Identification of potential diagnostic and prognostic biomarkers for papillary thyroid microcarcinoma (PTMC) based on TMT-labeled LC-MS/MS and machine learning

OBJECTIVES

To explore the molecular mechanisms underlying aggressive progression of papillary thyroid microcarcinoma and identify potential biomarkers.

METHODS

Samples were collected and sequenced using tandem mass tag-labeled liquid chromatography-tandem mass spectrometry. Differentially expressed proteins (DEPs) were identified and further analyzed using Mfuzz and protein-protein interaction analysis (PPI). Parallel reaction monitoring (PRM) and immunohistochemistry (IHC) were performed to validate the DEPs.

RESULTS

Five thousand, two hundred and three DEPs were identified and quantified from the tumor/normal comparison group or the N1/N0 comparison group. Mfuzz analysis showed that clusters of DEPs were enriched according to progressive status, followed by normal tissue, tumors without lymphatic metastases, and tumors with lymphatic metastases. Analysis of PPI revealed that DEPs interacted with and were enriched in the following metabolic pathways: apoptosis, tricarboxylic acid cycle, PI3K-Akt pathway, cholesterol metabolism, pyruvate metabolism, and thyroid hormone synthesis. In addition, 18 of the 20 target proteins were successfully validated with PRM and IHC in another 20 paired validation samples. Based on machine learning, the five proteins that showed the best performance in discriminating between tumor and normal nodules were PDLIM4, ANXA1, PKM, NPC2, and LMNA. FN1 performed well in discriminating between patients with lymph node metastases (N1) and N0 with an AUC of 0.690. Finally, five validated DEPs showed a potential prognostic role after examining The Cancer Genome Atlas database: FN1, IDH2, VDAC1, FABP4, and TG. Accordingly, a nomogram was constructed whose concordance index was 0.685 (confidence interval: 0.645-0.726).

CONCLUSIONS

PDLIM4, ANXA1, PKM, NPC2, LMNA, and FN1 are potential diagnostic biomarkers. The five-protein nomogram could be a prognostic biomarker.

[Efficacy of one-stage total spondylectomy and circumferential reconstruction for axial tumors through a combined anterior retropharyngeal-posterior approach]

Objective: To elucidate the safety and efficacy of one-stage total spondylectomy and circumferential reconstruction through a combined anterior retropharyngeal-posterior approach for axial tumors. Methods: A total of 20 patients with axial tumor who received total spondylectomy through a combined anterior retropharyngeal-posterior approach in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from February 2006 to December 2018 were retrospectively analyzed. Anterior reconstruction was performed with a special-shaped titanium mesh or three-dimensional printed (3DP) implants. The degree of local pain and neurological function was assessed by the visual analogue scale (VAS) and Frankel classification systems, respectively. Status of internal fixation and local recurrence was analyzed by radiological examination during follow-up. Results: Among the 20 patients, 12 were male and 8 were female with a mean age of (59.1±11.0) years (31 to 72 years). The mean operation time was (605.0±60.1) minutes (430 to 700 minutes) with a mean intraoperative blood loss of (1 250±347) ml (800 to 2 400 ml). The mean postoperative hospital stay was (13.2±2.8) days (8 to 20 days), and mean follow-up duration was (37.2±14.2) months(14 to 66 months). Anterior reconstructions were performed with a special-shaped titanium mesh in 14 patients and with 3DP implants in another 6 patients. Posterior occipital-cervical fixation was performed in 5 patients, while cervical fixation only in another 15 patients. The mean VAS score of pain at the last follow-up decreased significantly when compared with that before operation (1.6±0.6 vs 7.1±1.1, P<0.001). Nine patients with neurological deficits indicated significant improvement by at least 1 level at the last follow-up; among them, 2 cases of Frankel B improved to Frankel C and D, respectively; 3 cases of Frankel C all improved to Frankel D, and 4 cases of Frankel D improved to Frankel E. The perioperative complications included: 2 cases of vertebral artery injury, 2 cases of dysphagia, 3 cases of hoarseness and cough, 2 cases of cerebrospinal fluid leakage, and 1 case of greater occipital neuralgia. At the last follow-up, 5 patients died and 3 patients relapsed. Only 1 case suffered fixation failure due to local recurrence at the last follow up. Conclusions: One-stage total spondylectomy and circumferential reconstruction through a combined anterior retropharyngeal-posterior approach is safe and effective for axial tumors with favorable clinical outcomes and minor complications. Circumferential reconstruction with special-shaped titanium mesh or 3DP implant and posterior fixation can effectively reconstruct mechanical stability.

Measurement of the Absolute Branching Fraction and Decay Asymmetry of Λ→nγ

The radiative hyperon decay Λ→nγ is studied using (10087±44)×10^{6}  J/ψ events collected with the BESIII detector operating at BEPCII. The absolute branching fraction of the decay Λ→nγ is determined to be (0.832±0.038_{stat}±0.054_{syst})×10^{-3}, which is a factor of 2.1 lower and 5.6 standard deviations different than the previous measurement. By analyzing the joint angular distribution of the decay products, the first determination of the decay asymmetry α_{γ} is reported with a value of -0.16±0.10_{stat}±0.05_{syst}.

Observation of an Isoscalar Resonance with Exotic J^{PC}=1^{-+} Quantum Numbers in J/ψ→γηη^{'}

Using a sample of (10.09±0.04)×10^{9}  J/ψ events collected with the BESIII detector operating at the BEPCII storage ring, a partial wave analysis of the decay J/ψ→γηη^{'} is performed. The first observation of an isoscalar state with exotic quantum numbers J^{PC}=1^{-+}, denoted as η_{1}(1855), is reported in the process J/ψ→γη_{1}(1855) with η_{1}(1855)→ηη^{'}. Its mass and width are measured to be (1855±9_{-1}^{+6})  MeV/c^{2} and (188±18_{-8}^{+3})  MeV, respectively, where the first uncertainties are statistical and the second are systematic, and its statistical significance is estimated to be larger than 19σ.

