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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(4): 589-593, 2024 Aug 18.
Artículo en Chino | MEDLINE | ID: mdl-39041550

RESUMEN

OBJECTIVE: To analyze the incidence and progression of overactive bladder (OAB) symptoms following radical prostatectomy for prostate cancer patients and to identify related risk factors. METHODS: A retrospective study was conducted on 263 local stage prostate cancer patients who underwent radical prostatectomy at Peking University Third Hospital from January 2013 to May 2017. Clinical baseline information, comprehensive imaging features, perioperative parameters, preoperative urinary control status, pathological diagnosis, and the incidence of OAB within one year postoperatively were collected and analyzed. In the imaging features, two parameters were defined: Bladder wall thickness (BWT) and bladder mucosal smoothness (BMS), which were used to predict the occurrence of OAB. Patients were evaluated based on their clinical baseline characteristics, including age, body mass index (BMI), comorbidities, and prostate-specific antigen (PSA) levels. The imaging characteristics were assessed using preoperative MRI, focusing on BWT and BMS. Perioperative parameters included operative time, blood loss, and length of hospital stay. The OAB symptoms were assessed using the overactive bladder symptom score (OABSS) and the international prostate symptom score (IPSS). These scores were correlated with the postoperative incidence of OAB. RESULTS: Among the 263 patients who underwent radical prostatectomy, 52 (19.8%) exhibited OAB within one year postoperatively. Of the 40 patients with preoperative OAB symptoms, 17 (42.5%) showed remission postoperatively, while 23 (57.5%) had persistent symptoms. Additionally, 29 patients developed new-onset OAB, accounting for 55.77% of all postoperative OAB cases. Univariate analysis indicated that BWT, BMS, OABSS, and IPSS score were all associated with the occurrence of postoperative OAB. Further multivariate analysis identified BMS as an independent risk factor for long-term OAB (P < 0.001). CONCLUSION: Long-term postoperative overactive bladder is a common complication following radical prostatectomy. The findings suggest that preoperative MRI measurements of bladder wall thickness and bladder mucosal smoothness during bladder filling phase can predict the risk of OAB occurrence postoperatively. Identifying these risk factors preoperatively can help in counseling patients about potential complications and in developing strategies to mitigate the risk of developing OAB after surgery. Early detection and management of these parameters might improve the quality of life for patients undergoing radical prostatectomy.


Asunto(s)
Prostatectomía , Neoplasias de la Próstata , Vejiga Urinaria Hiperactiva , Humanos , Masculino , Vejiga Urinaria Hiperactiva/etiología , Vejiga Urinaria Hiperactiva/epidemiología , Prostatectomía/efectos adversos , Prostatectomía/métodos , Estudios Retrospectivos , Factores de Riesgo , Neoplasias de la Próstata/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Incidencia , Vejiga Urinaria , Imagen por Resonancia Magnética , Persona de Mediana Edad , Anciano , Antígeno Prostático Específico/sangre
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(4): 582-588, 2024 Aug 18.
Artículo en Chino | MEDLINE | ID: mdl-39041549

RESUMEN

OBJECTIVE: To investigate the prognostic factors for all-cause mortality in patients with muscle-invasive bladder cancer (MIBC) with intermediate-to-high-risk primary prostate cancer. METHODS: From January 2012 to October 2023, the clinical data of the patients with MIBC with intermediate-to-high-risk primary prostate cancer in Peking University Third Hospital were retrospectively analyzed. All the patients were monitored and the occurrence of all-cause death was documented as the outcome event in the prognostic study. Univariate and multivariate Cox proportional risk regression analysis models were implemented to search for independent influences on the prognosis of patients. For significant influencing factors (pathological T stage, M stage and perineural invasion of bladder cancer), survival curves were plotted before and after multifactorial Cox regression adjusting for confounding factors. RESULTS: A total of 32 patients were included in this study. The mean age was (72.5±6.6) years; the median preoperative total prostate specific antigen (tPSA) was 6.68 (2.47, 6.84) µg/L; the mean preoperative creatinine was (95±36) µmol/L, and the median survival time was 65 months. The majority of the patients (87.5%) had high-grade bladder cancer, 53.1% had lymphatic invasion, and 31.3% had perineural invasion. Prostate involvement was observed in 25.0% of the cases, and the positive rate of soft-tissue surgical margin was 37.5%. Multivariate Cox analysis revealed that preoperative creatinine level (HR=1.02, 95%CI: 1.01-1.04), pathological stage of bladder cancer T3 (HR=11.58, 95%CI: 1.38-97.36) and T4 (HR=19.53, 95%CI: 4.26-89.52) metastasis of bladder cancer (HR=9.44, 95%CI: 1.26-70.49) and perineural invasion of bladder cancer (HR=6.26, 95%CI: 1.39-28.27) were independent prognostic factors (P < 0.05). Survival curves with Log-rank test after adjusting for confounding factors demonstrated that bladder cancer pathology T3, T4, M1, and perineural invasion were unfavorable factors affecting the patients' survival prognosis (P < 0.05). CONCLUSION: Patients with MIBC with intermediate-to-high risk primary prostate cancer generally portends a poor prognosis. High preoperative serum creatinine, T3 or T4 pathological stage of bladder cancer, metastasis of bladder cancer and bladder cancer perineural invasion are poor prognostic factors for patients with MIBC with intermediate-to-high risk primary prostate cancer.


