Prevalence and associated factors of insomnia symptoms after ending China's dynamic zero-COVID policy: a cross-sectional survey of frontline nursing staff in Chinese hospitals.

Background: After the Chinese government announced the end of the dynamic zero-COVID policy on January 8, 2023, the COVID-19 pandemic peaked. Frontline nursing staff are at high risk of infection transmission due to their frequent contact with COVID-19 patients. In addition, due to the ending of China's dynamic zero-COVID policy, frontline nursing staff have grappled with increased workload, fatigue, and more. This study aimed to explore the prevalence of insomnia symptoms in frontline nursing staff and its influencing factors following the end of the policy. Methods: Between January and February 2023, this study was conducted by the Wenjuanxing platform to survey frontline nursing staff in a hospital in Wuhu City, Anhui Province. All the nursing staff included in this study had a COVID-19 infection. The questionnaires included the Athens Insomnia Scale (AIS), PC-PTSD-5 Chinese Version Scale, the Fear of COVID-19 Scale, The 2-item Connor-Davidson Resilience Scale (CD-RISC-2) Scale, and the burden of COVID-19 Scale. Binary logistic regression methods were used to identify variables associated with insomnia symptoms. Results: Among the 694 frontline nursing staff, 74.5% (517/694) exhibited insomnia symptoms. Fear of COVID-19 (p < 0.001), the burden of COVID-19 (p < 0.05), PTSD (p < 0.001), and higher technical titles (p < 0.008) were highly correlated with insomnia symptoms in frontline nursing staff. Psychological resilience (p < 0.001) was a protective factor for insomnia symptoms among frontline nursing staff. Conclusion: After ending China's dynamic zero-COVID policy, the prevalence of insomnia symptoms among frontline nursing staff is generally higher. This study highlights the association between insomnia symptoms and PTSD, fear of COVID-19, COVID-19 burden, and resilience. Psychological assistance is needed for frontline nursing staff to prevent insomnia symptoms and protect the mental health of frontline nursing staff after the end of China's dynamic zero-COVID policy.

The Physiological Response of Apricot Flowers to Low-Temperature Stress.

The growth and development of apricot flower organs are severely impacted by spring frosts. To better understand this process, apricot flowers were exposed to temperatures ranging from 0 °C to -8 °C, including a control at 18 °C, in artificial incubators to mimic diverse low-temperature environments. We aimed to examine their physiological reactions to cold stress, with an emphasis on changes in phenotype, membrane stability, osmotic substance levels, and antioxidant enzyme performance. Results reveal that cold stress induces significant browning and cellular damage, with a sharp increase in browning rate and membrane permeability below -5 °C. Soluble sugars and proteins initially rise as osmoprotectants, but their content decreases at lower temperatures. Proline content consistently increases, suggesting a protective role. Antioxidant enzyme activities, including catalase (CAT), peroxidase (POD), superoxide dismutase (SOD), and ascorbate peroxidase (APX), exhibit a complex pattern, with initial increases followed by declines at more severe cold conditions. Correlation and principal component analyses highlight the interplay between these responses, indicating a multifaceted adaptation strategy. The findings contribute to the understanding of apricot cold tolerance and inform breeding efforts for improved crop resilience.

Modified Theoretical Model Predicts Radial Support Capacity of Polymer Braided Stents.

