A comprehensive prognostic analysis of cause-specific mortality in patients with ovarian serous cystadenocarcinoma using a competing-risks model: a case study of the SEER database.

OBJECTIVE: This retrospective study employed a competing-risks analysis utilizing the Surveillance, Epidemiology, and End Results (SEER) database to identify precise prognostic factors associated with ovarian serous cystadenocarcinoma (OSCC) in patients. PATIENTS AND METHODS: Patients with OSCC during 2004-2015 were identified in the SEER database, and their clinicopathological, demographic, and survival data were examined. Univariate analysis using Gray's test and the cumulative incidence function was used to evaluate the prognoses of events of interest. The multivariate analysis involved several models, including the Cox proportional hazards, Fine-Gray, and cause-specific (CS) hazard function models, to estimate the hazard functions of competing risks. Hazard ratios were analyzed to identify the reliability of the prognostic factors. RESULTS: Among the 10,400 individuals diagnosed with OSCC, 5,713 died from the illness, and 1,125 died from other causes. The cumulative incidence rate of events of interest was found to be significant for ethnicity, age at diagnosis, histological grade, American Joint Committee on Cancer (AJCC) stage, chemotherapy and surgery status, tumor size, marital status, and local lymph node metastases (p<0.05). The multivariate analysis revealed that ethnicity, histological grade, surgery and chemotherapy status, age at diagnosis, AJCC stage, marital status, and distant metastases were independent prognostic factors in the Cox model (p<0.05). Finally, the Fine-Gray and CS models demonstrated that ethnicity, histological grade, surgery and chemotherapy status, age at diagnosis, AJCC stage, tumor size, marital status, and combination summary stage were all identified as independent prognostic factors (p<0.05). CONCLUSIONS: This study determined the risk factors for OSCC using a competing risk analysis model established by the SEER database. The findings can help clinicians understand OSCC better and provide more accurate medical support to affected patients.

Navigating their child's attachment-related difficulties: Parents' journey from shame into awareness.

Attachment-related difficulties frequently present in child and adolescent clinical services. Yet how parents engage with being informed of their child's attachment-related difficulties is little understood. In this qualitative study, ten parents with a birth child with attachment-related difficulties, as informed by a relevant service, and six healthcare professionals, were interviewed. The aim was to explore both perspectives on how parents experienced and engaged with this process, of their understanding of the child's difficulties and the supports they engaged with. Using grounded theory, the parental journey from shame to awareness is described, based around four main themes: failing as a parent, the process of making sense, a call to action, and awareness of attachment and interrelated difficulties. The intensity of shame and defensive processes felt by parents came through strongly in narratives, forming a key barrier to sense-making and action, while specific clinical, personal and support/resource characteristics facilitated progress. The findings highlight how parents can be better supported into a space of attachment-related awareness and understanding, which may in turn facilitate more positive outcomes for the child. The study also raises wide ranging implications relevant to all involved in the investment, planning and delivery of care for this client group.

Adaptive visual selection in feature space.

Visual perception relies on efficient selection of task-relevant information for prioritized processing. A prevalent mode of selection is feature-based selection, and a key question in the literature is the shape of the selection profile-that is, when a feature is selected, what is the landscape of priority for all features in that dimension? Past studies have reported conflicting findings with both monotonic and nonmonotonic profiles. We hypothesized that feature selection can be adaptively adjusted based on stimulus factors (feature competition) and task demands (selection precision). In three experiments, we manipulated these contextual factors in a central task while measuring selection profile in a peripheral task. We found a nonmonotonic, surround suppression, profile when feature competition and selection precision was high, but observed a monotonic profile when these factors were low. Furthermore, manipulation of selection precision alone can shape selection profile independent of feature competition. These findings reconcile previous conflicting results and importantly, demonstrate that feature selection is highly adaptive, allowing flexible allocation of processing resources to ensure efficient extraction of visual information.

Variants in the GPR146 Gene Are Associated With a Favorable Cardiometabolic Risk Profile.

