Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genoty...Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.展开更多
Background:Weight stigma is prevalent and has multiple sources,which have significant effects on individual,social,physical,and psychological health.This study evaluated the psychometric properties of the Thai version...Background:Weight stigma is prevalent and has multiple sources,which have significant effects on individual,social,physical,and psychological health.This study evaluated the psychometric properties of the Thai version of WeSEI to provide a valid tool to assess weight stigma in Thai young adults.Methods:A cross-sectional online survey recruited 517 Thai university students from October 2024 to May 2025.All participants completed demographic information and standardized self-reported instruments,including WeSEI,Depression,Anxiety,and Stress scale 21(DASS-21),Weight Self-Stigma Questionnaire(WSSQ),and Perceived Weight Stigma Scale(PWSS).The psychometric properties of the Thai version of WeSEI were examined via confirmatory factor analysis(CFA)with some validity indices.Results:The 7-factor structure of the Thai version of the WeSEI was supported across sex and weight status subgroups,indicating good construct validity.In addition,internal consistency(Cronbach’sα=0.972;McDonald’sω=0.972),convergent,and discriminant validity also indicated that the Thai version of the WeSEI had good psychometric properties and assessed weight stigma among young people in Thailand.Conclusions:Sound psychometric properties of the Thai adaptation of WeSEI allows the identification of various sources contributing to weight stigma and to identify those experiencing high levels of weight stigma.It also provides evidence to support targeted interventions to reduce weight stigma and its associated mental health impacts in further research.Further studies are necessary to explore the utilization of WeSEI for weight stigma in Thailand.展开更多
Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirecti...Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirectional Mendelian randomization(MR)to assess causal associations between lung cancer risk and thyroid dysfunction(hypothyroidism and hyperthyroidism)or functional traits(free thyroxine[FT4]and normal-range thyroid-stimulating hormone[TSH]).Furthermore,in the smoking-behavior-stratified MR analysis,we evaluated the mediating effect of thyroid-related phenotypes on the association between smoking behaviors and lung cancer.We demonstrated significant associations between lung cancer risk and hypothyroidism(hazard ratio[HR]=1.14,95%confidence interval[CI]=1.03–1.26,P=0.009)and hyperthyroidism(HR=1.55,95%CI=1.29–1.87,P=1.90×10^(-6))in the UKB.Moreover,the MR analysis indicated a causal effect of thyroid dysfunction on lung cancer risk(ORinverse variance weighted[IVW]=1.09,95%CI=1.05–1.13,P=3.12×10^(-6)for hypothyroidism;ORIVW=1.08,95%CI=1.04–1.12,P=8.14×10^(-5)for hyperthyroidism).We found that FT4 levels were protective against lung cancer risk(ORIVW=0.93,95%CI=0.87–0.99,P=0.030).Additionally,the stratified MR analysis demonstrated distinct causal effects of thyroid dysfunction on lung cancer risk among smokers.Hyperthyroidism mediated the effect of smoking behaviors,especially the age of smoking initiation(17.66%mediated),on lung cancer risk.Thus,thyroid dysfunction phenotypes play causal roles in lung cancer development exclusively among smokers and act as mediators in the causal pathway from smoking to lung cancer.展开更多
Background:Understanding the relationship between garlic and chronic diseases could help to improve prevention and reduce the burden of diseases.This study aimed to examine the association between garlic consumption a...Background:Understanding the relationship between garlic and chronic diseases could help to improve prevention and reduce the burden of diseases.This study aimed to examine the association between garlic consumption and the risk of chronic diseases.Methods:We included 26,524 participants from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)with data of the frequency of garlic consumption,7658 participants from the Xinjiang multiethnic cohort(XMC)study with data of garlic intake,and 141,684 participants from the UK Biobank(UKBB)with data of the preference for garlic.The dietary pattern of garlic,including the frequency of consuming garlic,garlic intake,and garlic preference information,was collected using a food questionnaire for each cohort.Logistic regression and structural equation modeling were used to assess the effect of garlic consumption on five common chronic diseases,which comprised cancer,diabetes,hypertension,respiratory diseases,and cardiovascular disease(CVD).Results:In the CLHLS cohort,individuals who consumed garlic almost every day had a significantly lower risk of five of the most common chronic diseases(cancer:odds ratio[OR]=0.51,95%confidence interval[CI]=0.30-0.81,p=0.006;diabetes:OR=0.58,95%CI=0.43-0.76,p<0.001;hypertension:OR=0.68,95%CI=0.61-0.77,p<0.001;respiratory diseases:OR=0.77,95%CI=0.67-0.87,p<0.001;and CVD:OR=0.69,95%CI=0.59-0.80,p<0.001).Similarly,in the XMC,there was a consistent protective effect of high garlic intake on hypertension,respiratory diseases and CVD.Additionally,in the UKBB cohort,individuals who liked garlic had a decreased risk of diabetes and CVD.Notably,in three cohorts,structural equation modeling results showed that there was a significant protective total effect of garlic consumption on the five common chronic diseases.展开更多
Background:Weight-related self-stigma(WRSS)is prevalent among individuals with different types of weight status and is associated with a range of negative health outcomes.Social support and coping models explain how i...Background:Weight-related self-stigma(WRSS)is prevalent among individuals with different types of weight status and is associated with a range of negative health outcomes.Social support and coping models explain how individuals may use different coping methods to deal with their mental health needs.Psychological distress(e.g.,depression and stress)could lead to overuse of social media and smartphones.When using social media or smartphones,individuals are likely to be exposed to negative comments regarding weight/shape/size posted on the social media.Consequently,individuals who experience problematic social media use(PSMU)or problematic smartphone use(PSPU)may develop WRSS.Therefore,the present study examined the roles of PSMU and PSPU as mediators in the relationship between psychological distress and WRSS.Methods:Using convenience sampling via an online survey,622 participants with a mean age of 23.70 years(SD=4.33)completed questions assessing sociodemographic variables,psychological distress,PSMU,PSPU,WRSS,and self-reported weight and height.Results:The hierarchical regression models showed that sex(β=0.08,p=0.01),BMI(β=0.39,p<0.001),depression(β=0.21,p=0.001),stress(β=0.18,p=0.01),PSMU(β=0.09,p=0.045),and PSPU(β=0.14,p=0.001)were significant factors for WRSS.Conclusion:The mediation models showed that both PSMU and PSPU were significant mediators in the relationships between depression and stress with WRSS.The present findings provide some evidence for understanding WRSS and has important implications for developing interventions to reduce its negative impact on individuals’health and well-being.展开更多
AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and d...AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic(UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and thevolunteer groups:(1) urethral angle;(2) bladder neck descent;(3) status of the periurethral ligaments,(4) vaginal shape;(5) urethral sphincter integrity, length and muscle thickness at mid urethra;(6) bladder neck funneling;(7) status of the puborectalis muscle;(8) pubo-vaginal distance. UDs parameters were assessed in the patient study group as follows:(1) urethral mobility angle on Q-tip test;(2) Valsalva leak point pressure(VLPP) measured at 250 cc bladder volume; and(3) maximum urethral closure pressure(MUCP). The UH type of SUI was defined with the Q-tip test angle over 30 degrees, and VLPP pressure over 60 cm H2 O. The ISD incontinence was defined with MUCP pressure below 20 cm H2 O, and VLPP pressure less or equal to 60 cm H2 O. We considered the associations between the MRI and clinical data and UDs using a variety of statistical tools to include linear regression, multivariate logistic regression and receiver operating characteristic(ROC) analysis. All statistical analyses were performed using STATA version 9.0(Stata Corp LP, College Station, TX).RESULTS: In the incontinent group, 52% have history of vaginal delivery trauma as compared to none in control group(P < 0.001). There was no difference between the continent volunteers and incontinent patients in body habitus as assessed by the body mass index. Pubovaginal distance and periurethral ligament disruption are significantly associated with incontinence; periurethral ligament symmetricity reduces the odds of incontinence by 87%. Bladder neck funneling and length of the suprapubic urethral sphincter are significantly associated with the type of incontinence on UDs; funneling reduced the odds of pure UH by almost 95%; increasing suprapubic urethral sphincter length at rest is highly associated with UH. Both MRI variables result in a predictive model for UDs diagnosis(area under the ROC = 0.944). CONCLUSION: MRI may play an important role in assessing the contribution of hypermobility and sphincteric dysfunction to the SUI in women when considering treatment options.展开更多
AIM To evaluate the prognostic significance of perioperative carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels in stageⅡ/Ⅲgastric cancer.METHODS From a multi-institutional retrospective databa...AIM To evaluate the prognostic significance of perioperative carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels in stageⅡ/Ⅲgastric cancer.METHODS From a multi-institutional retrospective database compiled by integrating clinical data from nine institutions,data of 998 patients who underwent curative resection for stageⅡ/Ⅲgastric cancer between 2010 and 2014 were retrieved and analyzed.The prognostic impact of the preoperative and postoperative levels and chronological changes in CEA,CA19-9 and their combination were evaluated.To test whether postoperative adjuvant chemotherapy alters the prognostic impact of perioperative CEA and CA19-9 levels,the hazard ratios for mortality were compared between patients who underwent surgery alone and patients who underwent surgery followed by adjuvant chemotherapy.RESULTS The prognostic impact of postoperative CEA and CA19-9 was superior to that of the preoperative levels.Multivariable analysis identified high postoperative CEA and CA19-9 levels as independent prognostic factors for overall survival.Disease-free survival rates clearly decreased in a stepwise manner in association with postoperative CEA and CA19-9 levels,and patients with high levels of both markers showed significantly poorer prognosis than other patient groups.When we analyzed perioperative changes in serum CEA and CA19-9 levels,patients with high levels before and after surgery had the worst disease-free survival rates among all patient groups.Patients with normalized CEA levels after surgery had a significantly lower disease-free survival rate than those with normal perioperative levels,whereas patients with normalized CA19-9 levels after surgery had equivalent survival to those with normal perioperative levels.The prognostic impact of high CEA levels was observably smaller in patients who underwent adjuvant chemotherapy than in patients who underwent surgery alone,whereas that of high CA19-9 was greater in patients who underwent adjuvant chemotherapy.High postoperative CEA levels were significantly associated with an increased prevalence of liver,lung and bone recurrences,and high postoperative CA19-9 levels were significantly associated with increased frequencies of lymph node and liver recurrences.CONCLUSION The evaluation of serum CEA and CA 19-9 levels both before and after surgery provides useful information for precise risk stratification after curative gastrectomy.展开更多
AIM To determine the usefulness of assigning narrow-band imaging(NBI)scores for predicting tumor grade and invasion depth in colorectal tumors.METHODS A total of 161 colorectal lesions were analyzed from138 patients w...AIM To determine the usefulness of assigning narrow-band imaging(NBI)scores for predicting tumor grade and invasion depth in colorectal tumors.METHODS A total of 161 colorectal lesions were analyzed from138 patients who underwent endoscopic or surgical resection after conventional colonoscopy and magnifying endoscopy with NBI.The relationships between the surface and vascular patterns of the lesions,as visualized with NBI,and the tumor grade and depth of submucosa(SM)invasion were determined histopathologically.Scores were assigned to distinct features of the surface microstructures of tubular and papillary-type lesions.Using a multivariate analysis,a model was developed for predicting the tumor grade and depth of invasion based on NBI-finding scores.RESULTS NBI findings that correlated with a high tumor grade were associated with the"regular/irregular"(P<0.0001)surface patterns and the"avascular area"pattern(P=0.0600).The vascular patterns of"disrupted vessels"(P=0.0714)and"thick vessels"(P=0.0133)but none of the surface patterns were associated with a depth of invasion of≥1000μm.In our model,a total NBIfinding score≥1 was indicative of a high tumor grade(sensitivity:0.97;specificity:0.24),and a total NBIfinding score≥9(sensitivity:0.56;specificity:1.0)was predictive of a SM invasion depth≥1000μm.Scores less than these cutoff values signified adenomas and a SM invasion depth<1000μm,respectively.Associations were also noted between selected NBI findings and tumor tissue architecture and histopathology.CONCLUSION Our multivariate statistical model for predicting tumor grades and invasion depths from NBI-finding scores may help standardize the diagnosis of colorectal lesions and inform therapeutic strategies.展开更多
AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliar...AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy.展开更多
PURPOSE:A phase Ⅱ study of bevacizumab(BVZ) plus irinotecan(CPT-11) was conducted in children with recurrent malignant glioma(MG) and intrinsic brainstem glioma(BSG).PATIENTS AND METHODS:Eligible patients received tw...PURPOSE:A phase Ⅱ study of bevacizumab(BVZ) plus irinotecan(CPT-11) was conducted in children with recurrent malignant glioma(MG) and intrinsic brainstem glioma(BSG).PATIENTS AND METHODS:Eligible patients received two doses of BVZ展开更多
AIM： To compare clinical presentation and ultrasound （US） and computed tomography （CT） sensitivity between intraluminal and infiltrating gallbladder carcinoma （GBCA）. METHODS： This retrospective study evaluate...AIM： To compare clinical presentation and ultrasound （US） and computed tomography （CT） sensitivity between intraluminal and infiltrating gallbladder carcinoma （GBCA）. METHODS： This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminaI-GBCA （n = 37） and infiltrating-GBCA （n = 28） groups. The clinical and laboratory findings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies, and outcome were compared between the two groups. RESULTS： There were no significant differences between the two groups with respect to female predominance, presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes. Compared with the patients with intraluminaI-GBCA, those with infiltrating-GBCA were significantly older （65.49 ± 1.51 years vs 73.07 ± 1.90 years）, had a higher frequency of jaundice （3/37 patients vs 13/28 patients） and fever （3/37 patients vs 10/28 patients）, higher alkaline phosphatase （119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L） and total bilirubin （1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L） levels, higher frequency of gallstones （12/37 patients vs 22/28 patients）, smaller gallbladder size （length, 7.47± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm）, and greater proportion of patients with 〈 12 mo survival （16/37 patients vs 18/28 patients）. The sensitivity for diagnosing intraluminal- GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively. The sensitivity for diagnosing infiltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by c-r, respectively. CONCLUSION： In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infiltrating-GBCA.展开更多
The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 p...The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 participants from the UK Biobank,with 75209 participants diagnosed with infectious diseases.Participants reporting the highest intake frequency of processed meat(odds ratio[OR]=1.0964,95%confidence interval[CI]:1.0622–1.1318)and red meat(OR=1.0895,95%CI:1.0563–1.1239)had a higher risk of infectious diseases,compared with those with the lowest intake frequency.Consuming fish 2.0–2.9 times(OR=0.8221,95%CI:0.7955–0.8496),cheese≥5.0 times(OR=0.8822,95%CI:0.8559–0.9092),fruit 3.0–3.9 servings(OR=0.8867,95%CI:0.8661–0.9078),and vegetables 2.0–2.9 servings(OR=0.9372,95%CI:0.9189–0.9559)per week were associated with a lower risk of infection.Low meat-eaters(OR=0.9404,95%CI:0.9243–0.9567),fish-eaters(OR=0.8391,95%CI:0.7887–0.8919),and vegetarians(OR=0.9154,95%CI:0.8561–0.9778)had a lower risk of infectious diseases,compared with regular meat-eaters.The mediation analysis revealed that glycosylated hemoglobin,white blood cell count,and body mass index served as the mediators in the associations between diet and infectious diseases.The current study indicates that the intake frequency of food groups is a risk factor for infectious diseases,and fish-eaters have a lower risk of infection.展开更多
Background: Many studies have underlined as caregiving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences. Objectives: The study of the structure of personality, ca...Background: Many studies have underlined as caregiving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences. Objectives: The study of the structure of personality, can help to understand the association between depression, intrapsychic and interpersonal processes of caregivers of Alzheimer’s disease patients and what kind of intervention can be planned to favor the stress burden management. Methods: Case group: Caregivers (CG) (n = 75);control group, Subjects not Caregivers (nCG) (n. 104). Tests: SASB questionnaire (Structural Analysis of Interpersonal Behavior) describing intrapsychic and interpersonal processes of the structure of personality validated on the basis of DSMIV;CDQ questionnaires—depression. Results: Intrapsychic level: From the results it emerged that CGs had lower autonomy in their choices, and lower acceptance of their own feelings, and exercised greater self-control exhausting themselves toward predetermined goals, and more depression compared to the control group. They may be not able to achieve psychic equilibrium in the presence of stress: they may likely become disoriented and engage in behaviors that may be self-defeating. SASB-Cl = Autonomy (p 0.001);SASB-Cl2-Autonomy and Love (p 0.001), SASB-CL3-Love (p 0.001);SASB-Cl4 Love and control (p 0.001), SASB-CL5-Control (p = 0.015), SASB-Cl6-Control and hate (p 0.001), SASB-Cl7-Hate (p Conclusions: Intrapsychic characteristics such as tendency to depression, inability to being in contact with their own feelings, excessive self-control may be linked to difficulties in facing burden of care and indicate serious difficulties to adaptation to burden condition. The knowledge of these modalities could allow to plan a psychotherapeutic and multidisciplinary intervention aimed at facing and overcoming the psychological distress of the caregiver.展开更多
Analysis of carcinogenicity data generally involves a trend test across all dose groups and a pairwise comparison of the high dose group with the control. The most commonly used test for a positive trend is the Cochra...Analysis of carcinogenicity data generally involves a trend test across all dose groups and a pairwise comparison of the high dose group with the control. The most commonly used test for a positive trend is the Cochran-Armitage test. This test is asymptotically normal. For the pairwise comparison of the high dose group with the control group, we propose two modifications: the first modification is to apply the test on the data from high dose and control groups after dropping the data from the low and the medium dose groups;the second modification is to adjust the test conditional on data from all dose groups. We compare the power performance of these two modifications for the pairwise comparisons.展开更多
