Science Progress最新文献

ObjectivesMetabolic dysfunction-associated fatty liver disease (MAFLD) poses a major global health burden due to risks of cirrhosis and liver cancer; however, the relationship between MAFLD and weight-adjusted-waist index (WWI) remains unclear. Our study aims to clarify this relationship and identify potential clinical predictors for MAFLD.MethodsA population-based cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 and 2015-2018. Multivariable logistic regression and Restricted Cubic Splines (RCS) was employed to examine the nonlinear association between WWI and MAFLD. Following this, a subgroup analysis was performed to detect any variations and ensure the robustness of the findings.ResultsThe study included 17,930 participants aged ≥ 18 years, with a mean age of 45.54 years and 48.43% males. The sample was comprised of 44.36% Non-Hispanic White, 20.69% Mexican American, 19.55% Non-Hispanic Black, 8.00% Other Hispanic, and 7.41% Other/Multi-Racial individuals. Among them, 5850 individuals were diagnosed with MAFLD. The study found a statistically significant association between WWI and MAFLD (odds ratio (OR) = 4.35, 95% confidence interval [95% CI]: 4.08-4.63), which remained significant even after adjusting for all relevant factors (OR = 2.73, 95% CI: 2.48-3.01). The RCS analysis revealed a significant nonlinear relationship between WWI and MAFLD (p < 0.05). Subgroup analysis indicated that WWI remained positively correlated with MAFLD, but no significant interaction was observed (p-interaction > 0.05)ConclusionsWWI is a significant predictor of MAFLD, suggesting its potential as a simple, non-invasive screening tool for the occurrence of MAFLD.

Adenoid cystic carcinoma (AdCC) is a malignancy that most frequently originates in the salivary glands of the head and neck, though it may also rarely occur in other sites such as the trachea or breast. It is characterized by its slow-growing nature in the early stages, along with distinctive features of perineural invasion and a tendency for late metastasis, particularly to the lungs. Recurrence or metastasis can occur even years after the initial treatment. Currently, no standardized clinical protocol exists for long-term follow-up. The disease can recur or metastasize even years after initial treatment. At present, no uniform clinical protocol exists for long-term follow-up. To our knowledge, no documented cases of retrograde metastasis from primary pulmonary AdCC to the tongue have been reported. We describe the case of a male patient in his 40s with primary low-grade pulmonary AdCC who developed lingual metastasis after aggressive treatment. This case highlights an unusual metastatic pattern and underscores the need for vigilant, long-term monitoring of patients with AdCC.

ObjectiveTo compare long-term survival in early-stage breast cancer patients treated with different radiation therapy modalities.MethodsData was retrospectively derived from SEER database. We compared overall survival (OS), breast cancer specific survival (BCSS) and second primary malignancies (SPM) in early-stage breast cancer patients treated with postoperative radiotherapy (PORT) versus those treated neoadjuvant radiotherapy (NART) and intraoperative radiotherapy (IORT) after propensity score matching by 1:1.ResultsA total of 457,166 patients were included in this study. After matching, the 20-year OS of 1441 patients in NART cohort was lower than that in PORT cohort (p < 0.01), particularly in hormone receptor positive patients (p < 0.01). NART were dependent prognostic factors for 20-year OS [Hazard Ratio (HR):1.21, 95%CI: 1.06-1.38, p < 0.01). No significant difference in BCSS was observed between NART and PORT treatments. Additionally, patients undergoing NART had a lower risk of all SPM (p = 0.01) and second solid cancers (p = 0.02) but a comparable risk of second hematological malignancies (p = 0.55) than patients administered PORT. HR-positive was a risk factor for SPM. No OS, BCSS or SPM risk difference were significantly observed in the 2096 pairs of IORT and PORT groups.ConclusionCompared to PORT, NART and IORT don't offer survival advantages for early-stage breast cancer patients. Altering the sequence of radiotherapy requires careful evaluation.

