RESUMEN
The escalating consumer demand for crabs results in a growing amount of waste, including shells, claws, and other non-edible parts. The resulting crab shell waste (CSW) is disposed of via incineration or landfills which causes environmental pollution. CSW represents a potential biological resource that can be transformed into valuable resources via pyrolysis technique. In this study, microwave pyrolysis of CSW using self-purging, vacuum, and steam activation techniques was examined to determine the biochar production yield and its performance in treating palm oil mill effluent (POME). The biochar produced through microwave pyrolysis exhibits yields ranging from 50 to 61 wt%, showing a hard texture, low volatile matter content (≤34.1 wt%), and high fixed carbon content (≥58.3 wt%). The KOH-activated biochar demonstrated a surface area of up to 177 m2/g that is predominantly composed of mesopores, providing a good amount of adsorption sites for use as adsorbent. The biochar activated with steam removed 8.3 mg/g of BOD and 42 mg/g of COD from POME. The results demonstrate that microwave pyrolysis of CSW is a promising technology to produce high-quality biochar as an adsorbent for POME treatment.
Asunto(s)
Braquiuros , Carbón Orgánico , Animales , Aceite de Palma , Microondas , Pirólisis , Vapor , Residuos Industriales/análisisRESUMEN
BACKGROUND: Minimal residual disease (MRD) is proposed to be responsible for tumor recurrence. The role of circulating tumor DNA (ctDNA) to detect MRD, monitor recurrence, and predict prognosis in liver cancer patients undergoing liver transplantation (LT) remains unrevealed. METHODS: Serial blood samples were collected to profile ctDNA mutational changes. Baseline ctDNA mutational profiles were compared with those of matched tumor tissues. Correlations between ctDNA status and recurrence rate (RR) and recurrence-free survival (RFS) were analyzed, respectively. Dynamic change of ctDNA was monitored to predict tumor recurrence. RESULTS: Baseline mutational profiles of ctDNA were highly concordant with those of tumor tissues (median, 89.85%; range 46.2-100%) in the 74 patients. Before LT, positive ctDNA status was associated with higher RR (31.7% vs 11.5%; p = 0.001) and shorter RFS than negative ctDNA status (17.8 vs 19.4 months; p = 0.019). After LT, the percentage of ctDNA positivity decreased (17.6% vs 47.0%; p < 0.001) and patients with positive ctDNA status had higher RR (46.2% vs 21.3%; p < 0.001) and shorter RFS (17.2 vs 19.2 months; p = 0.010). Serial ctDNA profiling demonstrated patients with decreased or constant negative ctDNA status had lower RR (33.3% vs 50.0%; p = 0.015) and favorable RFS (18.2 vs 15.0 months, p = 0.003) than those with increased or constant positive ctDNA status. Serial ctDNA profiling predicted recurrence months ahead of imaging evidence and serum tumor biomarkers. CONCLUSIONS: ctDNA could effectively detect MRD and predict tumor recurrence in liver cancer patients undergone LT.
