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1.
Blood Adv ; 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38527292

RESUMO

The human kinome, which comprises over five hundred kinases, plays a critical role in regulating numerous essential cellular functions. Although the dysregulation of kinases has been observed in various human cancers, the characterization and clinical implications of kinase expressions in myelodysplastic syndrome (MDS) have not been systematically investigated. In this study, we evaluated the kinome expression profiles of 341 adult patients with primary MDS and identified seven kinases (PTK7, KIT, MAST4, NTRK1, PAK6, CAMK1D, and PRKCZ) whose expression levels were highly predictive of compromised patient survival. We then constructed the KInase Stratification Score (KISS) by combining the weighted expressions of the seven kinases, and validated its prognostic significance in two external MDS cohorts. A higher KISS was associated with older age, higher peripheral blood and marrow blast percentages, higher Revised International Prognostic Scoring System (IPSS-R) risks, complex karyotype, and mutations in several adverse-risk genes in MDS, such as ASXL1, EZH2, NPM1, RUNX1, STAG2, and TP53. Multivariate analysis confirmed that a higher KISS was an independent unfavorable risk factor in MDS. Mechanistically, the KISS-high patients were enriched for genesets associated with hematopoietic and leukemic stem cell signatures. By investigating the Genomics of Drug Sensitivity in Cancer (GDSC) database, we identified axitinib and taselisib as candidate compounds that could potentially target the KISS-high myeloblasts. Altogether, our findings suggest that KISS holds the potential to improve the current prognostic scheme of MDS and inform novel therapeutic opportunities.

2.
Front Pediatr ; 12: 1336299, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38487471

RESUMO

Objectives: The management of patent ductus arteriosus (PDA) is a critical concern in premature infants, and different hospitals may have varying treatment policies, fluid management strategies, and incubator humidity. The Asian Neonatal Network Collaboration (AsianNeo) collected data on prematurity care details from hospitals across Asian countries. The aim of this study was to provide a survey of the current practices in the management of PDA in premature infants in Asian countries. Methods: AsianNeo performed a cross-sectional international questionnaire survey in 2022 to assess the human and physical resources of hospitals and clinical management of very preterm infants. The survey covered various aspects of hospitals resources and clinical management, and data were collected from 337 hospitals across Asia. The data collected were used to compare hospitals resources and clinical management of preterm infants between areas and economic status. Results: The policy of PDA management for preterm infants varied across Asian countries in AsianNeo. Hospitals in Northeast Asia were more likely to perform PDA ligation (p < 0.001) than hospitals in Southeast Asia. Hospitals in Northeast Asia had stricter fluid restrictions in the first 24 h after birth for infants born at <29 weeks gestation (p < 0.001) and on day 14 after birth for infants born at <29 weeks gestation (p < 0.001) compared to hospitals in Southeast Asia. Hospitals in Northeast Asia also had a more humidified environment for infants born between 24 weeks gestation and 25 weeks gestation in the first 72 h after birth (p < 0.001). A logistic regression model predicted that hospitals were more likely to perform PDA ligation for PDA when the hospitals had a stricter fluid planning on day 14 after birth [Odds ratio (OR) of 1.70, p = 0.048], more incubator humidity settings (<80% vs. 80%-89%, OR of 3.35, p = 0.012 and <80% vs. 90%-100%, OR of 5.31, p < 0.001). Conclusions: In advanced economies and Northeast Asia, neonatologists tend to adopt a more conservative approach towards fluid management, maintain higher incubator humidity settings and inclined to perform surgical ligation for PDA.