Prediction using T2-weighted magnetic resonance imaging-based radiomics of residual uterine myoma regrowth after high-intensity focused ultrasound ablation

OBJECTIVES

To develop and evaluate magnetic resonance imaging (MRI)-based radiomics models for predicting residual myoma regrowth within 1 year after high-intensity focused ultrasound (HIFU) ablation of uterine myomas.

METHODS

A retrospective analysis of residual myoma regrowth within 1 year was performed on 428 myomas in 339 patients who were diagnosed with uterine myoma and treated with HIFU ablation in two hospital centers. In total, 851 radiomics features were extracted from T2-weighted images (T2WI) obtained 1 day after HIFU ablation, and the least absolute shrinkage and selection operator in the training cohort (n = 243) was employed to select radiomics features. Support vector machines were adopted to develop radiomics, clinicoradiological and combined radiomics-clinical models to predict residual myoma regrowth, defined as an increase in residual myoma volume of > 10% between that at day 1 post HIFU and that at follow-up MRI within 1 year. These models were validated in both internal (n = 81) and external (n = 104) test cohorts. The predictive performance and clinical application of these models were assessed using receiver-operating-characteristics-curve analysis, the area under the curve (AUC) and decision-curve analysis.

RESULTS

The AUCs of the T2WI-based radiomics prediction model in the internal and external test cohorts were 0.834 (95% CI, 0.747-0.920) and 0.801 (95% CI, 0.712-0.889), respectively, and those of the clinicoradiological model were 0.888 (95% CI, 0.816-0.960) and 0.912 (95% CI, 0.851-0.973), respectively. The combined model had better predictive performance than either the radiomics or the clinicoradiological model, with AUC values of 0.922 (95% CI, 0.857-0.987) and 0.930 (95% CI, 0.880-0.980) in the internal and external test cohorts, respectively. Decision-curve analysis also indicated that application of the combined model has clinical value, this model achieving more net benefits than the other two models.

CONCLUSION

T2WI-based radiomics features can predict effectively the occurrence of residual myoma regrowth within 1 year after HIFU ablation of uterine myomas, which serves as an accurate and convenient reference for clinical decision-making. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Observation of an a_{0}-like State with Mass of 1.817 GeV in the Study of D_{s}^{+}→K_{S}^{0}K^{+}π^{0} Decays

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 6.32  fb^{-1} collected at center-of-mass energies between 4.178 and 4.226 GeV with the BESIII detector, we perform the first amplitude analysis of the decay D_{s}^{+}→K_{S}^{0}K^{+}π^{0} and determine the relative branching fractions and phases for intermediate processes. We observe an a_{0}-like state with mass of 1.817 GeV in its decay to K_{S}^{0}K^{+} for the first time. In addition, we measure the ratio {B[D_{s}^{+}→K[over ¯]^{*}(892)^{0}K^{+}]/B[D_{s}^{+}→K[over ¯]^{0}K^{*}(892)^{+}]} to be 2.35_{-0.23stat}^{+0.42}±0.10_{syst}. Finally, we provide a precision measurement of the absolute branching fraction B(D_{s}^{+}→K_{S}^{0}K^{+}π^{0})=(1.46±0.06_{stat}±0.05_{syst})%.

Maintenance effects of a gamification intervention on motivation and physical activity in patients with coronary heart disease: intermediate results of a randomized controlled trial

Background

Despite the benefits of cardiac rehabilitation and secondary prevention, patients with coronary heart disease frequently fail to meet their daily physical activity goals. When one is stuck in a cycle of bad habits, changing one's behavior can be very challenging. One of the difficulties to maintaining a healthy lifestyle may be a lack of motivation. The use of game design elements (such as points, leaderboards, progress bars, and badges) in non-game contexts to promote motivation and engagement is known as gamification. It could be a powerful tool for encouraging patients to engage in physical activity. However, solid ideas that utilize the fundamental experience and psychological impacts of gaming mechanics must be built upon.

Purpose

The aim of this study is to look into the impact of a smartphone-based gamification intervention on physical activity engagement and other related psychological outcomes in patients with coronary heart disease, as well as the 24-week maintenance of effects beyond the 12-week intervention.

Methods

Participants with coronary heart disease were randomly assigned to three groups (control group, individual group and team group). The individual and team groups received gamified behavior intervention based on behavioral economic principles. Based on the Individual group, the team earned social incentives (collaboration). The intervention lasted 12 weeks, with another 12 weeks of follow-up. The primary outcomes included the change in daily steps and the proportion of patient-days that step goals achieved. The secondary outcomes included competence, autonomous, relatedness and autonomous motivation.

Results

The follow-up period has now been completed by 65 participants (mean age 52.8+10.3, 18.2% female) completed the follow-up period. Compared with the control group (n=17), participants in the individual group (n=25) had a significantly greater increase in mean daily steps from baseline during the intervention group (difference 956; 95% CI, 243–1623; P&lt;0.01), and had a significantly greater proportion of patient-days that step goals achieved (difference 0.35; 95% CI, 0.03–0.12; P&lt;0.001), competence (difference 0.5, 95% CI, 0.3–0.7; P&lt;0.001), autonomous motivation (difference 3.2; 95% CI, 2.0–4.0; P&lt;0.001). However, no significant difference of change in step counts was found between team group (n=23) and control group. During the follow-up period, mean daily steps and autonomous motivation in the individual declined but remained significantly greater than that in the control arm compared with baseline (steps: difference 452; 95% CI, 138–818; P&lt;0.05) (motivation: difference 1.2; 95% CI, 0.3–1.8; P&lt;0.05).

Conclusions

A smartphone-based gamification intervention was found to be an effective strategy to enhance motivation and physical activity engagement, as well as having a great maintenance effect.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work is financially supported by a Construction Programme of Independent Innovation Ability of Community Health Nursing Engineering Laboratory in Jilin Province (Study code: 2020C038-8) awarded to FL.

