BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increas...BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increasingly utilized for pancreatic surveillance during routine health examinations.AIM To investigate the feasibility of these imaging modalities for screening in low-risk individuals.METHODS This retrospective study included patients at low risk for pancreatic cancer who underwent MRI or EUS at two health evaluation centers between March 2019 and December 2024.Basic characteristics,laboratory data,and imaging results were collected.RESULTS A total of 3364 low-risk individuals underwent pancreatic screening:1553(46.1%)received MRI,and 1811 underwent EUS.No significant differences were observed in age or sex distribution between the groups.In imaging screening,EUS demonstrated a higher detection rate of abnormal pancreatic lesions(12.8%vs 2.6%;P<0.001).MRI detected more cystic lesions than did EUS(P<0.001).EUS identified smaller nodular lesions compared to MRI(9.2 mm vs 18.0 mm;P=0.044).The MRI group had a higher number of confirmed intraductal papillary mucinous neoplasms(P=0.031),whereas the EUS group identified more suspected branch-duct intraductal papillary mucinous neoplasms(P<0.001).Pancreatic adenocarcinoma was found in three patients(0.08%),with no significant difference in detection rates between EUS and MRI(0.11%vs 0.06%;P=0.656).CONCLUSION In low-risk individuals,MRI and EUS offer comparable effectiveness for pancreatic cancer surveillance.The choice of imaging strategy for health evaluation depends on cost considerations and degree of invasiveness.展开更多
Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the modera...Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.展开更多
文摘BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increasingly utilized for pancreatic surveillance during routine health examinations.AIM To investigate the feasibility of these imaging modalities for screening in low-risk individuals.METHODS This retrospective study included patients at low risk for pancreatic cancer who underwent MRI or EUS at two health evaluation centers between March 2019 and December 2024.Basic characteristics,laboratory data,and imaging results were collected.RESULTS A total of 3364 low-risk individuals underwent pancreatic screening:1553(46.1%)received MRI,and 1811 underwent EUS.No significant differences were observed in age or sex distribution between the groups.In imaging screening,EUS demonstrated a higher detection rate of abnormal pancreatic lesions(12.8%vs 2.6%;P<0.001).MRI detected more cystic lesions than did EUS(P<0.001).EUS identified smaller nodular lesions compared to MRI(9.2 mm vs 18.0 mm;P=0.044).The MRI group had a higher number of confirmed intraductal papillary mucinous neoplasms(P=0.031),whereas the EUS group identified more suspected branch-duct intraductal papillary mucinous neoplasms(P<0.001).Pancreatic adenocarcinoma was found in three patients(0.08%),with no significant difference in detection rates between EUS and MRI(0.11%vs 0.06%;P=0.656).CONCLUSION In low-risk individuals,MRI and EUS offer comparable effectiveness for pancreatic cancer surveillance.The choice of imaging strategy for health evaluation depends on cost considerations and degree of invasiveness.
基金supported by Jiangsu Cancer Hospital Science and Technology Development Fund Project(NO.XHMS202404)Nanjing Medical Science and Technology Development Fund Project(GBX22289).
文摘Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.