Asunto(s)
Invasividad Neoplásica , Neoplasias de la Próstata , Neoplasias de la Vejiga Urinaria , Humanos , Masculino , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/mortalidad , Anciano , Pronóstico , Estudios Retrospectivos , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/mortalidad , Estadificación de Neoplasias , Modelos de Riesgos Proporcionales , Antígeno Prostático Específico/sangre , Factores de Riesgo , Tasa de Supervivencia
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(4): 661-666, 2024 Aug 18.
Artículo en Chino | MEDLINE | ID: mdl-39041562

RESUMEN

OBJECTIVE: To analyze the clinicopathological characteristics and prognosis of patients with multilocular cystic renal neoplasm of low malignant potential and compare the clinicopathological characteristics of patients with multilocular cystic renal neoplasm of low malignant potential who underwent different surgical methods. METHODS: Clinicopathological data and prognosis of patients admitted to Peking University Third Hospital from January 2010 to September 2023 were collected. Patients who underwent radical nephrectomy or nephron-sparing surgery and were pathologically diagnosed with multilocular cystic renal neoplasm of low malignant potential were identified. Based on the surgical methods, the patients were divided into radical nephrectomy group and nephron-sparing surgery group. The clinicopathological characteristics of the two groups were compared. RESULTS: A total of 35 patients were enrolled in this study. The median age at diagnosis was 53.0 (39.0-62.0) years. Among the 35 patients, 23 were males (65.7%) and 12 were females (34.3%). Nine patients underwent radical nephrectomy (25.7%), while 26 patients underwent nephron-sparing surgery (74.3%). The clinical T-stage of 35 patients did not exceed T2a stage. The median operation time was 145.0 min, and the median estimated intraoperative blood loss was 20.0 mL. The median postoperative hospitalization days was 6.0 d. The postoperative pathological results did not indicate renal sinus invasion, sarcomatous change, adrenal invasion or lymph node invasion. Based on the surgical methods, the patients were divided into a radical nephrectomy group and a nephron-sparing surgery group. There was no significant difference in clinicopathological charac-teristics between the two groups. Except for one patient who was lost to the follow-up, all the other patients were followed up for 8-111 months, with a median follow-up time of 70.5 months. Only one patient died from non-cancer-specific reasons, other patients had no tumor metastasis or recurrence. CONCLUSION: Patients with multilocular cystic renal neoplasm of low malignant potential have a good prognosis. There is no significant difference in clinicopathological characteristics of patients between nephron-sparing surgery group and radical nephrectomy group for multilocular cystic renal neoplasm of low malignant potential.


Asunto(s)
Neoplasias Renales , Nefrectomía , Humanos , Masculino , Femenino , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Persona de Mediana Edad , Adulto , Pronóstico , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Nefronas/patología , Tempo Operativo , Estudios Retrospectivos
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(4): 673-679, 2024 Aug 18.
Artículo en Chino | MEDLINE | ID: mdl-39041564