The effectiveness of eHealth interventions on moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants: a systematic review and meta-analysis

Background

Cardiac rehabilitation is a class IA recommendation for patients with cardiovascular diseases. Physical activity is the core component and core competency of cardiac rehabilitation programs. Cardiac rehabilitation guidelines recommend patients achieve at least thirty minutes of moderate-to-vigorous intensity physical activity five or more days per week. However many patients with cardiovascular diseases are failing to meet recommended daily physical activity levels. eHealth interventions may increase moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants.

Objectives

The objective of this study was to review the evidence of the effectiveness of eHealth interventions to increase moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants. The secondary objective was to examine the effectiveness of eHealth interventions on improving exercise capacity, cardiovascular risk profile and health-related quality of life.

Methods

A comprehensive search strategy was developed for four electronic databases (PubMed, Web of Science, Embase and The Cochrane Library); through December 16, 2021. All studies reporting on eHealth interventions designed to increase moderate-to-vigorous physical activity among cardiac rehabilitation participants were included. Multiple not-blind reviewers determined study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Collaboration Tool for randomized controlled trials and using the Effective Practice and Organisation of Care Cochrane Review Group for non-randomized controlled trials. Data quality using the Grading of Recommendations Assessment, Development and Evaluation professional guideline development tool. Data were pooled using a random-effects model. All statistical analyses were performed using Stata 17.

Results

Twenty-one studies were included in the review which fifteen were in the meta-analysis. The meta-analysis demonstrated eHealth interventions improved moderate-to-vigorous physical activity (standard mean difference = 0.17, 95% confidence interval: 0.07, 0.27, P&lt;0.001). No changes were observed in exercise capacity (P=0.09), cardiovascular risk profile (body mass index, P=0.19; waist circumference, P=0.7; systolic blood pressure, P=0.36; total cholesterol, P=0.72; plasma glucose, P=0.41) and health-related quality of life (P=0.12).

Conclusions

eHealth interventions are effective at increasing minutes/week of moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants. Future high-quality empirical studies are needed to evaluate the effectiveness of eHealth interventions delivered, with these sub-types (wearable devices, online web portal, smart phone application, messaging services and telephone calls) delivered alone or in combination delivered more conducive to moderate-to-high intensity physical activity.

Funding Acknowledgement

Type of funding sources: None.

[Mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 regimen in the treatment of pediatric Burkitt lymphoma]

Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.

Precise Measurements of Decay Parameters and CP Asymmetry with Entangled Λ-Λ[over ¯] Pairs

Based on 10 billion J/ψ events collected at the BESIII experiment, a search for CP violation in Λ decay is performed in the difference between CP-odd decay parameters α_{-} for Λ→pπ^{-} and α_{+} for Λ[over ¯]→p[over ¯]π^{+} by using the process e^{+}e^{-}→J/ψ→ΛΛ[over ¯]. With a five-dimensional fit to the full angular distributions of the daughter baryon, the most precise values for the decay parameters are determined to be α_{-}=0.7519±0.0036±0.0024 and α_{+}=-0.7559±0.0036±0.0030, respectively. The Λ and Λ[over ¯] averaged value of the decay parameter is extracted to be α_{avg}=0.7542±0.0010±0.0024 with unprecedented accuracy. The CP asymmetry A_{CP}=(α_{-}+α_{+})/(α_{-}-α_{+}) is determined to be -0.0025±0.0046±0.0012, which is one of the most precise measurements in the baryon sector. The reported results for the decay parameter will play an important role in the studies of the polarizations and CP violations for the strange, charmed and beauty baryons.

First Observation of the Direct Production of the χ_{c1} in e^{+}e^{-} Annihilation

We study the direct production of the J^{PC}=1^{++} charmonium state χ_{c1}(1P) in electron-positron annihilation by carrying out an energy scan around the mass of the χ_{c1}(1P). The data were collected with the BESIII detector at the BEPCII collider. An interference pattern between the signal process e^{+}e^{-}→χ_{c1}(1P)→γJ/ψ→γμ^{+}μ^{-} and the background processes e^{+}e^{-}→γ_{ISR}J/ψ→γ_{ISR}μ^{+}μ^{-} and e^{+}e^{-}→γ_{ISR}μ^{+}μ^{-} is observed by combining all the data samples. The χ_{c1}(1P) signal is observed with a significance of 5.1σ. This is the first observation of a C-even state directly produced in e^{+}e^{-} annihilation. The electronic width of the χ_{c1}(1P) resonance is determined to be Γ_{ee}=(0.12_{-0.08}^{+0.13})  eV, which is of the same order of magnitude as theoretical calculations.

Evidence for a Neutral Near-Threshold Structure in the K_{S}^{0} Recoil-Mass Spectra in e^{+}e^{-}→K_{S}^{0}D_{s}^{+}D^{*-} and e^{+}e^{-}→K_{S}^{0}D_{s}^{*+}D^{-}

We study the processes e^{+}e^{-}→K_{S}^{0}D_{s}^{+}D^{*-} and e^{+}e^{-}→K_{S}^{0}D_{s}^{*+}D^{-}, as well as their charge conjugated processes, at five center-of-mass energies between 4.628 and 4.699 GeV, using data samples corresponding to an integrated luminosity of 3.8  fb^{-1} collected by the BESIII detector at the BEPCII storage ring. Based on a partial reconstruction technique, we find evidence of a structure near the thresholds for D_{s}^{+}D^{*-} and D_{s}^{*+}D^{-} production in the K_{S}^{0} recoil-mass spectrum, which we refer to as the Z_{cs}(3985)^{0}. Fitting with a Breit-Wigner line shape, we find the mass of the structure to be (3992.2±1.7±1.6)  MeV/c^{2} and the width to be (7.7_{-3.8}^{+4.1}±4.3)  MeV, where the first uncertainties are statistical and the second are systematic. The significance of the Z_{cs}(3985)^{0} signal is found to be 4.6σ including both the statistical and systematic uncertainty. We report the Born cross section multiplied by the branching fraction at different energy points. The mass of the Z_{cs}(3985)^{0} is close to that of the Z_{cs}(3985)^{+}. Assuming SU(3) symmetry, the cross section of the neutral channel is consistent with that of the charged one. Hence, we conclude that the Z_{cs}(3985)^{0} is the isospin partner of the Z_{cs}(3985)^{+}.