BACKGROUND: In mice, GPR146 (G-protein-coupled receptor 146) deficiency reduces plasma lipids and protects against atherosclerosis. Whether these findings translate to humans is unknown. METHODS: Common and rare genetic variants in the GPR146 gene locus were used as research instruments in the UK Biobank. The Lifelines, The Copenhagen-City Heart Study, and a cohort of individuals with familial hypobetalipoproteinemia were used to find and study rare GPR146 variants. RESULTS: In the UK Biobank, carriers of the common rs2362529-C allele present with lower low-density lipoprotein cholesterol, apo (apolipoprotein) B, high-density lipoprotein cholesterol, apoAI, CRP (C-reactive protein), and plasma liver enzymes compared with noncarriers. Carriers of the common rs1997243-G allele, associated with higher GPR146 expression, present with the exact opposite phenotype. The associations with plasma lipids of the above alleles are allele dose-dependent. Heterozygote carriers of a rare coding variant (p.Pro62Leu; n=2615), predicted to be damaging, show a stronger reductions in the above parameters compared with carriers of the common rs2362529-C allele. The p.Pro62Leu variant is furthermore shown to segregate with low low-density lipoprotein cholesterol in a family with familial hypobetalipoproteinemia. Compared with controls, carriers of the common rs2362529-C allele show a marginally reduced risk of coronary artery disease (P=0.03) concomitant with a small effect size on low-density lipoprotein cholesterol (average decrease of 2.24 mg/dL in homozygotes) of this variant. Finally, mendelian randomization analyses suggest a causal relationship between GPR146 gene expression and plasma lipid and liver enzyme levels. CONCLUSIONS: This study shows that carriers of new genetic GPR146 variants have a beneficial cardiometabolic risk profile, but it remains to be shown whether genetic or pharmaceutical inhibition of GPR146 protects against atherosclerosis in humans.

Direct estimation and correction of residual aberrations in the reconstructed exit-wavefunction of a crystalline specimen.

Measuring residual aberrations up to second order using a crystalline specimen in transmission electron microscope is challenging. Here, we show by good examples of both experimental and simulated images that it is feasible to measure aberrations up to the second-order, using minimum amplitude contrast criterion for the exit wave function reconstructed. We propose a two-steps strategy for the task: (i) Firstly measuring defocus and two-fold astigmatism simultaneously to avoid error accumulation and to reduce the number of dimensions in parameters space. (ii) Then, with minimized misleading effects (or errors) in defocus and two-fold astigmatism, estimations of three-fold astigmatism and coma can be conducted more efficiently and effectively. Influences of other factors such as specimen structure, resolution and specimen thickness on the validity of the method are also discussed in detail. Our study provides a practical procedure for correcting residual aberrations in image wave using crystalline materials, which can then facilitate application of exit wave reconstruction technique to materials research.

A Group Parenting Intervention for Depressed Fathers (LTP + Dads): A Feasibility Study from Pakistan.

BACKGROUND: Globally, paternal depression is a neglected and under-researched area. AIMS: To feasibility test Learning Through Play Plus Dads (LTP+ Dads), a group parenting psychoeducation program adapted for depressed Pakistani fathers of children under 3 years of age. METHODS: Fathers with depression were recruited in Karachi, Pakistan, for a pre-post feasibility study. Ten sessions of group LTP+ Dads were offered over three months. Clinical assessments were administered at baseline, three (end of intervention), and six (follow-up) months and included the Edinburgh Postnatal Depression Scale, 17-item Hamilton Depression Rating Scale, Brief Disability Questionnaire, Multidimensional Scale of Perceived Social Support, Euro-Qol-5 Dimensions, Rosenberg Self-esteem Scale, Parenting Stress Index, and Knowledge, Attitude and Practices questionnaire. RESULTS: Of the 78 fathers approached, 34 consented to screening and 18 were eligible to participate. Participants had a mean age of 33 years, with a mean of 3.61 children. Most were unemployed and were from low-income households with low education backgrounds. The intervention was feasible and acceptable based on a recruitment rate of 100% of eligible participants and a 100% attendance rate for five of the 10 sessions. Fathers showed, on average, a reduction in depressive symptoms, an increase in most areas of knowledge, and positive attitudes about child development. Perceived social support, self-esteem, and functioning scores also increased. CONCLUSIONS: A low-cost, culturally adapted group intervention was found to be feasible and acceptable. Changes in depression, parenting-related, and other outcomes are promising and inform a future larger trial. TRIAL REGISTRATION: The trial was registered on Clinicaltrials.gov on 9 December 2020 (identifier: NCT04660253).

