Development and Validation of a Novel Machine Learning Model to Predict the Survival of Patients with Gastrointestinal Neuroendocrine Neoplasms.

INTRODUCTION: Well-calibrated models for personalized prognostication of patients with gastrointestinal neuroendocrine neoplasms (GINENs) are limited. This study aimed to develop and validate a machine-learning model to predict the survival of patients with GINENs. METHODS: Oblique random survival forest (ORSF) model, Cox proportional hazard risk model, Cox model with least absolute shrinkage and selection operator penalization, CoxBoost, Survival Gradient Boosting Machine, Extreme Gradient Boosting survival regression, DeepHit, DeepSurv, DNNSurv, logistic-hazard model, and PC-hazard model were compared. We further tuned hyperparameters and selected variables for the best-performing ORSF. Then, the final ORSF model was validated. RESULTS: A total of 43,444 patients with GINENs were included. The median (interquartile range) survival time was 53 (19-102) months. The ORSF model performed best, in which age, histology, M stage, tumor size, primary tumor site, sex, tumor number, surgery, lymph nodes removed, N stage, race, and grade were ranked as important variables. However, chemotherapy and radiotherapy were not necessary for the ORSF model. The ORSF model had an overall C index of 0.86 (95% confidence interval, 0.85-0.87). The area under the receiver operation curves at 1, 3, 5, and 10 years were 0.91, 0.89, 0.87, and 0.80, respectively. The decision curve analysis showed superior clinical usefulness of the ORSF model than the American Joint Committee on Cancer Stage. A nomogram and an online tool were given. CONCLUSION: The machine learning ORSF model could precisely predict the survival of patients with GINENs, with the ability to identify patients at high risk for death and probably guide clinical practice.

A Systematic Review and Quality Assessment of Cardiovascular Disease-Specific Health-Related Quality-of-Life Instruments Part I: Instrument Development and Content Validity.

OBJECTIVES: Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. METHODS: The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. RESULTS: The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. CONCLUSIONS: The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing a HRQoL instrument in CVD clinical studies and health economic evaluations.

Analysis of causes and prognostic impact of tube occlusion during hyperthermic intraperitoneal chemotherapy for appendiceal pseudomyxoma peritonei.

BACKGROUND: Appendiceal pseudomyxoma peritonei (PMP), a rare tumor from mucinous appendiceal origins, is treated with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). However, tubing blockages during HIPEC treatment pose a common challenge, impeding the smooth progression of therapy. Few studies to date have explored the incidence and risk factors of tube occlusion during HIPEC in patients with appendiceal PMP, as well as its adverse impact on postoperative complications. METHODS: From October 2017 to June 2023, a total of 80 patients with appendiceal PMP undergoing combined CRS and HIPEC were included in this study. Tubing blockage events were strictly defined, with patients experiencing blockages during HIPEC treatment allocated to the study group, while those with unobstructed perfusion were assigned to the control group. A comparative analysis was conducted between the two groups regarding post-HIPEC health assessments and occurrence of complications. Risk factors for luminal occlusion during closed HIPEC procedures were identified through univariate and multivariate analysis of data from 303 HIPEC treatments. RESULTS: Tubing blockages occurred in 41 patients (51.3%). The study group experienced prolonged gastrointestinal decompression time (4.1 ± 3.0 vs. 2.5 ± 1.7 days, P = 0.003) and prolonged time to bowel movement (6.1 ± 2.3 vs. 5.1 ± 1.8 days, P = 0.022) compared to the control group. There was no significant difference in the incidence of complications between the two groups. The 1-year survival rate postoperatively was 97%, and the 3-year survival rate was 81%, with no association found between tubing blockage and poorer survival. Additionally, In 303 instances of HIPEC treatment among these 80 patients, tube occlusion occurred in 89 cases (89/303, 29.4%). Multivariable logistic regression analysis revealed age, diabetes, hypertension, and pathology as independent risk factors for tube occlusion. CONCLUSION: Tubing blockages are a common occurrence during HIPEC treatment, leading to prolonged postoperative gastrointestinal functional recovery time. When patients are elderly and have concomitant hypertension and diabetes, along with a histological type of low-grade mucinous tumor, the risk of tube occlusion increases. However, this study did not find a significant correlation between tubing blockage and the incidence of postoperative complications or overall patient survival.

