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Pancreatic neuroendocrine tumors (PanNETs), though uncommon, have a high likelihood of spreading to other body parts. Previously, the genetic diversity and evolutionary patterns in metastatic PanNETs were not well understood. To investigate this, we performed multiregion sampling whole-exome sequencing (MRS-WES) on samples from 10 patients who had not received prior treatment for metastatic PanNETs. This included 29 primary tumor samples, 31 lymph node metastases, and 15 liver metastases. We used the MSK-MET dataset for survival analysis and validation of our findings. Our research indicates that mutations in the MEN1/DAXX genes might trigger the early stages of PanNET development. We categorized the patients based on the presence (MEN1/DAXXmut, n = 7) or absence (MEN1/DAXXwild, n = 3) of these mutations. Notable differences were observed between the two groups in terms of genetic alterations and clinically relevant mutations, confirmed using the MSK-MET dataset. Notably, patients with mutations in MEN1/DAXX/ATRX genes had a significantly longer median overall survival compared to those without these mutations (median not reached vs. 43.63 months, p = 0.047). Multiplex immunohistochemistry (mIHC) analysis showed a more prominent immunosuppressive environment in metastatic tumors, especially in patients with MEN1/DAXX mutations. These findings imply that MEN1/DAXX mutations lead PanNETs through a unique evolutionary path. The disease's progression pattern indicates that PanNETs can spread early, even before clinical detection, highlighting the importance of identifying biomarkers related to metastasis to guide personalized treatment strategies.
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Neoplasias Hepáticas , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Humanos , Sequenciamento do Exoma , Tumores Neuroendócrinos/genética , Genômica , Neoplasias Hepáticas/genética , Neoplasias Pancreáticas/genética , Microambiente TumoralRESUMO
Background: Hypoperfusion, a common manifestation of many critical illnesses, could lead to abnormalities in body surface thermal distribution. However, the interpretation of thermal images is difficult. Our aim was to assess the mortality risk of critically ill patients at risk of hypoperfusion in a prospective cohort by infrared thermography combined with deep learning methods. Methods: This post-hoc study was based on a cohort at high-risk of hypoperfusion. Patients' legs were selected as the region of interest. Thermal images and conventional hypoperfusion parameters were collected. Six deep learning models were attempted to derive the risk of mortality (range: 0 to 100%) for each patient. The area under the receiver operating characteristic curve (AUROC) was used to evaluate predictive accuracy. Results: Fifty-five hospital deaths occurred in a cohort consisting of 373 patients. The conventional hypoperfusion (capillary refill time and diastolic blood pressure) and thermal (low temperature area rate and standard deviation) parameters demonstrated similar predictive accuracies for hospital mortality (AUROC 0.73 and 0.77). The deep learning methods, especially the ResNet (18), could further improve the accuracy. The AUROC of ResNet (18) was 0.94 with a sensitivity of 84% and a specificity of 91% when using a cutoff of 36%. ResNet (18) presented a significantly increasing trend in the risk of mortality in patients with normotension (13 [7 to 26]), hypotension (18 [8 to 32]) and shock (28 [14 to 62]). Conclusions: Interpreting infrared thermography with deep learning enables accurate and non-invasive assessment of the severity of patients at risk of hypoperfusion.
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ABSTRACT: Background: Uneven body-surface thermal distribution is a manifestation of hypoperfusion and can be quantified by infrared thermography. Our aim was to investigate whether body-surface thermal inhomogeneity could accurately evaluate the severity of patients at risk of hypoperfusion. Methods: This was a prospective cohort study in which infrared thermography images were taken from unilateral legs of critically ill patients at high risk of hypoperfusion in a cardiac surgical intensive care unit. For each patient, five body-surface thermal inhomogeneity parameters, including standard deviation (SD), kurtosis, skewness, entropy, and low-temperature area rate (LTAR), were calculated. Demographic, clinical, and thermal characteristics of deceased and living patients were compared. The risk of mortality and capillary refill time (CRT) were chosen as the primary outcome and benchmarking parameter for hypoperfusion, respectively. The area under the receiver operating characteristic curve (AUROC) was used to evaluate predictive accuracy. Results: Three hundred seventy-three patients were included, and 55 (14.7%) died during hospital stay. Of inhomogeneity parameters, SD (0.738) and LTAR (0.768) had similar AUROC to CRT (0.757) for assessing mortality risk. Besides, there was a tendency for LTAR (1%-3%-7%) and SD (0.81°C-0.88°C-0.94°C) to increase in normotensive, hypotensive, and shock patients. These thermal parameters are associated with CRT, lactate, and blood pressure. The AUROC of a combined prediction incorporating three thermal inhomogeneity parameters (SD, kurtosis, and entropy) was considerably higher at 0.866. Conclusions: Body-surface thermal inhomogeneity provided a noninvasive and accurate assessment of the severity of critically ill patients at high risk of hypoperfusion.
