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INTRODUCTION AND OBJECTIVES: The increasing incidence of hepatocellular carcinoma (HCC) in China is an urgent issue, necessitating early diagnosis and treatment. This study aimed to develop personalized predictive models by combining machine learning (ML) technology with a demographic, medical history, and noninvasive biomarker data. These models can enhance the decision-making capabilities of physicians for HCC in hepatitis B virus (HBV)-related cirrhosis patients with low serum alpha-fetoprotein (AFP) levels. PATIENTS AND METHODS: A total of 6,980 patients treated between January 2012 and December 2018 were included. Pre-treatment laboratory tests and clinical data were obtained. The significant risk factors for HCC were identified, and the relative risk of each variable affecting its diagnosis was calculated using ML and univariate regression analysis. The data set was then randomly partitioned into validation (20 %) and training sets (80 %) to develop the ML models. RESULTS: Twelve independent risk factors for HCC were identified using Gaussian naïve Bayes, extreme gradient boosting (XGBoost), random forest, and least absolute shrinkage and selection operation regression models. Multivariate analysis revealed that male sex, age >60 years, alkaline phosphate >150 U/L, AFP >25 ng/mL, carcinoembryonic antigen >5 ng/mL, and fibrinogen >4 g/L were the risk factors, whereas hypertension, calcium <2.25 mmol/L, potassium ≤3.5 mmol/L, direct bilirubin >6.8 µmol/L, hemoglobin <110 g/L, and glutamic-pyruvic transaminase >40 U/L were the protective factors in HCC patients. Based on these factors, a nomogram was constructed, showing an area under the curve (AUC) of 0.746 (sensitivity = 0.710, specificity=0.646), which was significantly higher than AFP AUC of 0.658 (sensitivity = 0.462, specificity=0.766). Compared with several ML algorithms, the XGBoost model had an AUC of 0.832 (sensitivity = 0.745, specificity=0.766) and an independent validation AUC of 0.829 (sensitivity = 0.766, specificity = 0.737), making it the top-performing model in both sets. The external validation results have proven the accuracy of the XGBoost model. CONCLUSIONS: The proposed XGBoost demonstrated a promising ability for individualized prediction of HCC in HBV-related cirrhosis patients with low-level AFP.
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BACKGROUND: Chronic subdural hematomas (CSDHs) are common in the elderly, with a relatively high rate of recurrence after initial surgical intervention. Our research team previously created a predictive grading system, the Puerto Rico Recurrence Scale (PRRS), to identify patients at high risk of CSDH recurrence. In this study, we introduce a modification of the (mPRRS) that includes pneumocephalus volume, which has been independently associated with recurrence. METHODS: A single-center Puerto Rican population-based retrospective study was performed to analyze data for patients treated for CSDH at 1 institution between July 1, 2017, and December 31, 2019. Univariate and multivariate analyses were used to create a grading scale predictive of recurrence. Retrospective validation was conducted for the cohort. RESULTS: Of 108 patients included in the study, 42 had recurrence, and 66 had nonrecurrence. Postoperative subdural space, postoperative midline shift, and pneumocephalus volume were all higher with recurrence (P = 0.002, P = 0.009, and P < 0.001, respectively). Multivariate analysis was used to create a 6-point grading scale comprising 3 variables (pneumocephalus volume [< 10, 10-20, 21-30, and > 30 cm3], postoperative midline shift [< 0.4, 0.41-1.0, and > 1.0 cm], and laterality [unilateral and bilateral]). Recurrence rates progressively increased in low-risk to high-risk groups (2/18 [11%] vs 21/34 [62%]; P < 0.003). CONCLUSION: The mPRRS incorporating pneumocephalus measurement improves CSDH recurrence prediction. The mPRRS indicated that patients with higher scores have a greater risk of recurrence and emphasized the importance of measuring postoperative variables for prediction. The mPRRS grading scale for CSDHs may be applicable not only to the Puerto Rican population but also to the general population.
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Hematoma Subdural Crônico , Pneumocefalia , Humanos , Idoso , Estudos Retrospectivos , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/cirurgia , Hematoma Subdural Crônico/complicações , Pneumocefalia/diagnóstico por imagem , Pneumocefalia/cirurgia , Porto Rico , RecidivaRESUMO
ABSTRACT Introduction Relevant monitoring data show that falls have become the leading cause of death in adults over 65 years old, especially among elderly people who have no exercise habits. Physiological function decline caused by the aging process can be slowed with specific training. It is believed that exercises focusing on the core muscles can benefit balance ability among the elderly. Objective The paper explores how core muscle training impacts balance performance in the elderly. Methods The article randomly divides elderly volunteers (n=24) into two groups. The experimental group received specific core physical conditioning, and the control group received no intervention. The physical quality indicators of both groups were compared and statistically analyzed after the experiment. Results The physical fitness indicators (weight, aerobic endurance, static balance ability) in the groups differed (P<0.05). Conclusion Core training can improve the elderly´s functional physical ability and static balance capacity. Evidence level II; Therapeutic Studies - Investigating the results.