Similarities and Differences between Crystal and Enzyme Environmental Effects on the Electron Density of Drug Molecules.

The crystal interaction density is generally assumed to be a suitable measure of the polarization of a low-molecular weight ligand inside an enzyme, but this approximation has seldomly been tested and has never been quantified before. In this study, we compare the crystal interaction density and the interaction electrostatic potential for a model compound of loxistatin acid (E64c) with those inside cathepsin B, in solution, and in vacuum. We apply QM/MM calculations and experimental quantum crystallography to show that the crystal interaction density is indeed very similar to the enzyme interaction density. Less than 0.1 e are shifted between these two environments in total. However, this difference has non-negligible consequences for derived properties.

The profile of attentional modulation to visual features.

Although it is well established that feature-based attention (FBA) can enhance an attended feature, how it modulates unattended features remains less clear. Previous studies have generally supported either a graded profile as predicted by the feature-similarity gain model or a nonmonotonic profile predicted by the surround suppression model. To reconcile these different views, we systematically measured the attentional profile in three basic feature dimensions-orientation, motion direction, and spatial frequency. In three experiments, we instructed participants to detect a coherent feature signal against noise under attentional or neutral condition. Our results support a nonmonotonic hybrid model of attentional modulation consisting of feature-similarity gain and surround suppression for orientation and motion direction. For spatial frequency, we also found a similar nonmonotonic profile for higher frequencies than the attended frequency, but a lack of attentional modulation for lower frequencies than the attended frequency. The current findings can reconcile the discrepancies in the literature and suggest the hybrid model as a new framework for attentional modulation in feature space. In addition, a computational model incorporating known properties of spatial frequency channels and attentional modulations at the neural level reproduced the asymmetric attentional modulation, thus revealing a connection between surround suppression and the basic neural architecture of an early visual system.

Feasible atomic-resolution electron tomography for general crystal surfaces by quantitative reconstruction from a high-resolution image.

Whether or not the 3-dimensional surface morphologies of a crystal sample can be reconstructed at atomic-scale from a single 2-dimensional image becomes an interesting issue in high-resolution transmission electron microscopy, after the work by Jia et al. [1]. Here we propose an improved and self-validated algorithm to enhance such an electron tomography method and to make it applicable to more general crystal surfaces even with thin amorphous layers. Our study shows that a resolution in the beam (z) direction and a confidence level have to be defined and estimated after performing tomographic reconstruction in order to evaluate the quality and the reliability of its result. Applying the proposed procedure to the Si[110] image to recover the surface morphologies of a silicon crystal with amorphous contamination, the obtained results show that an atomic-resolution of 0.384 nm in the z-direction and a high confidence level of 95% are achieved for imaging the Si-surface structures, quantitatively described by tomographic parameters, i.e., the height (defocus) and the thickness (atom number) of Si-atomic columns.

Attention induces surround suppression in visual working memory.

Controversy currently exists regarding whether visual working memory (VWM) maintains sensory or non-sensory representations. Here, we tested the nature of VWM representations by leveraging a perceptual surround suppression effect when an item is attended. Participants performed a delayed-estimation task in which they memorized an array of six colors. A cue indicated which location was most likely probed. In separate experiments, we manipulated external attention (via a precue) or internal attention (via a retrocue). Both types of attention elicited a surround suppression effect, such that memory performance showed a Mexican-hat profile as a function of cue-probe offsets. Given the sensory origin of the surround suppression effect, our results thus provide compelling evidence that VWM maintenance relies on sensory mechanisms.

Measurement of Electric Fields Experienced by Urea Guest Molecules in the 18-Crown-6/Urea (1:5) Host-Guest Complex: An Experimental Reference Point for Electric-Field-Assisted Catalysis.