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Estado Terminal , Termografia , Humanos , Termografia/métodos , Estudos Prospectivos , Área Sob a Curva , Unidades de Terapia IntensivaRESUMO
OBJECTIVE: This study aimed to investigate the effects of the Sn100 kVp tube voltage mode on the image quality and radiation dose of computed tomography pulmonary angiography (CTPA). METHODS: A total of 145 patients who underwent CTPA were randomly divided into five groups: control group (120 kVp, 150 mAs), test group A (Sn100 kVp, 270 mAs), test group B (120 kVp, 30 mAs), test group C (70 kVp, 150 mAs), and test group D (80 kVp, 70 mAs). After image post-processing, the image quality and radiation dose of each group were analyzed. RESULTS: The computed tomography values of images in the four test groups were more than 250 HU, which met the criteria for diagnosis. The signal-to-noise ratio and contrast-to-noise ratio of the images in the four test groups were lower than those in the control group. The radiation dose in each test group was lower than in the control group. The radiation dose was lowest in test group A. CONCLUSION: The Sn100 kVp energy spectrum purification protocol can meet the requirements for clinical diagnosis, ensure image quality, and reduce the dose of radiation that patients receive.
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BACKGROUND: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide, but there is a shortage of effective biomarkers for its diagnosis. AIM: To explore blood exosomal micro ribonucleic acids (miRNAs) as potential biomarkers for HCC diagnosis. RESULTS: The principal component analysis suggested that daily alcohol consumption could alter the blood exosomal miRNA profiles of hepatitis B virus positive non-HCC patients through miR-3168 and miR-223-3p. The miRNA profiles also revealed the tumor stages of HCC patients. High expression of miR-455-5p and miR-30c-5p, which significantly correlated with better overall survival in tumor tissues, could also be detected in blood exosomes. Two pairs of miRNAs (miR-584-5p/miR-106-3p and miR-628-3p/miR-941) showed a 94.1% sensitivity and 68.4% specificity to differentiate HCC patients from non-HCC patients. The specificity of the combination was substantially influenced by alcohol consumption habits. CONCLUSION: This study suggested that blood exosomal miRNAs can be used as new non-invasive diagnostic tools for HCC. However, their accuracy could be affected by tumor stage and alcohol consumption habits.
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We propose a THz nondestructive analysis method based on multiple echoes and feature fusion. Conventionally, it is difficult to identify the debonding defects of the glue layer (II) due to the thin adhesive layer. To this end, a THz propagation model is established, and a quantitative method for determining the thickness of debonding defects based on multiple echoes is presented. The measurement error for preset defect thickness of 500 µm was 4%. Further, for determining the area of debonding defects, a feature fusion imaging algorithm is proposed to realize the lateral recognition of defects and quantitative analysis is used to improve the recognition ability of defects.
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Canopy temperature is one of promising signals for evaluating crop water status. The infrared thermal imager can provide real-time temperature distributions over larger areas with high spatial resolution. The main factors (the observation orientation, angle and distance) controlling the accuracy of measuring canopy temperature with the infrared thermal imaging were investigated in a cotton field. Moreover, the correlation relationships between the crop water stress index (CWSI), which was observed using different methods, and soil water content (SWC), leaf water potential (LWP), and stomatal conductance (g(s)) of cotton in different water treatments were analyzed. Results indicated that the CWSI, which was measured in the opposite direction of the sun with the observation angle of 45°, was in good correlation with LWP, g(s) and SWC, indicating it was a suitable observing method of canopy temperature. The canopy temperature gradually decreased with the increasing observation distance, so the calibration was necessary for long-distance measurement. By analyzing the relationship between the temperature at the dry/wet reference surface and the canopy temperature, we developed a suitable and simplified model of CWSI for cotton in the North China Plain.
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Gossypium/fisiologia , Temperatura , Água/fisiologia , China , Modelos Teóricos , Folhas de Planta/fisiologia , Solo , Espectrofotometria InfravermelhoRESUMO
It is important to improve the real-time irrigation forecasting precision by predicting real-time water consumption of cotton mulched with plastic film under drip irrigation based on meteorological data and cotton growth status. The model parameters for calculating ET0 based on Hargreaves formula were determined using historical meteorological data from 1953 to 2008 in Shihezi reclamation area. According to the field experimental data of growing season in 2009-2010, the model of computing crop coefficient Kc was established based on accumulated temperature. On the basis of crop water requirement (ET0) and Kc, a real-time irrigation forecast model was finally constructed, and it was verified by the field experimental data in 2011. The results showed that the forecast model had high forecasting precision, and the average absolute values of relative error between the predicted value and measured value were about 3.7%, 2.4% and 1.6% during seedling, squaring and blossom-boll forming stages, respectively. The forecast model could be used to modify the predicted values in time according to the real-time meteorological data and to guide the water management in local film-mulched cotton field under drip irrigation.
