Ultrasound-Based Radiomics for Predicting the WHO/ISUP Grading of Clear-Cell Renal Cell Carcinoma.

OBJECTIVE: To explore the performance of ultrasound image-based radiomics in predicting World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grading of clear-cell renal cell carcinoma (ccRCC). METHODS: A retrospective study was conducted via histopathological examination on participants with ccRCC from January 2021 to August 2023. Participants were randomly allocated to a training set and a validation set in a 3:1 ratio. The maximum cross-sectional image of the lesion on the preoperative ultrasound image was obtained, with the region of interest (ROI) delineated manually. Radiomic features were computed from the ROIs and subsequently normalized using Z-scores. Wilcoxon test and least absolute shrinkage and selection operator (LASSO) regression were applied for feature reduction and model development. The performance of the model was estimated by indicators including area under the curve (AUC), sensitivity and specificity. RESULTS: A total of 336 participants (median age, 57 y; 106 women) with ccRCC were finally included, of whom 243 had low-grade tumors (grade 1-2) and 93 had high-grade tumors (grade 3-4). A total of 1163 radiomic features were extracted from the ROIs for model construction and 117 informative radiomics features selected by Wilcoxon test were submitted to LASSO. Our ultrasound-based radiomics model included 51 features and achieved AUCs of 0.90 and 0.79 for the training and validation sets, respectively. Within the training set, the sensitivity and specificity measured 0.75 and 0.92, respectively, whereas in the validation set, the sensitivity and specificity measured 0.65 and 0.84, respectively. In the subgroup analysis, for the training and validation sets Philips AUCs were 0.91 and 0.75, Toshiba AUCs were 0.82 and 0.90, and General Electric AUCs were 0.95 and 0.82, respectively. CONCLUSION: Ultrasound-based radiomics can effectively predict the WHO/ISUP grading of ccRCC.

Assessing Consciousness in Patients with Disorders of Consciousness Using a Musical Stimulation Paradigm and Verifiable Criteria.

Numerous studies have shown that musical stimulation can activate corresponding functional brain areas. Electroencephalogram (EEG) activity during musical stimulation can be used to assess the consciousness states of patients with disorders of consciousness (DOC). In this study, a musical stimulation paradigm and verifiable criteria were used for consciousness assessment. Twentynine participants (13 healthy subjects, 6 patients in a minimally conscious state (MCS) and 10 patients in a vegetative state (VS)) were recruited, and EEG signals were collected while participants listened to preferred and relaxing music. Fusion features based on differential entropy (DE), common spatial pattern (CSP), and EEG-based network pattern (ENP) features were extracted from EEG signals, and a convolutional neural network-long short-term memory (CNN-LSTM) model was employed to classify preferred and relaxing music.The results showed that the average classification accuracy for healthy subjects reached 85.58%. For two of the patients in the MCS group, the classification accuracies reached 78.18% and 66.14%, and they were diagnosed with emergence from MCS (EMCS) two months later. The accuracies of three patients in the VS group were 58.18%, 64.32% and 62.05%, with two patients showing slight increases in scale scores. Our study suggests that musical stimulation could be an effective method for consciousness detection, with significant diagnostic implications for patients with DOC.

Dimethyl sulfoxide, an alternative for control of Nosema ceranae infection in honey bees (Apis mellifera).

Nosema ceranae is a microsporidian parasite that threatens current apiculture. N. ceranae-infected honey bees (Apis mellifera) exhibit morbid physiological impairments and reduced honey production, malnutrition, shorter life span, and higher mortality than healthy honey bees. In this study, we found that dimethyl sulfoxide (DMSO) could enhance the survival rate of N. ceranae-infected honey bees. Therefore, we investigated the effect of DMSO on N. ceranae-infected honey bees using comparative RNA sequencing analysis. Our results revealed that DMSO was able to affect several biochemical pathways, especially the metabolic-related pathways in N. ceranae-infected honey bees. Based on these findings, we conclude that DMSO may be a useful alternative for treating N. ceranae infection in apiculture.

Association between insulin resistance and vascular damage in an adult population in China: a cross-sectional study.