Observation of Resonance Structures in e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) and Mass Measurement of ψ_{2}(3823)

Using a data sample corresponding to an integrated luminosity of 11.3  fb^{-1} collected at center-of-mass energies from 4.23 to 4.70 GeV with the BESIII detector, we measure the product of the e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) cross section and the branching fraction B[ψ_{2}(3823)→γχ_{c1}]. For the first time, resonance structure is observed in the cross section line shape of e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) with significances exceeding 5σ. A fit to data with two coherent Breit-Wigner resonances modeling the sqrt[s]-dependent cross section yields M(R_{1})=4406.9±17.2±4.5  MeV/c^{2}, Γ(R_{1})=128.1±37.2±2.3  MeV, and M(R_{2})=4647.9±8.6±0.8  MeV/c^{2}, Γ(R_{2})=33.1±18.6±4.1  MeV. Though weakly disfavored by the data, a single resonance with M(R)=4417.5±26.2±3.5  MeV/c^{2}, Γ(R)=245±48±13  MeV is also possible to interpret data. This observation deepens our understanding of the nature of the vector charmoniumlike states. The mass of the ψ_{2}(3823) state is measured as (3823.12±0.43±0.13)  MeV/c^{2}, which is the most precise measurement to date.

Potential Application of Low-Intensity Focused Ultrasound in Rapidly Relieving Delayed-Onset Muscle Soreness Induced by High-Intensity Exercise

OBJECTIVES

To evaluate the efficacy of low-intensity focused ultrasound (LIFU) treatment on rapid relief of delayed-onset muscle soreness (DOMS) triggered by high-intensity exercise.

METHODS

A total of 16 healthy male college students were randomly divided into two groups: the LIFU group (n = 8) and the Sham group (n = 8). After the exercise protocol, the LIFU group received treatment, which parameters included that the power output was 2.5 W/cm² , the frequency was 1 MHz, and the treating time was 20 minutes. The Sham group was treated with LIFU without energy output. Visual analog scale was used to evaluate the level of DOMS in every participant. The activities of plasma creatine kinase, lactate dehydrogenase, and the plasma concentration were measured by spectrophotometry. Tumor necrosis factor-α and interleukin-6 of serum were analyzed by enzyme-linked immunosorbent assay.

RESULTS

The visual analog scale of quadriceps femoris and/or calf muscles in the LIFU group decreased significantly at 24 hours (P < 0.01) and 48 hours (P < .01) after the exercise protocol. Both the accumulation of lactic acid (P < .01) in muscle and the activity of lactate dehydrogenase (P < .01) reduced immediately after LIFU treatment. The activities of tumor necrosis factor-α and interleukin-6 24 hours lowered in the LIFU group (P < .01).

CONCLUSIONS

LIFU treatment could relieve muscle soreness rapidly and effectively in the early stages of DOMS. The application of LIFU may provide a potential strategy for clinical treatment for DOMS.

[Diethylhexyl phthalate induces anxiety-like behavior and learning and memory impairment in mice probably by damaging blood-brain barrier]

OBJECTIVE

To investigate the effects of diethylhexyl phthalate (DEHP) exposure on anxiety-like behaviors and learning and memory ability in mice and explore the underlying mechanism.

METHODS

Forty male ICR mice were randomized equally into control group (0 mg/kg) and 10, 50 and 100 mg/kg DEHP exposure groups, in which the mice were exposed to DEHP at the indicated doses by gavage for 4 weeks. After the treatments, the mice were assessed for behavioral changes using open filed test, elevated plus-maze and Morris water maze test. Brain tissues were collected from the mice for determination of malondialdehyde (MDA) content, pathologies and expressions of ZO-1 and occludin in the hippocampus.

RESULTS

Compared with the control group, the mice with DEHP exposure for 4 weeks exhibited no significant body weight change (P>0.05) but presented with obvious behavioral changes, manifested by reduced movement distance (P < 0.05) and time spent in the center of the open field (P < 0.05), reduced movement distance (P < 0.05) and time spent in the open arm of the elevated maze (P < 0.05), significantly increased latency of searching for the platform (P < 0.05), and decreased frequency of crossing the platform (P < 0.05). HE staining showed obvious vertebral cell death in the hippocampal CA1 to CA3 regions of the mice with DEHP exposure. The exposed mice showed significantly increased MDA content and decreased expressions of ZO-1 and occludin at both the mRNA and protein levels in the hippocampus (P < 0.05 or 0.01). Multivariate linear regression analysis suggested a close correlation between anxiety-like behaviors and learning and memory abilities in DEHP-exposed mice.

CONCLUSION

DEHP exposure may cause damages of the blood-brain barrier and the pyramidal cells in the hippocampus of mice, thereby inducing anxiety-like behaviors and learning and memory impairment.

[The prevention and therapy of corneal ulcers in patients with large-area thermal burns]

Objective: To evaluate the characteristics of ocular injury in patients with severe extensive thermal burns, and to explore the effective methods to prevent and treat corneal ulcers related to severe burns. Methods: A retrospective case series study. Between 2010 and 2019, Sixteen severe thermal burn patients with burn sizes>70% of the total body surface area involving the ocular region were admitted to the Burns and Plastic Surgery Division of Chinese PLA General Hospital, and consult with Ophthalmology Division. There were deep second-degree to fourth-degree burns in the eyelids. In the eleven surviving patients, 22 eyes presented ectropion. Eyelid full-thickness skin grafting (EFTSG) combined with or without tarsorrhaphy was performed in 20 eyes due to severe corneal exposure. Two eyes received partial blepharorrhaphy because of mild ectropion. The ocular manifestations and treatment outcomes were reviewed and assessed. Results: The majority of the patients were youth, and the average age was (36.8±10.4) years. The burn area was 84.0%±9.1% of the body surface area. Corneal ulcers secondary to lagophthalmos occurred at (35.1±15.6) days after burning in 75% (24/32) of eyes. Perforation was found in 18.8% (6/32) of eyes. Among the 22 operated eyes, the corneal ulcer was repaired in all 9 eyes receiving EFTSG with tarsorrhaphy, whereas ectropion recurred in 8 of 11 eyes only receiving EFTSG, and 4 eyes underwent further surgery due to corneal epithelial defects. Conclusions: In patients with severe large-area thermal burns, corneal ulcers are common complications. Prevention of corneal exposure is vital because the treatment of corneal ulceration is difficult due to eyelid deformity, inflammation and the absence of donor skin. Timely full-thickness skin grafting and blepharorrhaphy are effective approaches to preventing exposure keratopathy. To severe ulcers occur, conjunctival flap or Tenon's capsule covering combined with eyelid EFTSG and tarsorrhaphy is useful to rescue visual function.