ObjectiveThis study aimed to investigate the clinical characteristics of elderly chronic kidney disease (CKD) patients; and the correlation among their biochemical indicators, physical activity, and functional parameters. The findings of this study will hopefully a scientific basis for better understanding the causes and developing the best management methods for CKD in this population.MethodsIn total, 280 elderly patients with CKD participated in this cross-sectional study. All patients underwent a multidimensional assessment of clinical data, physical activity, and functional performance. Patients were stratified by disease severity into two groups: CKD stages 1-3 and stages 4-5. Additionally, they were categorized as sedentary or nonsedentary based on metabolic equivalent of task (MET) levels. Inter-group differences and correlations among the variables were subsequently analyzed.ResultsResearch findings indicated that although male patients predominated in the overall cohort, female patients were more prevalent among those with advanced CKD (stages 4-5) and those reporting a sedentary lifestyle, and these subgroups also demonstrated a higher likelihood of hypertension and anemia. Compared to patients with CKD stages 1-3, those in stages 4-5 had significantly lower estimated glomerular filtration rate (eGFR), hemoglobin, albumin, and MET values (P < .05), along with higher serum creatinine and Barthel Index of Activities of Daily Living (BADL) values (P < .05). Similarly, when compared to nonsedentary patients, those with a sedentary lifestyle exhibited lower eGFR, hemoglobin, and MET levels (P < .05), alongside elevated procalcitonin (PCT) and BADL values (P < .05). Correlation analyses further revealed that renal function was significantly associated with both BADL and MET values in the studied CKD population (P < .05). Our correlation analysis also revealed that renal function in elderly advanced CKD patients is closely associated with levels of PCT and Hb (P < .05). Moreover, among sedentary elderly CKD patients, renal function was correlated not only with PCT and Hb (P < .05), but also with albumin and physical activity levels MET (P < .05).ConclusionsOur study identified a predominance of female patients in advanced CKD stages and among those leading sedentary lifestyles. Furthermore, our findings suggest that renal function may be associated with physical activity and functional performance, with this relationship appearing most pronounced in sedentary individuals. The results also point to a potential interrelationship between renal function, inflammation, and nutritional status in advanced CKD.

ObjectiveTo establish a predictive model based on ultrasound (US) radiomics to determine whether the ablation zone of papillary thyroid microcarcinoma (PTMC) disappears within 24 months after microwave ablation (MWA).Study designRetrospective study.MethodsThis study enrolled 201 PTMC patients who underwent MWA in Affiliated Beijing Friendship Hospital of Capital Medical University between January 2013 and September 2020. All patients were followed up at 1 h, 1 month, 3 months, 6 months, 12 months, and 24 months after MWA. Radiomics features were extracted from the preoperative US images, and a Rad-score was constructed. Univariate and multivariate logistic regression analyses were used to screen out the independent clinical factors associated with the disappearance of the ablation zone after MWA, and a radiomics nomogram was established to predict whether the ablation zone of PTMC disappeared within 24 months after MWA. The performance of the model was validated in the testing cohort.Results75.6% of patients achieved the ablation zone disappeared within 24 months after MWA. The disappearance rate was significantly associated with MWA energy and baseline lesion volume (p < 0.05). The US radiomics nomogram integrated Rad-score, MWA energy, and baseline lesion volume. In the testing cohort, the area under the curve of this nomogram outperformed that of the clinical model and the radiomics model (0.772 vs 0.714 and 0.679, respectively).ConclusionsThe nomogram based on US radiomics can reliably identify whether lesions of PTMC will disappear within 24 months after MWA. The nomogram is useful for screening optimal candidates for MWA and may assist clinicians and patients in choosing the best treatment option between MWA and surgery.

ObjectiveColorectal cancer (CRC) patients with high microsatellite instability (MSI-H) and mismatch repair deficiency (dMMR) had heterogeneous pathology and distinct prognoses. This study aimed to examine the difference in the gene expression profile of dMMR/MSI-H CRC patients with different disease stages and explore the different molecular mechanisms of disease progression.MethodsA total of 47 patients with dMMR/MSI-H CRC were enrolled and retrospectively studied, including 27 stage II and 20 stage IV patients. Each patient had paired tumor tissue and white blood cell samples, which were analyzed by next-generation sequencing (NGS) of 416 cancer-relevant genes. Pathway enrichment analysis was then performed to analyze the disease stage-specific signaling pathways.ResultsA total of 2878 mutation sites, spanning 378 mutated genes, were detected from the 47 dMMR/MSI-H CRC patients. The mutation frequencies of SMARCA4, EPHA3, MTHFR, RAD50, and PDGFRB were significantly higher in stage II patients than in stage IV patients (p < 0.05), whereas the stage II patients had significantly lower mutation frequencies of TSC2, FGFR1, PTPN13, SMAD3, and STK11 than stage IV patients (p < 0.05). Sixty-three mutated genes were unique to stage II tumors, while 36 mutated genes were exclusively present in stage IV tumors. Pathway analyses demonstrated the PI3K-AKT pathway was shared by both stage II and stage IV tumors, whereas multiple other signaling pathways showed disease stage-specific enrichment.ConclusionThere were profound differences in mutational profile and molecular mechanisms between stage II and stage IV dMMR/MSI-H CRC.

ObjectivesThis study evaluates artificial intelligence (AI) reasoning capabilities in gynecologic cancer genetic counseling, comparing the performance of ChatGPT and DeepSeek models to guide patient-centered AI implementation in clinical genetics.MethodsUsing 40 National Comprehensive Cancer Network-aligned counseling scenarios, we conducted blinded dual-oncologist evaluations of two large language models. Methodological rigor included model anonymization, a pre-calibrated scoring framework, and validated metrics (Global Quality Scale and Patient Education Materials Assessment Tool) assessing informational coherence, understandability, and actionability.ResultsDeepSeek demonstrated superior informational breadth (mean character difference: -609.0, p < .0001) and visual communication (diagram integration, p < .01), with 49-fold greater probability in recommending clear and actionable actions (p < .01, OR = 49.0). ChatGPT excelled in concise summarization (22% faster response generation, p = .013).ConclusionStrategic AI model selection-leveraging DeepSeek's visually-rich, structured educational approach for complex information, and ChatGPT's concise, rapid summarization for efficient communication-enhances patient-centered genetic education when combined with clinician oversight. This framework supports healthcare's digital transformation by optimizing human-AI collaboration in hereditary cancer care.