There is a relative scarcity of large-scale population studies investigating the relationship between the insulin resistance index of homeostasis model assessment (HOMA-IR) and vascular damage. Therefore, we assessed the association between HOMA-IR and vascular damage in adults aged 18 years and older in China. A total of 17,985 research subjects were included. Vascular damage markers and relevant laboratory tests were measured. HOMA-IR was calculated as (fasting insulin * fasting blood glucose)/22.5. Vascular damage included arteriosclerosis (ba-PWV > 1800 cm/s), peripheral artery disease (ABI < 0.9), and microalbuminuria (UACR > 30 mg/g). The relationship between HOMA-IR and vascular damage was analyzed using the RCS. The restricted cubic spline (RCS) analysis suggested that HOMA-IR was nonlinearly associated with arteriosclerosis (P for no-liner < 0.01), peripheral artery disease (P for no-liner < 0.01), and microalbuminuria (P for no-liner < 0.01). Further segmented regression analyses revealed that in study subjects with HOMA-IR < 5, we found that HOMA-IR was associated with an increased OR for arteriosclerosis (OR: 1.36, 95% CI (1.28, 1.45), P < 0.01), peripheral artery disease (OR: 1.33, 95% CI (1.10, 1.60), P < 0.01) and microalbuminuria (OR: 1.59, 95% CI (1.49, 1.70), P < 0.01). HOMA-IR is an independent risk factor for vascular damage, both macrovascular and microvascular. The phenomenon of saturation of HOMA-IR with vascular damage needs further investigation.

Numerical and Experiment Analysis of Sapphire Sandwich-Structure Fabry-Perot Pressure Sensor through Fast Fourier Transform and Mean Square Error Demodulation Algorithm.

Pressure sensors prepared from sapphire exhibit excellent characteristics, including high-temperature resistance, high hardness, and resistance to electromagnetic interference. A Fast Fourier Transform and Mean Square Error (FFT-MSE) demodulation algorithm was employed to demodulate a sapphire sandwich-structure Fabry-Perot (F-P) pressure sensor. Through simulation analysis, the experimental results indicated that the demodulation error of the air cavity length in the range of 206 µm to 216 µm was less than 0.0008%. Compared to single demodulation methods and combined demodulation methods based on FFT or Minimum Mean Square Error (MMSE), the method proposed in this work reduced the demodulation error by more than three times and increased accuracy by more than six times. The algorithm was utilized to demodulate the sapphire sandwich-structure F-P pressure sensor, and the test results indicated that the fitting error of the sensor was less than 0.025% within the pressure range of 0 MPa to 10 MPa. The repeatability error was less than 0.066%, the zero-point deviation was 1.26%, and the maximum stability deviation was 0.0063% per 30 min. The algorithm effectively demodulated the actual cavity length variation in the sapphire sandwich-structure F-P pressure sensor, providing a solution for the performance evaluation of the sapphire sandwich-structure F-P pressure sensor.

Modeling of Material Removal Rate for the Fixed-Abrasive Double-Sided Planetary Grinding of a Sapphire Substrate.

Double-sided planetary grinding (DSPG) with a fixed abrasive is widely used in sapphire substrate processing. Compared with conventional free abrasive grinding, it has the advantages of high precision, high efficiency, and environmental protection. In this study, we propose a material removal rate (MRR) model specific to the fixed-abrasive DSPG process for sapphire substrates, grounded in the trajectory length of abrasive particles. In this paper, the material removal rate model is obtained after focusing on the theoretical analysis of the effective number of abrasive grains, the indentation depth of a single abrasive grain, the length of the abrasive grain trajectory, and the groove repetition rate. To validate this model, experiments were conducted on sapphire substrates using a DSPG machine. Theoretical predictions of the material removal rate were then juxtaposed with experimental outcomes across varying grinding pressures and rotational speeds. The trends between theoretical and experimental values showed remarkable consistency, with deviations ranging between 0.2% and 39.2%, thereby substantiating the model's validity. Moreover, leveraging the insights from this model, we optimized the disparity in the material removal rate between two surfaces of the substrate, thereby enhancing the uniformity of the machining process across both surfaces.

Prospective comparison of 68Ga-DOTA-ibandronate and bone scans for detecting bone metastases in breast cancer.