[Predictive value of blood cell parameters in the diagnosis of vasovagal syncope in children]

Objective: To investigate the predictive value of blood cell parameters in children with vasovagal syncope (VVS). Methods: In this case-control study, the VVS group included 111 patients with unexplained syncope or prodromata who were diagnosed with VVS by head-up tilt test in the Second Xiangya Hospital, Central South University from January 2018 to October 2020, and 111 healthy children were enrolled as control. The differences in blood cell parameters between the 2 groups were compared by t test and Mann-Whitney U test. Multivariate binary Logistic regression was used to analyze the independent correlation factors of VVS, and receiver operating characteristic (ROC) curve to explore the predictive value of blood cell parameters for diagnosing VVS. Results: Sex composition ratios were consistent in the 2 groups (51 males vs. 60 females), while the age of the VVS group was higher than that of the control group (11.0 (8.0, 12.5) vs. 8.0 (7.0, 11.0) years, Z=4.39, P<0.001). Compared with the control group, VVS group had lower level of white blood cell (WBC) (6.0 (5.3, 7.1)×10⁹ vs. 8.6 (6.7, 10.1)×10⁹/L, Z=-7.96, P<0.001), lymphocyte (LY) (2.3 (1.9, 2.7)×10⁹ vs. 4.0 (2.8, 6.3)×10⁹/L, Z=-8.49, P<0.001), lymphocyte ratio (0.39 (0.33, 0.44) vs. 0.52 (0.37, 0.69), Z=-5.59, P<0.001), monocyte (0.3 (0.3, 0.4)×10⁹ vs. 0.4 (0.3, 0.6)×10⁹/L, Z=-6.19, P<0.001), eosinophil (0.1 (0.1, 0.2)×10⁹ vs. 0.2 (0.2, 0.4)×10⁹/L, Z=-5.75, P<0.001), mean corpuscular-hemoglobin concentration (MCHC) ((328±12) vs. (333±11) g/L, t=-3.27, P<0.001) and blood platelet (263 (235, 313)×10⁹ vs. 341 (295, 409)×10⁹/L, Z=-2.69, P<0.001), but higher neutrophil ratio (0.53 (0.48, 0.58) vs. 0.37 (0.22, 0.54), Z=5.86, P<0.001), hematocrit (0.39±0.04 vs. 0.37±0.04, t=2.75, P=0.006), mean corpuscular volume (MCV) (85 (82, 88) vs. 81 (78, 84) fl, Z=5.56, P<0.001), mean corpuscular hemoglobin (28 (27, 29) vs. 27 (26, 28) pg, Z=3.39, P=0.001), red cell distribution width (39 (37, 41) vs. 37 (36, 40) fl, Z=4.02, P<0.001) and mean platelet volume (11 (10, 11) vs. 10 (9, 11) fl, Z=2.81, P=0.005) levels. After adjusting for confounding factors such as sex and age, LY (OR=0.42, 95%CI 0.29-0.62, P<0.001), WBC (OR=0.75, 95%CI 0.59-0.95, P=0.015), MCHC (OR=0.94, 95%CI 0.91-0.97, P<0.001) were independent negative correlation factors of VVS, while MCV (OR=1.08, 95%CI 1.01-1.15, P=0.021) was independent positive correlation factor. ROC curve showed that the combination of LY, WBC, MCV and MCHC had acceptable predictive value for the diagnosis of VVS, with area under curve of 0.88, sensitivity of 0.80, specificity of 0.83, and Youden index of 0.63. Conclusions: Compared with healthy children, the blood cell parameters usually change in those with VVS. Combination of LY, WBC, MCHC and MCV can facilitate the diagnosis of VVS in children with unexplained syncope or prodromata.

Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus

The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip.

PURPOSE

To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L_1-4) in elderly men with type 2 diabetes mellitus (T2DM).

METHODS

We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score <  - 1.0).

RESULTS

Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm², P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075-74.222], P = 0.043).  CONCLUSION: Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.

[Preliminary evaluation on the efficacy of emergency transcatheter aortic valve replacement: a multicenter study]