RESUMEN

OBJECTIVE: To predict the 3-year cancer-specific survival (CSS) of patients with non-metastatic T3a renal cell carcinoma after surgery. METHODS: A total of 336 patients with pathologically confirmed T3a N0-1M0 renal cell carcinoma (RCC) who underwent surgical treatment at the Department of Urology, Peking University Third Hospital from March 2013 to February 2021 were retrospectively collected. The patients were randomly divided into a training cohort of 268 cases and an internal validation cohort of 68 cases at an 4 ∶ 1 ratio. Using two-way Lasso regression, variables were selected to construct a nomogram for predicting the 3-year cancer-specific survival (CSS) of the patients with T3aN0-1M0 RCC. Performance assessment of the nomogram included evaluation of discrimination and calibration ability, as well as clinical utility using measures such as the concordance index (C-index), time-dependent area under the receiver operating characteristic curve [time-dependent area under the curve (AUC)], calibration curve, and decision curve analysis (DCA). Risk stratification was determined based on the nomogram scores, and Kaplan-Meier survival analysis and Log-rank tests were employed to compare progression-free survival (PFS) and cancer-specific survival (CSS) among the patients in the different risk groups. RESULTS: Based on the Lasso regression screening results, the nomogram was constructed with five variables: tumor maximum diameter, histological grading, sarcomatoid differentiation, T3a feature, and lymph node metastasis. The baseline data of the training and validation sets showed no statistical differences (P>0.05). The consistency indices of the column diagram were found to be 0.808 (0.708- 0.907) and 0.903 (0.838-0.969) for the training and internal validation sets, respectively. The AUC values for 3-year cancer-specific survival were 0.843 (0.725-0.961) and 0.923 (0.844-1.002) for the two sets. Calibration curves of both sets demonstrated a high level of consistency between the actual CSS and predicted probability. The decision curve analysis (DCA) curves indicated that the column diagram had a favorable net benefit in clinical practice. A total of 336 patients were included in the study, with 35 cancer-specific deaths and 69 postoperative recurrences. According to the line chart, the patients were divided into low-risk group (scoring 0-117) and high-risk group (scoring 119-284). Within the low-risk group, there were 16 tumor-specific deaths out of 282 cases and 36 postoperative recurrences out of 282 cases. In the high-risk group, there were 19 tumor-specific deaths out of 54 cases and 33 post-operative recurrences out of 54 cases. There were significant differences in progression-free survival (PFS) and cancer-specific survival (CSS) between the low-risk and high-risk groups (P < 0.000 1). CONCLUSION: A nomogram model predicting the 3-year CSS of non-metastatic T3a renal cell carcinoma patients was successfully constructed and validated in this study. This nomogram can assist clinicians in accurately assessing the long-term prognosis of such patients.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Nomogramas , Humanos , Carcinoma de Células Renales/mortalidad , Carcinoma de Células Renales/cirugía , Carcinoma de Células Renales/patología , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Curva ROC , Estimación de Kaplan-Meier , Tasa de Supervivencia
5.
Allergy Asthma Clin Immunol ; 20(1): 34, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773574

RESUMEN

PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease characterized by inflammation of the nasal and sinus mucosa. The inflammatory patterns may differ among patients, leading to different subtypes based on the dominant inflammatory cell type. This study aimed to compare the differences in cytokine expression and disease severity between plasma cell-dominant and eosinophil-dominant subtypes in patients with CRSwNP. METHODS: This study included 53 CRSwNP patients and 19 control subjects who did not have asthma or a history of cigarette smoking. The expression of cytokines and inflammatory cells was assessed via enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry, respectively. RESULTS: Among the cytokines analyzed, only IL-6 was significantly different between the two subtypes. A greater proportion of mast cells and IgE cells was present in plasma cell-dominant CRSwNP patients than in eosinophil-dominant group. For the three disease severity scores (LMK-CT, TPS and SNOT-22), objective scores (LMK-CT and TPS) were greater in the eosinophil-dominant CRSwNP group, while the opposite result was shown for the subjective score (SNOT-22). Additionally, the percentage of plasma cell-dominant cells was significantly positively correlated with disease severity according to the TPS and SNOT-22 scores. CONCLUSIONS: Our data revealed that plasma cell-dominant inflammation, a subtype of type 2 CRS, was significantly correlated with subjective disease severity. The study also highlights the role of IL-6, IgE and mast cells as distinguishing factors between eosinophil-dominant and plasma cell-dominant CRSwNP. This information could be useful for clinical diagnosis and personalized treatment.

6.
Risk Manag Healthc Policy ; 17: 1165-1176, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38737417

RESUMEN

Objective: This study aimed to evaluate the impact of twin pregnancies with antiphospholipid antibody (aPL) positivity, a rare and complex clinical condition that remains a huge challenge for management. Methods: This study enrolled twin-pregnant women at our hospital between January 2018 and August 2023. Women with and without aPL positivity were selected using propensity score matching (PSM). Clinical features and pregnancy outcomes were compared between the two groups in the PSM cohort. To analyze the effect of aPL positivity on pregnancy outcomes, multivariate logistic models were used to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among the 773 women with twin pregnancies, aPL positivity was found in 26 women (3.36%). In the PSM cohort, there were 24 twin-pregnant women with positive aPL, and 48 women without aPL were selected as controls. Twin-pregnant women with aPL positivity had a higher proportion of abortion (8.33% vs 0, P = 0.043), preterm birth < 34 weeks (33.33% vs 8.33%, P = 0.007) and very low birthweight (<1500 g) (20.83% vs 4.17%, P = 0.016) than the control group. In addition, stillbirth of one fetus was observed in one twin-pregnant woman with positive aPL. Multivariate logistic regression analysis revealed that twin pregnancy with aPL positivity was associated with preterm birth < 34 weeks (aOR = 2.76, 95% CI: 0.83-4.70, P = 0.005), very low birthweight (<1500 g) (OR = 2.40, 95% CI: 0.18-4.67, P = 0.034) and small for gestational age (SGA) (aOR = 1.66, 95% CI: 0.22-3.10, P =0.024). Conclusion: Twin pregnancies with aPL positivity were correlated with obstetric complications, including abortion, preterm birth < 34 weeks and very low birthweight (<1500 g). The detection of aPL may be of clinical significance for women with twin pregnancies and should be considered in future studies.