Introduction: 68Ga labeled DOTA-Ibandronate (68Ga-DOTA-IBA) positron emission tomography/computed tomography (PET/CT), is a novel bone-targeting imaging tracer and promising diagnostic method for bone metastases detection. Therefore, this study aimed to compare 68Ga-DOTA-IBA PET/CT to the 99mTc-MDP whole-body bone scan (WBBS) for detecting bone metastases in breast cancer (BC). Materials and methods: In this prospective study, 45 women with BC underwent imaging via 68Ga-DOTA-IBA PET/CT and 99mTc-MDP WBBS. Clinical and demographic information as well as BC imaging features were recorded. The two methods were compared in terms of their detection rate for bone metastases and the number of lesions. Results: The 45 women were aged 53.5 ± 11.0 years. The bone metastases detection rate with 68Ga-DOTA-IBA PET/CT was 100% (45/45) and with 99mTc-MDP WBBS was 95.6% (43/45). A total of 546 bone metastases lesions were detected. The lesion detection rate using 68Ga-DOTA-IBA PET/CT was 100% (546/546) and using 99mTc-MDP WBBS was 67.8% (370/546). More lesions were found at each site via 68Ga-DOTA-IBA than via 99mTc-MDP WBBS. Conclusions: 68Ga-DOTA-IBA PET/CT is a more sensitive method than 99mTc-MDP WBBS for assessing bone metastases in BC and may therefore represent a useful imaging technique for bone metastases, while offering a visual basis for 177Lu-DOTA-IBA diagnosis and therapy response assessments for BC. Further validation using a broader study cohort is warranted to confirm these findings. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=170163, identifier ChiCTR2200064487.

Q-factor and wavelength adjustable ultra-perfect absorption under critical coupling through epsilon-near-zero-based absorbers.

Perfect absorption with adjustable Q factor and wavelength is essential in both theory and application. To address this issue, a structure composed of an epsilon-near-zero (ENZ)- SiO2 grating and a multilayer dielectric structure was designed. In the structure, the intrinsic loss is related to the ENZ thickness, while the external leakage depends on the grating parameters. By adjusting the ENZ film thickness, the intrinsic loss rate was tuned to match the external leakage rate corresponding to different grating parameters, realizing the critical couplings with different Q factors and wavelengths. Under critical coupling, the absorption rate reached a maximum of 99.999%, demonstrating ultra-perfect absorption. The Q factor was adjusted from 4350 to 35800, and the absorption wavelength was modified from 1050 to 1282 nm. The design work may provide new ideas for developing wavelength- and Q-selective absorbers, optical modulators, dielectric sensors, and photodetectors.

Biodegradable Long-Circulating Nanoagonists Optimize Tumor-Tropism Chemo-Metalloimmunotherapy for Boosted Antitumor Immunity by Cascade cGAS-STING Pathway Activation.

The activation of cyclic GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING) has been recognized as one of the most promising immunotherapeutic strategies to induce innate antitumor immune responses. However, it is far from effective to just activate the cGAS-STING pathway, owing to abundant immunosuppressive cells that infiltrate the tumor microenvironment (TME) to impair antitumor immunity. Here, we present the smart design of biodegradable Mn-doped mesoporous silica (MM) nanoparticles with metal-organic framework (MOF) gating and hyaluronic acid (HA)-modified erythrocyte membrane (eM) camouflaging to coload cisplatin (CDDP) and SR-717 (a STING agonist) for long-circulating tumor-tropism synergistic chemo-metalloimmunotherapy by cascade cGAS-STING activation. Once internalized by tumor cells, the acidity/redox-responsive gated MOF rapidly disintegrates to release SR-717 and exposes the dual-responsive MM to decompose with CDDP release, thus inducing damage to double-stranded DNA (dsDNA) in cancer cells. As tumor-specific antigens, these dsDNA fragments released from tumor cells can trigger cGAS-STING activation and enhance dendritic cell (DC) maturation and cytotoxic T cell (CTL) infiltration, thus giving rise to excellent therapeutic effects for efficient tumor regression. Overall, this custom-designed biodegradable long-circulating nanoagonist represents a paradigm of nanotechnology in realizing the synergistic cooperation of chemotherapy and metalloimmunotherapy based on cascade cGAS-STING activation for future oncological applications.

PVP-assisted synthesis of NiSnO3 firmly anchored on graphene as a high-performance lithium battery: A combination of theoretical and experimental study.