AIM: To assess inter- and intra-rater reliability(agreement) between two region of interest(ROI) methods in pediatric spinal cord diffusion tensor imaging(DTI). METHODS: Inner-Field-of-View DTI data previously acquire...AIM: To assess inter- and intra-rater reliability(agreement) between two region of interest(ROI) methods in pediatric spinal cord diffusion tensor imaging(DTI). METHODS: Inner-Field-of-View DTI data previously acquired from ten pediatric healthy subjects(mean age = 12.10 years) was used to assess for reliability. ROIs were drawn by two neuroradiologists on each subject data twice within a 3-mo interval. ROIs were placed on axial B0 maps along the cervical spine using free-hand and fixed-size ROIs. Agreement analyses for fractional anisotropy(FA), axial diffusivity, radial diffusivity and mean diffusivity were performed using intra-class-correlation(ICC) and Cronbach's alpha statistical methods.RESULTS: Inter- and intra-rater agreement between the two ROI methods showed moderate(ICC = 0.5) to strong(ICC = 0.84). There were significant differences between raters in the number of pixels selected using free-hand ROIs(P < 0.05). However, no significant differences were observed in DTI parameter values. FA showed highest variability in ICC values(0.10-0.87). Cronbach's alpha showed moderate-high values for raters and ROI methods. CONCLUSION: The study showed that high reproducibility in spinal cord DTI can be achieved, and demonstrated the importance of setting detailed methodology for post-processing DTI data, specifically the placement of ROIs.展开更多
Background: Using baseline data from the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC), we assessed disease characteristics and prevalence of select comorbidities among subjects with schizophrenia in di...Background: Using baseline data from the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC), we assessed disease characteristics and prevalence of select comorbidities among subjects with schizophrenia in different clinical settings across 18 countries. ZODIAC was a randomized, open-label, one-year, large simple trial (LST) that enrolled 18,239 individuals with schizophrenia. Methods: Subjects were randomized to open-label treatment with ziprasidone (n = 9120) or olanzapine (n = 9119) in naturalistic (usual care) settings and followed for one year. Study sites (n = 749) applied minimal selection criteria in an attempt to make the study population as representative as possible of those receiving treatment in “real world” circumstances across the countries. Results: Mean patient age was 41 years, 55% were male, 34% were markedly ill or presented with more severe disease, and 66% of subjects had one or more select comorbid conditions [i.e. heart attack, stroke, hypertension, CAD/angina, high cholesterol/triglycerides, diabetes, or overweight (BMI ≥ 25)] at baseline. History of suicide attempt was greatest in the US (38%), compared with Sweden (34%), Brazil/South America (26%), Asia (23%), and Eastern Europe (20%). Overweight or obesity was the most prevalent comorbid risk factor, representing 60% of enrolled subjects, 70% of US subjects compared with 30% in Asia and 52% - 64% in the other regions studied. High cholesterol/triglycerides levels were found in 23% of US subjects compared with a relatively low prevalence in other countries (3% - 11%). History of cardiovascular or diabetes-related comorbidities was found in 31% of subjects. Current smoking (46.5%) and past smoking (11.8%) were common with men dominating the proportion of current smokers: US (61%);Asia (60%);Sweden (50%);Eastern Europe (49%);and Latin America (44%). Conclusions: Our findings indicate substantial baseline variations across countries in demographics, comorbid conditions, and psychiatric disease history. These data provide an international epidemiologic picture of schizophrenia and may help guide future research and treatment initiatives.展开更多
While Influenza B viruses currently circulating worldwide are of two distinct evolutionary hemagglutinin lineages, current trivalent inactivated influenza virus vaccines (TIV) contain only a single component. Single d...While Influenza B viruses currently circulating worldwide are of two distinct evolutionary hemagglutinin lineages, current trivalent inactivated influenza virus vaccines (TIV) contain only a single component. Single doses of TIV containing B antigen of B/Florida/4/2006 (Yamagata-like) or B/Brisbane/60/2008 (Victoria-like) were administered during 2008/2009 and 2009/2010 influenza seasons, respectively. The objective of this study was to evaluate the immunological response against different lineages of B antigens in school-aged children. A non-randomized sero-epidemiological study was conducted and the immunogenicity responses based on sero-protection rate and geometric mean titre ratio (GMTR) of hemagglutination inhibition (HI) antibodies were measured before and after immunization as well as post-influenza season. Our results suggested that school-aged children under the age of 9 years receiving TIV vaccination induced and retained higher level of sero-protection rate (66.7% and 69% for the 2008-09 and 2009-10 season, respectively) to the homologous lineage than the heterologous lineage post-vaccination (19.4% and 27.6% for the 2008-09 and 2009-10 season, respectively). The need for the quadrivalent TIV by including both lineages of influenza B viruses is recommended in this study, particularly for children under the age of 9 years.展开更多
Objective:To identify the febrile characteristics and clinical presentations associated with fatality in hospitalized adult patients with dengue virus(DENV)infections.Methods:A total of 289 adult hospitalized patients...Objective:To identify the febrile characteristics and clinical presentations associated with fatality in hospitalized adult patients with dengue virus(DENV)infections.Methods:A total of 289 adult hospitalized patients with laboratoryconfirmed DENV infections were examined,of which 22 were fatal and 267 were non-fatal.A comparison of the clinical and laboratory characteristics was retrospectively conducted of the deceased and surviving individuals.Multivariate logistic regression and receiver operating characteristic curve analysis were performed to identify predictors of fatality.Results:Fatal patients exhibited significantly more comorbidities,particularly renal and cardiac comorbidities,and they were,in general,older than control individuals(P<0.0001).The results of logistic regression analysis showed that febrile duration of less than four days before arriving in the Emergency Department(OR=5.34;95%CI:1.39–20.6),episode of hypotension in the Emergency Department(OR=6.95;95%CI:2.40–20.1),and comorbidity with congestive heart failure(OR=11.26;95%CI:2.31–54.79)were all significantly associated with inpatient fatality due to DENV infection.The ROC curve analysis indicated that the final prognostic model yielded an area under the curve of 0.87(95%CI:0.79–0.97)for fatality.Conclusions:The aforementioned clinical findings may help clinicians predict fatality among adult inpatients with DENV infection.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.82220108002 to F.C.and Grant No.82273737 to R.Z.)the U.S.National Institutes of Health(Grant Nos.CA209414,HL060710,and ES000002 to D.C.C.,Grant Nos.CA209414 and CA249096 to Y.L.)+1 种基金the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)supported by the Qing Lan Project of the Higher Education Institutions of Jiangsu Province and the Outstanding Young Level Academic Leadership Training Program of Nanjing Medical University.