Asunto(s)
ADN Tumoral Circulante , Neoplasias Hepáticas , Trasplante de Hígado , Humanos , ADN Tumoral Circulante/genética , Recurrencia Local de Neoplasia/genética , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirugía , Biomarcadores de Tumor/genéticaRESUMEN
E-waste, encompassing discarded materials from outdated electronic equipment, often ends up intermixed with municipal solid waste, leading to improper disposal through burial and incineration. This improper handling releases hazardous substances into water, soil, and air, posing significant risks to ecosystems and human health, ultimately entering the food chain and water supply. Formal e-waste recycling, guided by circular economy models and zero-discharge principles, offers potential solutions to this critical challenge. However, implementing a circular economy for e-waste management due to chemical and energy consumption may cause environmental impacts. Consequently, advanced sustainability assessment tools, such as Life Cycle Assessment (LCA), have been applied to investigate e-waste management strategies. While LCA is a standardized methodology, researchers have employed various routes for environmental assessment of different e-waste management methods. However, to the authors' knowledge, there lacks a comprehensive study focusing on LCA studies to discern the opportunities and limitations of this method in formal e-waste management strategies. Hence, this review aims to survey the existing literature on the LCA of e-waste management under a circular economy, shedding light on the current state of research, identifying research gaps, and proposing future research directions. It first explains various methods of managing e-waste in the circular economy. This review then evaluates and scrutinizes the LCA approach in implementing the circular bioeconomy for e-waste management. Finally, it proposes frameworks and procedures to enhance the applicability of the LCA method to future e-waste management research. The literature on the LCA of e-waste management reveals a wide variation in implementing LCA in formal e-waste management, resulting in diverse results and findings in this field. This paper underscores that LCA can pinpoint the environmental hotspots for various pathways of formal e-waste recycling, particularly focusing on metals. It can help address these concerns and achieve greater sustainability in e-waste recycling, especially in pyrometallurgical and hydrometallurgical pathways. The recovery of high-value metals is more environmentally justified compared to other metals. However, biometallurgical pathways remain limited in terms of environmental studies. Despite the potential for recycling e-waste into plastic or glass, there is a dearth of robust background in LCA studies within this sector. This review concludes that LCA can offer valuable insights for decision-making and policy processes on e-waste management, promoting environmentally sound e-waste recycling practices. However, the accuracy of LCA results in e-waste recycling, owing to data requirements, subjectivity, impact category weighting, and other factors, remains debatable, emphasizing the need for more uncertainty analysis in this field.
Asunto(s)
Residuos Electrónicos , Eliminación de Residuos , Administración de Residuos , Humanos , Animales , Ecosistema , Residuos Electrónicos/análisis , Reciclaje/métodos , Administración de Residuos/métodos , Electrónica , Metales , Estadios del Ciclo de VidaRESUMEN
Heavy metal pollution has attracted increasing concern due to its high toxicity and persistence. A suitable extraction procedure for available heavy metals in soil is necessary for assessing the ecological risk. In this work, the single extraction methods aided by shaking and microwaves were investigated and analyzed for their ability to extract available heavy metals from soil samples, and a total of 42 soil samples were collected from suburbs of Zhengzhou city in China. The extraction efficiency of Cu, Zn, As, and Cd in the certified fluvo-aquic soil was compared using eight different types of solutions: CaCl2, CH3COONH4, NH4NO3, CH3COOH, Na2EDTA, DTPA, HNO3, and NH4H2PO4. Results indicated that the shaking-assisted method that utilized Na2EDTA as an extractant demonstrated satisfactory efficiency and was chosen for further optimization and that the optimal conditions were obtained using 0.05 M Na2EDTA at pH 7, soil-liquid ratio 1:20, and extraction duration 2 h, which gained the perfect extraction efficiency ranging from 85.8 to 109.5%. The proposed approach has been applied to extract available Cu, Zn, As, and Cd in soils of Zhengzhou suburbs, where the mean values varied from 0.129 to 6.881 mg/kg. The bioavailability of different heavy metals in the soil varies greatly, with Cd having the highest activity in the survey region. Significant (p < 0.01) positive relationships were observed between the available state and the total amount of all the heavy metals. The assessment of health risks associated with heavy metals indicated that there was no risk for chronic non-carcinogenic effects. Even though the total amount of metal elements in suburban soil of Zhengzhou is 1.6% with high carcinogenic risk, the risk of available elements is still within the acceptable range, which verified that the risk grade obtained by the total amount is higher than the actual risk.
Asunto(s)
Cadmio , Metales Pesados , Ácido Edético , Monitoreo del Ambiente , China , Medición de Riesgo , SueloRESUMEN
This study evaluated the efficacy and safety of three-dimensional printing model-assisted percutaneous transhepatic one-step biliary fistulation (PTOBF) combined with rigid choledochoscopy for intrahepatic bile duct stones in patients with type I bile duct classification. The clinical data of 63 patients with a type I intrahepatic bile duct were reviewed from January 2019 to January 2023; 30 patients who underwent 3D printed model-assisted PTOBF combined with rigid choledochoscopy composed the experimental group and 33 patients who underwent simple PTOBF combined with rigid choledochoscopy composed the control group. Six indicators, including one-stage operation time and clearance rate, final removal rate, bleeding volume, channel size and complications, were observed and analyzed in the two groups. The one-stage and final removal rate in the experimental group was higher than that in the control group (P = 0.034, P = 0.014 versus control group). The time of one-stage operation, bleeding volume, and incidence of complications in the experimental group were significantly lower than those in the control group (P < 0.001, P = 0.039, P = 0.026 versus control group). Compared with simple PTOBF combined with rigid choledochoscopy, 3D printed model-assisted PTOBF combined with rigid choledochoscopy is a safer and more effective method for treating intrahepatic bile duct stones.