BACKGROUND AND OBJECTIVE: Self-expanding polymer braided stents are expected to replace metallic stents in the treatment of Peripheral Arterial Disease, which seriously endangers human health. To restore the patency of blocked peripheral arteries with different properties and functions, the radial supporting capacity of the stent should be considered corresponding to the vessel. A theoretical model can be established as an effective method to study the radial supporting capacity of the stent which can shorten the stent design cycle and realize the customization of the stent according to lesion site. However, the classical model developed by Jedwab and Clerc of radial force is only limited to metallic braided stents, and the predictions for polymer braided stents are deviated. METHODS: In this paper, based on the limitation of the J&C model for polymer braided stents, a modified radial force model for polymer braided stents was proposed, which considered the friction between monofilaments and the torsion of the monofilaments. And the modified model was verified by radial force tests of polymer braided stents with different structures and monofilaments. RESULTS: Compared with the J&C model, the proposed modified model has better predictability for the radial force of polymer braided stents that prepared with different braided structure and polymer monofilaments. The root mean squared error of modified model is 0.041±0.026, while that of the J&C model is 0.246±0.111. CONCLUSIONS: For polymer braided stents, the friction between the polymer monofilaments and the torsion of the monofilaments during the radial compression cannot be ignored. The radial force prediction accuracy of the modified model considering these factors was significantly improved. This work provides a research basis on the theoretical model of polymer braided stents, and improves the feasibility of rapid personalized customization of polymer braided stents.

Leisure crafting and work engagement among Chinese ICU nurses: The multiple mediation effect of recovery experience and humanistic care ability.

AIMS: Based on the conservation of resources theory, this study explored the intermediary role of intensive care unit (ICU) nurses' recovery experience and humanistic care ability between leisure crafting and work engagement. BACKGROUND: As the ICU is an important life-saving department, the level of work engagement of nurses directly affect the quality of life and health outcomes of patients. Actively seeking countermeasures to improve the work engagement level of ICU nurses is of great significance to enhancing the nursing quality of the ICU. According to the theory of resource conservation, the resources owned by individuals are limited and must be replenished promptly and effectively to maintain relatively stable physical, mental, and working states. Therefore, determining ways for ICU nurses to supplement the consumed resources effectively and efficiently in a limited time to maintain a high level of work engagement is the main concern of this study. METHODS: In this cross-sectional study from January 2023 to March 2023, 478 ICU nurses were recruited by convenience sampling. The survey tools included the Leisure Crafting Scale, the Utrecht Work Engagement Scale-9, the Caring Ability Inventory, and the Recovery Experience Questionnaire. Descriptive data and Pearson correlation coefficients were analyzed via SPSS 26.0 (IBM Corp.). PROCESS v4.0 (by Andrew F. Hayes) Macro Model 6 was applied to analyze the serial multiple mediator models. We used the STROBE checklist to report the results. RESULTS: First, the results showed that leisure crafting, humanistic care ability, and recovery experience were positively correlated with work engagement. Second, recovery experience and humanistic care ability played a partially mediating role between leisure crafting and work engagement, respectively. Third, recovery experience and humanistic care ability also had a serial mediation effect between leisure crafting and work engagement. CONCLUSION: The findings of the study indicated that improving nurses' active control of leisure time may have particularly positive effects on ICU nurses' work engagement through increasing recovery experience and humanistic care ability. IMPLICATIONS FOR NURSING AND NURSING POLICY: Administrators can formulate intervention measures to improve the leisure crafting level of ICU nurses, promote work-life balance, which enhances recovery and supports engagement with patient-focused humanistic care, and have a positive impact on the work engagement of ICU nurses.

DCPNet: a dual-channel parallel deep neural network for high quality computer-generated holography.

Recent studies have demonstrated that a learning-based computer-generated hologram (CGH) has great potential for real-time, high-quality holographic displays. However, most existing algorithms treat the complex-valued wave field as a two-channel spatial domain image to facilitate mapping onto real-valued kernels, which does not fully consider the computational characteristics of complex amplitude. To address this issue, we proposed a dual-channel parallel neural network (DCPNet) for generating phase-only holograms (POHs), taking inspiration from the double phase amplitude encoding method. Instead of encoding the complex-valued wave field in the SLM plane as a two-channel image, we encode it into two real-valued phase elements. Then the two learned sub-POHs are sampled by the complementary 2D binary grating to synthesize the desired POH. Simulation and optical experiments are carried out to verify the feasibility and effectiveness of the proposed method. The simulation results indicate that the DCPNet is capable of generating high-fidelity 2k POHs in 36 ms. The optical experiments reveal that the DCPNet has excellent ability to preserve finer details, suppress speckle noise and improve uniformity in the reconstructed images.