Tiny NiSnO3 nanoparticles with the assistance of polyvinylpyrrolidone (PVP) are prepared to uniformly and stably "bond" on the surface of graphene to form a stable NiSnO3/RGO-PVP structure. At the same time, the excellent performance of lithium-ion batteries (LIBs) with the use of NiSnO3/RGO-PVP structure is verified through a dual combination of experiment and theory. The resulting NiSnO3/RGO-PVP structure enhanced the performance of LIBs with high cycling stability and better rate capability; even after undergoing rate performance tests at different high current densities, the NiSnO3/RGO-PVP electrode can still reach a capacity of 624 mA h g-1 at 200 mA g-1 after 400 cycles. The superior electrochemical performance of NiSnO3/RGO-PVP nanocomposites can be attributed to the synergistic effects between tiny NiSnO3 nanoparticles synthesized with the assistance of PVP and RGO, which can be verified through first-principles calculations based on DFT. The charge transfer between NiSnO3 and RGO through an electron density difference indicates a strong interaction between the two. Meanwhile, the low adsorption energies (-3.914, -0.77, and -0.65 eV), low diffusion barriers (0.025, 0.49, and 0.141 eV), and high diffusion coefficients (1.79 × 10-3, 5.38 × 10-11, and 2.97 × 10-5 cm2 s-1) of lithium ions at three different positions indicate the excellent rate performance of the NiSnO3/RGO-PVP heterostructure, which is consistent with experimental results. This work analyzes the excellent electrochemical performance of NiSnO3/RGO-PVP from the experimental results and supports the reliability of the experimental results through theoretical calculations.

Removal of sulfonamide antibiotics by constructed wetland substrate with NaOH-modified corn straw biochar under different operating conditions.

This study examined the elimination of sulfonamide antibiotics (SAs) by constructed wetland substrates with NaOH-modified corn straw biochar and assessed the impact of environmental conditions on the effectiveness of SAs removal. The study demonstrated that the constructed wetland substrate with NaOH-modified biochar significantly eliminated eight SAs, with a removal rate of over 94 %. During the removal process, the intermediates will undergo regeneration of the parent compounds under low DO concentrations. This was based on the linear stepwise regression analysis and Geodetector models. The results showed that SA types COD, NH4+-N, TN, and DO had a stronger influence. The dominant bacteria in the constructed wetland system were mainly affected by antibiotic concentration, DO, NH4+-N and NO3--N, which affected the removal of antibiotics. Overall, the constructed wetland substrate with NaOH-modified corn straw biochar can be effectively employed as an ecological method for eliminating SAs from the environment.

Interactive and lag effects of environmental factors on the density of schistosome-transmitting Oncomelania hupensis: A twelve-year monthly repeated survey.

Schistosomiasis is a significant public health threat, and Oncomelania hupensis is the only intermediate host for schistosoma japonicum. We conducted 12-year monthly repeated surveys to explore the interactive and lag effects of environmental factors on snail density and to monitor their long-term and seasonal trends in a bottomland around the Dongting Lake region in China. Relevant environmental data were obtained from multiple sources. A Bayesian kernel machine regression model and a Bayesian temporal model combined with a distributed lag model were constructed to analyze interactive and lag effects of environmental factors on snail density. The results indicated the average annual snail density in the study site exhibited an increasing and then decreasing trend, peaking in 2013. Snail densities were the highest in October and the lowest in January in a year. Normalized Difference Vegetation Index (NDVI) and water level were the most effective predictors of snail density, with potential interactions among temperature, precipitation, and NDVI. The mean minimum temperature in January, water level, precipitation and NDVI were positively correlated with snail density at lags ranging from 1 to 4 months. These findings could serve as references for relevant authorities to monitor the changing trend of snail density and implement control measures, thereby reducing the occurrence of schistosomiasis.

Treatment response of venlafaxine induced alterations of gut microbiota and metabolites in a mouse model of depression.