Better to give? A systematic review of prosocial spending and happiness.

Considerable research has amassed a plethora of evidence indicating that prosocial spending has a consistently positive effect on individual happiness. Nevertheless, this effect may be subject to various influencing factors that researchers have yet to systematically examine. The purpose of this systematic review is twofold: first, to document the empirical evidence of the relationship between prosocial spending and happiness, and second, to systematically categorize the influential factors affecting this relationship from the perspective of mediators and moderators. To achieve this goal, this systematic review incorporates the influential factors identified by researchers into an intra-individual, inter-individual, and methodological framework. Ultimately, this review includes 14 empirical studies that have effectively fulfilled the aforementioned two objectives. The systematic review concludes that engaging in prosocial spending consistently demonstrates a positive effect on individual happiness, irrespective of cultural or demographic factors, although the complexity of this relationship necessitates consideration of mediating and moderating factors, as well as methodological nuances.

How solitude relates to well-being in old age: A review of inter-individual differences.

Older adults are more likely to live alone and engage in solitary activities than young adults, leading to decrement in their well-being. However, researchers have discovered beneficial implications of solitude, and some of them even have established that the negative and positive effects of solitude coexist. The study's purposes are to investigate the relationship between solitude and well-being among older adults and to further examine the inter-individual differences in this relationship. In the database of Google Scholar, the systematic review methods are used and 17 articles meet the inclusion criteria. The study concludes that older adults experience solitude both negatively and positively; the complex relationship between solitude and well-being can be better understood and explained by inter-individual differences based on intrapersonal, interpersonal, and cultural factors. This systematic review adopts a perspective that spans individual and social/cultural levels and helps grasp the link between solitude and well-being in older adults. Based on this review, the researcher can develop appropriate interventions to help older people maximize the benefits of solitude while minimizing the drawbacks to further achieve a higher quality of life.

Pro-sociality and happiness across national cultures: A hierarchical linear model.

Research from both Empirical studies and Positive Psychology has indicated that pro-sociality has a universal effect on happiness; however, this does not take into account the national or cultural differences of a given country. The hierarchical linear model (HLM) is employed in this study to investigate the link between pro-sociality and happiness at the individual level, as well as the effect of four national cultures (i.e., power distance, individualism versus collectivism, masculinity versus femininity, and uncertainty avoidance) at the country/territory level on this relationship. This study utilizes the public World Value Survey dataset, which adopts random probability representative adult samples from 32 countries or territories (N = 53,618; Mage = 44.10, SD = 16.51). Results suggest that pro-sociality is associated with happiness, even when accounting for demographics and the country/territory code. Additionally, the country/territory level displays variations in happiness, which can be partially explained by masculinity versus femininity (positively) and uncertainty avoidance (negatively). Moreover, the connection between pro-sociality and happiness is not influenced by national cultures. This research provides evidence for the universal happiness reward of pro-sociality. Implications, restrictions, and potential future research directions are discussed.

Abnormal Regional Spontaneous Neural Activity in Nonarteritic Anterior Ischemic Optic Neuropathy: A Resting-State Functional MRI Study.