PD-L1 Expression and Ultrasound Characteristics in Papillary Thyroid Carcinoma and Its Effect on Recurrence.

AIM: Programmed death-ligand 1 (PD-L1) is a component of the tumor microenvironment, which is closely involved in the occurrence and development of tumors. We investigated the correlation between the expression of PD-L1 and ultrasound characteristics in papillary thyroid carcinoma (PTC) and its effect on recurrence. PATIENTS AND METHODS: Fifty-two patients at the Department of General Surgery of Qingdao Municipal Hospital underwent thyroid ultrasonic examination before surgery and their clinicopathological variables were collected. Then, immunohistochemistry staining was conducted to evaluate the PD-L1 expression in tumors and adjacent normal tissues. The correlations of PD-L1 expression with clinicopathological and ultrasound characteristics were analyzed. RESULTS: The expression of PD-L1 was positive in 59.7% (40/67) of PTC tumor tissues. In clinicopathological analyses, PD-L1 positivity was related to multifocality of tumors (p=0.031). In analyses of ultrasound characteristics, the expression of PD-L1 was positively correlated with halo sign (p=0.035), capsular invasion (p=0.003), microcalcification (p=0.02), and recurrence (p=0.009). In multivariate logistic analysis of ultrasonic characteristics and recurrence of thyroid carcinoma, microcalcification [odds ratio=13.349, 95% confidence interval (CI)=2.052-86.832, p=0.007] and the halo sign (odds ratio=15.273, 95% CI=1.451-160.747, p=0.023) were factors associated with recurrence of PTC. In the multivariate Cox regression analysis, positive PD-L1 staining [hazard ratio (HR)=5.031, 95% CI=1.092-23.172, p=0.038] and a halo sign (HR=4.998, 95% CI=1.084-23.051, p=0.039) were independent predictors for poorer recurrence-free survival. Positive expression of PD-L1 predicted worse recurrence-free survival in the subgroup of patients with a halo sign (HR=6.537, 95% CI=1.863-22.94, p=0.037). CONCLUSION: Positive expression of PD-L1 in PTC affects the clinical and ultrasonic characteristics of the tumor and may negatively affect the prognosis of patients with PTC.

LncRNA CCAT1 facilitates the progression of gastric cancer via PTBP1-mediated glycolysis enhancement.

BACKGROUND: Gastric cancer (GC) is one of the most prevalent malignant tumors of the digestive system. As a hallmark of cancer, energy-related metabolic reprogramming is manipulated by multiple factors, including long non-coding RNAs (lncRNAs). Notably, lncRNA CCAT1 has been identified as a crucial regulator in tumor progression. Nevertheless, the precise molecular mechanisms underlying the involvement of CCAT1 in metabolic reprogramming of GC remain unclear. METHODS: Gain- and loss-of-function experiments were performed to evaluate the roles of CCAT1 in tumorigenesis and glycolysis of GC. Bioinformatics analyses and mechanistic experiments, such as mass spectrometry (MS), RNA-pulldown, and RNA immunoprecipitation (RIP), were employed to reveal the potential interacting protein of CCAT1 and elucidate the regulatory mechanism of CCAT1 in GC glycolysis. Moreover, the nude mice xenograft assay was used to evaluate the effect of CCAT1 on GC cells in vivo. RESULTS: In this study, we identified that CCAT1 expression was significantly elevated in the tissues and plasma exosomes of GC patients, as well as GC cell lines. Functional experiments showed that the knockdown of CCAT1 resulted in a substantial decrease in the proliferation, migration and invasion of GC cells both in vitro and in vivo through decreasing the expression of glycolytic enzymes and glycolytic rate. Conversely, overexpression of CCAT1 exhibited contrasting effects. Mechanistically, CCAT1 interacted with PTBP1 and effectively maintained its stability by inhibiting the ubiquitin-mediated degradation process. As a critical splicing factor, PTBP1 facilitated the transition from PKM1 to PKM2, thereby augmenting the glycolytic activity of GC cells and ultimately fostering the progression of GC. CONCLUSIONS: Our findings demonstrate that CCAT1 plays a significant role in promoting the proliferation, migration, and invasion of GC cells through the PTBP1/PKM2/glycolysis pathway, thus suggesting CCAT1's potential as a biomarker and therapeutic target for GC.

