Enhancing Weakly Supervised Semantic Segmentation with Multi-label Contrastive Learning and LLM Features Guidance.

Histopathological whole-slide image (WSI) segmentation is essential for precise tissue characterization in medical diagnostics. However, traditional approaches require labor-intensive pixel-level annotations. To this end, we study weakly supervised semantic segmentation (WSSS) which uses patch-level classification labels, reducing annotation efforts significantly. However, the complexity of WSIs and the challenge of sparse classification labels hinder effective dense pixel predictions. Moreover, due to the multi-label nature of WSI, existingapproachesofsingle-labelcontrastivelearningdesignedfortherepresentationofsingle-category, neglecting the presence of other relevant categories and thus fail to adapt to WSI tasks. This paper presents a novel multilabel contrastive learning method for WSSS by incorporating class-specific embedding extraction with LLM features guidance. Specifically, we propose to obtain class-specific embeddings by utilizing classifier weights, followed by a dot-product-based attention fusion method that leverages LLM features to enrich their semantics, facilitating contrastive learning between different classes from single image. Besides, we propose a Robust Learning approach that leverages multi-layer features to evaluate the uncertainty of pseudo-labels, thereby mitigating the impact of noisy pseudo-labels on the learning process of segmentation. Extensive experiments have been conducted on two Histopathological image segmentation datasets, i.e. LUAD dataset and BCSS dataset, demonstrating the effectiveness of our methods with leading performance.

Adsorption/desorption characteristics of methane on moist shale under high temperature and pressure: an experimental and molecular simulation study.

The adsorption/desorption characteristics of methane (CH4) on moist shale are of great significance for shale gas exploration and production. However, the influence of moisture on CH4 adsorption/desorption under high temperature and pressure conditions, which is consistent to shale reservoirs (burial depths about 3500-4500 m) in China, remained unclear. In this study, quantitative analysis toward moisture dependence of CH4 adsorption/desorption capability on shales was investigated through experimentation and molecular dynamics simulation under moisture contents of 0%, 0.204%, 0.445%, 0.677%, and 0.965%. Results show that with increasing moisture content, the isothermal adsorption capacity of CH4 decrease, and it reaches 36.80% and 10.00% at moisture content of 0.965% in experimentation and simulation, respectively. Simultaneously, the hysteresis index of CH4 desorption increase by 19.64% and 4.52%. The role of water molecules hindering CH4 desorption under low and high moisture content was clarified. At low moisture content, water molecules are mainly adsorbed on the pore walls, thereby reducing the size of the pore throat and hindering CH4 transport pathways. At high moisture content, many water molecules escape from the original adsorption sites and form clusters in the middle of the pores, blocking the pore throats. Meanwhile, CH4 is re-adsorbed onto the exposed adsorption sites of water, which leads to CH4 desorption hysteresis. The results provide valuable insights for shale gas exploration and production under practical water-bearing shale reservoir conditions.

RBM25 is required to restrain inflammation via ACLY RNA splicing-dependent metabolism rewiring.

Spliceosome dysfunction and aberrant RNA splicing underline unresolved inflammation and immunopathogenesis. Here, we revealed the misregulation of mRNA splicing via the spliceosome in the pathogenesis of rheumatoid arthritis (RA). Among them, decreased expression of RNA binding motif protein 25 (RBM25) was identified as a major pathogenic factor in RA patients and experimental arthritis mice through increased proinflammatory mediator production and increased hyperinflammation in macrophages. Multiomics analyses of macrophages from RBM25-deficient mice revealed that the transcriptional enhancement of proinflammatory genes (including Il1b, Il6, and Cxcl10) was coupled with histone 3 lysine 9 acetylation (H3K9ac) and H3K27ac modifications as well as hypoxia inducible factor-1α (HIF-1α) activity. Furthermore, RBM25 directly bound to and mediated the 14th exon skipping of ATP citrate lyase (Acly) pre-mRNA, resulting in two distinct Acly isoforms, Acly Long (Acly L) and Acly Short (Acly S). In proinflammatory macrophages, Acly L was subjected to protein lactylation on lysine 918/995, whereas Acly S did not, which influenced its affinity for metabolic substrates and subsequent metabolic activity. RBM25 deficiency overwhelmingly increased the expression of the Acly S isoform, enhancing glycolysis and acetyl-CoA production for epigenetic remodeling, macrophage overactivation and tissue inflammatory injury. Finally, macrophage-specific deletion of RBM25 led to inflammaging, including spontaneous arthritis in various joints of mice and inflammation in multiple organs, which could be relieved by pharmacological inhibition of Acly. Overall, targeting the RBM25-Acly splicing axis represents a potential strategy for modulating macrophage responses in autoimmune arthritis and aging-associated inflammation.