Objectives: To explore the efficacy and safety of emergency transcatheter aortic valve replacement (TAVR). Methods: Data of patients who underwent emergency TAVR in eight centers, namely Fuwai Hospital, Wuhan Asia Heart Hospital, Xijing Hospital, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Guangdong Provincial People's Hospital, Zhongshan Hospital Affiliated to Fudan University, the First Affiliated Hospital of Zhengzhou University, the Second Xiangya Hospital of Central South University, between May 2017 and December 2020 were retrospectively analyzed. The use of mechanical circulatory support system (MCS) and the results of laboratory tests (N-terminal B-type natriuretic peptide (NT-proBNP)) and echocardiography (mean aortic valve cross valve pressure difference and left ventricular ejection fraction) before and after operation were collected. The primary endpoint was all-cause death, and the secondary endpoints were stroke, major bleeding, major vascular complications, myocardial infarction, permanent pacemaker implantation, and acute renal injury. Device success was caculated, which refered to absence of procedural mortality and correct positioning of a single prosthetic heart valve into the proper anatomical location and intended performance of the prosthetic heart valve (mean aortic valve gradient<20 mmHg(1 mmHg=0.133 kPa) or peak velocity<3 m/s, with no moderate or severe prosthetic valve regurgitation). Kaplan-Meier survival curve was used to estimate the survival rate of patients during follow-up. Results: This study included 48 patients. The age was (72.5±8.1) years, and 34 patients were males (70.8%). Device success rate was 91.7% (44/48). The mean aortic valve transvalvular pressure was significantly decreased after operation ((12.3±6.4)mmHg vs. (60.2±23.8)mmHg, P<0.000 1). Left ventricular ejection fraction was significantly increased ((41.5±11.7)% vs. (31.0±11.3)%, P<0.000 1). NT-proBNP significantly decreased (3 492.0 (1 638.8, 7 165.5) ng/L vs. 12 418.5 (6 693.8, 35 000.0) ng/L, P<0.000 1). In-hospital all-cause mortality was 8.3% (4/48). During hospitalization, the rate of stroke was 2.1% (1/48), major bleeding was 6.3% (3/48), major vascular complications was 10.4% (5/48), myocardial infarction was 4.2% (2/48), permanent pacemaker implantation was 6.3% (3/48), and the rate of acute renal injury was 12.5% (6/48). MCS was used in 20 patients (41.7%). The median follow-up time was 196 days. During the follow-up, one patient died (due to systemic metastasis of pancreatic cancer), two cases suffered new myocardial infarction and one case received permanent pacemaker implantation. The survival rate of 30 days, 1 year and 2 years after the operation were 91.7% (44/48), 89.6% (43/48), 89.6% (43/48), respectively. Conclusion: Emergency TAVR may be a safe and effective treatment for patients with severe decompensated aortic valve stenosis.

First Measurement of High-Energy Reactor Antineutrinos at Daya Bay

This Letter reports the first measurement of high-energy reactor antineutrinos at Daya Bay, with nearly 9000 inverse beta decay candidates in the prompt energy region of 8-12 MeV observed over 1958 days of data collection. A multivariate analysis is used to separate 2500 signal events from background statistically. The hypothesis of no reactor antineutrinos with neutrino energy above 10 MeV is rejected with a significance of 6.2 standard deviations. A 29% antineutrino flux deficit in the prompt energy region of 8-11 MeV is observed compared to a recent model prediction. We provide the unfolded antineutrino spectrum above 7 MeV as a data-based reference for other experiments. This result provides the first direct observation of the production of antineutrinos from several high-Q_{β} isotopes in commercial reactors.

Observation of a State X(2600) in the π^{+}π^{-}η' System in the Process J/ψ→γπ^{+}π^{-}η'

Based on (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, the process J/ψ→γπ^{+}π^{-}η^{'} is studied using two largest decay channels of the η^{'} meson, η^{'}→γπ^{+}π^{-} and η^{'}→ηπ^{+}π^{-}, η→γγ. A new resonance, which we denote as the X(2600), is observed with a statistical significance larger than 20σ in the π^{+}π^{-}η^{'} invariant mass spectrum, and it has a connection to a structure around 1.5  GeV/c^{2} in the π^{+}π^{-} invariant mass spectrum. A simultaneous fit on the π^{+}π^{-}η^{'} and π^{+}π^{-} invariant mass spectra with the two η^{'} decay modes indicates that the mass and width of the X(2600) state are 2618.3±2.0_{-1.4}^{+16.3}  MeV/c^{2} and 195±5_{-17}^{+26}  MeV, where the first uncertainties are statistical, and the second systematic.

Effects of deoxynivalenol on the histomorphology of the liver and kidneys and the expression of MAPKs in weaned rabbits

Deoxynivalenol (DON) is widely present in grain-based feeds and food. It has attracted great attention due to its high contamination rate and strong toxicity. The objective of this study was to analyse the toxic effects of DON on the liver and kidneys of weaned rabbits. 45 weaned male rabbits were allocated into control, low DON dose (0.5 mg/kg body weight), and high DON dose (1.5 mg/kg body weight) groups. Saline or DON was administrated intragastrically in the empty stomach of rabbits every morning. After 24 days of treatment, liver and kidney samples were collected for histological, reverse transcription-quantitative polymerase chain reaction (qRT-PCR), and immunohistochemistry analyses. Haematoxylin eosin staining showed that 0.5 mg/kg BW DON caused mild damage to the liver and kidney morphology, while 1.5 mg/kg body weight DON resulted in hepatic vacuolation and necrosis, as well as tubular stenosis and lesions. Data from qRT-PCR, Western blot, and immunohistochemistry revealed that the mRNA and protein expression and the distribution range of extracellular signal-regulated kinase, p38, and c-Jun NH2-terminal kinase were increased in the liver and kidneys. In conclusion, DON at the tested concentrations damaged the liver and kidneys of rabbits by affecting the expression of key proteins from the mitogen-activated protein kinase signalling pathway. The damage extent was proportional to the amount of DON ingested.

Observation of J/ψ Electromagnetic Dalitz Decays to X(1835), X(2120), and X(2370)

Using a sample of about 10^{10}  J/ψ events collected at a center-of-mass energy sqrt[s]=3.097  GeV with the BESIII detector, the electromagnetic Dalitz decays J/ψ→e^{+}e^{-}π^{+}π^{-}η^{'}, with η^{'}→γπ^{+}π^{-} and η^{'}→π^{+}π^{-}η, have been studied. The decay J/ψ→e^{+}e^{-}X(1835) is observed with a significance of 15σ, and also an e^{+}e^{-} invariant-mass dependent transition form factor of J/ψ→e^{+}e^{-}X(1835) is presented for the first time. The intermediate states X(2120) and X(2370) are also observed in the π^{+}π^{-}η^{'} invariant-mass spectrum with significances of 5.3σ and 7.3σ. The corresponding product branching fractions for J/ψ→e^{+}e^{-}X, X→π^{+}π^{-}η^{'} [X=X(1835), X(2120), and X(2370)] are reported.