Asunto(s)
Laparoscopía , Humanos , Laparoscopía/métodos , Conductos Biliares Intrahepáticos/cirugía , Incidencia , Tempo OperativoRESUMEN
Advanced intrahepatic cholangiocarcinoma (ICC) has a dismal prognosis. Here, we report the efficacy and safety of combining toripalimab, lenvatinib, and gemcitabine plus oxaliplatin (GEMOX) as first-line therapy for advanced ICC. Thirty patients with pathologically confirmed advanced ICC received intravenous gemcitabine (1 g/m2) on Days 1 and 8 and oxaliplatin (85 mg/m2) Q3W for six cycles along with intravenous toripalimab (240 mg) Q3W and oral lenvatinib (8 mg) once daily for one year. The expression of programmed death-ligand 1 (PD-L1) and genetic status was investigated in paraffin-embedded tissues using immunohistochemistry and whole-exome sequencing (WES) analysis. The primary endpoint was the objective response rate (ORR). Secondary outcomes included safety, overall survival (OS), progression-free survival (PFS), disease control rate (DCR) and duration of response (DoR). As of July 1, 2022, the median follow-up time was 23.5 months, and the ORR was 80%. Twenty-three patients achieved partial response, and one achieved complete response. Patients (21/30) with DNA damage response (DDR)-related gene mutations showed a higher ORR, while patients (14/30) with tumor area positivity ≥1 (PD-L1 staining) showed a trend of high ORR, but without significant difference. The median OS, PFS, and DoR were 22.5, 10.2, and 11.0 months, respectively. The DCR was 93.3%. Further, 56.7% of patients experienced manageable grade ≥3 adverse events (AEs), commonly neutropenia (40.0%) and leukocytopenia (23.3%). In conclusion, toripalimab plus lenvatinib and GEMOX are promising first-line regimens for the treatment of advanced ICC. A phase-III, multicenter, double-blinded, randomized study to validate our findings was approved by the National Medical Products Administration (NMPA, No. 2021LP01825).Trial registration Clinical trials: NCT03951597.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias de los Conductos Biliares , Colangiocarcinoma , Humanos , Antígeno B7-H1 , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Neoplasias de los Conductos Biliares/genética , Conductos Biliares Intrahepáticos , Colangiocarcinoma/tratamiento farmacológico , Colangiocarcinoma/genética , Oxaliplatino/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéuticoRESUMEN
BACKGROUND: P16INK4A is a surrogate signature compensating for the specificity and/or sensitivity deficiencies of the human papillomavirus (HPV) DNA and Papanicolaou smear (Pap) co-test for detecting high-grade cervical squamous intraepithelial lesions or worse (HSIL+). However, traditional p16INK4A immunostaining is labour intensive and skill demanding, and subjective biases cannot be avoided. Herein, we created a high-throughput, quantitative diagnostic device, p16INK4A flow cytometry (FCM) and assessed its performances in cervical cancer screening and prevention. METHODS: P16INK4A FCM was built upon a novel antibody clone and a series of positive and negative (p16INK4A -knockout) standards. Since 2018, 24 100-women (HPV-positive/-negative, Pap-normal/-abnormal) have been enrolled nationwide for two-tier validation work. In cross-sectional studies, age- and viral genotype-dependent expression of p16INK4A was investigated, and optimal diagnostic parameter cut-offs (using colposcopy and biopsy as a gold standard) were obtained. In cohort studies, the 2-year prognostic values of p16INK4A were investigated with other risk factors by multivariate regression analyses in three cervicopathological conditions: HPV-positive Pap-normal, Pap-abnormal biopsy-negative and biopsy-confirmed LSIL. RESULTS: P16INK4A FCM detected a minimal ratio of 0.01% positive cells. The p16INK4A -positive ratio was 13.9 ± 1.8% among HPV-negative NILM women and peaked at the ages of 40-49 years; after HPV infection, the ratio increased to 15.1 ± 1.6%, varying with the carcinogenesis of the viral genotype. Further increments were found in women with neoplastic lesions (HPV-negative: 17.7 ± 5.0-21.4 ± 7.2%; HPV-positive: 18.0 ± 5.2-20.0 ± 9.9%). Extremely low expression of p16INK4A was observed in women with HSILs. As the HPV-combined double-cut-off-ratio criterion was adopted, a Youden's index of 0.78 was obtained, which was significantly higher than that (0.72) of the HPV and Pap co-test. The p16INK4A -abnormal situation was an independent HSIL+ risk factor for 2-year outcomes in all three cervicopathological conditions investigated (hazard ratios: 4.3-7.2). CONCLUSIONS: FCM-based p16INK4A quantification offers a better choice for conveniently and precisely monitoring the occurrence of HSIL+ and directing risk-stratification-based interventions.