RESUMO Introdução Dados relevantes de monitoramento mostram que as quedas se tornaram a principal causa de morte em adultos maiores de 65 anos, especialmente entre idosos que não têm hábitos de exercício. O declínio das funções fisiológicas causado pelo processo de envelhecimento pode ser retardado com treinos específicos e acredita-se que exercícios concentrados na musculatura do core podem beneficiar a capacidade de equilíbrio entre idosos. Objetivo Este artigo explora o impacto do treino muscular do core no desempenho do equilíbrio nos idosos. Métodos O artigo divide os voluntários idosos (n=24) em dois grupos de forma aleatória. O grupo experimental recebeu condicionamento físico específico do core enquanto o grupo controle não recebeu intervenção. Os indicadores de qualidade física dos dois grupos foram comparados e analisados estatisticamente após o experimento. Resultados Os indicadores de aptidão física (peso, resistência aeróbica, capacidade de equilíbrio estático) dos dois grupos diferenciaram-se (P<0,05). Conclusão O condicionamento físico do core pode melhorar a aptidão física funcional e a capacidade de equilíbrio estático dos idosos. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.
RESUMEN Introducción Datos relevantes de seguimiento muestran que las caídas se han convertido en la principal causa de muerte en adultos mayores de 65 años, especialmente entre los ancianos que no tienen hábitos de ejercicio. El declive de las funciones fisiológicas provocado por el proceso de envejecimiento puede ralentizarse con un entrenamiento específico y se cree que los ejercicios centrados en los músculos del core pueden beneficiar la capacidad de equilibrio entre las personas mayores. Objetivo Este artículo explora el impacto del entrenamiento de los músculos del core en el rendimiento del equilibrio en los ancianos. Métodos El artículo divide a los voluntarios de edad avanzada (n=24) en dos grupos al azar. El grupo experimental recibió un acondicionamiento físico básico específico mientras que el grupo de control no recibió ninguna intervención. Los indicadores de calidad física de los dos grupos fueron comparados y analizados estadísticamente después del experimento. Resultados Los indicadores de aptitud física (peso, resistencia aeróbica, capacidad de equilibrio estático) de los dos grupos fueron diferentes (P<0,05). Conclusión El condicionamiento físico del core puede mejorar la aptitud funcional y la capacidad de equilibrio estático de los ancianos. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.
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Abstract Rabbit with hypercholesterolaemia is an important model for studying cholesterol metabolism disease. This study aimed to evaluate the expression stability of nine reference genes for quantitative PCR (qPCR) analysis in adrenal gland, liver, spleen, and kidney tissue from rabbits with hypercholesterolaemia. In total, 30 male Harbin Large White (HLW) rabbits were fed a normal feed (n = 15) or a high cholesterol feed (n = 15) for 8 weeks to induce hypercholesterolaemia. Nine reference genes were verified by qPCR using cDNA extracted from rabbit tissue samples. For qPCR analysis, reference genes were evaluated using the RefFinder and GeNorm algorithms. Overall, seven rabbits with hypercholesterolaemia were identified based on body weight and total cholesterol measurements. Combining the results of the RefFinder and GeNorm algorithms, the most stable reference genes were hypoxanthine phosphoribosyltransferase 1 (Hprt1) and eukaryotic translation elongation factor 1 alpha 1 (Eef1a1) in the adrenal gland, β-2-microglobulin (B2m) and glyceraldehyde-3-phosphate dehydrogenase (Gapdh) in the liver, tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein zeta (Ywhaz) and Gapdh in the spleen, and peptidylprolyl isomerase (Ppia), β-actin (Actb), succinate dehydrogenase complex subunit A flavoprotein (Sdha), and B2m in the kidney. Taken together, our results confirmed that Hprt1 and Eef1a1, B2m and Gapdh, Ywhaz and Gapdh, and Ppia, Actb, Sdha, and B2m were the best reference genes for qPCR analyses in adrenal gland, liver, spleen, and kidney tissue, respectively, of rabbits with hypercholesterolaemia.