Community characteristics of macroinvertebrates and ecosystem health assessment in Qin River, a main tributary of the Yellow River in China.

To know well the ecosystem health status of Qin River, a main tributary of the Yellow River and the largest river in Jincheng region, macroinvertebrates from 49 sampling sites in the Qin River and its largest tributary, the Dan River, were investigated, and community characteristics were analyzed in the autumn of 2020; a Benthic index of Biotic Integrity (B-IBI) was established based on four metrics by a series of steps. The results showed that a total of 38 species of macroinvertebrates were collected and identified, belonging to 6 orders and 19 families, consisting of 17 Insecta species, 13 Gastropoda species, and 4 Oligochaeta species. Four species in Insecta belonged to EPT (E, Ephemeroptera; P, Plecoptera; T, Trichoptera); 10 species in Insecta belonged to Chironomidae and Tipulidae families. All species in Gastropoda belonged to Basematophora order, and, especially, Bellamya aeruginosa is highly tolerant to nutrients. All species in Oligochaetes belonged to Tubificidae family, which indicates eutrophication and low-dissolved oxygen. The dominant species in the study were Ephemera orientalis, Chironomus riparius Meigen, and Limnodrilus claparedianus. The final B-IBI scores varied from 0.75 to 3.75, with 5 sites in "excellent," 10 sites in "good," 10 sites in "normal" status, 12 sites in "poor" status, 12 sites in "very poor." "Very poor" and "poor" sites were mainly located in the middle reach of the Qin River and upper-middle reach of the Dan River in Jincheng region. B-IBI strongly differentiated the reference sites and impaired sites, suggesting the suitability of the B-IBI in the Qin River basin. Significantly negative correlations between NH4+-N, TN, and B-IBI indicated the B-IBI characterized well the influence of nitrogen pollution.

Role of T2 mapping of magnetic resonance imaging in the differentiation of endometrial cancer and benign endometrial lesions

PURPOSE: The T2 mapping of magnetic resonance imaging (MRI) in endometrial cancer (EC), benign endometrial lesions (BELs), and normal endometrium (NE) has rarely been reported. This study aimed to determine the T2 values of MRI in EC, BELs, and NE to investigate whether the T2 values can differentiate them and to assess the aggressiveness of EC. METHODS: In total, 73 patients [EC, 51 (age, 57.4 ± 5.4 years); BELs, 22 (age, 57.8 ± 11.8 years)] and 23 normal volunteers (age, 56.1 ± 6.6 years) were included. The T2 values of MRI of the EC (type I and II), BEL, and NE groups were described and compared. The relationships between the T2 values of MRI in EC and the pathological characteristics [International Federation of Gynecology and Obstetrics (FIGO) stage and grade] were analyzed. RESULTS: The median T2 values of NE, BEL, and EC were 197.5 (142.9-324.0) ms, 131.1 (103.2-247.9) ms, and 103.0 (71.6-243.5) ms (P < 0.001), respectively. The median T2 values of type I and type II EC were 100.8 (71.62-130.44) ms and 125.7 (119.7-243.5) ms, respectively. There were significant differences in the T2 values among the NE, BEL, type I EC, and type II EC groups (P < 0.001) except for between the type II EC and BEL groups (P = 0.938). The T2 value of MRI in type I EC was significantly lower than that in type II EC (P = 0.001). There were no significant differences in patients with type I EC having different FIGO stages (P = 0.273) or tumor grades (P = 0.686). CONCLUSION: T2 mapping of MRI has the potential to quantitatively differentiate between EC, BELs, and NE as well as between type I and type II EC.

Cloning and Functional Identification of Gibberellin Receptor SvGID1s Gene of Salix viminalis.