Clopidogrel and Aspirin Initiated Between 24 to 72 Hours for Mild Ischemic Stroke: A Subgroup Analysis of the INSPIRES Randomized Clinical Trial.

Importance: Prior trials showed that dual antiplatelet therapy could reduce the risk of early new stroke in patients with acute mild ischemic stroke or transient ischemic attack (TIA) within 24 hours of symptom onset. However, it is currently uncertain whether dual antiplatelet therapy can reduce the risk of early new stroke in patients with a more delayed initiation time window. Objective: To evaluate the efficacy and safety of clopidogrel and aspirin among patients with mild ischemic stroke or TIA when initiated within 24 hours, from more than 24 hours to 48 hours, and from more than 48 hours to 72 hours. Design, Setting, and Participants: The Intensive Statin and Antiplatelet Therapy for Acute High-Risk Intracranial or Extracranial Atherosclerosis randomized clinical trial was a double-blind, placebo-controlled, multicenter, 2-by-2 factorial randomized clinical trial conducted at 222 hospitals in China from September 17, 2018, to October 15, 2022. All patients with acute mild ischemic stroke and TIA were included in this subgroup analysis and categorized into 3 groups according to time from symptom onset to randomization (group 1: ≤24 hours; group 2: >24 to ≤48 hours; and group 3: >48 to 72 hours). Patients were followed up for 90 days. Interventions: All patients received clopidogrel combined with aspirin (clopidogrel 300 mg loading dose on day 1, followed by 75 mg daily on days 2 to 90, and aspirin 100 to 300 mg on the first day and then 100 mg daily for days 2 to 90) or aspirin alone (100 to 300 mg on day 1 and then 100 mg daily for days 2 to 90) within 72 hours after symptom onset. Main Outcomes and Measures: The primary outcome was new stroke (ischemic or hemorrhagic) within 90 days. The primary safety outcome was moderate-to-severe bleeding, according to Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries criteria. Results: This analysis included a total of 6100 patients (3050 in the clopidogrel-aspirin group and 3050 in the aspirin group). The median age was 65 years (IQR, 57-71 years), and 3915 patients (64.2%) were male. In the population with time to randomization of 24 hours or less, stroke occurred in the next 90 days in 97 of 783 patients (12.4%); among those randomized from more than 24 hours to 48 hours, in 211 of 2552 patients (8.3%) among those randomized from more than 24 hours to 48 hours, and in 193 of 2765 patients (7.0%). The clopidogrel-aspirin group had a lower risk of new stroke within 90 days compared with the aspirin alone group both in patients with time to randomization of from 48 to 72 hours (5.8% vs 8.2%; hazard ratio [HR], 0.70 [95% CI, 0.53-0.94]), of more than 24 to 48 hours (7.6% vs 8.9%; HR, 0.85 [95% CI, 0.65-1.12]), and of 24 hours or less (11.5% vs 13.4%; HR, 0.83 [95% CI, 0.55-1.25]) (P = .38 for interaction). Among those with time to randomization of more than 48 to 72 hours, moderate-to-severe bleeding occurred in 12 patients (0.9%) in the clopidogrel-aspirin group and in 6 patients (0.4%) in the aspirin-alone group (HR, 2.00 [95% CI, 0.73-5.43]), while moderate-to-severe bleeding in those with time to randomization of more than 24 hours to 48 hours occurred in 9 patients (0.7%) in the clopidogrel-aspirin group and in 4 patients (0.3%) in the aspirin-alone group (HR, 2.25 [95% CI, 0.68-7.39]) and in those with time to randomization of within 24 hours, occurred in 6 patients (1.5%) in the clopidogrel-aspirin group and in 3 patients (0.8%) in the aspirin-alone group (HR, 1.57 [95% CI, 0.36-6.83]) (P = .92 for interaction). Conclusions and Relevance: In this randomized clinical trial of antiplatelet therapy in China, patients with mild ischemic stroke or TIA had consistent benefit from dual antiplatelet therapy with clopidogrel and aspirin vs aspirin alone when initiated within 72 hours after symptom onset, with a similar increase in the risk of moderate-to-severe bleeding. Patients should receive dual antiplatelet therapy with clopidogrel and aspirin within 72 hours after symptom onset. Trial Registration: ClinicalTrials.gov Identifier: NCT03635749.