High-resolution synchrotron and neutron single-crystal diffraction data of 18-crown-6/(pentakis)urea measured at 30 K are combined, with the aim of better appreciating the electrostatics associated with intermolecular interactions in condensed matter. With two 18-crown-6 molecules and five different urea molecules in the crystal, this represents the most ambitious combined X-ray/synchrotron and neutron experimental charge density analysis to date on a cocrystal or host-guest system incorporating such a large number of unique molecules. The dipole moments of the five urea guest molecules in the crystal are enhanced considerably compared to values determined for isolated molecules, and 2D maps of the electrostatic potential and electric field show clearly how the urea molecules are oriented with dipole moments aligned along the electric field exerted by their molecular neighbors. Experimental electric fields in the range of 10-19 GV m-1, obtained for the five different urea environments, corroborate independent measurements of electric fields in the active sites of enzymes and provide an important experimental reference point for recent discussions focused on electric-field-assisted catalysis.

Revisiting a Historical Concept by Using Quantum Crystallography: Are Phosphate, Sulfate and Perchlorate Anions Hypervalent?

There are many examples of atoms in molecules that violate Lewis' octet rule, because they have more than four electron pairs assigned to their valence. These atoms are referred to as hypervalent. However, hypervalency may be regarded as an artifact arising from Lewis' description of molecules, which is based on the assumption that electrons are localized in two-center two-electron bonds and lone pairs. In the present paper, the isoelectronic phosphate (PO4 3- ), sulfate (SO4 2- ) and perchlorate (ClO4 - ) anions were examined with respect to the concept of hypervalency. Lewis formulas containing a hypervalent central atom exist for all three anions. Based on X-ray wavefunction refinements of high-resolution X-ray diffraction data of representative crystal structures (MgNH4 PO4 ⋅6 H2 O, Li2 SO4 ⋅H2 O, and KClO4 ), complementary bonding analyses were performed. In this way, experimental information from the new field of quantum crystallography validate long-known facts, or refute long-standing misunderstandings. It is shown that the P-O and S-O bonds are highly polarized covalent bonds and, thus, the increase in the valence population following three-center four-electron bonding is not sufficient to yield hypervalent phosphorus or sulfur atoms, respectively. However, for the highly covalent Cl-O bond, most bonding indicators imply a hypervalent chlorine atom.

Attention to colors induces surround suppression at category boundaries.

We investigated how attention to a visual feature modulates representations of other features. The feature-similarity gain model predicts a graded modulation, whereas an alternative model asserts an inhibitory surround in feature space. Although evidence for both types of modulations can be found, a consensus has not emerged in the literature. Here, we aimed to reconcile these different views by systematically measuring how attention modulates color perception. Based on previous literature, we also predicted that color categories would impact attentional modulation. Our results showed that both surround suppression and feature-similarity gain modulate perception of colors but they operate on different similarity scales. Furthermore, the region of the suppressive surround coincided with the color category boundary, suggesting a categorical sharpening effect. We implemented a neural population coding model to explain the observed behavioral effects, which revealed a hitherto unknown connection between neural tuning shift and surround suppression.

An improved iterative wave function reconstruction algorithm in high-resolution transmission electron microscopy.

Exit wavefunction reconstruction is a powerful image processing technique to enhance the resolution and the signal-to-noise ratio for atomic-resolution imaging in both aberration uncorrected and corrected transmission electron microscopes. The present study aims to improve the performance of the iterative wavefunction reconstruction algorithm in comparison not only with its conventional form but also with the popular commercial Trueimage software for exit wavefunction reconstruction. It is shown that by implementing a wave propagation procedure for refining its image alignment, the iterative wavefunction reconstruction algorithm can be greatly improved in accurately retrieving the wavefunctions while keeping its original advantages, which allow the reconstruction be performed with less images and a larger defocus step in the data set of through-focus image series. In addition, calculations of this algorithm can be accelerated drastically by the graphic processing unit (GPU) hardware programming using the popular computer unified device architecture language, whose computing speed can be 25-38 times as fast as a central processing unit (CPU) program.

Recurrent minor strokes/TIA with a right to left shunt.

A patient came to our institution for evaluation and closure of suspected patent foramen ovale actively manifesting as cerebrovascular accident. Through further studies, we found the presence of a pulmonary arteriovenous fistula, which was subsequently and successfully closed through non-invasive percutaneous selective segmental pulmonary artery embolisation.

[Efficacy analysis of T type tube dilatation in adult cervical tracheal stenosis].