7.
iScience ; 27(3): 109206, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38439977

RESUMEN

The cognitive and behavioral functions of the human brain are supported by its frequency multiplexing mechanism. However, there is limited understanding of the dynamics of the functional network topology. This study aims to investigate the frequency-specific topology of the functional human brain using 7T rs-fMRI data. Frequency-specific parcellations were first performed, revealing frequency-dependent dynamics within the frontoparietal control, parietal memory, and visual networks. An intrinsic functional atlas containing 456 parcels was proposed and validated using stereo-EEG. Graph theory analysis suggested that, in addition to the task-positive vs. task-negative organization observed in static networks, there was a cognitive control system additionally from a frequency perspective. The reproducibility and plausibility of the identified hub sets were confirmed through 3T fMRI analysis, and their artificial removal had distinct effects on network topology. These results indicate a more intricate and subtle dynamics of the functional human brain and emphasize the significance of accurate topography.

8.
Brain Res Bull ; 210: 110925, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38493835

RESUMEN

Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have widely explored the temporal connection changes in the human brain following long-term sleep deprivation (SD). However, the frequency-specific topological properties of sleep-deprived functional networks remain virtually unclear. In this study, thirty-seven healthy male subjects underwent resting-state fMRI during rested wakefulness (RW) and after 36 hours of SD, and we examined frequency-specific spectral connection changes (0.01-0.08 Hz, interval = 0.01 Hz) caused by SD. First, we conducted a multivariate pattern analysis combining linear SVM classifiers with a robust feature selection algorithm, and the results revealed that accuracies of 74.29%-84.29% could be achieved in the classification between RW and SD states in leave-one-out cross-validation at different frequency bands, moreover, the spectral connection at the lowest and highest frequency bands exhibited higher discriminative power. Connection involving the cingulo-opercular network increased most, while connection involving the default-mode network decreased most following SD. Then we performed a graph-theoretic analysis and observed reduced low-frequency modularity and high-frequency global efficiency in the SD state. Moreover, hub regions, which were primarily situated in the cerebellum and the cingulo-opercular network after SD, exhibited high discriminative power in the aforementioned classification consistently. The findings may indicate the frequency-dependent effects of SD on the functional network topology and its efficiency of information exchange, providing new insights into the impact of SD on the human brain.


Asunto(s)
Mapeo Encefálico , Privación de Sueño , Humanos , Masculino , Privación de Sueño/diagnóstico por imagen , Vías Nerviosas/patología , Encéfalo/patología , Vigilia , Imagen por Resonancia Magnética/métodos
9.
Cancer Biol Ther ; 25(1): 2325126, 2024 12 31.
Artículo en Inglés | MEDLINE | ID: mdl-38445610

RESUMEN

Ovarian cancer (OC) is a form of gynecological malignancy that is associated with worse patient outcomes than any other cancer of the female reproductive tract. Topoisomerase II α (TOP2A) is commonly regarded as an oncogene that is associated with malignant disease progression in a variety of cancers, its mechanistic functions in OC have yet to be firmly established. We explored the role of TOP2A in OC through online databases, clinical samples, in vitro and in vivo experiments. And initial analyses of public databases revealed high OC-related TOP2A expression in patient samples that was related to poorer prognosis. This was confirmed by clinical samples in which TOP2A expression was elevated in OC relative to healthy tissue. Kaplan-Meier analyses further suggested that higher TOP2A expression levels were correlated with worse prognosis in OC patients. In vitro, TOP2A knockdown resulted in the inhibition of OC cell proliferation, with cells entering G1 phase arrest and undergoing consequent apoptotic death. In rescue assays, TOP2A was confirmed to regulate cell proliferation and cell cycle through AKT/mTOR pathway activity. Mouse model experiments further affirmed the key role that TOP2A plays as a driver of OC cell proliferation. These data provide strong evidence supporting TOP2A as an oncogenic mediator and prognostic biomarker related to OC progression and poor outcomes. At the mechanistic level, TOP2A can control tumor cell growth via AKT/mTOR pathway modulation. These preliminary results provide a foundation for future research seeking to explore the utility of TOP2A inhibitor-based combination treatment regimens in platinum-resistant recurrent OC patients.