Gibberellins (GAs) play a key role in the transition from vegetative growth to flowering and the GA receptor GID1 (GIBBERELLIN INSENSITIVE DWARF1) is the central part of GA-signaling. The differential expression of SvGID1 was found in the transcriptome sequencing in our previous study, which was further verified at different stages of flowering of Salix viminalis. In order to reveal the function GID1 of S. viminalis, two genes of SvGID1b and SvGID1c were cloned and transformed into Arabidopsis thaliana, respectively. The results showed that the full ORF length of SvGID1b and SvGID1c genes were both 1035 bp, encoding 344 amino acids, which were typical globular proteins. The peptide chain contained more α-helix structure, and had 99% similarity with GID1b and GID1c amino acid sequences of Salix suchowensis. Phylogenetic analysis showed that SvGID1s had close genetic relationship with woody plants such as Populus alba and Populus tomentosa, and had far genetic relationship with rice. After overexpression in A. thaliana, the total gibberellin, active gibberellin content and the expression level of GA3ox1, the key gene for GA4 synthesis, were not significantly different from those in the wild-type, while the expression levels of FUL, SOC1 and FT, the key genes for flowering in plants, were increased, and the expression levels of FLC and GAI were decreased. The ectopic expression of SvGID1s increased the sensitivity of plants to gibberellin and enhanced gibberellin effect, caused early bolting, budding and flowering, led to higher plant, longer hypocotyl and other phenomena. The results provide a theoretical basis for clarifying the regulation of gibberellin on flower bud differentiation of flowering plants.

High-Resolution Vessel Wall MRI in Assessing Postoperative Restenosis of Intracranial Atherosclerotic Disease Before Drug-Coated Balloon Treatment: An Outcome Prediction Study.

BACKGROUND: Postoperative restenosis frequently occurs in intracranial atherosclerotic disease (ICAD) patients after drug-coated balloon (DCB) treatment. However, high-risk plaques associated with postoperative restenosis remain to be explored. PURPOSE: To assess whether high-resolution vessel wall MRI (HR-VWI) contributes to the identification of high-risk plaques associated with postoperative restenosis before DCB treatment. STUDY TYPE: Retrospective. SUBJECTS: A total of 70 patients with ICAD who underwent DCB treatment. FIELD STRENGTH/SEQUENCE: 3.0 T; magnetic resonance angiography, HR-VWI. ASSESSMENT: All patients underwent HR-VWI examination prior to DCB treatment. Digital subtraction angiography (DSA) measurement was assessed 6 months (±1 month) after operation to determine the vessel restenosis, classifying patients into three groups of no stenosis, mild stenosis (<50%), and restenosis (>50%). Clinical factors and HR-VWI characteristics, including vessel and lumen area at maximal lumen narrowing (MLN), plaque area and length, degree of stenosis, plaque burden, remodeling index, and enhancement amplitude, were compared among three groups. Clinical factors and HR-VWI characteristics were separately evaluated for the association with postoperative restenosis. STATISTICAL TESTS: Kolmogorov-Smirnov test, intra-class correlation coefficient, Kruskal Wallis H test, Mann-Whitney U test, receiver operating characteristic (ROC) curve, multivariable linear regression analysis. P-values <0.05 was considered statistically significant. RESULTS: During the follow-up DSA measurement, 13 lesions (18.5%) showed restenosis. With HR-VWI, significant differences among three groups were observed in plaque length, lumen area of MLN, degree of stenosis, enhancement amplitude, and plaque burden. In ROC analysis, plaque length (area under the curve [AUC] = 0.809), and enhancement amplitude (AUC = 0.880) provided higher efficacy in identification of high-risk plaques associated with postoperative restenosis than degree of stenosis (AUC = 0.746) and plaque burden (AUC = 0.759). Multivariable linear regression analysis showed that plaque length and enhancement amplitude were independent prognostic factors of postoperative restenosis. DATA CONCLUSION: HR-VWI has the potential to identify high-risk plaques in ICAD patients before DCB treatment. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 2.