[Successful prediction and the process of the weaning of veno-arterial extracorporeal membrane oxygenation]

The weaning of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is one of the clinical challenges, and hospitals have developed experience-based strategies, so there is still a lack of unified standards and procedures for weaning. This paper discusses this issue from the definition of weaning success, evaluation of patients before weaning, predictive indicators, weaning process, etc. Summarizing research progress and problems so that providing guidance for the development of ECMO in the future, such as perfecting weaning process and putting forward scoring system to predict weaning success and clinical outcome.

Smartphone-based gamification intervention to increase physical activity participation among patients with coronary heart disease: intermediate results of a randomized controlled trial

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work is financially supported by a Construction Programme of Independent Innovation Ability of Community Health Nursing Engineering Laboratory in Jilin Province (Study code: 2020C038-8) awarded to FL.

Background

Despite the benefits, patients with coronary heart disease are less likely to engage in physical activity. Gamification is the use of game design elements (such as points, leaderboards, progress bars, and badges) in nongame contexts to increase motivation and engagement. Scientific evidence suggests that smartphone-based gamification interventions have the potential to increase physical activity participation. However, empirical evidence on the efficacy of such interventions among patients with coronary heart disease is still emerging.

Purpose

This study incorporates behavioral economics into a gamification intervention based on a smartphone app (WeChat applet) to explore whether a gamification intervention can improve participation in physical activity and other related physical and psychological outcomes in patients with coronary heart disease.

Methods

A group of 108 participants (mean age 53.0+10.5, 18.5% female) with coronary heart disease were randomly assigned to three groups (Control group: WeChat applet+step goal setting; Individual group: WeChat applet+step goal setting+gamification; Team group: WeChat applet+step goal setting+gamification+collaboration). The primary outcomes included the change in daily steps and the proportion of patient-days that step goals achieved. Patients also completed Psychological Needs Satisfaction in Exercise Scale (PNSE), Behavioural Regulation in Exercise Questionnaire (BREQ)-3, Physical Activity Enjoyment Scale (PACES), Generalised Anxiety Disorder (GAD)-7, Patient Health Questionnaire (PHQ)-9 at baseline, 12 weeks and 24 weeks.

Results

Compared with the control group (n=36), participants in the individual group (n=36) had a significantly greater increase in mean daily steps from baseline during the intervention group (difference 988; 95% CI, 259 - 1717; P&lt;0.01), and had a significantly greater proportion of patient-days that step goals achieved (difference 0.38; 95% CI, 0.04 - 0.13; P&lt;.001), competence (difference 0.6, 95% CI, 0.3 - 0.8; P&lt;.001), autonomous motivation (difference 3.3; 95% CI, 2.2 to 4.4; P&lt;.001), weight (difference -1.2, 95% CI, -1.8 to -0.6; P&lt;.001), BMI (difference -0.4; 95% CI -0.6 to -0.2; P&lt;.001) and waist circumference (difference -1.2; 95% CI -1.7 to -0.6; P&lt;.001). Participants in team group (n=36) had a significantly greater increase in competence (difference 0.3; 95% CI 0.1 to 0.6; P&lt;.001), relatedness (difference 0.9; 95% CI 0.7 to 1.2; P&lt;.001), autonomous motivation (difference 3.0; 95% CI 2.1 to 4.0; P&lt;.001),however, no significant difference of change in step counts was found between team group and control group.

Conclusions

A smartphone-based gamification intervention may be an effective way to promote physical activity in patients with coronary heart disease within 12 weeks if we incorporate appropriate game elements into the smartphone application.

Magnetic resonance imaging parameter-based machine learning for prognosis prediction of high-intensity focused ultrasound ablation of uterine fibroids

Objectives: To develop and apply magnetic resonance imaging (MRI) parameter-based machine learning (ML) models to predict non-perfused volume (NPV) reduction and residual regrowth of uterine fibroids after high-intensity focused ultrasound (HIFU) ablation.Methods: MRI data of 573 uterine fibroids in 410 women who underwent HIFU ablation from the Chongqing Haifu Hospital (training set, N = 405) and the First Affiliated Hospital of Chongqing Medical University (testing set, N = 168) were retrospectively analyzed. Fourteen MRI parameters were screened for important predictors using the Boruta algorithm. Multiple ML models were constructed to predict NPV reduction and residual fibroid regrowth in a median of 203.0 (interquartile range: 122.5-367.5) days. Furthermore, optimal models were used to plot prognostic prediction curves.Results: Fourteen features, including postoperative NPV, indicated predictive ability for NPV reduction. Based on the 10-fold cross-validation, the best average performance of multilayer perceptron achieved with R² was 0.907. In the testing set, the best model was linear regression (R² =0.851). Ten features, including the maximum thickness of residual fibroids, revealed predictive power for residual fibroid regrowth. Random forest model achieved the best performance with an average area under the curve (AUC) of 0.904 (95% confidence interval (CI), 0.869-0.939), which was maintained in the testing set with an AUC of 0.891 (95% CI, 0.850-0.929).Conclusions: ML models based on MRI parameters can be used for prognostic prediction of uterine fibroids after HIFU ablation. They can potentially serve as a new method for learning more about ablated fibroids.

[Research advances on mesenchymal stem cells and their derivatives in the treatment of acne scars]

Acne is a common chronic inflammatory disease of the skin that often occurs on the face, and acne scars are often secondary to the healing process of acne, which often leads to impaired appearance and psychological disorders of patients. The current treatment for acne scars is extremely difficult. With the development of regenerative medicine, stem cell transplantation has become a new treatment for acne scars. In recent years, it has been reported that stem cells and their derivatives can effectively antagonize the formation of acne scars. Therefore, this paper briefly reviews the basic and clinical researches on the treatment of acne scars with various mesenchymal stem cells and their derivatives, aiming to provide theoretical basis and reference for the stem cell therapy of acne scars.