3.
J Mol Graph Model ; 129: 108731, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38430696

RESUMO

The energy stability and electronic structural of graphene and defective graphene oxide (GO) parallel to the surface of LiFePO4 (010) were theoretically investigated by using first-principles density functional theory calculations within the DFT + U framework. The calculated formation energy shows that GO coating on the surface of LiFePO4 (010) is energetically favorable and has higher bond strength compared to graphene. The calculation of the electronic structure indicates that the emergence of band in-gap states originates from graphene coating, with adsorbed O atoms contributing significantly above the Fermi level. Electron density difference indicate that GO stands on the LFP (010) surface through C-O and Fe-O bonds, rather than relying on van der Waals forces placed parallel to the LFP crystal, with the chemical bond at the LFP/GO interface (Fe-O-C) both anchoring the coated carbon layer and promoting electron conductivity at the interface. In addition, LFP/GO shows superior electrochemical performance, Atomic Populations suggests that the average Fe-O bonding on the surface of LiFePO4 (010) was clearly changed after graphene or GO coating, which led to the expansion of Li+ channels and favored the migration insertion and extraction of Li+.


Assuntos
Grafite , Carbono , Condutividade Elétrica , Eletrônica
4.
Nano Lett ; 24(11): 3532-3540, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38457281

RESUMO

Developing dynamic nanostructures for in situ regulation of biological processes inside living cells is of great importance in biomedical research. Herein we report the cascaded assembly of Y-shaped branched DNA nanostructure (YDN) during intracellular autophagy. YDN contains one arm with semi-i-motif sequence and Cy3-BHQ2, and another arm with an apurinic/apyrimidinic (AP) site and Cy5-BHQ3. Upon uptake by cancer cells, intermolecular i-motif structures are formed in response to lysosomal H+, causing the formation of YDN-dimer and the recovery of Cy3 fluorescence; when escapes occur from the lysosome to the cytoplasm, the YDN-dimer responds to the overexpressed APE1, leading to the assembly of YDN into the DNA network and the fluorescence recovery of Cy5. Simultaneously, the cascaded assembly activates autophagy, and thus the process of assembly of YDN and autophagy flux can be spatiotemporally coupled. This work illustrates the potential of DNA nanostructures for the in situ regulation of intracellular dynamic events with spatiotemporal control.


Assuntos
Carbocianinas , Nanoestruturas , Neoplasias , DNA/química , Nanoestruturas/química , Reparo do DNA , Autofagia , Neoplasias/genética
5.
Sci Adv ; 10(8): eadj0347, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38394210

RESUMO

Hexanucleotide repeat expansion in C9ORF72 (C9) is the most prevalent mutation among amyotrophic lateral sclerosis (ALS) patients. The patients carry over ~30 to hundreds or thousands of repeats translated to dipeptide repeats (DPRs) where poly-glycine-arginine (GR) and poly-proline-arginine (PR) are most toxic. The structure-function relationship is still unknown. Here, we examined the minimal neurotoxic repeat number of poly-GR and found that extension of the repeat number led to a loose helical structure disrupting plasma and nuclear membrane. Poly-GR/PR bound to nucleotides and interfered with transcription. We screened and identified a sulfated disaccharide that bound to poly-GR/PR and rescued poly-GR/PR-induced toxicity in neuroblastoma and C9-ALS-iPSC-derived motor neurons. The compound rescued the shortened life span and defective locomotion in poly-GR/PR expressing Drosophila model and improved motor behavior in poly-GR-injected mouse model. Overall, our results reveal structural and toxicity mechanisms for poly-GR/PR and facilitate therapeutic development for C9-ALS.


Assuntos
Esclerose Amiotrófica Lateral , Animais , Camundongos , Humanos , Esclerose Amiotrófica Lateral/tratamento farmacológico , Esclerose Amiotrófica Lateral/genética , Dipeptídeos/farmacologia , Arginina/genética , Sulfatos , Drosophila/genética , Dano ao DNA , Expansão das Repetições de DNA , Proteína C9orf72/genética , Proteína C9orf72/metabolismo
6.
Angew Chem Int Ed Engl ; 63(14): e202319073, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38353346