Asunto(s)
Neoplasias Ováricas , Proteínas Proto-Oncogénicas c-akt , Animales , Femenino , Humanos , Ratones , Carcinoma Epitelial de Ovario , Proliferación Celular , ADN-Topoisomerasas de Tipo II/genética , Neoplasias Ováricas/genética , Serina-Treonina Quinasas TOR
10.
Environ Sci Pollut Res Int ; 31(11): 16865-16883, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38324151

RESUMEN

Small and medium-sized businesses (SMEs) increasingly know the benefits of improving resource efficiency and closing loops. These benefits include lowering material costs, establishing competitive advantages, and gaining access to new markets. As a consequence of implementing new regulations, manufacturing companies, particularly those in the automobile industry, are compelled to modify and change their business practices related to the circular economy (CE). More stringent the implementation of environmentally responsible policies and strengthening environmental regulations. CE is the most important factor in improving environmental conditions since it reduces waste and boosts output. This facet calls for the attention of fresh academics and policymakers with years of relevant expertise. Recent studies have investigated how green logistics management might improve a company's overall performance in terms of environmental responsibility. However, we believe that the connection between environmentally responsible companies is not a direct one but rather one that is mediated by the practices of circular economies. We investigate the direct and indirect effects of the environmentally responsible impact of proper logistics management on organizations' overall environmental performance via the application of circular economy practices. Our theoretical underpinnings are the resource-based viewpoint and the resource dependence theory. This research also investigates whether or not the traceability of the supply chain has a mitigating influence on the connections. We evaluated the hypotheses using the PLS-SEM method, drawing on the empirical data provided by 245 Chinese factories considered modest or medium size. The results demonstrate that the management of green logistics has a constructive effect on circular economy practices and businesses' sustainability performance. In addition, although it greatly impacts circular economy practice among SMEs, supply chain traceability does not attenuate the connection between eco-friendly supply chain management and environmental impact. Green logistics management in SMEs is linked to improved sustainability performance via the circular economy practice. To further verify the efficacy of the mediation, we also ran the sober test. Our results strengthen knowledge of circular economy, environmentally friendly logistics management practices, and sustainability performance while advancing natural resource-based planning and the resource dependence theory, which are the two approaches. Given the scarcity of information research analyzing the interplay between these factors, our results are very significant.


Asunto(s)
Comercio , Industrias , Ambiente , Pequeña Empresa , Organizaciones
11.
J Integr Neurosci ; 23(2): 33, 2024 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-38419437

RESUMEN

BACKGROUND: Emotions are thought to be related to distinct patterns of neural oscillations, but the interactions among multi-frequency neural oscillations during different emotional states lack full exploration. Phase-amplitude coupling is a promising tool for understanding the complexity of the neurophysiological system, thereby playing a crucial role in revealing the physiological mechanisms underlying emotional electroencephalogram (EEG). However, the non-sinusoidal characteristics of EEG lead to the non-uniform distribution of phase angles, which could potentially affect the analysis of phase-amplitude coupling. Removing phase clustering bias (PCB) can uniform the distribution of phase angles, but the effect of this approach is unknown on emotional EEG phase-amplitude coupling. This study aims to explore the effect of PCB on cross-frequency phase-amplitude coupling for emotional EEG. METHODS: The technique of removing PCB was implemented on a publicly accessible emotional EEG dataset to calculate debiased phase-amplitude coupling. Statistical analysis and classification were conducted to compare the difference in emotional EEG phase-amplitude coupling prior to and post the removal of PCB. RESULTS: Emotional EEG phase-amplitude coupling values are overestimated due to PCB. Removing PCB enhances the difference in coupling strength between fear and happy emotions in the frontal lobe. Comparable emotion recognition performance was achieved with fewer features after removing PCB. CONCLUSIONS: These findings suggest that removing PCB enhances the difference in emotional EEG phase-amplitude coupling patterns and generates features that contain more emotional information. Removing PCB may be advantageous for analyzing emotional EEG phase-amplitude coupling and recognizing human emotions.


Asunto(s)
Electroencefalografía , Emociones , Humanos , Electroencefalografía/métodos , Emociones/fisiología , Miedo , Análisis por Conglomerados , Lóbulo Frontal
12.
Artículo en Inglés | MEDLINE | ID: mdl-38382917

RESUMEN

INTRODUCTION: Our objective was to conduct a systematic review and meta-analysis of studies evaluating the oncological and reproductive outcomes of patients with endometrial atypical hyperplasia (AH) and endometrioid endometrial cancer (EEC) undergoing conservative therapy with hysteroscopic resection (HR). MATERIAL AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews and meta-analyses. The study strictly followed the methodological framework proposed by the Cochrane Handbook and was retrospectively registered in PROSPERO (CRD42023469986). Searches were conducted in PubMed, Embase, and the Cochrane Library, from inception to October 10, 2023. A checklist based on items of the Newcastle-Ottawa Scale and the Methodological Index for Non-randomized Studies was used for quality assessment. The primary end points for this meta-analysis were complete response (CR), pregnancy, and live birth rates following HR-based therapy in patients with EEC or AH. The secondary end point was the recurrence rate (RR). RESULTS: Twenty-one articles involving 407 patients with clinical stage IA, low or intermediate grade, EEC, and 444 patients with AH managed with HR-based conservative treatment were included for this systematic review. CR to HR-based conservative therapy was achieved in 88.6% of patients with EEC and 97.0% of patients with AH. Of these, 30.6% and 24.2%, respectively, had live births. The overall pooled disease RR was 18.3% and 10.8% in patients with EEC and AH, respectively. Further subset analyses revealed that EEC patients with body mass index (BMI) ≤28 kg/m2 had higher CR rates as well as higher chances of pregnancy and live birth (91.6% CR, 32.9% pregnancy, 31.1% live birth) compared with patients with BMI >28 kg/m2 (86.4% CR, 28.4% pregnancy, 23.0% live birth). The HR followed by oral progestogen subgroup had higher CR rates and higher chances of pregnancy and live birth (91.8% CR, 36.3% pregnancy, 28.2% live birth) than the HR followed by the levonorgestrel intrauterine system subgroup (82.5% CR, 25.3% pregnancy, 16.3% live birth). CONCLUSIONS: Hysteroscopic resection followed by progestins appears to be a promising choice for fertility-sparing treatment in young patients with AH and EEC, with effective and safe responses. The live birth rate remains to be improved by providing medical guidance and encouragement.