As a key core component of wind turbine generators, the rolling bearings in the gearbox directly affect the overall performance and reliability of the wind turbine generators. Accurate prediction and timely diagnosis can effectively improve the efficiency of the wind turbine generators. This paper takes the rolling bearing operation data as the research object and proposes a bearing fault classification research method based on the combination of variational mode decomposition (VMD) optimization and convolutional neural network-bidirectional gated recurrent unit (CNN-BiGRU)-Attention model. Firstly, to address the sensitivity of intrinsic mode function (IMF) components in the VMD decomposition process, an improved RIEM algorithm is adopted to optimize the hyperparameters of the VMD algorithm. This process aims to adaptively adjust the penalty factor and decomposition layers of the VMD algorithm and find the optimal IMF component to determine the most suitable IMF component in the signal data. Secondly, to fully explore the complex characteristics of fault signals, composite multi-scale slope entropy is used to extract features from the optimized input data. By conducting multidimensional analysis on the local and global characteristics of the signal at different time scales, efficient representation of fault features is achieved. Finally, based on MATLAB, a simulation experiment platform is established. This paper conducts research on the classification of rolling bearing faults through the CNN-BiGRU-Attention model. The results show that the model established in this paper has significant effects and stable performance. The research in this paper provides new technical ideas for fault diagnosis of rolling bearings in wind turbine generator gear.

Wellbore instability in deep hard-brittle shale formations, primarily induced by hydration-driven strength degradation upon interaction with water-based fluids, poses a critical challenge to hydrocarbon extraction. Conventional triaxial testing for assessing shale hydration behavior is often constrained by substantial sample requirements, extended duration, and high operational costs. In response, this study develops an efficient alternative approach centered on the indentation hardness method. While standard indentation tests are typically limited to hardness and plasticity coefficients, this work establishes theoretical models-based on contact mechanics, elasticity theory, and the Mohr-Coulomb criterion-to derive elastic modulus, Poisson's ratio, and uniaxial compressive strength from indentation data. Experimental analysis of homogenized Longmaxi shale revealed a dense, low-porosity microstructure dominated by non-expansive clay minerals and quartz. Freshwater immersion tests displayed a three-stage absorption trend-rapid, slow, and stable-reaching near-saturation after 72 hours. Pronounced mechanical degradation was observed within the initial 300 hours of immersion, characterized by marked reductions in compressive strength, elastic modulus, and indentation hardness, alongside a stepwise increase in Poisson's ratio; this degradation trend decelerated thereafter. Validation experiments confirmed that single-point indentation hardness measurements provide mechanical equivalence to uniaxial compression responses. As a result, indentation testing on shale chips following fluid immersion offers an efficient and reliable means of evaluating time-dependent fluid-rock interactions. The proposed methodology minimizes core material requirements, enhances operational efficiency, and mitigates the influence of heterogeneity, thereby offering considerable practical value for shale hydration assessment and wellbore stability forecasting.

ObjectiveQuantify recruitment of Native Hawaiian and Pacific Islander (NHPI) participants from 22 Alzheimer's disease (AD) clinical trials over 5 years and utilize choropleth maps as a visual tool to identify where in the Hawaiian community recruited participants are located in order to better inform future recruitment efforts and improve equity and population diversity for future AD clinical trials.MethodsA retrospective chart review was conducted at a dual-site origin clinical trial center in Hawai'i. Inclusion criteria were a diagnosis of mild cognitive impairment and participation in one or more AD clinical trials conducted between 2020 and 2024. Demographic information of clinical trial participants was collected via chart review and included self-identified race/ethnicity, age, residence, and number of clinical trials the patient has participated in. Clinical trial participants were categorized by ZIP codes established by the US Census Bureau. Differences across race/ethnicity groups were assessed using either Pearson's Chi-squared test or Fisher's exact test.ResultsA total of 244 patients participated across the state of Hawai'i in 22 AD clinical trials between 2020 and 2024. Of this total, 169 (69%) patients provided their race/ethnicity, and 75 (31%) did not provide their race/ethnicity. White patients had the highest percentage of participation (44%), followed by Asian patients (34%) and NHPI patients (15%). The population distribution visualized in this study's choropleth maps suggests that NHPI were under-recruited from the west side of O'ahu.ConclusionsOur retrospective study applied choropleth maps to visualize the recruitment data and patterns of AD clinical trials. By utilizing choropleth maps to analyze recruitment areas, the NHPI community and other underrepresented populations may benefit from targeted, culturally informed recruitment strategies.