文摘Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.
基金Hualien Tzu-Chi Hospital of the Buddhist Tzu Chi Medical Foundation.
文摘Background:Weight stigma is prevalent and has multiple sources,which have significant effects on individual,social,physical,and psychological health.This study evaluated the psychometric properties of the Thai version of WeSEI to provide a valid tool to assess weight stigma in Thai young adults.Methods:A cross-sectional online survey recruited 517 Thai university students from October 2024 to May 2025.All participants completed demographic information and standardized self-reported instruments,including WeSEI,Depression,Anxiety,and Stress scale 21(DASS-21),Weight Self-Stigma Questionnaire(WSSQ),and Perceived Weight Stigma Scale(PWSS).The psychometric properties of the Thai version of WeSEI were examined via confirmatory factor analysis(CFA)with some validity indices.Results:The 7-factor structure of the Thai version of the WeSEI was supported across sex and weight status subgroups,indicating good construct validity.In addition,internal consistency(Cronbach’sα=0.972;McDonald’sω=0.972),convergent,and discriminant validity also indicated that the Thai version of the WeSEI had good psychometric properties and assessed weight stigma among young people in Thailand.Conclusions:Sound psychometric properties of the Thai adaptation of WeSEI allows the identification of various sources contributing to weight stigma and to identify those experiencing high levels of weight stigma.It also provides evidence to support targeted interventions to reduce weight stigma and its associated mental health impacts in further research.Further studies are necessary to explore the utilization of WeSEI for weight stigma in Thailand.
基金funded by the National Natural Science Foundation of China(Grant Nos.82220108002 to F.C.,82273737 to R.Z.,82473728 to Y.W.)the US National Institutes of Health(Grant Nos.CA209414,HL060710,ES000002 to D.C.C.,CA209414,CA249096 to Y.L.)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).R.Z.was partially supported by the Qing Lan Project of the Higher Education Institutions of Jiangsu Province and the Outstanding Young-Level Academic Leadership Training Program of Nanjing Medical University.
文摘Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirectional Mendelian randomization(MR)to assess causal associations between lung cancer risk and thyroid dysfunction(hypothyroidism and hyperthyroidism)or functional traits(free thyroxine[FT4]and normal-range thyroid-stimulating hormone[TSH]).Furthermore,in the smoking-behavior-stratified MR analysis,we evaluated the mediating effect of thyroid-related phenotypes on the association between smoking behaviors and lung cancer.We demonstrated significant associations between lung cancer risk and hypothyroidism(hazard ratio[HR]=1.14,95%confidence interval[CI]=1.03–1.26,P=0.009)and hyperthyroidism(HR=1.55,95%CI=1.29–1.87,P=1.90×10^(-6))in the UKB.Moreover,the MR analysis indicated a causal effect of thyroid dysfunction on lung cancer risk(ORinverse variance weighted[IVW]=1.09,95%CI=1.05–1.13,P=3.12×10^(-6)for hypothyroidism;ORIVW=1.08,95%CI=1.04–1.12,P=8.14×10^(-5)for hyperthyroidism).We found that FT4 levels were protective against lung cancer risk(ORIVW=0.93,95%CI=0.87–0.99,P=0.030).Additionally,the stratified MR analysis demonstrated distinct causal effects of thyroid dysfunction on lung cancer risk among smokers.Hyperthyroidism mediated the effect of smoking behaviors,especially the age of smoking initiation(17.66%mediated),on lung cancer risk.Thus,thyroid dysfunction phenotypes play causal roles in lung cancer development exclusively among smokers and act as mediators in the causal pathway from smoking to lung cancer.
基金supported by Natural Science Foundation of Jiangsu Province(BK20230003)Science and Technology Department of Xinjiang Uyghur Autonomous Region(2022TSYCTD0013)the National Natural Science Foundation of China(82173601).
文摘Background:Understanding the relationship between garlic and chronic diseases could help to improve prevention and reduce the burden of diseases.This study aimed to examine the association between garlic consumption and the risk of chronic diseases.Methods:We included 26,524 participants from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)with data of the frequency of garlic consumption,7658 participants from the Xinjiang multiethnic cohort(XMC)study with data of garlic intake,and 141,684 participants from the UK Biobank(UKBB)with data of the preference for garlic.The dietary pattern of garlic,including the frequency of consuming garlic,garlic intake,and garlic preference information,was collected using a food questionnaire for each cohort.Logistic regression and structural equation modeling were used to assess the effect of garlic consumption on five common chronic diseases,which comprised cancer,diabetes,hypertension,respiratory diseases,and cardiovascular disease(CVD).Results:In the CLHLS cohort,individuals who consumed garlic almost every day had a significantly lower risk of five of the most common chronic diseases(cancer:odds ratio[OR]=0.51,95%confidence interval[CI]=0.30-0.81,p=0.006;diabetes:OR=0.58,95%CI=0.43-0.76,p<0.001;hypertension:OR=0.68,95%CI=0.61-0.77,p<0.001;respiratory diseases:OR=0.77,95%CI=0.67-0.87,p<0.001;and CVD:OR=0.69,95%CI=0.59-0.80,p<0.001).Similarly,in the XMC,there was a consistent protective effect of high garlic intake on hypertension,respiratory diseases and CVD.Additionally,in the UKBB cohort,individuals who liked garlic had a decreased risk of diabetes and CVD.Notably,in three cohorts,structural equation modeling results showed that there was a significant protective total effect of garlic consumption on the five common chronic diseases.