Antidepressants remain the first-line treatment for depression. However, the factors influencing medication response are still unclear. Accumulating evidence implicates an association between alterations in gut microbiota and antidepressant response. Therefore, the aim of this study is to investigate the role of the gut microbiota-brain axis in the treatment response of venlafaxine. After chronic social defeat stress and venlafaxine treatment, mice were divided into responders and non-responders groups. We compared the composition of gut microbiota using 16 S ribosomal RNA sequencing. Meanwhile, we quantified metabolomic alterations in serum and hippocampus, as well as hippocampal neurotransmitter levels using liquid chromatography-mass spectrometry. We found that the abundances of 29 amplicon sequence variants (ASVs) were significantly altered between the responders and non-responders groups. These ASVs belonged to 8 different families, particularly Muribaculaceae. Additionally, we identified 38 and 39 differential metabolites in serum and hippocampus between the responders and non-responders groups, respectively. Lipid, amino acid, and purine metabolisms were enriched in both serum and hippocampus. In hippocampus, the concentrations of tryptophan, phenylalanine, gamma-aminobutyric acid, glutamic acid, and glutamine were increased, while the level of succinic acid was decreased in the responders group, compared with the non-responders group. Our findings suggest that the gut microbiota may play a role in the antidepressant effect of venlafaxine by modulating metabolic processes in the central and peripheral tissues. This provides a novel microbial and metabolic framework for understanding the impact of the gut microbiota-brain axis on antidepressant response.

Association study of NAFLD with pericoronary adipose tissue and pericardial adipose tissue: Diagnosis of stable CAD patients with NAFLD based on radiomic features.

BACKGROUND AND AIM: Nonalcoholic fatty liver disease (NAFLD) is prone to complicated cardiovascular disease, and we aimed to identify patients with NAFLD who are prone to developing stable coronary artery disease (CAD). METHODS AND RESULTS: We retrospectively recruited adults who underwent coronary computed tomography angiography (CTA). A total of 127 NAFLD patients and 127 non-NAFLD patients were included in this study. Clinical features and imaging parameters were analysed, mainly including pericardial adipose tissue (PAT), pericoronary adipose tissue (PCAT), and radiomic features of 6792 PCATs. The inflammatory associations of NAFLD patients with PAT and PCAT were analysed. Clinical features (model 1), CTA parameters (model 2), the radscore (model 3), and a composite model (model 4) were constructed to identify patients with NAFLD with stable CAD. The presence of NAFLD resulted in a greater inflammatory involvement in all three coronary arteries (all P < 0.01) and was associated with increased PAT volume (r = 0.178**, P < 0.05). In the presence of NAFLD, the mean CT value of the PAT was significantly correlated with the fat attenuation index (FAI) in all three vessels and had the strongest correlation with the RCA FAI (r = 0.55, p < 0.001). A total of 9 radiomic features were screened by LASSO regression to calculate radiomic scores. In the model comparison, model 4 had the best performance of all models (AUC 0.914 [0.863-0.965]) and the highest overall diagnostic value of the model (sensitivity: 0.814, specificity: 0.941). CONCLUSIONS: NAFLD correlates with PAT volume and PCAT inflammation. Furthermore, combining clinical features, CTA parameters, and radiomic scores can improve the efficiency of early diagnosis of stable CAD in patients with NAFLD.

Clinical Effectiveness and Safety of Transarterial Chemoembolization: Hepatic Artery Infusion Chemotherapy Plus Tyrosine Kinase Inhibitors With or Without Programmed Cell Death Protein-1 Inhibitors for Unresectable Hepatocellular Carcinoma-A Retrospective Study.

BACKGROUND: Locoregional treatment with transarterial chemoembolization (TACE) or hepatic artery infusion chemotherapy (HAIC) and systemic targeted immunotherapy with tyrosine kinase inhibitors (TKI) and programmed cell death protein-1 (PD-1) inhibitors in the treatment of unresectable hepatocellular carcinoma (uHCC) have achieved promising efficacy. The retrospective study aimed to evaluate the efficacy and safety of TACE and HAIC plus TKI with or without PD-1 for uHCC. PATIENTS AND METHODS: From November 2020 to February 2024, the data of 44 patients who received TACE-HAIC + TKI + PD-1 (THKP group) and 34 patients who received TACE-HAIC + TKI (THK group) were retrospectively analyzed. Primary outcomes were overall survival (OS) and progress-free survival (PFS), and secondary outcomes were objective response rate (ORR), disease control rate (DCR), conversion rates, and adverse events (AEs). RESULTS: A total of 78 patients were recruited in our single-center study. The patients in THKP group had prolonged median OS [25 months, 95% confidence interval (CI) 24.0-26.0 vs 18 months, 95% CI 16.1-19.9; p = 0.000278], median PFS [16 months, 95% CI 14.1-17.9 vs 12 months 95% CI 9.6-14.4; p = 0.004] and higher ORR (38.6% vs 23.5%, p = 0. 156) and DCR (88.6% vs 64.7%, p = 0.011) compared with those in THK group. Multivariate analysis showed that treatment option and alpha-fetoprotein (AFP) level were independent prognostic factors of OS and PFS. The frequency of AEs were similar between the two groups. CONCLUSIONS: The THKP group had better efficacy for uHCC than the THK group, with acceptable safety.