Objective: To explore altered regional neuronal activity in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and its correlation with clinical performances using the regional homogeneity (ReHo) method, which is based on resting-state functional magnetic resonance imaging (fMRI). Method: Thirty-one patients with NAION (20 males, 11 females) and 31 age- and sex-matched normal controls (NCs) (20 males, 11 females) were enrolled in the study. All patients underwent ophthalmic examination, including eyesight, intraocular pressure measurement, optimal coherence tomography (OCT), visual field analysis, and fMRI scans. After ReHo was calculated, we investigated group differences in results between the patients and NCs. We analyzed the relationship between ReHo values for different brain regions in patients with NAION and intraocular pressure, visual field analysis, and OCT. A receiver operating characteristic (ROC) curve was used to assess the diagnostic ability of the ReHo method. Results: Compared with NCs, patients with NAION exhibited higher ReHo values in the left middle frontal gyrus, left middle cingulate gyrus, left superior temporal gyrus, and left inferior parietal lobule. Additionally, they exhibited lower ReHo values in the right lingual gyrus, left putamen/lentiform nucleus, and left superior parietal lobule. ReHo values in the left superior parietal lobule were negatively correlated with right retinal nerve fiber layer values (r = -0.462, P = 0.01). The area under the ROC curve for each brain region indicated that the ReHo method is a credible means of diagnosing patient with NAION. Conclusion: NAION was primarily associated with dysfunction in the default mode network, which may reflect its underlying neural mechanisms.

All-optical signal processing in few-layer bismuthene coated microfiber: towards applications in optical fiber systems.

Two-dimensional (2D) bismuthene can find its wide potential applications due to its appealing optical and electronic properties. Especially, bismuthene exhibits layer-count dependent direct bandgaps and strong light-matter interaction, enabling its applications in all-optical signal processing area that can overcome the bottle-neck in existing electrical signal processing. However, light-bismuthene interaction based on main stream optical fiber systems and its application in all-optical signal processing is relatively less investigated. In this work, few-layer bismuthene, synthesized with facile solution processing method, is coated onto a piece of microfiber. The experimental results show that this device can operate as an optical Kerr switcher and a four-wave-mixing-based wavelength converter under different configuration. The results including wavelength applicability, information bandwidth, eye diagrams in combination with bit-error rate (BER) performance and stability measurements confirm its feasibility in optical fiber systems. To the best of our knowledge, it is first prototypic device reported in this work for bismuthene in all-optical signal processing optical fiber systems.

Black phosphorus quantum dot based all-optical signal processing: ultrafast optical switching and wavelength converting.

As a unique two-dimensional material, few-layered black phosphorus (BP) nanosheets have shown promising applications in electronics and optoelectronics. Black phosphorus quantum dots (BPQDs) have attracted attention due to the unique properties of BP combined with the edge effects. In this paper, we report on the all-optical application of BPQD based on its nonlinear Kerr effect. BPQDs were synthesized using a liquid exfoliation method combined with probe sonication and bath sonication. BPQD deposited on the microfiber as an optical device was demonstrated as the Kerr switcher with extinction ratio of 20 dB and four-wave mixing based wavelength converter with -40 dB conversion efficiency. These findings suggest that BPQD-based novel nonlinear photonics devices could be further developed in the applications of next generation high-speed optical communication.

The relationships among parental psychological control/autonomy support, self-trouble, and internalizing problems across adolescent genders.

This study aimed to explore the relationships among early adolescents' perceived parental psychological control/autonomy support, self-trouble, and internalizing problems as well as the potential gender differences in these relationships. Multiple-group path analysis was performed on the data collected from 1,089 adolescents in Beijing junior high schools. Results revealed that parental psychological control (autonomy support) was associated with adolescents' more (fewer) internalizing problems, and self-trouble acted as a mediator in these two relationships. Moreover, only the indirect relationship between parental autonomy support and internalizing problems via self-trouble was moderated by gender, with girls showing a little stronger indirect effect than boys, and specifically, it was the relationship between autonomy support and self-trouble that existed gender differences, with girls showing higher coefficient than boys. The relationship between parental psychological control/autonomy support and early adolescents' internalizing problems was discussed with regard to self-trouble and gender differences.

Perylene bisimide with diphenylacrylonitrile on side-chain: strongly fluorescent liquid crystal with large pseudo Stokes shift based on AIE and FRET effect.