基金supported in part by(received funding from)the Ministry of Science and Technology,Taiwan(MOST 110-2410-H-006-115,MOST 111-2410-H-006-100)the National Science and Technology Council,Taiwan(NSTC 112-2410-H-006-089-SS2)+1 种基金the Higher Education Sprout Project,the Ministry of Education at the Headquarters of University Advancement at the National Cheng Kung University(NCKU)the 2021 Southeast and South Asia and Taiwan Universities Joint Research Scheme(NCKU 31).
文摘Background:Weight-related self-stigma(WRSS)is prevalent among individuals with different types of weight status and is associated with a range of negative health outcomes.Social support and coping models explain how individuals may use different coping methods to deal with their mental health needs.Psychological distress(e.g.,depression and stress)could lead to overuse of social media and smartphones.When using social media or smartphones,individuals are likely to be exposed to negative comments regarding weight/shape/size posted on the social media.Consequently,individuals who experience problematic social media use(PSMU)or problematic smartphone use(PSPU)may develop WRSS.Therefore,the present study examined the roles of PSMU and PSPU as mediators in the relationship between psychological distress and WRSS.Methods:Using convenience sampling via an online survey,622 participants with a mean age of 23.70 years(SD=4.33)completed questions assessing sociodemographic variables,psychological distress,PSMU,PSPU,WRSS,and self-reported weight and height.Results:The hierarchical regression models showed that sex(β=0.08,p=0.01),BMI(β=0.39,p<0.001),depression(β=0.21,p=0.001),stress(β=0.18,p=0.01),PSMU(β=0.09,p=0.045),and PSPU(β=0.14,p=0.001)were significant factors for WRSS.Conclusion:The mediation models showed that both PSMU and PSPU were significant mediators in the relationships between depression and stress with WRSS.The present findings provide some evidence for understanding WRSS and has important implications for developing interventions to reduce its negative impact on individuals’health and well-being.
基金Supported by The Radiological Society of North America and the Society of Computed Body Tomography and Magnetic Resonance
文摘AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic(UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and thevolunteer groups:(1) urethral angle;(2) bladder neck descent;(3) status of the periurethral ligaments,(4) vaginal shape;(5) urethral sphincter integrity, length and muscle thickness at mid urethra;(6) bladder neck funneling;(7) status of the puborectalis muscle;(8) pubo-vaginal distance. UDs parameters were assessed in the patient study group as follows:(1) urethral mobility angle on Q-tip test;(2) Valsalva leak point pressure(VLPP) measured at 250 cc bladder volume; and(3) maximum urethral closure pressure(MUCP). The UH type of SUI was defined with the Q-tip test angle over 30 degrees, and VLPP pressure over 60 cm H2 O. The ISD incontinence was defined with MUCP pressure below 20 cm H2 O, and VLPP pressure less or equal to 60 cm H2 O. We considered the associations between the MRI and clinical data and UDs using a variety of statistical tools to include linear regression, multivariate logistic regression and receiver operating characteristic(ROC) analysis. All statistical analyses were performed using STATA version 9.0(Stata Corp LP, College Station, TX).RESULTS: In the incontinent group, 52% have history of vaginal delivery trauma as compared to none in control group(P < 0.001). There was no difference between the continent volunteers and incontinent patients in body habitus as assessed by the body mass index. Pubovaginal distance and periurethral ligament disruption are significantly associated with incontinence; periurethral ligament symmetricity reduces the odds of incontinence by 87%. Bladder neck funneling and length of the suprapubic urethral sphincter are significantly associated with the type of incontinence on UDs; funneling reduced the odds of pure UH by almost 95%; increasing suprapubic urethral sphincter length at rest is highly associated with UH. Both MRI variables result in a predictive model for UDs diagnosis(area under the ROC = 0.944). CONCLUSION: MRI may play an important role in assessing the contribution of hypermobility and sphincteric dysfunction to the SUI in women when considering treatment options.
文摘AIM To evaluate the prognostic significance of perioperative carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels in stageⅡ/Ⅲgastric cancer.METHODS From a multi-institutional retrospective database compiled by integrating clinical data from nine institutions,data of 998 patients who underwent curative resection for stageⅡ/Ⅲgastric cancer between 2010 and 2014 were retrieved and analyzed.The prognostic impact of the preoperative and postoperative levels and chronological changes in CEA,CA19-9 and their combination were evaluated.To test whether postoperative adjuvant chemotherapy alters the prognostic impact of perioperative CEA and CA19-9 levels,the hazard ratios for mortality were compared between patients who underwent surgery alone and patients who underwent surgery followed by adjuvant chemotherapy.RESULTS The prognostic impact of postoperative CEA and CA19-9 was superior to that of the preoperative levels.Multivariable analysis identified high postoperative CEA and CA19-9 levels as independent prognostic factors for overall survival.Disease-free survival rates clearly decreased in a stepwise manner in association with postoperative CEA and CA19-9 levels,and patients with high levels of both markers showed significantly poorer prognosis than other patient groups.When we analyzed perioperative changes in serum CEA and CA19-9 levels,patients with high levels before and after surgery had the worst disease-free survival rates among all patient groups.Patients with normalized CEA levels after surgery had a significantly lower disease-free survival rate than those with normal perioperative levels,whereas patients with normalized CA19-9 levels after surgery had equivalent survival to those with normal perioperative levels.The prognostic impact of high CEA levels was observably smaller in patients who underwent adjuvant chemotherapy than in patients who underwent surgery alone,whereas that of high CA19-9 was greater in patients who underwent adjuvant chemotherapy.High postoperative CEA levels were significantly associated with an increased prevalence of liver,lung and bone recurrences,and high postoperative CA19-9 levels were significantly associated with increased frequencies of lymph node and liver recurrences.CONCLUSION The evaluation of serum CEA and CA 19-9 levels both before and after surgery provides useful information for precise risk stratification after curative gastrectomy.