Polysaccharide Conjugates' contribution to mellow and thick taste of Pu-erh ripe tea, besides Theabrownin.

Mellow and thick taste (MTT) is considered to be a typical taste characteristic of high-quality Pu-erh ripe tea. However, the role of polysaccharide conjugates remains unclear. In this study, the infusion of different grades of Pu-erh ripe tea was isolated to fractions by sensory-guided ultrafiltration technology and the key taste substances of MTT in Pu-erh ripe tea were identified and confirmed in the sensory reconstruction experiment. Further separation, purification and structural identification of the polysaccharide conjugates were carried out. Involving in aggregation morphology, the ultrafiltration fraction exhibited obvious MTT than other fractions. The main MTT compound (PRTPS-5), mainly composed of the rhamnose, galactose, arabinose and mannose, had a molecular weight of 22.93 kDa. The main chain of PRTPS-5 comprised α-L-Araf-(1→, →2,4)-α-L-Rhap-(1→, →2)-α-L-Rhap-(1→, α-D-Galp-(1→, →4)-α-D-GalpA-6-OMe-(1→, →4)-α-D-Manp-(1→, →3,6)-ß-D-Galp-(1 â†’ and →5)-α-L-Araf-(1 â†’ and contained multiple pectic characteristic peaks. This result had scientific guiding significance for the quality enhancement of Pu-erh ripe tea.

Deterministic processes influence bacterial more than fungal community assembly during the development of biological soil crusts in the desert ecosystem.

Biological soil crusts (biocrusts) constitute a crucial biological component of the soil surface in arid and semi-arid ecosystems. Understanding the variations in soil microbial community assembly across biocrust successional stages is essential for a deeper comprehension of microbial biodiversity and desert ecosystem functioning. However, knowledge about the mechanisms of microbial community assembly and the factors influencing its development remains limited. In this study, we utilized amplicons sequencing to assess the compositions of bacterial and fungal communities in bare sand and three types of biocrusts (light cyanobacterial biocrusts, dark cyanobacterial biocrusts, and moss crusts). Subsequently, we analyzed the ecological processes shaping microbial community composition and structure, along with the influencing factors. Our results revealed a significant increase in bacterial diversity and no significant changes in fungal diversity during biocrust development. The relative abundances of the copiotrophic bacteria (e.g., Actinobacteria, Acidobacteria, and Bacteroidetes) showed significant increases, while oligotrophic bacteria (e.g., Proteobacteria and Firmicutes) decreased over time. Moreover, the relative abundances of Ascomycota, which exhibit strong resistance to adverse environmental conditions, significantly decreased, whereas Basidiomycota, known for their ability to degrade lignin, significantly increased throughout biocrust development. Additionally, stochastic processes (dispersal limitation and drift) predominantly drove the assemblies of both bacterial and fungal communities. However, the relative importance of deterministic processes (homogeneous selection) in bacterial assembly increased during biocrust development. Structural equation modeling indicated that bacterial community assembly was primarily related to soil water content, whereas fungal community assembly was primarily related to total organic carbon. These findings provide a scientific foundation for investigating the formation and development of biocrusts, and further insights into the conservation and sustainable management of biocrust resources under future climate change scenarios.

Baseline serum glutamate: Implications for diagnosis and prediction in mild cognitive impairment and Alzheimer's disease of the Alzheimer's Disease Neuroimaging Initiative.