A novel perylene bisimide (PBI) derivative with an AIE-active diphenylacrylonitrile unit positioned at the terminal N-imide position through a flexible spacer has been synthesized and characterized. The DSC, POM and XRD studies confirmed that it could self-assemble into a stable hexagonal columnar liquid-crystalline phase between 56 °C and 160 °C. This PBI derivative also exhibited strong fluorescence in solution, thin film and mesophase based on the cooperative mechanism of AIE and FRET between the diphenylacrylonitrile group and perylene moiety. The pseudo Stokes shift was as large as 283 nm, and the fluorescence quantum yields were as high as 0.62-0.79 in solution and 0.68-0.86 in solid state. This study provides a good strategy for converting the columnar liquid crystal with ACQ effect to one with the AIE effect, successfully filling the gap between the excellent columnar mesomorphic properties and strong fluorescence in solid state.

A fluorescent sensor based on aggregation-induced emission: highly sensitive detection of hydrazine and its application in living cell imaging.

Aggregation-induced emission (AIE) molecules eliminate the aggregation-caused quenching (ACQ) phenomenon effectively and exhibit excellent properties of a fluorescent sensor in the aggregated state. In this paper, an allochroic fluorescent sensor based on AIE molecules with a diphenylacrylonitrile structure was prepared in high yield by a simple procedure. This molecule possessed good AIE properties and exhibited a sensitive sensor ability for aliphatic amines with an obvious color change from orange to blue-green. The detailed investigation on the detection of hydrazine suggested that the detection limit for hydrazine was 3.67 × 10-6 M, and the highly sensitive sensor for hydrazine was not influenced by other species. The sensor mechanism was confirmed by using 1H NMR and MS spectra. The sensor for hydrazine was successfully applied in a test paper, exhibiting good practical application potential for detecting hydrazine. The experiment of living cell imaging suggested that this sensor showed superior bioimaging performance and presented sensitive detection for hydrazine with an obvious color change from orange to blue-green.

MiR-181b modulates chemosensitivity of glioblastoma multiforme cells to temozolomide by targeting the epidermal growth factor receptor.

Temozolomide (TMZ) is a promising chemotherapeutic agent to treat Glioblastoma multiforme (GBM). However, resistance to TMZ develops quickly with a high frequency. The mechanisms underlying GBM cells' resistance to TMZ are not fully understood. MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate protein expression by cleaving or repressing the translation of target mRNAs. Recently, miRNAs have been discovered to play important roles in drug resistance. A previous study showed that miR-181b in involved in glioma tumorigenesis. Thus, it would be valuable to explore the functions and mechanisms of miR-181b in regulating GMB cells' sensitivity to TMZ. In this study, quantitative real-time reverse transcription PCR (qRT-PCR) data indicated that miR-181b was significantly downregulated in recurrent GBM tissues compared with initial GBM tissues. We also found that miR-181b overexpression increased the chemo-sensitivity of GBM cells to TMZ and potentiated TMZ-induced apoptosis in vitro and in vivo. Moreover, we demonstrated that the epidermal growth factor receptor (EGFR) was a direct target of miR-181b: restoration of EGFR rescued the inhibitory effects of miR-181b and TMZ treatment. Taken together, our data support strongly an important role for miR-181b in conferring TMZ resistance by targeting EGFR expression.

Analysis of internet use behaviors among clinical medical students in China.

BACKGROUND: The availability of internet-based information resources is increasing and the appropriate use of such resources is an important subject for clinical medical students. The aims of this study were to investigate the behaviors of clinical medical students regarding the use of internet-based activities, to analyze the behavior and characteristics of the students' information demands, and to discuss the behaviors and time preferences related to internet use of students with different levels of education. METHODS: Librarians obtained real-time feedback from 999 clinical medical students to record online activities. The data was recorded in a standard form and then analyzed statistically. RESULTS: There were significant differences in the use of the internet for learning activities among the different groups of clinical medical students (P < 0.0001). Learning accounted for 73.5% of all internet use for doctoral candidates, 47.6% of internet use for master's candidates, 28.7% of internet use for seven-year undergraduate students, and 14.1% of use for five-year undergraduate students. There was also a significant difference in the proportions of leisure and e-commerce activities among the student groups (P < 0.0001), with five-year students displaying the highest total proportion of these activities (59.4% and 18.8%). Internet use for entertainment activities was the same for all groups of clinical medical students. Time of day of internet use was consistent across all student groups, but internet use differed by day of the week (P < 0.01). There was no difference among the time of day of internet use for learning, leisure and entertainment activities during a single day (P > 0.05), but e-commerce activities varied according to time of day (P < 0.05). Learning and e-commerce activities by clinical medical students did not vary by day of the week (P > 0.05), but the distributions of leisure and entertainment activities were different according to day of the week (P < 0.05). CONCLUSIONS: A stronger demand for learning is associated with a higher academic level of clinical medical students. Differences exist among student groups regarding internet use behaviors and internet use during different time periods.