RESUMO

Immunotherapy faces insufficient immune activation and limited immune effectiveness. Herein, we report a smart DNA hydrogel that enables the release of multivalent functional units at the tumor site to enhance the efficacy of immunotherapy. The smart DNA hydrogel was assembled from two types of ultra-long DNA chains synthesized via rolling circle amplification. One DNA chain contained immune adjuvant CpG oligonucleotides and polyaptamers for loading natural killer cell-derived exosomes; the other chain contained multivalent G-quadruplex for loading photodynamic agents. DNA chains formed DNA hydrogel through base-pairing. HhaI restriction endonuclease sites were designed between functional units. Upon stimuli in the tumor sites, the hydrogel was effectively cleaved by the released HhaI and disassembled into functional units. Natural killer cell-derived exosomes played an anti-tumor role, and the CpG oligonucleotide activated antigen-presenting cells to enhance the immunotherapy. Besides the tumor-killing effect of photodynamic therapy, the generated cellular debris acted as an immune antigen to further enhance the immunotherapeutic effect. In a mouse melanoma orthotopic model, the smart DNA hydrogel as a localized therapeutic agent, achieved a remarkable tumor suppression rate of 91.2 %. The smart DNA hydrogel exhibited enhanced efficacy of synergistic immunotherapy and photodynamic therapy, expanding the application of DNA materials in biomedicine.


Assuntos
Melanoma , Fotoquimioterapia , Animais , Camundongos , Melanoma/tratamento farmacológico , Hidrogéis , DNA , Imunoterapia , Modelos Animais de Doenças , Linhagem Celular Tumoral
7.
Small Methods ; : e2301236, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38351479

RESUMO

Deoxyribonucleic acid (DNA)-based hydrogels are emerging as promising functional materials for biomedical applications. However, the shelf-time of DNA hydrogels in biological media is severely shortened by nucleases, which limit the application of DNA hydrogels. Herein, a DNA hydrogel with long shelf-time is reported for 3D cell culture. Poly-(L-lysine) (PLL) is introduced as both a cross-linker and a protectant. The electrostatic interaction between PLL and DNA drove the formation of hydrogel. PLL coating on DNA increased the steric hindrance between DNA and nucleases, thus weakening the digestion of nucleases toward phosphodiester bond. As a result, the shelf-time of DNA/PLL hydrogel for 3D cell culture is extended from generally 1 day to longer than 15 days, which has not been achieved previously. Notably, poly-AS1411-aptamers are integrated to DNA/PLL hydrogels for anchoring U87 cells, and the cell encapsulation efficiency of the DNA/PLL hydrogels with aptamer is 4-time higher than that of the hydrogels without aptamer. DNA/PLL hydrogel provided a favorable microenvironment to support the proliferation of cells, which formed cell spheroid in 15 days. This protective coating strategy solves the long-standing problem on the shelf-time of DNA hydrogel, and is envisioned to promote the development of DNA hydrogel in more biomedical applications.

8.
Vaccines (Basel) ; 12(2)2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38400123

RESUMO

Vaccinations can serve as an important preventive measure against the porcine epidemic diarrhea (PED) virus that currently threatens the swine industry. This study focuses on the development of a fusion protein vaccine, FliC99-mCOE, which combines the N-terminus of flagellin (FliC99) with a modified core neutralizing epitope (mCOE) of PEDV. In silico immunoinformatic analysis confirmed the construct's non-toxic, non-allergenic, and highly antigenic nature. Molecular docking and molecular dynamics (MD) simulations demonstrated FliC99-mCOE's strong binding to the TLR-5 immunological receptor. Repeated exposure simulations and immunological simulations suggested enhanced cell-mediated immunity. Both FliC99-mCOE and an inactivated PEDV vaccine were produced and tested in mice. The results from cell proliferation, ELISA, and neutralization assays indicated that FliC99-mCOE effectively stimulated cellular immunity and neutralized PEDV. We conclude that the FliC99-mCOE fusion protein may serve as a promising vaccine candidate against PEDV.