Development and validation of a nomogram to predict impacted ureteral stones via machine learning.

BACKGROUND: To develop and evaluate a nomogram for predicting impacted ureteral stones using some simple and easily available clinical features. METHODS: From June 2019 to July 2022, 480 patients who underwent ureteroscopic lithotripsy (URSL) for ureteral calculi were enrolled in the study. From the eligible study population between June 2019 and December 2020, a training and validation set was randomly generated in a 7:3 ratio. To further evaluate the generalization performance of the nomogram, we performed an additional validation using the data from January 2021 to July 2022. Lasso regression analysis was used to identify the most useful predictive features. Subsequently, a multivariate logistic regression algorithm was applied to select independent predictive features. The predictive performance of the nomogram was assessed using Receiver Operating Characteristic (ROC) curves, calibration curves and decision Curve Analysis (DCA). The Hosmer-Lemeshow Test was utilized to evaluate the overall goodness of fit of the nomogram. RESULTS: Multivariate logistic regression analysis showed that flank pain, hydronephrosis, stone length/width, HU below (Hounsfield unit density of the ureter center below the stone), HU above/below (HU above divided by HU below) and UWT (ureteral wall thickness) were ascertained as independent predictors of impacted ureteral stones. The nomogram showed outstanding performance within the training dataset, with the area under the curve (AUC) of 0.907. Moreover, the AUC was 0.874 in the validation dataset. The ROC curve, calibration curve, DCA curve and Hosmer-Lemeshow Test suggested that the nomogram maintains excellent clinical applicability and demonstrates commendable performance. Similar results were achieved in the test dataset as well. CONCLUSIONS: We established a nomogram that can be effectively used for preoperative diagnosis of impacted ureteral stones, which is of great significance for the treatment of this disease.

Efficacy and Safety Evaluation of 177Lu-FAP-2286 in the Treatment of Advanced Lung Cancer.

PURPOSE: The aim of this study was to evaluate the efficacy and safety of peptide-targeted radionuclide therapy (PTRT) with 177Lu-FAP-2286 in advanced lung cancer. PATIENTS AND METHODS: This single-center prospective study included 9 patients diagnosed with advanced lung cancer. These patients met the inclusion criteria and received PTRT with 177Lu-FAP-2286. Short-term efficacy was assessed using RECIST 1.1 and PERCIST 1.0 criteria. Long-term efficacy was evaluated through overall survival, progression-free survival (PFS), overall response rate, EORTC QLQ-C30 v3.0, Eastern Cooperative Oncology Group, and Karnofsky Performance Status. Toxicity response was assessed using CTCAE v5.0. RESULTS: The results based on RECIST 1.1 and PERCIST 1.0 criteria were comparable, with 44% of patients showing a partial metabolic response, 33.3% with stable metabolic disease, and 22.22% with progressive metabolic disease. The highest metabolic response after treatment reached 66.89%, and the overall response rate could reach 77.78%. In the long-term efficacy assessment, the median overall survival and PFS were 10 months and 6 months, respectively. The 2 patients with the lowest PFS (3 months) started PTRT relatively late. EORTC QLQ-C30 v3.0, Eastern Cooperative Oncology Group, and Karnofsky Performance Status scores showed that the overall health status, symptom response, and quality of life of patients improved after 177Lu-FAP-2286 treatment. The most noticeable improvements in clinical symptoms were dyspnea and cancer-related pain. No grade III/IV toxicity events were observed during follow-up period, and fibrinogen decreased significantly after treatment. CONCLUSIONS: 177Lu-FAP-2286 has the potential to be a viable PTRT option for patients with advanced lung cancer.