strong causal effect of smoking initiation on a reduced risk of PD.

Effect of rt-PA intravenous thrombolysis on the prognosis of patients with minor ischemic stroke.

AIMS: The evidence of rt-PA intravenous thrombolysis in patients with minor ischemic stroke (MIS) is still controversial. This study aims to investigate the effect of rt-PA intravenous thrombolysis on the prognosis of patients with MIS. METHODS: We continuously enrolled and analyzed patients with MIS admitted into our hospital within 24 h after symptom onset between January 2016 and December 2018, including 96 patients received intravenous thrombolysis within 4.5 h after symptom onset and 84 patients not received intravenous thrombolysis. A favorable long-term outcome was a 90-day mRS score of 0-1. Good short-term outcome was a 7-day NIHSS score of 0 or less than NIHSS onset. RESULTS: There were no statistical differences between two groups of patients' age, gender, history of hypertension, coronary heart disease, atrial fibrillation, smoking, drinking, and baseline NIHSS score. Patients with history of stroke (22.62% vs. 10.42%, p < 0.05) and diabetes (46.43% vs. 22.92%, p = 0.01) were higher in group of non-thrombolysis. The difference of NIHSS score after 7 days was statistically different between the two groups (p < 0.05), while there was no significant difference in 90-day mRS score. Logistic regression analysis indicated that the prognosis of patients was correlated with neutrophil ratio and CRP at admission. CONCLUSION: Patients with MIS received intravenous thrombolysis may be associated with earlier neurological improvement, but might has no significant effect on long-term prognosis. The level of neutrophil ratio and CRP at admission are risk factors determining the prognosis, which requires further research.

Treatment patterns and survival outcomes for small-cell lung cancer patients - a Swedish single center cohort study.

Objectives: This real-world study on small-cell lung cancer (SCLC) patients aimed to investigate treatment patterns, outcome of re-challenge with platinum doublet chemotherapy (PDCT), and associations between clinical characteristics and survival outcomes.Material and methods: This retrospective single center cohort study was based on patients diagnosed with SCLC between 2008 and 2016 at the Karolinska University Hospital, Stockholm, Sweden. Patients were divided into two subgroups; limited disease (LD), receiving concomitant chemo- and radiotherapy and extensive disease (ED), receiving palliative PDCT. The progression-free survival (PFS) was defined as the interval between the start of CT and the earliest date of documented progression. 'Refractory relapse' (Rr) and 'Sensitive relapse' (Sr) were defined as relapse occurring < or ≥180 days after start of PDCT, respectively. The results for treatment patterns were reported as numbers and percentages of patients, and descriptive analyses including medians and 95% confidence intervals (CIs). The Cox proportional hazards regression model was applied to assess the relationship between clinical characteristics and overall survival (OS).Results: The study included 544 patients; 408 with ED and 136 patients had LD. The median PFS and OS for ED patients were 5.1 and 7.0, respectively. In the ED subgroup, Sr occurred in 169 patients (41%), with a longer median OS when compared to Rr patients (10.8 vs. 3.6 months). Patients with LD had a median PFS and OS of 12 and 24 months, respectively. Some LD patients did not show a sign of relapse (22%). The majority of LD patients who relapsed had Sr (66%), with a longer median OS when compared to patients with Rr (20.9 vs. 7.8 mo).Conclusions: The survival outcomes for ED and LD SCLC patients correspond to historical data. Patients with Sr after 1st line therapy might benefit from re-challenge with PDCT in the 2nd line setting.

Low-potential immunosensor-based detection of the vascular growth factor 165 (VEGF165) using the nanocomposite platform of cobalt metal-organic framework.

The vascular endothelial growth factor 165 (VEGF165) is a quintessential biomarker in cancers. An easy and precise tool for the early detection of malignancies is required for rapid care and metastasis prevention. Cobalt-based metal-organic framework (Co-BTC-GO-MOF) nanoparticles have been used as a signal carrier for the anti-VEGF165 signaling antibody. Cobalt-based MOF was synthesized using cobalt (Co), benzene-1,3,5-tricarboxylate (BTC), and graphene oxide (GO) applying a hydrothermal method. Structure, compositions, size and morphology of the qualified sensor are determined by using distinctive analytical techniques. The Co-MOF nanoparticles are found to be thermostable, as revealed by thermal stability assay. The strategy utilises an impedimetric and differential pulse voltammetry (DPV) techniques in the presence of the [Fe(CN)6]3-/4- redox system. Compared to earlier results, this assay resulted in higher sensitivity with the limit of detection (LOD) found to be 5.23 pM in a 0.01 M buffer solution of pH 7.4 using linear scale voltammetry at room temperature. The resulting Co-BTC-GO-MOF immunosensor shows high responsiveness and selectivity in detecting VEGF165 in real-time serum samples of cancer patients. The electrochemical performance studies confirm that the intended proposed immunosensor could pave the way for the future advancement of high-performance, sensitive, reproducible and robust immunosensors for the cost-effective and initial phase detection of cancer in the future.