PURPOSE: Numerous studies have highlighted a close link between metabolic imbalances and Alzheimer's Disease (AD). The advancement of metabolomics has recently enabled the exploration of characteristic metabolic changes associated with AD. Studies indicate that serum glutamate (Glu) levels may correlate with mild cognitive impairment (MCI) and AD. This study aims to further elucidate the characteristics of baseline serum Glu levels in MCI and AD. METHODS: This study included 783 participants from the Alzheimer's Disease Neuroimaging Initiative-1 (ADNI-1) cohort, categorized into cognitively normal (CN, n = 224), stable MCI (sMCI, n = 181), progressive MCI (pMCI, n = 193), and AD (n = 185). The study aimed to analyze the diagnostic value of baseline serum Glu, to explore its predictive capability for the progression from CN to MCI or AD, and from MCI to AD, and to analyze the relationship between serum Glu and cerebrospinal fluid (CSF) biomarkers and cognitive functions in different diagnostic groups. RESULTS: Compared to the CN and sMCI groups, the pMCI group showed significantly lower levels of serum Glu, and the AD group also had lower Glu levels compared to the sMCI group. However, serum Glu did not show significant diagnostic value for MCI and AD. Lower levels of serum Glu could predict the progression from MCI to AD. CONCLUSION: Serum Glu levels can predict the progression from MCI to AD, suggesting that it could provide new insights into the pathophysiological mechanisms of AD. However, serum Glu may not be an ideal peripheral biomarker for AD.

Causal Association Between Sedentary Behaviors and Health Outcomes: A Systematic Review and Meta-Analysis of Mendelian Randomization Studies.

BACKGROUND: Different types of sedentary behavior are associated with several health outcomes, but the causality of these associations remains unclear. OBJECTIVES: To conduct a systematic review and meta-analysis of Mendelian randomization (MR) studies investigating the associations between sedentary behaviors and health outcomes. METHODS: A systematic search on PubMed, Embase, Web of Science, Scopus, and PsycINFO up to August 2023 was conducted to identify eligible MR studies. We selected studies that assessed associations of genetically determined sedentary behaviors and health outcomes. A meta-analysis was conducted to examine the causal associations when two or more MR studies were available. We graded the evidence level of each MR association based on the results of the main method and sensitivity analyses in MR studies. RESULTS: A total of 31 studies with 168 MR associations between six types of sedentary behavior and 47 health outcomes were included. Results from meta-analyses suggested a total of 47 significant causal associations between sedentary behaviors and health outcomes. Notably, more leisure TV watching is robustly correlated with increased risks of myocardial infarction, coronary artery disease, all-cause ischemic stroke, and type 2 diabetes. Conversely, robust inverse associations were observed between leisure computer use and risks of rheumatoid arthritis, Alzheimer's disease, and gastroesophageal reflux disease. CONCLUSION: These findings suggest that different types of sedentary behavior have distinct causal effects on health outcomes. Therefore, interventions should focus not only on reducing sedentary time but also on promoting healthier types of sedentary behavior. PROSPERO REGISTRATION: CRD42023453828.

Is galvanic VEMP a prediction of the nerve origin and damage in patients of vestibular schwannoma.

AIMS/OBJECTIVES: Unlike air-conducted sounds (ACS) and bone-conducted vibration (BCV), galvanic vestibular stimulation (GVS) evokes vestibular evoked myogenic potentials (VEMPs) from the vestibular nerve. MATERIALS AND METHODS: Case-control study was conducted in unilateral VS patients pre-operatively. Healthy ears were controls. Patients examined ACS, BCV and GVS ocular VEMP (oVEMP) and cervical VEMP (cVEMP), caloric test, video head impulse test (vHIT), suppression head impulse paradigm (SHIMP) and pure tone audiometry (PTA). RESULTS: Seven (26.9%) tumors affected left ear and 19 (73.1%) on the right(p < .05). Response rates in VS group were statistically lower than control except for ACS-cVEMP (p < .05). Response rates of VEMPs in VS patients decreased with the tumor size grows. But not all BCV and GVS VEMPs disappeared in the largest tumor group. Abnormal rates of caloric test, vHIT gains and SHIMP were found. CONCLUSIONS AND SIGNIFICANCE: Response rates of GVS VEMPs decreased with the residual functional nerve fibers. GVS VEMPs help to differentiating labyrinthine and retro-labyrinthine lesions. GVS combined with BCV VEMPs probably reflex the tumor origin from the eighth cranial nerve and/or the remaining vestibular function.

Impact of heat treatment on the flavor stability of Longjing green tea beverages: Metabolomic insights and sensory correlations.