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Animais , Coelhos , Fator de Iniciação 1 em Eucariotos , Glândulas Suprarrenais , Reação em Cadeia da Polimerase em Tempo Real/instrumentação , Hipercolesterolemia/induzido quimicamente , Hipoxantina Fosforribosiltransferase/análiseRESUMO
Nine imported Zika virus (ZIKV) infections (four through temperature monitoring and epidemiological investigation at entry and five by active surveillance tracking of index case contacts during follow-up; from Venezuela [n = 5], Samoa [n = 3] and both Samoa and Fiji [n = 1]) were detected in mainland China from February 1 to 29, 2016. The minimal incubation period lasted 5.2 days, with mean lag time to diagnosis of 2.6 days. Diagnosis relied on positive real-time reverse transcriptase polymerase chain reaction for ZIKV RNA in serum (n = 7), urine (n = 4) or saliva (n = 3), respectively. All cases recovered rapidly without serious complications.
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Sangue/virologia , RNA Viral/sangue , Viagem , Urina/virologia , Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , China , Fiji , Humanos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Samoa , Venezuela , Infecção por Zika virus/virologiaRESUMO
BACKGROUND: Osteoarthritis (OA) is a common arthritic disease and multifactorial whole-joint disease. Interactions of chemokines and OA is inadequately documented. RESULTS: In vivo and in vitro studies were conducted to investigate monocyte chemoattractant protein 1 (MCP-1) and receptor chemokine (C-C motif) receptor 2 (CCR2) in chondrocyte degradation and cartilage degeneration. Chondrocytes from 16 OA patients and 6 normal controls were involved in this study. After stimulation of MCP-1, the expression of MCP-1 and CCR2 increased significantly (P < 0.001) and the expression of MMP-13 also increased (P < 0.05). MCP-1 stimulation also induced (or enhanced) the apoptosis of OA chondrocytes (P < 0.05). Additionally, the degradation of cartilage matrix markers (metalloproteinase 3 and 13, MMP3 and MMP13) in the culture medium of normal chondrocytes was also assessed. Furthermore, intra-articular injection of MCP-1 in mouse knees induced cartilage degradation and the CCR2 antagonist did not impede cartilage destroy in rats knees of monosodium iodoacetate (MIA) model. CONCLUSIONS: The results of this study demonstrate that the MCP-1-CCR2 ligand-receptor axis plays a special role in the initiation and progression of OA pathology. Patients with ambiguous etiology can gain some insight from the MCP-1-CCR2 ligand-receptor axis.
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Quimiocina CCL2/metabolismo , Condrócitos/metabolismo , Osteoartrite do Joelho/fisiopatologia , Receptores CCR2/metabolismo , Adolescente , Idoso , Animais , Apoptose/fisiologia , Quimiocina CCL2/genética , Condrócitos/enzimologia , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Feminino , Fibroblastos/metabolismo , Humanos , Técnicas In Vitro , Ácido Iodoacético , Masculino , Proteínas Matrilinas/metabolismo , Metaloproteinase 13 da Matriz/metabolismo , Metaloproteinase 3 da Matriz/metabolismo , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Ratos Sprague-Dawley , Receptores CCR2/antagonistas & inibidores , Receptores CCR2/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Membrana Sinovial/citologia , Adulto JovemRESUMO
An extracellular ß-agarase was purified from Pseudoalteromonas sp. NJ21, a Psychrophilic agar-degrading bacterium isolated from Antarctic Prydz Bay sediments. The purified agarase (Aga21) revealed a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, with an apparent molecular weight of 80 kDa. The optimum pH and temperature of the agarase were 8.0 and 30 °C, respectively. However, it maintained as much as 85% of the maximum activities at 10 °C. Significant activation of the agarase was observed in the presence of Mg(2+), Mn(2+), K(+); Ca(2+), Na(+), Ba(2+), Zn(2+), Cu(2+), Co(2+), Fe(2+), Sr(2+) and EDTA inhibited the enzyme activity. The enzymatic hydrolyzed product of agar was characterized as neoagarobiose. Furthermore, this work is the first evidence of cold-adapted agarase in Antarctic psychrophilic bacteria and these results indicate the potential for the Antarctic agarase as a catalyst in medicine, food and cosmetic industries.
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Adaptação Fisiológica/fisiologia , Ágar/metabolismo , Glicosídeo Hidrolases/metabolismo , Pseudoalteromonas/enzimologia , Adaptação Fisiológica/genética , Regiões Antárticas , Proteínas de Bactérias/metabolismo , Temperatura Baixa , Dissacarídeos/biossíntese , Sedimentos Geológicos/microbiologia , Glicosídeo Hidrolases/isolamento & purificação , Hidrólise , RNA Ribossômico 16S/genéticaRESUMO
An extracellular β-agarase was purified from