948 THE DEVELOPMENT OF A DYSPHAGIA CUP TO IMPROVE WATER INTAKE AND REDUCE CAREGIVER BURDEN IN CHANGI GENERAL HOSPITAL (CGH)

 

At any one time, &gt;60% of the beds in the 1,000 bedded CGH is occupied by an elderly &gt;65. Ensuring adequate water intake among the elderly patients is a challenge. Hence, 90% of our elderly inpatients in the acute wards did not consume the recommended daily allowance of fluid. Causes for poor water consumption included dysphagia requiring thickened fluids, manpower reasons, patient and environmental factors. The Geriatrician led a team to explore, designed and developed a dysphagia cup to improve fluid intake for the elderly inpatients, with input from nursing, occupational and speech therapists. The plan-do-study-act methodology was employed in this study. Training was provided to nursing staff and caregivers prior to issuing the cups.

Results

The cup improves availability of water for the patients, encourages autonomy so the patients may drink independently without aspirating, reduces caregiver burden while thickening prior to serving fluids and improves patient care.

The improved water consumption reduces adverse outcomes associated with dehydration such as delirium, constipation and long length of stay. Results showed improvement in water consumption among 75% of the patients, with 62% increase in amount of fluid consumption. 83% of patients were able to drink independently with &gt;90% caregiver (nurses and family) satisfaction. The cups saved nursing time significantly, projected to save 14 full time nurses a year and 67% improvement in nursing productivity, for CGH.

Conclusion

Encouraging the elderly to drink is labour intensive and time consuming, especially for patients with dysphagia. Time saving was proven for thickening fluids and since patients drink independently, time was saved for assisting/supervising patients while drinking. Since the cup has measuring gauge, it was faster to thicken fluids. The cup holds enough fluids for several serving, the caregiver need not prepare to thicken fluids prior to every serving.

Probing CP symmetry and weak phases with entangled double-strange baryons

Though immensely successful, the standard model of particle physics does not offer any explanation as to why our Universe contains so much more matter than antimatter. A key to a dynamically generated matter-antimatter asymmetry is the existence of processes that violate the combined charge conjugation and parity (CP) symmetry1. As such, precision tests of CP symmetry may be used to search for physics beyond the standard model. However, hadrons decay through an interplay of strong and weak processes, quantified in terms of relative phases between the amplitudes. Although previous experiments constructed CP observables that depend on both strong and weak phases, we present an approach where sequential two-body decays of entangled multi-strange baryon-antibaryon pairs provide a separation between these phases. Our method, exploiting spin entanglement between the double-strange Ξ- baryon and its antiparticle2 [Formula: see text], has enabled a direct determination of the weak-phase difference, (ξP - ξS) = (1.2 ± 3.4 ± 0.8) × 10-2 rad. Furthermore, three independent CP observables can be constructed from our measured parameters. The precision in the estimated parameters for a given data sample size is several orders of magnitude greater than achieved with previous methods3. Finally, we provide an independent measurement of the recently debated Λ decay parameter αΛ (refs. 4,5). The [Formula: see text] asymmetry is in agreement with and compatible in precision to the most precise previous measurement4.

Altered dynamic functional topology in first-episode untreated patients with schizophrenia can aid in early diagnosis

Introduction

There is a growing consensus on brain networks that it is not immutable but rather a dynamic complex system for adapting environment. The neuroimaging research studying how brain regions work collaboratively with dynamic methods had demonstrated its effectiveness in revealing the neural mechanisms of schizophrenia.

Objectives

To investigate altered dynamic brain functional topology in first-episode untreated schizophrenia patients (SZs) and establish classification models to find objective brain imaging biomarkers.

Methods

Resting-state-functional magnetic resonance data for SZs and matched healthy controls were obtained(Table1).

Power-264-template was used to extract nodes and sliding-window approach was carried out to establish functional connectivity matrices. Functional topology was assessed by eigenvector centrality(EC) and node efficiency and its time-fluctuating was evaluated with coefficient of variation(CV). Group differences of dynamic topology and correlation analysis between Positive and Negative Syndrome Scale(PANSS) scores and topology indices showing group differences, which also were used in establishing classification models, was examed.

Results

The CV of node efficiency in angular and paracingulate gyrus was larger in SZs. There are 13 nodes assigned into several brain networks displaying altered CV of EC between groups(Figure1.A). Fluctuation of EC of the node in DMN, which was lower in SZs, showed negative correlation with PANSS total scores(Figure1.B). Dynamic functional topology of above nodes was used to train classification models and demonstrated 80% and 71% accuracy for support vector classification(SVC) and random forest(RF), respectively(Figure2).

Conclusions

Dynamic functional topology illustrated a capability in identifying SZs. Aberrated dynamics of DMN relevant to severity of patient’s symptoms could reveal the reason why it contributed to classification.

Disclosure

No significant relationships.

Brain controllability and clinical relevance in schizophrenia

Introduction

Apart from the psychiatric symptoms, cognitive deficits are also the core symptoms of schizophrenia. Brain network control theory provided information on the role of a specific brain region in the cognitive control process, helping understand the neural mechanism of cognitive impairment in schizophrenia.

Objectives

To characterize the control properties of functional brain network in first-episode untreated patients with schizophrenia and the relationships between controllability and psychiatric symptoms, as well as exploring the predictive value of controllability in differentiating patients from healthy controls (HCs).

Methods

Average and modal controllability of brain networks were calculated and compared between 133 first-episode untreated patients with schizophrenia and 135 HCs. The associations between controllability and clinical symptoms were evaluated using sparse canonical correlation analysis. Support vector machine (SVM) and SVM-recursive feature elimination combined with the controllability were performed to establish the individual prediction model.

Results

Compared to HCs, the patients with schizophrenia showed increased average controllability and decreased modal controllability in dorsal anterior cingulate cortex (dACC). Brain controllability predominantly in somatomotor, default mode, and visual networks was associated with the positive symptomatology of schizophrenia. The established model could identify patients with an accuracy of 0.68. Furthermore, the most discriminative features were located in dACC, medial prefrontal lobe, precuneus and superior temporal gyrus.

Conclusions

Altered controllability in dACC may play a critical role in the neuropathological mechanisms of cognitive deficit in schizophrenia, which could drive the brain function to different states to cope with varied cognitive tasks. As symptom-related biomarkers, controllability could be also beneficial to individual prediction in schizophrenia.

Disclosure

No significant relationships.