The flavor stability of tea beverages during storage has long been a concern. The study aimed to explore the flavor stability of Longjing green tea beverage using accelerated heat treatment trials, addressing the shortage of lengthy storage trials. Sensory evaluations revealed changes in bitterness, umami, overall harmonization, astringency, and ripeness as treatment duration increased. Accompanied by a decrease in L-values, ΔE and an increase in a and b-values. Seventeen non-volatile metabolites and three volatile metabolites were identified differential among samples by metabolomics, with subsequent correlation analysis indicating associations between sensory attributes and specific metabolites. Umami was linked to epigallocatechin 3,5-digallate and alpha-D-glucopyranose, astringency was correlated with ellagic acid and 1-ethyl-1H-pyrrole. Ripeness showed associations with ellagic acid, 6,7-dihydroxycoumarin, heptanal, and benzaldehyde, and overall harmonization was linked to 6,7-dihydroxycoumarin, ß-myrcene, α-terpineol, and heptanal. A series of verification tests confirmed the feasibility of accelerated heat treatment trials to replace traditional storage trials. These results offer valuable insights into unraveling the complex relationship between sensory and chemical profiles of green tea beverages.

Effect of SBRT plus immunotherapy on immune status and survival quality of NSCLC patients: A study of combined radiotherapy and immunotherapy.

BACKGROUND: non-small cell lung cancer (NSCLC) accounts for more than 80% of all lung cancer populations. Stereotactic radiotherapy (SBRT) is mainly suitable for early NSCLC patients who are not suitable for surgery or refuse surgery. OBJECTIVE: To analyze the effects of stereotactic radiotherapy (SBRT) plus immunotherapy for non-small cell lung cancer (NSCLC) patients on their immune status and survival quality. METHODS: NSCLC patients admitted to our hospital from 2019-2022 were divided into 61 cases in control group (SBRT) and 60 cases in observation group (SBRT plus immunotherapy) by the randomized numerical table method to compare the efficacy, the level of tumor markers in the serum, the level and activity of the immune cells in the peripheral blood and the Kahlil's functional status (KPS) scores. RESULTS: The observation group had a higher efficacy rate than that of the control group (P< 0.05). There was no statistical difference between the two groups in serum tumor marker content, immune cell level and activity in peripheral blood and KPS score before treatment (P> 0.05). After treatment, serum tumor markers were lower than those in control group, and immune cell level, NK cell-related activity and KPS score were higher than those in control group (P< 0.05). CONCLUSION: SBRT plus immunotherapy can reduce the level of various tumor markers, improve the immune status and quality of survival for NSCLC patients.

General synthesis of high-entropy oxides and carbon-supported high-entropy oxides by mechanochemistry.

High-entropy oxides (HEOs) have been receiving a lot of attention due to their excellent properties. However, current common methods for preparing HEOs usually involve high-temperature processes. The development of green synthesis techniques remains an important issue. Carbon-supported HEOs have shown excellent performance in electrochemical energy storage in recent years. Crucially, the traditional methods cannot synthesize carbon-supported HEOs under N2 or air atmospheres. Toward this end, a universal method for preparing carbon-supported HEOs was proposed. During this process, without high-temperature post-treatment, high-entropy LaMnO3 could be synthesized in 2 hours using the mechanical ball-milling method. Furthermore, this method was universal and has been proved in the synthesis of a series of HEOs such as PrVO3, SmVO3, and MgAl2O4. The LaMnO3 species synthesized by this method exhibit excellent catalytic performance in CO combustion and could maintain a conversion rate of over 97% for 350 hours. Subsequently, carbon-supported HEOs could be obtained with 0.5 hours of additional ball-milling, offering significant advantages over traditional methods. This process provides a potential method to synthesize carbon-supported HEOs.

Maternal high-fat diet regulates offspring hepatic ABCG5 expression and cholesterol metabolism via the gut microbiota and its derived butyrate.