Prosocial Behavior and Well-Being: An Empirical Review of the Role of Basic Psychological Need Satisfaction.

Although prosocial behavior is positively associated with one's well-being, researchers have yet to reach a consensus on the role played by basic psychological need satisfaction (BPNS) in this association. A systematic review of the existing empirical literature is conducted in this article to summarize and synthesize the relationship between prosocial behavior and well-being, with a special emphasis on the multifaceted role of BPNS (i.e. mediation, moderation, and concurrent mediation and moderation). Nineteen articles have been identified that meet the criteria of the research focus, being empirical and peer-reviewed. Results suggest that BPNS can act as a mediator, moderator, and differing mediation and moderation roles. Prosocial behavior can both individually and jointly satisfy the three needs for autonomy, competence, and relatedness, thus enhancing well-being. Moreover, the positive correlation between prosocial behavior and well-being can be augmented by a high level of satisfaction of one or multiple needs. Furthermore, those who have higher satisfaction of autonomy, competence, or relatedness display a greater increase in well-being after engaging in prosocial behavior, which can be mediated by BPNS. Drawing on these findings, the current body of work is evaluated in terms of its strengths and weaknesses, and potential future directions are explored.

Bioinspired Thermal Conductive Cellulose Nanofibers/Boron Nitride Coating Enabled by Co-Exfoliation and Interfacial Engineering.

Thermal conductive coating materials with combination of mechanical robustness, good adhesion and electrical insulation are in high demand in the electronics industry. However, very few progresses have been achieved in constructing a highly thermal conductive composites coating that can conformably coat on desired subjects for efficient thermal dissipation, due to their lack of materials design and structure control. Herein, we report a bioinspired thermal conductive coating material from cellulose nanofibers (CNFs), boron nitride (BN), and polydopamine (PDA) by mimicking the layered structure of nacre. Owing to the strong interfacial strength, mechanical robustness, and high thermal conductivity of CNFs, they do not only enhance the exfoliation and dispersion of BN nanoplates, but also bridge BN nanoplates to achieve superior thermal and mechanical performance. The resulting composites coating exhibits a high thermal conductivity of 13.8 W/(m·K) that surpasses most of the reported thermal conductive composites coating owing to the formation of an efficient thermal conductive pathway in the layered structure. Additionally, the coating material has good interface adhesion to conformably wrap around various substrates by scalable spray coating, combined with good mechanical robustness, sustainability, electrical insulation, low-cost, and easy processability, which makes our materials attractive for electronic packaging applications.

Self-focused autonomy, other-focused pro-sociality, and well-being: a cross-national cluster analysis.

Through cluster analysis, this study seeks to identify various clusters that differ in the level of self-focused and other-focused caring (e.g., autonomy and pro-sociality) and to contrast the happiness and life satisfaction among them. This approach is based on the notion that unifying autonomy and pro-sociality is more advantageous than separating them for well-being, which follows the theories and empirical studies. The World Value Survey dataset (N = 76897; Mage = 43.02, SD = 16.37) is used, which uses random probability representative adult samples from 51 countries or territories. Results suggest that autonomy and pro-sociality both have distinct implications for happiness and life satisfaction. Four distinct clusters are identified: autonomous (high self-focused and low other-focused), prosocial (low self-focused and high other-focused), flourished (high self-focused and high other-focused), and indifferent (low self-focused and low other-focused). In terms of indicators of well-being, the flourished group has the highest levels of happiness and life satisfaction, followed by the autonomous group, the prosocial group, and the indifferent group. It appears that individuals who exhibit both high self-focused and high other-focused caring attain the greatest well-being. The implications, limitations, and potential directions for future research are discussed.