13.
J Integr Neurosci ; 23(1): 18, 2024 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-38287841

RESUMEN

BACKGROUND: Affective computing has gained increasing attention in the area of the human-computer interface where electroencephalography (EEG)-based emotion recognition occupies an important position. Nevertheless, the diversity of emotions and the complexity of EEG signals result in unexplored relationships between emotion and multichannel EEG signal frequency, as well as spatial and temporal information. METHODS: Audio-video stimulus materials were used that elicited four types of emotions (sad, fearful, happy, neutral) in 32 male and female subjects (age 21-42 years) while collecting EEG signals. We developed a multidimensional analysis framework using a fusion of phase-locking value (PLV), microstates, and power spectral densities (PSDs) of EEG features to improve emotion recognition. RESULTS: An increasing trend of PSDs was observed as emotional valence increased, and connections in the prefrontal, temporal, and occipital lobes in high-frequency bands showed more differentiation between emotions. Transition probability between microstates was likely related to emotional valence. The average cross-subject classification accuracy of features fused by Discriminant Correlation Analysis achieved 64.69%, higher than that of single mode and direct-concatenated features, with an increase of more than 7%. CONCLUSIONS: Different types of EEG features have complementary properties in emotion recognition, and combining EEG data from three types of features in a correlated way, improves the performance of emotion classification.


Asunto(s)
Emociones , Miedo , Masculino , Humanos , Femenino , Adulto Joven , Adulto , Reconocimiento en Psicología , Electroencefalografía/métodos , Análisis Discriminante
14.
Oncologist ; 29(2): 151-158, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-37672362

RESUMEN

OBJECTIVE: The objective of this study was to explore the application of radiomics combined with machine learning to establish different models to assist in the diagnosis of venous wall invasion in patients with renal cell carcinoma and venous tumor thrombus and to evaluate the diagnostic efficacy. MATERIALS AND METHODS: We retrospectively reviewed the data of 169 patients in Peking University Third Hospital from March 2015 to January 21, who was diagnosed as renal mass with venous invasion. According to the intraoperative findings, 111 patients were classified to the venous wall invasion group and 58 cases in the non-invasion group. ITK-snap was used for tumor segmentation and PyRadiomics 3.0.1 package was used for feature extraction. A total of 1598 features could be extracted from each CT image. The patients were divided into training set and testing set by time. The elastic-net regression with 4-fold cross-validation was used as a dimension-reduction method. After feature selection, a support vector machines (SVM) model, a logistic regression (LR) model, and an extra trees (ET) model were established. Then the sensitivity, specificity, accuracy, and the area under the curve (AUC) were calculated to evaluate the diagnostic performance of each model on the testing set. RESULTS: Patients before September 2019 were divided into the training set, of which 88 patients were in the invasion group and 42 patients were in the non-invasion group. The others were in the testing set, of which 32 patients were in the invasion group and 16 patients were in the non-invasion group. A total of 34 radiomics features were obtained by the elastic-net regression. The SVM model had an AUC value of 0.641 (95% CI, 0.463-0.769), a sensitivity of 1.000, and a specificity of 0.062. The LR model had an AUC value of 0.769 (95% CI, 0.620-0.877), a sensitivity of 0.913, and a specificity of 0.312. The ET model had an AUC value of 0.853 (95% CI, 0.734-0.948), a sensitivity of 0.783, and a specificity of 0.812. Among the 3 models, the ET model had the best diagnostic effect, with a good balance of sensitivity and specificity. And the higher the tumor thrombus grade, the better the diagnostic efficacy of the ET model. In inferior vena cava tumor thrombus, the sensitivity, specificity, accuracy, and AUC of ET model can be improved to 0.889, 0.800, 0.857, 0.878 (95% CI, 0.745-1.000). CONCLUSION: Machine learning combined with radiomics method can effectively identify whether venous wall was invaded by tumor thrombus and has high diagnostic efficacy with an AUC of 0.853 (95% CI, 0.734-0.948).