Asunto(s)
Infecciones por Papillomavirus , Lesiones Intraepiteliales Escamosas , Neoplasias del Cuello Uterino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Inhibidor p16 de la Quinasa Dependiente de Ciclina , Estudios Transversales , Detección Precoz del Cáncer , Citometría de Flujo , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Proteínas Inhibidoras de las Quinasas Dependientes de la CiclinaRESUMEN
With the synchronous development of highway construction and the urban economy, automobiles have entered thousands of households as essential means of transportation. This paper reviews the latest research progress in using phytoremediation technology to remediate the environmental pollution caused by automobile exhaust in recent years, including the prospects for stereoscopic forestry. Currently, most automobiles on the global market are internal combustion vehicles using fossil energy sources as the primary fuel, such as gasoline, diesel, and liquid or compressed natural gas. The composition of vehicle exhaust is relatively complex. When it enters the atmosphere, it is prone to a series of chemical reactions to generate various secondary pollutants, which are very harmful to human beings, plants, animals, and the eco-environment. Despite improving the automobile fuel quality and installing exhaust gas purification devices, helping to reduce air pollution, the treatment costs of these approaches are expensive and cannot achieve zero emissions of automobile exhaust pollutants. The purification of vehicle exhaust by plants is a crucial way to remediate the environmental pollution caused by automobile exhaust and improve the environment along the highway by utilizing the ecosystem's self-regulating ability. Therefore, it has become a global trend to use phytoremediation technology to restore the automobile exhaust pollution. Now, there is no scientific report or systematic review about how plants absorb vehicle pollutants. The screening and configuration of suitable plant species is the most crucial aspect of successful phytoremediation. The mechanisms of plant adsorption, metabolism, and detoxification are reviewed in this paper to address the problem of automobile exhaust pollution.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Ambientales , Animales , Humanos , Emisiones de Vehículos/análisis , Biodegradación Ambiental , Ecosistema , Contaminantes Atmosféricos/análisis , Gasolina/análisis , Contaminación del Aire/prevención & controlRESUMEN
Radionuclides released from nuclear contamination harm the environment and human health. Nuclear pollution spread over large areas and the costs associated with decontamination is high. Traditional remediation methods include both chemical and physical, however, these are expensive and unsuitable for large-scale restoration. Bioremediation is the use of plants or microorganisms to remove pollutants from the environment having a lower cost and can be upscaled to eliminate contamination from soil, water and air. It is a cheap, efficient, ecologically, and friendly restoration technology. Here we review the sources of radionuclides, bioremediation methods, mechanisms of plant resistance to radionuclides and the effects on the efficiency of biological adsorption. Uptake of radionuclides by plants can be facilitated by the addition of appropriate chemical accelerators and agronomic management, such as citric acid and intercropping. Future research should accelerate the use of genetic engineering and breeding techniques to screen high-enrichment plants. In addition, field experiments should be carried out to ensure that this technology can be applied to the remediation of nuclear contaminated sites as soon as possible.