9.
Blood Cancer J ; 14(1): 15, 2024 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-38253683

RESUMO

Acute myeloid leukemia (AML) with CEBPA bZIP in-frame mutations (CEBPAbZIP-inf) is classified within the favorable-risk group by the 2022 European LeukemiaNet (ELN-2022). However, heterogeneous clinical outcomes are still observed in these patients. In this study, we aimed to investigate the mutation profiles and transcriptomic patterns associated with poor outcomes in patients with CEBPAbZIP-inf. One hundred and thirteen CEBPAbZIP-inf patients were identified in a cohort of 887 AML patients homogeneously treated with intensive chemotherapy. Concurrent WT1 or DNMT3A mutations significantly predicted worse survival in AML patients with CEBPAbZIP-inf. RNA-sequencing analysis revealed an enrichment of interferon (IFN) signaling and metabolic pathways in those with a shorter event-free survival (EFS). CEBPAbZIP-inf patients with a shorter EFS had higher expression of IFN-stimulated genes (IRF2, IRF5, OAS2, and IFI35). Genes in mitochondrial complexes I (NDUFA12 and NDUFB6) and V (ATP5PB and ATP5IF1) were overexpressed and were associated with poorer survival, and the results were independently validated in the TARGET AML cohort. In conclusion, concurrent WT1 or DNMT3A mutations and a dysregulated immune and metabolic state were correlated with poor survival in patients with CEBPAbZIP-inf, and upfront allogeneic transplantation may be indicated for better long-term disease control.


Assuntos
Leucemia Mieloide Aguda , Adulto , Humanos , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/terapia , Perfilação da Expressão Gênica , Mutação , Intervalo Livre de Progressão , Redes e Vias Metabólicas , Proteínas Estimuladoras de Ligação a CCAAT/genética , NADPH Desidrogenase
10.
Int J Urol ; 31(4): 410-418, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38169055

RESUMO

PURPOSE: To investigate the prognostic impact of variant histology (VH) on oncological outcomes in patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU). PATIENTS AND METHODS: A total of 1239 patients with clinically localized UTUC who underwent RNU at a single institution between January 2005 and June 2020 were included. The VH was reviewed by a uro-pathologist at our institution. The Cox regression model was used to perform multivariate analysis, including VH and other established prognostic factors for post-RNU oncological outcomes (intravesical recurrence [IVR], non-urothelial recurrence, and cancer-specific death). RESULTS: Of the 1239 patients with UTUC, 384 patients (31%) were found to have VH. Advanced tumor stage, lymph node metastasis, high tumor grade, lymphovascular invasion, open surgery, and renal pelvis had a significantly larger proportion of UTUC with VH compared to pure UTUC (all p < 0.05). VH was an independent prognostic factor associated with less IVR identified by multivariate analysis, more non-urothelial recurrence, and more cancer-specific mortality. CONCLUSION: Patients with VH account for 31% with UTUC treated with RNU in this cohort. VH was an independent prognostic factor associated with more non-urothelial recurrence and cancer-specific mortality but less IVR.


Assuntos
Carcinoma de Células de Transição , Neoplasias Ureterais , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/cirurgia , Nefroureterectomia , Carcinoma de Células de Transição/cirurgia , Carcinoma de Células de Transição/patologia , Estudos Retrospectivos , Neoplasias Ureterais/cirurgia , Neoplasias Ureterais/patologia , Recidiva Local de Neoplasia/patologia
11.
Adv Mater ; 36(15): e2309534, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38199243