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Humanos , Carcinoma de Células Renales/diagnóstico por imagen , Radiómica , Estudios Retrospectivos , Neoplasias Renales/diagnóstico por imagen , Tomografía Computarizada por Rayos X
15.
J Neurosci Methods ; 402: 110014, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-37995853

RESUMEN

Depressed mood has been proposed to possibly possess a unique mode of defocused attention. However, this argument needs to be supported by experimental evidence based on attentional performance. The present study used a perceptual load paradigm, combining factors of perceptual load, distractor-target compatibility, and eccentricity, to investigate the degree of attentional distraction in depressed mood. In addition, the mode of attentional distraction associated with depressed mood was explored with the time-frequency features of electroencephalography (EEG). The behavioral results showed that the high depressed mood (HD) group had significantly higher attentional distraction than the low depressed mood (LD) group. EEG results showed that 1) the beta power (especially beta-2, 18-30 Hz) of the two groups differed in the medio-late part of the attentional distraction, with significantly lower power in the HD group than in the LD group; 2) the results of the correlation between beta-2 power and depression scores revealed a significant negative correlation. These results imply that beta-2 is a potential marker that may be sensitive to depressed mood during attentional processing, which was further supported by the classification results of the support vector machine (SVM) with 80.65% accuracy between the HD and LD groups.


Asunto(s)
Atención , Depresión , Electroencefalografía
16.
IEEE Trans Biomed Eng ; 71(4): 1139-1150, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37906494

RESUMEN

Nowadays, how to estimate vigilance with higher accuracy has become a hot field of research direction. Although the increasing available modalities opens the door for amazing new possibilities to achieve good performance, the uncertain cross-modal interaction still poses a real challenge to the multimodal fusion. In this paper, a cross-modality alignment method has been proposed based on the contrastive learning for extracting shared but not the same information among modalities. The contrastive learning is adopted to minimize the intermodal differences by maximizing the similarity of semantic representation of modalities. Applying our proposed modeling framework, we evaluated our approach on SEED-VIG dataset consisting of EEG and EOG signals. Experiments showed that our study achieved state-of-the-art multimodal vigilance estimation performance both in intra-subject and inter-subject situations, the average of RMSE/CORR were improved to 0.092/0.893 and 0.144/0.887, respectively. In addition, analysis on the frequency bands showed that theta and alpha activities contain valuable information for vigilance estimation, and the correlation between them and PERCLOS can be significantly improved by contrastive learning. We argue that the proposed method in the inter-subject case could offer the possibility of reducing the high-cost of data annotation, and further analysis may provide an idea for the application of multimodal vigilance regression.


Asunto(s)
Aprendizaje , Vigilia , Incertidumbre
17.
J Neurosci Methods ; 402: 110015, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38000636

RESUMEN

Spectral regression (SR), a graph-based learning regression model, can be used to extract features from graphs to realize efficient dimensionality reduction. However, due to the SR method remains a regularized least squares problem and being defined in L2-norm space, the effect of artifacts in EEG signals cannot be efficiently resisted. In this work, to further improve the robustness of the graph-based regression models, we propose to utilize the prior distribution estimation in the Bayesian framework and develop a robust hierarchical Bayesian spectral regression framework (named HB-SR), which is designed with the hierarchical Bayesian ensemble strategies. In the proposed HB-SR, the impact of noises can be effectively reduced by the adaptive adjustment approach in model parameters with the data-driven manner. Specifically, in the current work, three different distributions have been elaborately designed to enhance the universality of the proposed HB-SR, i.e., Gaussian distribution, Laplace distribution, and Student-t distribution. To objectively evaluate the performance of the HB-SR framework, we conducted both simulation studies and emotion recognition experiments based on emotional EEG signals. Experimental results have consistently indicated that compared with other existing spectral regression methods, the proposed HB-SR can effectively suppress the influence of noises and achieve robust EEG emotion recognition.


Asunto(s)
Electroencefalografía , Emociones , Humanos , Teorema de Bayes , Electroencefalografía/métodos , Simulación por Computador , Aprendizaje
18.
Artículo en Inglés | MEDLINE | ID: mdl-38082896

RESUMEN

Light, and sound are persistently out of sync for subjective temporal perception called point of subjective simultaneity (PSS). It is stable within individuals but variable among individuals. Previous studies found that spontaneous alpha power, functioning in attention-related brain states, predicts individual PSS in the temporal order judgment (TOJ) task. However, the neural mechanisms underlying individual differences in audiovisual PSS have not been elucidated in the simultaneity judgment (SJ) task. A hypothesis that the spontaneous alpha band power might reflect the individual subjective temporal bias was proposed. We designed an SJ task EEG experiment where subjects judged whether the beep-flash stimuli are synchronous to test the above hypothesis. We primarily explored the correlation between the alpha-band power differences (visual- and auditory-leading conditions) with individual PSS. We used the V50A (~50% proportion of synchronous responses) to represent visual-leading conditions while A50V represents auditory-leading ones. We found the higher alpha power difference (V50A - A50V) predicted larger individual PSS. This study extends previous results and found that individual difference effects in the alpha band power also exist in the SJ task. The results suggested that alpha power might be associated with a spontaneous attentional state and reflect individuals' subjective temporal bias.