Asunto(s)
Contaminantes Ambientales , Contaminantes del Suelo , Humanos , Biodegradación Ambiental , Contaminantes del Suelo/química , Fitomejoramiento , Plantas , Suelo , RadioisótoposRESUMEN
Microplastics are among the major contaminations in terrestrial and marine environments worldwide. These persistent organic contaminants composed of tiny particles are of concern due to their potential hazards to ecosystem and human health. Microplastics accumulates in the ocean and in terrestrial ecosystems, exerting effects on living organisms including microbiomes, fish and plants. While the accumulation and fate of microplastics in marine ecosystems is thoroughly studied, the distribution and biological effects in terrestrial soil call for more research. Here, we review the sources of microplastics and its effects on soil physical and chemical properties, including water holding capacity, bulk density, pH value as well as the potential effects to microorganisms and animals. In addition, we discuss the effects of microplastics in combination with other toxic environmental contaminants including heavy metals and antibiotics on plant growth and physiology, as well as human health and possible degradation and remediation methods. This reflect is an urgent need for monitoring projects that assess the toxicity of microplastics in soil and plants in various soil environments. The prospect of these future research activities should prioritize microplastics in agro-ecosystems, focusing on microbial degradation for remediation purposes of microplastics in the environment.
Asunto(s)
Microplásticos , Contaminantes Químicos del Agua , Animales , Humanos , Ecosistema , Suelo , Plásticos/toxicidad , Cadena Alimentaria , Monitoreo del AmbienteRESUMEN
For purpose of clarifying the impact on particle size of bulking agents on humification and relevant mechanisms, different length (<2 cm, 2 cm, 5 cm, 10 cm) of branch and straw were blended with swine manure individually for 100 days aerobic composting. Results demonstrated that, 2 cm and 5 cm of branch and straw promoted the highest degradation of DOC by 41.49 % and 58.42 %, and increased the humic substances by 23.81 % and 55.82 % in maturity stage, respectively, compared with other treatments. As shown in microbial consequence, the maximum relative abundance of humus funguses increased by 99.55 % and 99.92 % at phylum, and 98.95 % and 99.24 % at genus in 2 cm and 5 cm of branch and straw treatment, thus verifying the result in variation of humus content. In a word, particle size could result in obvious impact on humification, and the optimized size were about 2 cm and 5 cm of branch and straw.
Asunto(s)
Compostaje , Porcinos , Animales , Estiércol , Tamaño de la Partícula , Sustancias Húmicas/análisis , SueloRESUMEN
Background: Hepatocellular carcinoma (HCC) is a malignant tumor with a high rate of recurrence and m metastasis that does not respond well to current therapies and has a very poor prognosis. Disulfidptosis is a novel mode of cell death that has been analyzed as a novel therapeutic target for HCC cells. Methods: This study integrated bulk ribonucleic acid (RNA) sequencing datasets, spatial transcriptomics (ST), and single-cell RNA sequencing to explore the landscape of disulfidptosis and the immune microenvironment of HCC cells. Results: We developed a novel model to predict the prognosis of patients with HCC based on disulfidptosis. The model has good stability, applicability, and prognostic and immune response prediction abilities. N-myc downregulated gene1 (NDRG1) may contribute to poor prognosis by affecting macrophage differentiation, thus allowing HCC cells to evade the immune system. Conclusion: Our study explores the disulfidptosis of HCC cells through multi-omics and establishes a new putative model that explores possible targets for HCC treatment.