Maternal high-fat diet intake has profound effects on the long-term health of offspring, predisposing them to a higher susceptibility to obesity and metabolic dysfunction-associated steatotic liver disease. However, the detailed mechanisms underlying the role of a maternal high-fat diet in hepatic lipid accumulation in offspring, especially at the weaning age, remain largely unclear. In this study, female C57BL/6J mice were randomly assigned to either a high-fat diet or a control diet, and lipid metabolism parameters were assessed in male offspring at weaning. Gut microbiota analysis and targeted metabolomics of short-chain fatty acids (SCFAs) in these offspring were further performed. Both in vivo and in vitro studies were conducted to explore the role of butyrate in hepatic cholesterol excretion in the liver and HepG2 cells. Our results showed that maternal high-fat feeding led to obesity and dyslipidemia, and exacerbated hepatic lipid accumulation in the livers of offspring at weaning. We observed significant decreases in the abundance of the Firmicutes phylum and the Allobaculum genus, known as producers of SCFAs, particularly butyrate, in the offspring of dams fed a high-fat diet. Additionally, maternal high-fat diet feeding markedly decreased serum butyrate levels and down-regulated ATP-binding cassette transporters G5 (ABCG5) in the liver, accompanied by decreased phosphorylated AMP-activated protein kinase (AMPK) and histone deacetylase 5 (HADC5) expressions. Subsequent in vitro studies revealed that butyrate could induce ABCG5 activation and alleviate lipid accumulation via the AMPK-pHDAC5 pathway in HepG2 cells. Moreover, knockdown of HDAC5 up-regulated ABCG5 expression and promoted cholesterol excretion in HepG2 cells. In conclusion, our study provides novel insights into how maternal high-fat diet feeding inhibits hepatic cholesterol excretion and down-regulates ABCG5 through the butyrate-AMPK-pHDAC5 pathway in offspring at weaning.

Trend analysis of stroke subtypes mortality attributable to high body-mass index in China from 1990 to 2019.

BACKGROUND: The prevalence of stroke disability associated with high BMI has significantly increased over the past three decades. However, it remains uncertain whether high body-mass index (BMI) exerts a similar impact on the disease burden of different stroke subtypes. The aim of this study is to assess the long-term trends of stroke and subtypes mortality attributable to high BMI in China between 1990 and 2019. METHODS: Data on stroke and subtypes mortality attributable to high BMI in China was extracted in the Global Burden of Disease (GBD) 2019. The trends of age-standardized mortality rate (ASMR) were calculated using the linear regression and age-period-cohort framework. RESULTS: The changing trend of ASMR on stroke attributable to high BMI in China differed among subtypes, with an estimated annual percentage change (EAPC) and 95%CI of 2.04 (1.86 to 2.21) for ischemic stroke (IS), 0.36 (-0.03 to 0.75) for intracerebral hemorrhage (ICH), and - 4.62 (-5.44 to -3.78) for subarachnoid hemorrhage (SAH). Net and local drift analyses revealed a gradual increase in the proportion of older people with IS and a gradual increase in the proportion of younger people with hemorrhagic strokes. The cohort and period rate ratios varied by subtype, showing an increasing trend for IS and ICH but a decreasing trend for SAH. The stroke mortality attributable to high BMI increased significantly with age for IS and ICH, peaking between ages 50-70 for SAH. Notably, males had higher ASMR related to stroke but exhibited slighter declines or higher growth compared to females in China. Moreover, the population affected by fatal strokes tended to be older among females but more evenly distributed across a wider age range encompassing both younger and older individuals. CONCLUSION: The research findings indicate a rising trend in the ASMR of stroke and subtypes attributable to high BMI in China from 1990 to 2019, with different patterns of change for different subtypes, genders and ages. Consequently, it is imperative for public health authorities in China to formulate guidelines for specific stroke subtypes, genders and ages to prevent the burden of stroke attributable to high BMI.

Preliminary effects of risk-adapted PSA screening for prostate cancer after integrating PRS-specific and age-specific variation.

Background: Although the risk of prostate cancer (PCa) varies across different ages and genetic risks, it's unclear about the effects of genetic-specific and age-specific prostate-specific antigen (PSA) screening for PCa. Methods: Weighed and unweighted polygenic risk scores (PRS) were constructed to classify the participants from the PLCO trial into low- or high-PRS groups. The age-specific and PRS-specific cut-off values of PSA for PCa screening were determined with time-dependent receiver-operating-characteristic curves and area-under-curves (tdAUCs). Improved screening strategies integrating PRS-specific and age-specific cut-off values of PSA were compared to traditional PSA screening on accuracy, detection rates of high-grade PCa (Gleason score ≥7), and false positive rate. Results: Weighted PRS with 80 SNPs significantly associated with PCa was determined as the optimal PRS, with an AUC of 0.631. After stratifying by PRS, the tdAUCs of PSA with a 10-year risk of PCa were 0.818 and 0.816 for low- and high-PRS groups, whereas the cut-off values were 1.42 and 1.62 ng/mL, respectively. After further stratifying by age, the age-specific cut-off values of PSA were relatively lower for low PRS (1.42, 1.65, 1.60, and 2.24 ng/mL for aged <60, 60-64, 65-69, and ≥70 years) than high PRS (1.48, 1.47, 1.89, and 2.72 ng/mL). Further analyses showed an obvious interaction of positive PSA and high PRS on PCa incidence and mortality. Very small difference in PCa risk were observed among subgroups with PSA (-) across different age and PRS, and PCa incidence and mortality with PSA (+) significantly increased as age and PRS, with highest risk for high-PRS/PSA (+) in participants aged ≥70 years [HRs (95%CI): 16.00 (12.62-20.29) and 19.48 (9.26-40.96)]. The recommended screening strategy reduced 12.8% of missed PCa, ensured high specificity, but not caused excessive false positives than traditional PSA screening. Conclusion: Risk-adapted screening integrating PRS-specific and age-specific cut-off values of PSA would be more effective than traditional PSA screening.