RESUMO

Photodynamic therapy (PDT) depends on the light-irradiated exciting of photosensitizer (PS) to generate reactive oxygen species (ROS), which faces challenges and limitations in hypoxia and antioxidant response of cancer cells, and limited tissue-penetration of light. Herein, a multifunctional DNA/upconversion nanoparticles (UCNPs) complex is developed which enables controlled co-delivery of CRISPR-Cas9, hemin, and protoporphyrin (PP) for synergistic PDT. An ultralong single-stranded DNA (ssDNA) is prepared via rolling circle amplification (RCA), which contains recognition sequences of single guide RNA (sgRNA) for loading Cas9 ribonucleoprotein (RNP), G-quadruplex sequences for loading hemin and PP, and linker sequences for combining UCNP. Cas9 RNP cleaves the antioxidant regulator nuclear factor E2-related factor 2 (Nrf2), improving the sensitivity of cancer cells to ROS, and enhancing the synergistic PDT effect. The G-quadruplex/hemin DNAzyme mimicks horseradish peroxidase (HRP) to catalyze the endogenous H2O2 to O2, overcoming hypoxia condition in tumors. The introduced UCNP converts NIR irradiation with deep tissue penetration to light with shorter wavelength, exciting PP to transform the abundant O2 to 1O2. The integration of gene editing and PDT allows substantial accumulation of 1O2 in cancer cells for enhanced cell apoptosis, and this synergistic PDT has shown remarkable therapeutic efficacy in a breast cancer mouse model.


Assuntos
Nanopartículas , Neoplasias , Fotoquimioterapia , Camundongos , Animais , Sistemas CRISPR-Cas , Espécies Reativas de Oxigênio/metabolismo , Antioxidantes , Hemina , Peróxido de Hidrogênio , RNA Guia de Sistemas CRISPR-Cas , Nanopartículas/uso terapêutico , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Hipóxia , Linhagem Celular Tumoral , Neoplasias/tratamento farmacológico
12.
World J Mens Health ; 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38164036

RESUMO

PURPOSE: Numerous studies have produced conflicting findings regarding the efficacy of statins in prostate cancer treatment. Our objective was to examine the correlation between statin usage and clinical outcomes in Taiwanese men with de novo metastatic prostate cancer. MATERIALS AND METHODS: We identified patients diagnosed with de novo metastatic prostate cancer from the Chang Gung Research Database spanning the years 2007 to 2020. To minimize confounding bias, we employed the inverse probability of treatment weighting (IPTW) method. Clinical outcomes were assessed using IPTW-adjusted Kaplan-Meier curves. Multivariate Cox proportional hazard regression analysis was utilized to evaluate the association between mortality and clinical factors. RESULTS: The study cohort comprised 1,716 statin users and 276 non-users. Patients who used statins exhibited a longer median overall survival (85.4 months compared to 58.2 months; p=0.001) and cancer-specific survival (112.6 months compared to 75.7 months; p<0.001) compared to non-users. The median time to the development of castration-resistant status was similar between statin users and non-users (p=0.069). Multivariable Cox proportional hazards regression analysis, after IPTW adjustment, demonstrated that statin use was associated with improved overall survival. CONCLUSIONS: Our study indicates that the use of statins following a de novo metastatic prostate cancer diagnosis enhances survival outcomes. However, statins did not appear to delay the onset of castration-resistant status. Further large-scale and long-term studies are warranted to investigate the biological effects of statins in men with prostate cancer.

13.
J Psychiatr Res ; 171: 9-16, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38219285

RESUMO

Major depressive disorder (MDD) is a highly prevalent psychiatric disorder with remarkable inter-subject variability in clinical manifestations. Neuroimaging changes of the cerebellum have been recently proposed as a way to characterize MDD-related brain disruptions and might further explain various clinical symptoms. However, the cerebellar contributions to MDD clinical heterogeneity remain largely unknown. The analyzed data consisted of 251 MDD patients and 235 matching healthy controls (HC). The inter-subject variability of functional connectomes (IVFC) was estimated via Pearson's correlation analysis between each pair of the cerebellar and cerebral regions based on resting-state functional magnetic resonance imaging (rs-fMRI). A partial least squares (PLS) regression analysis was performed to determine the potential dimension linking the IVFC to clinical symptom measures. The results indicated that similar spatial distribution patterns of the cerebellar IVFC were observed between MDD and HC, but the MDD group exhibited abnormal IVFC alterations in the bilateral Cerebelum_4_5, bilateral Cerebelum_6, Vermis_1_2 and Vermis_8. The PLS model revealed that the IVFC pattern in the left Cerebelum_6 was significantly associated with three HAMD-17 items including the work and activities, psychomotor retardation, and depressed mood. These findings provided new evidence for the cerebellar changes in MDD. Specifically, we found that the altered inter-subject variability measurements correlated with clinical manifestations of this illness. Elucidating this variability could prove helpful for the evaluation of MDD heterogeneity as well as for understanding its pathophysiological mechanism.