Objective:To investigate the efficacy, recurrence and strategy of T silicone tube dilatation for cicatricial stenosis of cervical trachea in adults.Method:Cinical data of 37 cases with the cervical tracheal stenosis were retrospectively analyzed, who were firstly treated by T shape silicone tube dilation for at least 10 months, from Jun 2006 to Jun 2016.Result:In 37 adult patients with cicatricial stenosis of the trachea, 29 cases were caused by tracheal intubation or incision, 6 cases were traumatic, and 2 cases were multiple osteochondritis. Twentythree cases were experienced one time surgery and extubated successfully, 8 cases were experienced 2 times and more than 2 times surgery (sternohyoid muscle flap pedicled hyoid bone with T tube expansion in 3 cases, tracheal endoscopic dilatation in 2 cases, T tube dilatation in 3 cases), extubation success rate of 83.7%. Among the 6 cases with failure of extubation, 2 cases were multiple osteochondritis, 3 cases had severe scar constitution, 1 cases were lost of follow-up.Conclusion:T type silicon tube expansion for the treatment of adult cervical tracheal stenosis can be achieved relatively high decannulation rate. For recurrent stenosis, we can consider to use various methods of expansion, and improve the decannulation rate. Intratracheal granulation tissuextubation after exbation should be observed for at least 1 month. For concurrent with polychondritis and severe scar the constitution, the operation should be carefully chosen.

Linear MgCp*2 vs Bent CaCp*2: London Dispersion, Ligand-Induced Charge Localizations, and Pseudo-Pregostic C-H···Ca Interactions.

In the family of metallocenes, MgCp*2 (Cp* = pentamethylcyclopentadienyl) exhibits a regular linear sandwich structure, whereas CaCp*2 is bent in both the gas phase and solid state. Bending is typically observed for metal ions which possess a lone pair. Here, we investigate which electronic differences cause the bending in complexes lacking lone pairs at the metal atoms. The bent gas-phase geometry of CaCp*2 suggests that the bending must have an intramolecular origin. Geometry optimizations with and without dispersion effects/d-type polarization functions on MCp2 and MCp*2 gas-phase complexes (M = Ca, Mg) establish that attractive methyl···methyl London dispersion interactions play a decisive role in the bending in CaCp*2. A sufficient polarizability of the metal to produce a shallow bending potential energy curve is a prerequisite but is not the reason for the bending. Concomitant ligand-induced charge concentrations and localizations at the metal atoms are studied in further detail, for which real-space bonding and orbital-based descriptors are used. Low-temperature crystal structures of MgCp*2 and CaCp*2 were determined which facilitated the identification and characterization of intermolecular pseudo-pregostic interactions, C-H···Ca, in the CaCp*2 crystal structure.

The Elusive Structural Origin of Plastic Bending in Dimethyl Sulfone Crystals with Quasi-isotropic Crystal Packing.

Bending in molecular crystals is typically associated with the anisotropy of intermolecular interactions. The intriguing observation is reported of plastic bending in dimethyl sulfone, which exhibits nearly isotropic crystal packing and interaction topology, defying the known structural models of bending crystals. The origin of the bending phenomenon has been explored in terms of intermolecular interaction energies, experimental X-ray charge density analysis, and variable temperature neutron diffraction studies. H⋅⋅⋅H dihydrogen interactions and differences in electrostatic complementarity between molecular layers are found to facilitate the bending behavior.

[Epidemiological analysis of malaria prevalence in Jiangsu Province in 2015].

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015, so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015, and the cases increased by 14.08% compared with those in 2014. All the malaria cases were imported, and 5 cases (1.23%) were from Southeast Asia and 400 (98.77%) were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province, where Taizhou, Lianyungang, Nantong, Huaian and Yangzhou cities accounted for 68.64% of all the cases in the province. Jiangsu Institute of Parasitic Diseases (JIPD) reference lab checked all the cases and classified 299 falciparum malaria cases, 13 vivax malaria cases, 18 quartan malaria cases, 71 ovale malaria cases, and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province, there are no local malaria cases for 4 consecutive years, but the imported cases are on the rise. Compared to 2014, the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases, improve malaria diagnosis and treatment abilities for all levels of medical institutions, and promote the abilities of Plasmodium check, and focus survey and disposal of all Center for Disease Control (CDC) staffs across Jiangsu Province.