Asunto(s)
Percepción del Tiempo , Percepción Visual , Humanos , Percepción Visual/fisiología , Percepción Auditiva/fisiología , Individualidad , Percepción del Tiempo/fisiología , Encéfalo/fisiología
19.
Front Hum Neurosci ; 17: 1180533, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37900730

RESUMEN

Introduction: Emotion recognition plays a crucial role in affective computing. Recent studies have demonstrated that the fuzzy boundaries among negative emotions make recognition difficult. However, to the best of our knowledge, no formal study has been conducted thus far to explore the effects of increased negative emotion categories on emotion recognition. Methods: A dataset of three sessions containing consistent non-negative emotions and increased types of negative emotions was designed and built which consisted the electroencephalogram (EEG) and the electrocardiogram (ECG) recording of 45 participants. Results: The results revealed that as negative emotion categories increased, the recognition rates decreased by more than 9%. Further analysis depicted that the discriminative features gradually reduced with an increase in the negative emotion types, particularly in the θ, α, and ß frequency bands. Discussion: This study provided new insight into the balance of emotion-inducing stimuli materials.

20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 55(5): 818-824, 2023 Oct 18.
Artículo en Chino | MEDLINE | ID: mdl-37807734

RESUMEN

OBJECTIVE: Constructing a predictive model for urinary incontinence after laparoscopic radical prostatectomy (LRP) based on prostatic gland related MRI parameters. METHODS: In this study, 202 cases were included. All the patients were diagnosed with prostate cancer by prostate biopsy and underwent LRP surgery in Peking University Third Hospital. The preoperative MRI examination of all the patients was completed within 1 week before the prostate biopsy. Prostatic gland related parameters included prostate length, width, height, prostatic volume, intravesical prostatic protrusion length (IPPL), prostate apex shape, etc. From the first month after the operation, the recovery of urinary continence was followed up every month, and the recovery of urinary continence was based on the need not to use the urine pad all day long. Logistic multivariate regression analysis was used to analyze the influence of early postoperative recovery of urinary continence. Risk factors were used to draw the receiver operator characteristic (ROC) curves of each model to predict the recovery of postoperative urinary continence, and the difference of the area under the curve (AUC) was compared by DeLong test, and the clinical net benefit of the model was evaluated by decision curve analysis (DCA). RESULTS: The average age of 202 patients was 69.0 (64.0, 75.5) years, the average prostate specific antigen (PSA) before puncture was 12.12 (7.36, 20.06) µg/L, and the Gleason score < 7 points and ≥ 7 points were 73 cases (36.2%) and 129 cases (63.9%) respectively, with 100 cases (49.5%) at T1/T2 clinical stage, and 102 cases (50.5%) at T3 stage. The prostatic volume measured by preoperative MRI was 35.4 (26.2, 51.1) mL, the ratio of the height to the width was 0.91 (0.77, 1.07), the membranous urethral length (MUL) was 15 (11, 16) mm, and the IPPL was 2 (0, 6) mm. The prostatic apex A-D subtypes were 67 cases (33.2%), 80 cases (39.6%), 24 cases (11.9%) and 31 cases (15.3%), respectively. The training set and validation set were 141 cases and 61 cases, respectively. The operations of all the patients were successfully completed, and the urinary continence rate was 59.4% (120/202) in the 3 months follow-up. The results of multivariate analysis of the training set showed that the MUL (P < 0.001), IPPL (P=0.017) and clinical stage (P=0.022) were independent risk factors for urinary incontinence in the early postoperative period (3 months). The nomogram and clinical decision curve were made according to the results of multivariate analysis. The AUC value of the training set was 0.885 (0.826, 0.944), and the AUC value of the validation set was 0.854 (0.757, 0.950). In the verification set, the Hosmer-Lemeshow goodness-of-fit test was performed on the model, and the Chi-square value was 5.426 (P=0.711). CONCLUSION: Preoperative MUL, IPPL, and clinical stage are indepen-dent risk factors for incontinence after LRP. The nomogram developed based on the relevant parameters of MRI glands can effectively predict the recovery of early urinary continence after LRP. The results of this study require further large-scale clinical research to confirm.


Asunto(s)
Laparoscopía , Neoplasias de la Próstata , Incontinencia Urinaria , Masculino , Humanos , Próstata/diagnóstico por imagen , Próstata/cirugía , Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/patología , Incontinencia Urinaria/etiología , Laparoscopía/efectos adversos , Laparoscopía/métodos , Imagen por Resonancia Magnética/efectos adversos , Recuperación de la Función , Estudios Retrospectivos
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