Assuntos
Conectoma , Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/diagnóstico , Conectoma/métodos , Imageamento por Ressonância Magnética/métodos , Encéfalo , Cerebelo/diagnóstico por imagem
14.
Colloids Surf B Biointerfaces ; 234: 113675, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38103428

RESUMO

Human interference and incorrect use of pesticides are easy to induce red imported fire ant (RIFA) escape and migrate from a nest, resulting in ineffective control of RIFA. In order to avoid RIFA alert, we designed an amphiphilic PSI-mPEG-Boc-DAH loaded Pyr to make the microparticles with effective controlled release. The investigation showed that the quantity of Pyr released by Pyr@PSI-mPEG-Boc-DAH under acidic environment was only 36.40 ± 1.90% at 48 h, whereas the release rate of original Pyr was 75.23 ± 5.71%. And the RIFA mortality rate of 1 ppm Pyr in Pyr@PSI-mPEG-Boc-DAH microparticles at 48 h was only 7.78%, which was significantly lower than that of the Pyr (47.78%). Futhermore, the death rate increased sharply after 48 h, and reached 95.84% within a week after using Pyr@PSI-mPEG-Boc-DAH microparticles. Moreover, PSI-mPEG-Boc-DAH carriers could be absorbed and even transported to crop of the RIFA for subsequent trophallaxis by using fluorescence tracking. In the field experiment, the reduction rate of Pyr@PSI-mPEG-Boc-DAH treatment was achieved 99.89% after 7 d. Pyr@PSI-mPEG-Boc-DAH didn't cause RIFA to be alarmed within 48 h and could kill nearly all of ants in the nest after 7 d, which showed a very good control effect in the field experiment. This work provided a new idea and guidance for the effective control RIFA and the development of sustainable agriculture.


Assuntos
Formigas , 60601 , Animais , Humanos , Polímeros , Polietilenoglicóis
15.
J Chin Med Assoc ; 87(2): 196-201, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38132568

RESUMO

BACKGROUND: This study aimed to explore the impact of diabetes on overactive bladder (OAB) presentations and related predictors of healthcare-seeking behavior among adults aged ≥ 40 years in China, Taiwan, and South Korea. METHODS: An internet-based survey was conducted to assess the prevalence of diabetes, OAB presentations, and self-perceived urinary symptoms by a multi-national sample of 8284 individuals who completed the survey between June 2, 2015 and July 31, 2015. Independent associations with health-seeking behavior for urinary symptoms were estimated with odds ratio (OR) with 95% confidence interval (95% CI) using multivariate logistic regression. RESULTS: Diabetes was reported in 13.6% of participants and OAB was 20.8%. Diabetic participants were older than non-diabetic participants in both sexes. Participants with diabetes reported a higher rate of OAB (43.1%) and increased bothersome symptoms associated with OAB than those without diabetes. Participants with diabetes (OR, 3.07 [2.39-3.96]], urgent incontinence (OR, 2.38 [1.86-3.03]), frequency (OR, 1.86 [1.45-2.38]), and nocturia (OR, 1.14 [1.05-1.24]) were associated with healthcare-seeking behavior. CONCLUSION: The proportion of diabetic participants with OAB was 2.5-fold higher than those without diabetes. Diabetes, urinary frequency, nocturia, and urgent incontinence are predictors of medical treatment-seeking behavior, but the key symptom of OAB-urgency is not a predictor of treatment-seeking behavior. It is important for clinicians to recognize the interplay between diabetes and OAB and to early identify various bothersome urinary symptoms for better health outcomes in daily practice.