Predictive Role of Elevated Neutrophil-Lymphocyte Ratio for Bone Metastasis in Esophageal Cancer.

PURPOSE: Research on bone metastasis in esophageal cancer (EC) is relatively limited. Once bone metastasis occurs in patients, their prognosis is poor, and it severely affects their quality of life. Currently, there is a lack of convenient tumor markers for early identification of bone metastasis in EC. Our research aims to explore whether neutrophil-lymphocyte ratio (NLR) can predict bone metastasis in patients with EC. METHODS: Retrospective analysis of clinical indicators was performed on 604 patients with EC. They were divided into groups based on whether or not there was bone metastasis, and the patients' coagulation-related tests, blood routine, tumor markers and other indicators were collected. The receiver operating characteristic curve (ROC) were used to determine the predictive ability of parameters such as NLR for bone metastasis in EC, and univariate and multivariate logistic regression analyses were conducted to determine the impact of each indicator on bone metastasis. Using binary logistic regression to obtain the predictive probability of NLR combined with tumor markers. RESULTS: ROC curves analysis suggested that the area under the curve (AUC) of the NLR was 0.681, with a sensitivity of 79.2% and a specificity of 52.6%, which can be used as a predictive factor for bone metastasis in EC. Multivariate logistic regression analysis showed that high NLR (odds ratio [OR]: 2.608, 95% confidence interval [CI]: 1.395-4.874, P = 0.003) can function as an independent risk factor for bone metastasis in patients with EC. Additionally, high PT, high APTT, high FDP, high CEA, high CA724, low hemoglobin, and low platelet levels can also predict bone metastasis in EC. When NLR was combined with tumor markers, the area under the curve was 0.760 (95% CI: 0.713-0.807, P < 0.001), significantly enhancing the predictability of bone metastasis in EC. CONCLUSION: NLR, as a convenient, non-invasive, and cost-effective inflammatory indicator, could predict bone metastasis in EC. Combining NLR with tumor markers can significantly improve the diagnostic accuracy of bone metastasis in EC.

Corrigendum: Association between meeting 24-h movement guidelines and health in children and adolescents aged 5-17 years: a systematic review and meta-analysis.

[This corrects the article DOI: 10.3389/fpubh.2024.1351972.].

Causal associations of fatigue and functional outcome after ischemic stroke: a mediation Mendelian randomization study.