Molecular mechanism of antibody neutralization of coxsackievirus A16.

Coxsackievirus A16 (CVA16) causes hand, foot and mouth disease in infants and young children. However, no vaccine or anti-viral agent is currently available for CVA16. Here, the functions and working mechanisms of two CVA16-specific neutralizing monoclonal antibodies (MAbs), 9B5 and 8C4, are comprehensively investigated. Both 9B5 and 8C4 display potent neutralization in vitro and prophylactic and therapeutic efficacy in a mouse model of CVA16 infection. Mechanistically, 9B5 exerts neutralization primarily through inhibiting CVA16 attachment to cell surface via blockade of CVA16 binding to its attachment receptor, heparan sulfate, whereas 8C4 functions mainly at the post-attachment stage of CVA16 entry by interfering with the interaction between CVA16 and its uncoating receptor SCARB2. Cryo-EM studies show that 9B5 and 8C4 target distinct epitopes located at the 5-fold and 3-fold protrusions of CVA16 capsids, respectively, and exhibit differential binding preference to three forms of naturally occurring CVA16 particles. Moreover, 9B5 and 8C4 are compatible in formulating an antibody cocktail which displays the ability to prevent virus escape seen with individual MAbs. Together, our work elucidates the functional and structural basis of CVA16 antibody-mediated neutralization and protection, providing important information for design and development of effective CVA16 vaccines and antibody therapies.

Identification and Characterization of the HD-Zip Gene Family and Dimerization Analysis of HB7 and HB12 in Brassica napus L.

Homeodomain-leucine zipper (HD-Zip) genes encode plant-specific transcription factors, which play important roles in plant growth, development, and response to environmental stress. These genes have not been fully studied in allopolyploid Brassica napus, an important kind of oil crop. In this study, 165 HD-Zip genes were identified in B. napus and classified into four subfamilies. If proteins belong to the same subfamily, they exhibit similarities in gene structure, motifs, and domain distribution patterns. BnHD-Zip genes were unevenly distributed in the An and Cn subgenomes. Whole genome triplication (WGT) events may be major mechanisms accounting for this gene family expansion. Orthologous gene analysis showed that the process of this gene family expansion was accompanied by domain loss. We further found three genes homologous to HB7 and three genes homologous to HB12, all induced by PEG, ABA, and NaCl treatment. HB7 could not form homodimers but could form heterodimers with HB12 based on yeast two-hybrid assays. The results of this study provide valuable information for further exploration of the HD-Zip gene family in B. napus.

Assessment of postpartum haemorrhage for placenta accreta: Is measurement of myometrium thickness and dark intraplacental bands using MRI helpful?

BACKGROUND: This study aimed to investigate the predictive values of magnetic resonance imaging (MRI) myometrial thickness grading and dark intraplacental band (DIB) volumetry for blood loss in patients with placenta accreta spectrum (PAS). METHODS: Images and clinical data were acquired from patients who underwent placenta MRI examinations and were diagnosed with PAS from March 2015 to January 2021. Two radiologists jointly diagnosed, processed, and analysed the MR images of each patient. The analysis included MRI-based determination of placental attachment, as well as myometrial thickness grading and DIB volumetry. The patients included in the study were divided into three groups according to the estimated blood loss volume: in the general blood loss (GBL) group, the estimated blood loss volume was < 1000 ml; in the massive blood loss (MBL) group, the estimated blood loss volume was ≥ 1000 ml and < 2000 ml; and in the extremely massive blood loss (ex-MBL) group, the estimated blood loss volume was ≥ 2000 ml. The categorical, normally distributed, and non-normally distributed data were respectively analysed by the Chi-square, single-factor analysis of variance, and Kruskal-Wallis tests, respectively. The verification of correlation was completed by Spearman correlation analysis. The evaluation capabilities of indicators were assessed using receiver operating characteristic curves. RESULTS: Among 75 patients, 25 were included in the GBL group, 26 in the MBL group, and 24 in the ex-MBL group. A significant negative correlation was observed between the grade of myometrial thickness and the estimated blood loss (P < 0.001, ρ = - 0.604). There was a significant positive correlation between the volume of the DIB and the estimated blood loss (P < 0.001, ρ = 0.653). The areas under the receiver operating characteristic curve of the two MRI features for predicting blood loss ≥ 2000 ml were 0.776 and 0.897, respectively. CONCLUSIONS: The grading and volumetric MRI features, myometrial thickness, and volume of DIB, can be used as good prediction indicators of the risk of postpartum haemorrhage in patients with PAS.