文摘AIM To determine the usefulness of assigning narrow-band imaging(NBI)scores for predicting tumor grade and invasion depth in colorectal tumors.METHODS A total of 161 colorectal lesions were analyzed from138 patients who underwent endoscopic or surgical resection after conventional colonoscopy and magnifying endoscopy with NBI.The relationships between the surface and vascular patterns of the lesions,as visualized with NBI,and the tumor grade and depth of submucosa(SM)invasion were determined histopathologically.Scores were assigned to distinct features of the surface microstructures of tubular and papillary-type lesions.Using a multivariate analysis,a model was developed for predicting the tumor grade and depth of invasion based on NBI-finding scores.RESULTS NBI findings that correlated with a high tumor grade were associated with the"regular/irregular"(P<0.0001)surface patterns and the"avascular area"pattern(P=0.0600).The vascular patterns of"disrupted vessels"(P=0.0714)and"thick vessels"(P=0.0133)but none of the surface patterns were associated with a depth of invasion of≥1000μm.In our model,a total NBIfinding score≥1 was indicative of a high tumor grade(sensitivity:0.97;specificity:0.24),and a total NBIfinding score≥9(sensitivity:0.56;specificity:1.0)was predictive of a SM invasion depth≥1000μm.Scores less than these cutoff values signified adenomas and a SM invasion depth<1000μm,respectively.Associations were also noted between selected NBI findings and tumor tissue architecture and histopathology.CONCLUSION Our multivariate statistical model for predicting tumor grades and invasion depths from NBI-finding scores may help standardize the diagnosis of colorectal lesions and inform therapeutic strategies.
文摘AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy.
文摘PURPOSE:A phase Ⅱ study of bevacizumab(BVZ) plus irinotecan(CPT-11) was conducted in children with recurrent malignant glioma(MG) and intrinsic brainstem glioma(BSG).PATIENTS AND METHODS:Eligible patients received two doses of BVZ
文摘AIM： To compare clinical presentation and ultrasound （US） and computed tomography （CT） sensitivity between intraluminal and infiltrating gallbladder carcinoma （GBCA）. METHODS： This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminaI-GBCA （n = 37） and infiltrating-GBCA （n = 28） groups. The clinical and laboratory findings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies, and outcome were compared between the two groups. RESULTS： There were no significant differences between the two groups with respect to female predominance, presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes. Compared with the patients with intraluminaI-GBCA, those with infiltrating-GBCA were significantly older （65.49 ± 1.51 years vs 73.07 ± 1.90 years）, had a higher frequency of jaundice （3/37 patients vs 13/28 patients） and fever （3/37 patients vs 10/28 patients）, higher alkaline phosphatase （119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L） and total bilirubin （1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L） levels, higher frequency of gallstones （12/37 patients vs 22/28 patients）, smaller gallbladder size （length, 7.47± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm）, and greater proportion of patients with 〈 12 mo survival （16/37 patients vs 18/28 patients）. The sensitivity for diagnosing intraluminal- GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively. The sensitivity for diagnosing infiltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by c-r, respectively. CONCLUSION： In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infiltrating-GBCA.
基金supported by the National Natural Science Foundation of China(Grant Nos.82173585 and 82273741)the Natural Science Foundation of Jiangsu Higher Education Institutions of China(Grant Nos.21KJB330005 and 22KJB330007)+1 种基金the Nanjing Major Science and Technology Project(Grant No.2021-11005)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 participants from the UK Biobank,with 75209 participants diagnosed with infectious diseases.Participants reporting the highest intake frequency of processed meat(odds ratio[OR]=1.0964,95%confidence interval[CI]:1.0622–1.1318)and red meat(OR=1.0895,95%CI:1.0563–1.1239)had a higher risk of infectious diseases,compared with those with the lowest intake frequency.Consuming fish 2.0–2.9 times(OR=0.8221,95%CI:0.7955–0.8496),cheese≥5.0 times(OR=0.8822,95%CI:0.8559–0.9092),fruit 3.0–3.9 servings(OR=0.8867,95%CI:0.8661–0.9078),and vegetables 2.0–2.9 servings(OR=0.9372,95%CI:0.9189–0.9559)per week were associated with a lower risk of infection.Low meat-eaters(OR=0.9404,95%CI:0.9243–0.9567),fish-eaters(OR=0.8391,95%CI:0.7887–0.8919),and vegetarians(OR=0.9154,95%CI:0.8561–0.9778)had a lower risk of infectious diseases,compared with regular meat-eaters.The mediation analysis revealed that glycosylated hemoglobin,white blood cell count,and body mass index served as the mediators in the associations between diet and infectious diseases.The current study indicates that the intake frequency of food groups is a risk factor for infectious diseases,and fish-eaters have a lower risk of infection.
文摘Background: Many studies have underlined as caregiving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences. Objectives: The study of the structure of personality, can help to understand the association between depression, intrapsychic and interpersonal processes of caregivers of Alzheimer’s disease patients and what kind of intervention can be planned to favor the stress burden management. Methods: Case group: Caregivers (CG) (n = 75);control group, Subjects not Caregivers (nCG) (n. 104). Tests: SASB questionnaire (Structural Analysis of Interpersonal Behavior) describing intrapsychic and interpersonal processes of the structure of personality validated on the basis of DSMIV;CDQ questionnaires—depression. Results: Intrapsychic level: From the results it emerged that CGs had lower autonomy in their choices, and lower acceptance of their own feelings, and exercised greater self-control exhausting themselves toward predetermined goals, and more depression compared to the control group. They may be not able to achieve psychic equilibrium in the presence of stress: they may likely become disoriented and engage in behaviors that may be self-defeating. SASB-Cl = Autonomy (p 0.001);SASB-Cl2-Autonomy and Love (p 0.001), SASB-CL3-Love (p 0.001);SASB-Cl4 Love and control (p 0.001), SASB-CL5-Control (p = 0.015), SASB-Cl6-Control and hate (p 0.001), SASB-Cl7-Hate (p Conclusions: Intrapsychic characteristics such as tendency to depression, inability to being in contact with their own feelings, excessive self-control may be linked to difficulties in facing burden of care and indicate serious difficulties to adaptation to burden condition. The knowledge of these modalities could allow to plan a psychotherapeutic and multidisciplinary intervention aimed at facing and overcoming the psychological distress of the caregiver.