Asunto(s)
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Muerte Celular , Línea Celular , Inmunoterapia , Microambiente TumoralRESUMEN
Biomass rapid pyrolysis technology is easy to implement in continuous production and industrial application, and has become one of the leading technologies in the field of world renewable energy development. Agricultural and forestry waste is an important resource of renewable energy in China. In general, abandoned leaves in forest areas cause serious waste of resources. Its utilization may help to settle the problems of energy deficiency and environment pollution. In this study, Aesculus chinensis Bunge leaves (A. Bunge) are used as the research object to study the pyrolysis and extract. The results showed that there are a lot of bioactive components in A. Bunge leaves extract, including acetamide, 5-hydroxymethylfurfural, R-limonene, d-mannose, and dihydroxyacetone. The active components of A. Bunge leaves supply scientific evidence for the exploration and exploitation of this plant. The pyrolysis products of A. Bunge leaves are rich in organic acids, aldehydes, and ketones, which means that A. Bunge leaves can be used as a crude material for the manufacturing of bio-oil or bio-fuel. The pyrolysis products include batilol, pregnenolone, benzoic acid, butyrolactone, and propanoic acid, which can be used in biological medicine, chemical crude materials, and industrial raw material reagents. Therefore, A. Bunge leaves can be used as a good crude material for bio-oil or biofuel production. Combining A. Bunge leaves and fast pyrolysis methods can effectively solve the problem of forestry and agricultural residues in the future.
RESUMEN
This study aimed to establish three-dimensional models of the biliary tract of Chinese people using the Hisense computer-aided surgery (CAS) system and to explore the branching patterns and variation types of the biliary system under the study of 3D reconstruction of the biliary tract. Three-dimensional models of the biliary tract were reconstructed in 50 patients using the Hisense CAS system. The branching patterns of intrahepatic bile ducts were observed. The biliary tract was classified according to the confluence of the right posterior sectoral duct (RPSD), right anterior sectoral duct (RASD) and left hepatic duct (LHD), and the presence or absence of accessory hepatic ducts. The 3D models of the bile ducts were successfully reconstructed in 50 Chinese patients. The branching patterns of the bile ducts were classified into seven types. The anatomy of the bile ducts was typical in 54% of cases (n = 27), showed triple confluence in 10% (n = 5), and crossover anomaly in 14% (n = 7), which means anomalous drainage of the RPSD into the LHD, anomalous drainage of the RPSD into the common hepatic duct (CHD) in 10% (n = 5), anomalous drainage of the RPSD into the cystic duct (CD) in 2% (n = 1), absence of left main hepatic duct in 1% (n = 1), presence of accessory duct in 8% (n = 4). Among them, there were three cases of accessory hepatic ducts coexisting with other variation types. By using the Hisense CAS system to establish 3D models of the biliary tract of the Chinese people, we established the branching model of the second-order bile ducts, which has important value for the classification of the biliary system and its variation types.
RESUMEN
Background: The clinical benefit of hepatectomy in patients with liver metastases from gastrointestinal stromal tumors (GIST) has not been well defined in this era of tyrosine kinase inhibitor (TKI). Our study aims to demonstrate the survival advantage of adding hepatectomy in patients with GIST liver metastases. Methods: Information on patients with metastatic GIST treated or consulted between January 2006 and December 2018 was retrieved. Patients without extrahepatic metastases were included and classified into the surgical (S group) and non-surgical (NS group). Clinicopathological features were compared and their association with survival was assessed. Results: A total of 119 patients were included in this retrospective analysis, 62 in the S group and 59 in the NS group. Comparison of clinicopathological features showed that a markedly higher proportion of patients in the S group had ≤3 hepatic lesions (79.0% vs. 29.8%, p<0.001). After a median follow-up duration of 56 months, patients in the S group had significantly better progression-free survival (PFS) and marginally improved overall survival (OS) than those in the NS group (3y PFS:86.2% vs. 64.6%, p=0.002; 5y OS: 91.5% vs. 78.3%, p=0.083). After propensity score matching, multivariate analysis identified hepatectomy as the only significant prognostic factor for PFS while age, hepatectomy and max tumor diameter were significant predictor for OS. Conclusions: Addition of hepatectomy provided longer disease control in patients with metastatic GIST confined to the liver. Upfront hepatectomy followed by imatinib therapy is worthwhile trying in patients with single and easily removable lesions.