Background and objectives: Fatigue has been associated with adverse effects on recovery from ischemic stroke based on previous observational research. The purpose of our study was to explore the potential causal association of fatigue with poor functional outcome after ischemic stroke by employing Mendelian randomization (MR). Methods: A set of instrumental variables, comprising 36 single-nucleotide polymorphisms (SNPs) that are only related to fatigue, were derived from a genome-wide association study (GWAS) that included 449,019 general individuals. The functional outcomes after ischemic stroke were derived from a GWAS (Genetics of Ischemic Stroke Functional Outcome Network) involving 6,021 survivors. Two-sample MR methods were used to assess the causal effect, including inverse variance weighted, MR-Egger, weighted median, simple mode, and weighted mode. In bidirectional MR analysis, the reverse causal association was analyzed using the Wald ratio method. The mediation effects of lipid metabolites were analyzed using two-step MR analysis. Results: Genetic liability to fatigue was causally associated with the poor functional outcome (modified Rankin Scale ≥3 at 3 months) after ischemic stroke (OR = 4.20, 95%CI [1.11-15.99], p < 0.05). However, genetic predicted poor functional outcome after ischemic stroke was not associated with fatigue (OR = 1.00, 95%CI [0.99-1.02], p > 0.05). The results of the two-step MR showed that cholesteryl esters to total lipids ratio in large very low-density lipoprotein (VLDL) (ME = -0.13, p < 0.05); concentration of very large VLDL particles (ME = -0.13, p < 0.05); free cholesterol in large VLDL (ME = -0.13, p < 0.05); free cholesterol to total lipids ratio in very large VLDL (ME = -0.22, p < 0.05); phospholipids in large VLDL (ME = -0.15, p < 0.05); phospholipids in very large VLDL (ME = -0.13, p < 0.05); phospholipids to total lipids ratio in large high-density lipoprotein (HDL) (ME = -0.17, p < 0.05); total lipids in very large VLDL (ME = -0.14, p < 0.05); triglycerides in small VLDL (ME = -0.11, p < 0.05); and triglycerides to total lipids ratio in large HDL (ME = -0.10, p < 0.05) assumed a pivotal role in mediating the association between fatigue and poor functional outcome after ischemic stroke. Conclusion: Our study provides evidence supporting the causal association between fatigue and the poor functional outcome after ischemic stroke, which emphasizes the importance of implementing interventions aimed at addressing fatigue. This could offer a therapeutic target to improve recovery after ischemic stroke and warrant exploration in a clinical context. One potential mechanism by which fatigue affects functional outcomes after ischemic stroke is through the action of lipid metabolites.

Improvements in Patient-Reported Functioning after Lung Transplant is Associated with Improved Quality of Life and Survival.

Lung transplantation aims to improve health-related quality of life (HRQL) and survival. While lung function improvements are associated with these outcomes, the association between physical functioning and these outcomes is less clear. We investigated the association between changes in patient-reported physical functioning and HRQL, chronic lung allograft dysfunction (CLAD), and survival after lung transplantation. This single-center prospective cohort study analyzed 220 lung transplant recipients who completed the 15-item Lung Transplant Valued Life Activities (LT-VLA) before and repeatedly after transplant. HRQL was assessed using generic, respiratory disease-specific, and utility measures. Associations between 0.3-point changes (the minimally important difference) in LT-VLA as a time-varying predictor on HRQL, CLAD, and mortality were tested using linear regression and Cox proportional hazard models. Models were adjusted for demographics, disease diagnosis, and post-operative lung function as a time-varying covariate. Participants were 45% female and 75% White, with a mean age of 56 (±12) years. Each 0.3-point improvement in LT-VLA was associated with substantially improved HRQL across all measures (adjusted p-values <0.01). Each 0.3-point improvement in LT-VLA was associated with a 13% reduced hazard of CLAD (adjusted HR: 0.87, 95% CI: 0.76-0.99, p=0.03) and a 19% reduced hazard of mortality (adjusted HR: 0.81, 95% CI: 0.67-0.95, p=0.01). Improvements in patient-reported physical functioning after lung transplantation are associated with improved HRQL and reduced risk of CLAD and death, independent of allograft function. The simplicity of the LT-VLA suggests it could be a valuable monitoring or outcome measure in both clinical and research settings.

Effectiveness of platelet-rich plasma in treating female hair loss: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Hair loss profoundly affects women's physical appearance and psychological health. Platelet-rich plasma (PRP) therapy has gained attention as a potential treatment for female hair loss. This systematic review and meta-analysis aim to evaluate the efficacy and safety of PRP in treating different forms of female hair loss. METHODS: A comprehensive search was conducted across PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and ClinicalTrials.gov from January 2000 to May 2024. The focus was on randomized controlled trials investigating PRP treatment for various types of hair loss in women. The research protocol is registered with International Prospective Register of Systematic Reviews (CRD42024556190). The quality of the studies was evaluated using the Cochrane risk of bias tool (RoB 2). RESULTS: A total of 21 studies comprising 628 participants were included in the analysis. PRP treatment was found to significantly enhance hair density and thickness. Additionally, there was a significant reduction in the number of hairs pulled in the PRP group. Adverse effects were generally mild and transient, with no notable difference in pain or discomfort between the PRP and control groups (risk ratio: 1.01; 95% CI: 0.87-1.18). CONCLUSION: PRP therapy effectively enhances hair density and thickness in women with hair loss, with a favorable safety profile. However, the effects of PRP on hair density and thickness vary with dosage, injection duration, and ethnicity, indicating the need for tailored treatment protocols.