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Irrigação Agrícola/métodos , Gossypium/crescimento & desenvolvimento , Modelos Teóricos , Plásticos , Temperatura , ÁguaRESUMO
A field experiment with two irrigation cycles and two irrigating water quotas at squaring stage and blossoming-boll forming stage was conducted in Urumqi of Xinjiang Autonomous Region, Northwest China in 2008-2009, aimed to explore the high-efficient irrigation index of cotton drip irrigation under film mulching. The effects of different water treatments on the seed yield, water consumption, and water use efficiency (WUE) of cotton were analyzed. In all treatments, there was a high correlation between the cotton water use and the evaporation from pan installed above the plant canopy. In high-yield cotton field (including the treatment T4 which had 10 days and 7 days of irrigation cycle with 30.0 mm and 37.5 mm of irrigating water quota at squaring stage and blossoming-boll forming stage, respectively in 2008, and the treatment T1 having 7 days of irrigation cycle with 22.5 mm and 37.5 mm of irrigating water quota at squaring stage and blossoming-boll forming stage, respectively in 2009), the pan-crop coefficient (Kp) at seedling stage, squaring stage, blossoming-boll forming stage, and boll opening stage was 0.29-0.30, 0.52-0.53, 0.74-0.88, and 0.19-0.20, respectively. As compared with the other treatments, T4 had the highest seed cotton yield (5060 kg x hm(-2)) and the highest WUE (1.00 kg x m(-3)) in 2008, whereas T1 had the highest seed cotton yield (4467 kg x hm(-2)) and the highest WUE (0.99 kg x m(-3)) in 2009. The averaged cumulative pan evaporation in 7 days and 10 days at squaring stage was 40-50 mm and 60-70 mm, respectively, and that in 7 days at blossoming-boll forming stage was 40-50 mm. It was suggested that in Xinjiang cotton area, irrigating 45 mm water for seedling emergence, no irrigation both at seedling stage and at boll opening stage, and irrigation was started when the pan evaporation reached 45-65 mm and 45 mm at squaring stage and blossoming-boll stage, respectively, the irrigating water quota could be determined by multiplying cumulative pan evaporation with Kp (the Ko was taken as 0.5, 0.75, 0.85, and 0.75 at squaring stage, early blossoming, full-blossoming, and late blossoming stage, respectively), which could be the high efficient irrigation index to obtain high yield and WUE in drip irrigation cotton field and to save irrigation water resources.
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Irrigação Agrícola/métodos , Biomassa , Gossypium/crescimento & desenvolvimento , Transpiração Vegetal/fisiologia , Água/metabolismo , Agricultura/métodos , China , Ecossistema , Água/análiseRESUMO
Glioma is the most malignant tumor in the brain, the origin of glioma is still unknown. Recently some papers indicated that glioma may be developed from cerebral cavernous malformation (CCM). We describe a man with a right temporal lobe CCM, after gamma-knife radiotherapy, the patient developed a low-grade astrocytoma in the area of the preexistent CCM. This case, together with other reports, may indicated an oncogenetic properties of CCM, and we proposed that CCM may be a pre-glioma lesion.
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Glioma/patologia , Hemangioma Cavernoso do Sistema Nervoso Central/patologia , Glioma/diagnóstico por imagem , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico por imagem , Humanos , Masculino , RadiografiaRESUMO
To develop a suitable tillage mode and irrigation schedule of transplanted cotton following wheat harvest under sprinkler irrigation, a field experiment was conducted to study the effects of different tillage modes (conventional tillage and no-tillage) and different irrigation schedules (45 and 22.5 mm of irrigating water quota) on the water consumption, seed yield, water use efficiency, and fiber quality of cotton. Comparing with conventional tillage, no-tillage decreased the soil evaporation among cotton plants by 20.3%. Whether with conventional tillage or with no-tillage, deficit irrigation (22.5 mm of irrigating water quota) did not affect seed yield and fiber quality, while decreased the water consumption and improved the water use efficiency. No-tillage with 22.5 mm of irrigating water quota under sprinkler irrigation not only decreased the soil evaporation effectively, but also achieved water-saving, high quality and high yield of transplanted cotton following wheat harvest.