Evaluation of resistance to radial cyclic loads of poly(L-lactic acid) braided stents with different braiding angles.

Poly(L-lactic acid) (PLLA) braided stents have superior biocompatibility and flexibility, substituting metal stents in peripheral blood vessels. However, the radial supporting capacity of PLLA braided stent should be improved to bear the dynamic load from the peripheral artery. This paper evaluated the radial support performance of PLLA braided stents with different braiding angles after the radial cyclic loads test. The results indicate that braiding angle of stents is an important parameter affecting its ability to resist radial cyclic loads. The stent with a smaller braiding angle has better initial radial support but insufficient durability, while the stent with a larger braiding angle could maintain adequate radial support and suitable ability to resist radial cyclic loads. The theoretical analysis, verified by observing the surface morphology of filament crossover points, found that filaments of the stents with smaller braiding angles have more significant axial displacement and axial rotation angle during radial compression, which made the friction phenomenon more intense and led to insufficient ability to resist radial cyclic loads. This study could provide a meaningful idea for preparing biodegradable braided stents with suitable ability to resist radial cyclic loads.

Magnetic resonance spectroscopy associations with clinicopathologic features of estrogen-dependent endometrial cancer.

BACKGROUND: We studied the magnetic resonance spectroscopy (MRS) associations with clinicopathologic features of estrogen-dependent endometrial cancer (type I EC). METHODS: Totally 45 patients with type I EC who underwent preoperative multi-voxel MRS at 3.0 T were enrolled. The mean ratio of the Cho peak integral to the unsuppressed water peak integral (Cho/water) of the tumor was calculated. The Cho/water and apparent diffusion coefficient (ADC) of type I EC with and without local invasion, as well as with different levels of Ki-67 staining index (SI) (≤ 40% and > 40%), were compared. Correlation test was used to examine the relationship of Cho/water, as well as mean ADC, with Ki-67 SI, tumor stage, and tumor grade. RESULTS: The mean Cho/water of EC with Ki-67 SI ≤ 40% (2.28 ± 0.93) × 10-3 was lower than that with Ki-67 SI > 40% (4.08 ± 1.00) × 10-3 (P < 0.001). The mean Cho/water of EC with deep and superficial myometrial invasion was (3.41 ± 1.26) × 10-3 and (2.43 ± 1.11) × 10-3, respectively (P = 0.011). There was no significant difference in Cho/water between type I EC with and without cervical invasioin ([2.68 ± 1.00] × 10-3 and [2.77 ± 1.28] × 10-3, P = 0.866). The mean Cho/water of type I EC with and without lymph node metastasis was (4.02 ± 1.90) × 10-3 and (2.60 ± 1.06) × 10-3, respectively (P = 0.014). The Cho/water was positively correlated with the Ki-67 SI (r = 0.701, P < 0.001). There were no significant differences in ADC among groups (all P > 0.05). CONCLUSION: MRS is helpful for preoperative assessment of clinicopathological features of type I EC.

Value of Whole-Thyroid CT-Based Radiomics in Predicting Benign and Malignant Thyroid Nodules.