The Effects of Repeated Attachment Security Priming on Social Anxiety and Attention Bias: A Randomized Controlled Trial.

BACKGROUND: Although the clinical utility of attachment security priming has been suggested in recent years, the effect of attachment security priming on social anxiety and its core symptoms (i.e., attention bias) remains unspecified. Therefore, the present study explored the potential effectiveness of repeated attachment security priming in alleviating social anxiety and attention bias among Chinese college students. METHODS: Fifty-six college students with high social anxiety were randomly assigned to the attachment security priming group (n = 30) or control group (n = 26). The priming group completed seven attachment security priming sessions over 2 weeks (every 2 days), and the control group was assigned to a waitlist for 2 weeks. RESULTS: The results revealed that individuals in the priming group reported less social anxiety after 2 weeks of security attachment priming, and those in the control group did not change significantly. The results also showed that there was no significant change in the attention bias of individuals with social anxiety before and after the intervention. CONCLUSIONS: Our findings indicate that attachment security priming is a promising alternative intervention option for social anxiety. The potential clinical implications of security attachment priming are discussed.

Highly stable lithium sulfur batteries enhanced by flocculation and solidification of soluble polysulfides in routine ether electrolyte.

Lithium-sulfur batteries (LSBs) are among the most promising next-generation high energy density energy-storage systems. However, practical application has been hindered by fundamental problems, especially shuttling by the higher-order polysulfides (PSs) and slow redox kinetics. Herein, a novel electrolyte-based strategy is proposed by adding an ultrasmall amount of the low-cost and commercially available cationic antistatic agent octadecyl dimethyl hydroxyethyl quaternary ammonium nitrate (SN) into a routine ether electrolyte. Due to the strong cation-anion interaction and bridge-bonding with SN, rapid flocculation of the soluble polysulfide intermediates into solid-state polysulfide-SN sediments is found, which significantly inhibited the adverse shuttling effect. Moreover, a catalytic effect was also demonstrated for conversion of the polysulfide-SN intermediates, which enhanced the redox kinetics of Li-S batteries. Encouragingly, for cells with only 0.1 % added SN, an initial specific capacity of 783.6 mAh/g and a retained specific capacity of 565.7 mAh/g were found at 2C after 200 cycles, which corresponded to an ultralow capacity decay rate of only 0.014 % per cycle. This work may provide a simple and promising regulation strategy for preparing highly stable Li-S batteries.

A repeat-dose toxicity study of human umbilical cord mesenchymal stem cells in NOG mice by intravenous injection.

BACKGROUND: Stem cell-based therapies have demonstrated great potential in several clinical trials. However, safety data on stem cell application remain inadequate. This study evaluated the toxicity of human umbilical cord mesenchymal stem cells (hUC-MSCs) in NOD/Shi-scid/IL-2 Rγnull (NOG) mice. RESEARCH DESIGN AND METHODS: Mice were administered hUC-MSCs intravenously at doses of 3.5 × 106 cells/kg and 3.5 × 107 cells/kg. Toxicity was assessed by clinical observation, behavioral evaluation, pathology, organ weight, and histopathology. We determined the distribution of hUC-MSCs using a validated qPCR method and colonization using immunohistochemistry. RESULTS: No significant abnormal effects on clinical responses, body weight, or food intake were observed in the mice, except for two in the high-dose group that died during the last administration. Mouse activity in the high-dose group decreased 6 h after the first administration. Terminal examination revealed dose-dependent changes in hematology. The mice in the high-dose group displayed pulmonary artery wall plaques and mild alveolar wall microthrombi. hUC-MSCs colonized primarily the lung tissues and were largely distributed there 24 h after the final administration. CONCLUSIONS: The no observed adverse effect level for intravenous administration of hUC-MSCs in NOG mice over a period of 3 w was 3.5 × 106 cells/kg.