RESUMEN
Identifying people with a high risk of developing diabetes among those with prediabetes may facilitate the implementation of a targeted lifestyle and pharmacological interventions. We aimed to establish machine learning models based on demographic and clinical characteristics to predict the risk of incident diabetes. We used data from the free medical examination service project for elderly people who were 65 years or older to develop logistic regression (LR), decision tree (DT), random forest (RF), and extreme gradient boosting (XGBoost) machine learning models for the follow-up results of 2019 and 2020 and performed internal validation. The receiver operating characteristic (ROC), sensitivity, specificity, accuracy, and F1 score were used to select the model with better performance. The average annual progression rate to diabetes in prediabetic elderly people was 14.21%. Each model was trained using eight features and one outcome variable from 9607 prediabetic individuals, and the performance of the models was assessed in 2402 prediabetes patients. The predictive ability of four models in the first year was better than in the second year. The XGBoost model performed relatively efficiently (ROC: 0.6742 for 2019 and 0.6707 for 2020). We established and compared four machine learning models to predict the risk of progression from prediabetes to diabetes. Although there was little difference in the performance of the four models, the XGBoost model had a relatively good ROC value, which might perform well in future exploration in this field.
RESUMEN
Early identification of individuals at high risk of diabetes is crucial for implementing early intervention strategies. However, algorithms specific to elderly Chinese adults are lacking. The aim of this study is to build effective prediction models based on machine learning (ML) for the risk of type 2 diabetes mellitus (T2DM) in Chinese elderly. A retrospective cohort study was conducted using the health screening data of adults older than 65 years in Wuhan, China from 2018 to 2020. With a strict data filtration, 127,031 records from the eligible participants were utilized. Overall, 8298 participants were diagnosed with incident T2DM during the 2-year follow-up (2019-2020). The dataset was randomly split into training set (n = 101,625) and test set (n = 25,406). We developed prediction models based on four ML algorithms: logistic regression (LR), decision tree (DT), random forest (RF), and extreme gradient boosting (XGBoost). Using LASSO regression, 21 prediction features were selected. The Random under-sampling (RUS) was applied to address the class imbalance, and the Shapley Additive Explanations (SHAP) was used to calculate and visualize feature importance. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. The XGBoost model achieved the best performance (AUC = 0.7805, sensitivity = 0.6452, specificity = 0.7577, accuracy = 0.7503). Fasting plasma glucose (FPG), education, exercise, gender, and waist circumference (WC) were the top five important predictors. This study showed that XGBoost model can be applied to screen individuals at high risk of T2DM in the early phrase, which has the strong potential for intelligent prevention and control of diabetes. The key features could also be useful for developing targeted diabetes prevention interventions.
RESUMEN
BACKGROUND: Solitary plasmacytoma and unicentric Castleman disease (UCD) are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes, respectively. CASE SUMMARY: A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat. 18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid, and computed tomography (CT) revealed osteolytic lesions. Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells. Systemic work-up ruled out the possibility of POEMS syndrome, lymphoma, and multiple myeloma, leading to a final diagnosis of solitary hyoid plasmacytoma with UCD. The patient underwent partial hyoid resection and selective neck dissection, followed by intensity-modulated radiotherapy. 99mTc-MDP single-photon emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up. CONCLUSION: The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.
RESUMEN
Hepatic oval cells have strong proliferation and differentiation capabilities and are activated when chronic liver injury occurs or when liver function is severely impaired. Peroxisome proliferation-activated receptors (PPARs) are ligand-dependent, sequence-specific nuclear transcription factors. PPARγ is closely related to liver diseases (such as liver cancer, liver fibrosis and non-alcoholic fatty liver disease). As the main effector downstream of the Hippo signaling pathway, YAP can activate the hepatic progenitor cell program, and different expression or activity levels of YAP can determine different liver cell fates. We found that troglitazone (TRO), a classic PPARγ activator, can inhibit the growth of hepatic oval cells, and flow cytometry results showed that TRO inhibited the growth of WB-F344 cells by arresting the cells in the G0/1 phase. Western blot results also confirmed changes in G0/1 phase-related protein expression. Further experiments showed that PPARγ agonists induced hepatic oval cell proliferation inhibition and cell cycle G0/1 phase arrest through the Hippo/YAP pathway. Our experiment demonstrated, for the first time, the relationship between PPARγ and the Hippo/YAP pathway in liver oval cells and revealed that PPARγ acts as a negative regulator of liver regeneration by inhibiting the proliferation of oval cells.