The objective of this research is to explore the value of whole-thyroid CT-based radiomics in predicting benign (noncancerous) and malignant thyroid nodules. The imaging and clinical data of 161 patients with thyroid nodules that were confirmed by pathology were retrospectively analyzed. The entire thyroid regions of interest (ROIs) were manually sketched for all 161 cases. After extracting CT radiomic features, the patients were divided into a training group (128 cases) and a test group (33 cases) according to the 4:1 ratio with stratified random sampling (fivefold cross validation). All the data were normalized by the maximum absolute value and screened using selection operator regression analysis and K best. The data generation model was trained by logistic regression. The effectiveness of the model in differentiating between benign and malignant thyroid nodules was validated by a receiver operating characteristic (ROC) curve. After data grouping, eigenvalue screening, and data training, the logistic regression model with the maximum absolute value normalized was constructed. For the training group, the area under the ROC curve (AUC) was 94.4% (95% confidence interval: 0.941-0.977); the sensitivity and specificity were 89.7% and 86.7%, respectively; and the diagnostic accuracy was 87.6%. For the test group, the AUC was 94.2% (95% confidence interval: 0.881-0.999); the sensitivity and specificity were 89.4% and 86.8%, respectively; and the diagnostic accuracy was 87.6%. The CT radiomic model of the entire thyroid gland is highly efficient in differentiating between benign and malignant thyroid nodules.

A MRI-based radiomics nomogram for evaluation of renal function in ADPKD.

OBJECTIVES: This study is aimed to establish a fusion model of radiomics-based nomogram to predict the renal function of autosomal dominant polycystic kidney disease (ADPKD). METHODS: One hundred patients with ADPKD were randomly divided into training group (n = 69) and test group (n = 31). The radiomics features were extracted from T1-weighted fat suppression images (FS-T1WI) and T2-weighted fat suppression images (FS-T2WI). Decision tree algorithm was employed to build radiomics model to get radiomics signature. Then multivariate logistic regression analysis was used to establish the radiomics nomogram based on independent clinical factors, conventional MR imaging variables and radiomics signature. The receiver operating characteristic (ROC) analysis and Delong test were used to compare the performance of radiomics model and radiomics nomogram model, and the decision curve to evaluate the clinical application value of radiomics nomogram model in the evaluation of renal function in patients with ADPKD. RESULTS: Fourteen radiomics features were selected to establish radiomics model. Based on FS-T1WI and FS-T2WI sequences, the radiomics model showed good discrimination ability in training group and test group [training group: (AUC) = 0.7542, test group (AUC) = 0.7417]. The performance of radiomics nomogram model was significantly better than that of radiomics model in all data sets [radiomics model (AUC) = 0.7505, radiomics nomogram model (AUC) = 0.8435, p value = 0.005]. The analysis of calibration curve and decision curve showed that radiomics nomogram model had more clinical application value. CONCLUSION: radiomics analysis of MRI can be used for the preliminary evaluation and prediction of renal function in patients with ADPKD. The radiomics nomogram model shows better prediction effect in renal function evaluation, and can be used as a non-invasive renal function prediction tool to assist clinical decision-making. Trial registration ChiCTR, ChiCTR2100046739. Registered 27 May 2021-retrospectively registered, http://www.ChiCTR.org.cn/showproj.aspx?proj=125955.

Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms.

BACKGROUND: Research has demonstrated that higher social support is associated with better psychological health, quality of life, cognition, activities of daily living and social participation, but the relationship between social support and sleep quality remains unknown. AIMS: This study aimed to assess the incidence of poor sleep quality, clarify the relationship between social support and sleep quality amongst stroke patients and determine whether anxiety and depression symptoms mediate this relationship. METHODS: We conducted a quantitative, cross-sectional study involving 238 patients with stroke (median age of 61 [range 29-87] years, 68.1% male) recruited from a comprehensive tertiary care hospital between September 2019 and January 2020. A self-administered, structured questionnaire was used for the survey. The mediating effect of anxiety and depression symptoms was assessed using the bootstrap method via Model 4 (parallel mediation) of the SPSS PROCESS macro. RESULTS: Results showed that the incidence of poor sleep quality amongst stroke patients was 65%. Mediation analysis showed that social support exerted significant direct effects on sleep quality, and anxiety and depression symptoms mediated the relationship between social support and sleep quality. CONCLUSION: Measures should be taken to enhance social support to improve the sleep quality of stroke patients.