Assuntos
Diabetes Mellitus , Noctúria , Bexiga Urinária Hiperativa , Adulto , Masculino , Feminino , Humanos , Bexiga Urinária Hiperativa/epidemiologia , Noctúria/complicações , Noctúria/epidemiologia , Estudos Transversais , Taiwan/epidemiologia , Diabetes Mellitus/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , China/epidemiologia , República da Coreia/epidemiologia
16.
J Formos Med Assoc ; 2023 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-38044211

RESUMO

OBJECTIVE: This study aimed to assess the impact of preoperative chronic kidney disease (CKD) on the oncological outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent standard radical nephroureterectomy (RNU). METHODS: A total of 1172 UTUC patients who received RNU at a single center in Taiwan between February 2005 and August 2019 were included. The patients were categorized into two groups based on their preoperative CKD stage: CKD stage ≤3 (811 patients) and CKD stage >3 (361 patients). The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula. The study investigated the oncological outcomes, including intravesical recurrence, non-urothelial recurrence, and cancer-specific mortality, stratified by preoperative CKD status. RESULTS: The main findings indicated that UTUC patients with CKD stage >3 in Taiwan exhibited a higher proportion of females (p < 0.001), a greater history of concurrent bladder cancer (p = 0.003), more multifocal tumor behavior (p < 0.001), a higher incidence of carcinoma in situ (p = 0.008), increased rates of intravesical recurrence (p < 0.001), a lower prevalence of smoking history (p = 0.003), lower utilization of adjuvant chemotherapy (p < 0.001), reduced occurrence of non-urothelial recurrence (p < 0.001), and lower cancer-specific mortality (p = 0.006) compared to patients with CKD stage ≤3. Multivariate Cox regression analysis revealed significant differences in intravesical recurrence (p = 0.014) and non-urothelial recurrence (p = 0.006) between the CKD stage >3 and CKD stage ≤3 groups. The study also demonstrated that patients with concurrent bladder cancer and variant histology had higher rates of intravesical recurrence, non-urothelial recurrence, and cancer-specific mortality. The CKD stage >3 group exhibited lower rates of intravesical recurrence (p = 0.0014), higher rates of non-urothelial recurrence (p < 0.0001), and increased cancer-specific mortality (p = 0.0091) compared to the CKD stage ≤3 group in the 5-year free survival analysis. CONCLUSION: In Taiwan, UTUC patients with CKD stage >3 exhibit distinct characteristics compared to the general population with urothelial carcinoma. They are associated with a non-smoking status, a higher proportion of females, and less aggressive pathological features. Additionally, CKD stage >3 can serve as a clinical indicator for intravesical and non-urothelial recurrence. Further investigation into molecular aspects and treatment modifications for these patients is warranted.

17.
JCO Clin Cancer Inform ; 7: e2300081, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38048516

RESUMO

PURPOSE: To develop and validate natural language processing (NLP)-assisted machine learning (ML)-based classification models to confirm diagnoses of monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) from electronic health records (EHRs) in the Veterans Health Administration (VHA). MATERIALS AND METHODS: We developed precompiled lexicons and classification rules as features for the following ML classifiers: logistic regression, random forest, and support vector machines (SVMs). These features were trained on 36,044 EHR documents from a random sample of 400 patients with at least one International Classification of Disease code for MGUS diagnosis from 1999 to 2021. The best-performing feature combination was calibrated in the validation set (17,826 documents/200 patients) and evaluated in the testing set (9,250 documents/100 patients). Model performance in diagnosis confirmation was compared with manual chart review results (gold standard) using recall, precision, accuracy, and F1 score. For patients correctly labeled as disease-positive, the difference between model-identified diagnosis dates and the gold standard was also computed. RESULTS: In the testing set, the NLP-assisted classification model using SVMs achieved best performance in both MGUS and MM confirmation with recall/precision/accuracy/F1 of 98.8%/93.3%/93.0%/96.0% for MGUS and 100.0%/92.3%/99.0%/96.0% for MM. Dates of diagnoses matched (±45 days) with those of gold standard in 73.0% of model-confirmed MGUS and 84.6% of model-confirmed MM. CONCLUSION: An NLP-assisted classification model can reliably confirm MGUS and MM diagnoses and dates and extract laboratory results using automated interpretation of EHR data. This algorithm has the potential to be adapted to other disease areas in VHA EHR system.