文摘Analysis of carcinogenicity data generally involves a trend test across all dose groups and a pairwise comparison of the high dose group with the control. The most commonly used test for a positive trend is the Cochran-Armitage test. This test is asymptotically normal. For the pairwise comparison of the high dose group with the control group, we propose two modifications: the first modification is to apply the test on the data from high dose and control groups after dropping the data from the low and the medium dose groups;the second modification is to adjust the test conditional on data from all dose groups. We compare the power performance of these two modifications for the pairwise comparisons.
基金Supported by The Shriners Hospitals for Children,No.#8956
文摘AIM: To assess inter- and intra-rater reliability(agreement) between two region of interest(ROI) methods in pediatric spinal cord diffusion tensor imaging(DTI). METHODS: Inner-Field-of-View DTI data previously acquired from ten pediatric healthy subjects(mean age = 12.10 years) was used to assess for reliability. ROIs were drawn by two neuroradiologists on each subject data twice within a 3-mo interval. ROIs were placed on axial B0 maps along the cervical spine using free-hand and fixed-size ROIs. Agreement analyses for fractional anisotropy(FA), axial diffusivity, radial diffusivity and mean diffusivity were performed using intra-class-correlation(ICC) and Cronbach's alpha statistical methods.RESULTS: Inter- and intra-rater agreement between the two ROI methods showed moderate(ICC = 0.5) to strong(ICC = 0.84). There were significant differences between raters in the number of pixels selected using free-hand ROIs(P < 0.05). However, no significant differences were observed in DTI parameter values. FA showed highest variability in ICC values(0.10-0.87). Cronbach's alpha showed moderate-high values for raters and ROI methods. CONCLUSION: The study showed that high reproducibility in spinal cord DTI can be achieved, and demonstrated the importance of setting detailed methodology for post-processing DTI data, specifically the placement of ROIs.
文摘Background: Using baseline data from the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC), we assessed disease characteristics and prevalence of select comorbidities among subjects with schizophrenia in different clinical settings across 18 countries. ZODIAC was a randomized, open-label, one-year, large simple trial (LST) that enrolled 18,239 individuals with schizophrenia. Methods: Subjects were randomized to open-label treatment with ziprasidone (n = 9120) or olanzapine (n = 9119) in naturalistic (usual care) settings and followed for one year. Study sites (n = 749) applied minimal selection criteria in an attempt to make the study population as representative as possible of those receiving treatment in “real world” circumstances across the countries. Results: Mean patient age was 41 years, 55% were male, 34% were markedly ill or presented with more severe disease, and 66% of subjects had one or more select comorbid conditions [i.e. heart attack, stroke, hypertension, CAD/angina, high cholesterol/triglycerides, diabetes, or overweight (BMI ≥ 25)] at baseline. History of suicide attempt was greatest in the US (38%), compared with Sweden (34%), Brazil/South America (26%), Asia (23%), and Eastern Europe (20%). Overweight or obesity was the most prevalent comorbid risk factor, representing 60% of enrolled subjects, 70% of US subjects compared with 30% in Asia and 52% - 64% in the other regions studied. High cholesterol/triglycerides levels were found in 23% of US subjects compared with a relatively low prevalence in other countries (3% - 11%). History of cardiovascular or diabetes-related comorbidities was found in 31% of subjects. Current smoking (46.5%) and past smoking (11.8%) were common with men dominating the proportion of current smokers: US (61%);Asia (60%);Sweden (50%);Eastern Europe (49%);and Latin America (44%). Conclusions: Our findings indicate substantial baseline variations across countries in demographics, comorbid conditions, and psychiatric disease history. These data provide an international epidemiologic picture of schizophrenia and may help guide future research and treatment initiatives.
文摘While Influenza B viruses currently circulating worldwide are of two distinct evolutionary hemagglutinin lineages, current trivalent inactivated influenza virus vaccines (TIV) contain only a single component. Single doses of TIV containing B antigen of B/Florida/4/2006 (Yamagata-like) or B/Brisbane/60/2008 (Victoria-like) were administered during 2008/2009 and 2009/2010 influenza seasons, respectively. The objective of this study was to evaluate the immunological response against different lineages of B antigens in school-aged children. A non-randomized sero-epidemiological study was conducted and the immunogenicity responses based on sero-protection rate and geometric mean titre ratio (GMTR) of hemagglutination inhibition (HI) antibodies were measured before and after immunization as well as post-influenza season. Our results suggested that school-aged children under the age of 9 years receiving TIV vaccination induced and retained higher level of sero-protection rate (66.7% and 69% for the 2008-09 and 2009-10 season, respectively) to the homologous lineage than the heterologous lineage post-vaccination (19.4% and 27.6% for the 2008-09 and 2009-10 season, respectively). The need for the quadrivalent TIV by including both lineages of influenza B viruses is recommended in this study, particularly for children under the age of 9 years.
基金supported by National Cheng Kung University Hospital(NCKUH-10505033)
文摘Objective:To identify the febrile characteristics and clinical presentations associated with fatality in hospitalized adult patients with dengue virus(DENV)infections.Methods:A total of 289 adult hospitalized patients with laboratoryconfirmed DENV infections were examined,of which 22 were fatal and 267 were non-fatal.A comparison of the clinical and laboratory characteristics was retrospectively conducted of the deceased and surviving individuals.Multivariate logistic regression and receiver operating characteristic curve analysis were performed to identify predictors of fatality.Results:Fatal patients exhibited significantly more comorbidities,particularly renal and cardiac comorbidities,and they were,in general,older than control individuals(P<0.0001).The results of logistic regression analysis showed that febrile duration of less than four days before arriving in the Emergency Department(OR=5.34;95%CI:1.39–20.6),episode of hypotension in the Emergency Department(OR=6.95;95%CI:2.40–20.1),and comorbidity with congestive heart failure(OR=11.26;95%CI:2.31–54.79)were all significantly associated with inpatient fatality due to DENV infection.The ROC curve analysis indicated that the final prognostic model yielded an area under the curve of 0.87(95%CI:0.79–0.97)for fatality.Conclusions:The aforementioned clinical findings may help clinicians predict fatality among adult inpatients with DENV infection.