Assuntos
Gamopatia Monoclonal de Significância Indeterminada , Mieloma Múltiplo , Veteranos , Humanos , Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Processamento de Linguagem Natural , Registros Eletrônicos de Saúde , Mieloma Múltiplo/diagnóstico
19.
Zool Stud ; 62: e47, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37965299

RESUMO

octurnal animals use their vision and acute hearing to adapt to the nighttime environment. Light pollution has become a serious problem for nocturnal animals in coastal areas, especially nesting sea turtles and sea turtle hatchlings. Hatchlings use visual clues to find the ocean. However, when the artificial light is stronger than the natural light, hatchlings become either misoriented, disoriented or both. Due to rapid tourism development on Lanyu Island, new sources of light pollution, especially streetlights, pose a serious threat to sea turtle hatchlings. In this study, we used a portable lamp constructed by Liteon Inc. on a circular area of a turtle nesting beach to see how artificial light sources could affect green turtle hatchlings' sea finding behavior. In the experiments, we tested hatchling behavior under different lamp settings (strong or weak light intensity; white or yellow light; lamp shield presence or absence) and moon visibilities (moonlit or moonless). The hatchlings' crawling tracks and locations at the end of the trials were recorded. Results showed that the light intensity had no effect on hatchling sea finding behavior. White light had a stronger impact on hatchling sea finding behavior than yellow light. When the lamp shield was installed on moonlit nights, more hatchings were able to find the sea under both white and yellow lights. Thus, it is recommended that light shields be installed on the streetlights of Lanyu Island in order to protect the sea turtle hatchlings effectively.

20.
BMC Public Health ; 23(1): 2346, 2023 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-38012695

RESUMO

BACKGROUND: Most studies have focused on the risk factors, treatment, and care of affective psychosis, and several have reported a relationship between ambient air quality and this psychosis. Although an association has been reported between psychosis and genes, studies mainly explored the associations between one type of psychosis and one gene; few have identified genes related to affective psychosis. This study investigates the genetic and environmental factors of affective psychosis. METHODS: In this retrospective longitudinal study, 27 604 participants aged 30-70 were selected from Taiwan Biobank. The participants' propensity scores were calculated based on their demographic information, and propensity score matching was performed to divide the participants into an experimental (i.e., affective psychosis) and control group at a 1:5 ratio. Plink was used to analyze the major and minor types of gene expression related to affective psychosis, and PM2.5 exposure was incorporated into the analyses. RESULTS: According to the generalized estimating equation analysis results, 8 single nucleotide polymorphisms (SNPs) belonging to the ANK3, BDNF, CACNA1C, and GRID1 genotypes were significantly correlated with depressive disorder (P < .001), with the majority belonging to the ANK3 and CACNA1C. A total of 5 SNPs belonging to the CACNA1C, GRID1, and SIRT1 genotypes were significantly correlated with bipolar disorder (P < .001), with the majority belonging to the CACNA1C. No significant correlation was identified between ambient air pollution and affective psychosis. CONCLUSIONS: CACNA1C and GRID1 are common SNP genotypes for depressive disorder and bipolar disorder and should be considered associated with affective psychosis.


Assuntos
Bancos de Espécimes Biológicos , Predisposição Genética para Doença , Humanos , Estudos Retrospectivos , Estudos Longitudinais , Taiwan/epidemiologia , Canais de Cálcio Tipo L/genética , Transtornos do Humor , Polimorfismo de Nucleotídeo Único , Material Particulado/efeitos adversos , Estudo de Associação Genômica Ampla
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