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Objectives: This study aims to compare outcomes following a negative surveillance MRI study by surgery-MRI interval and investigate factors associated with second breast cancers in women with a personal history of breast cancer (PHBC). Methods: This retrospective study included 1552 consecutive women (mean age, 53 years) with a PHBC and a negative prevalence surveillance breast MRI result between August 2014 and December 2016. The incidence and characteristics of second breast cancers were reviewed and compared according to surgery-MRI interval (< 3 years vs ≥ 3 years). Logistic regression analysis was used to investigate associations with clinical-pathologic characteristics. Results: Twenty-five second breast cancers occurred after negative MRI. The incidence of second breast cancers or local-regional recurrence did not significantly differ by surgery-MRI interval. The median intervals between MRI to second breast cancer detection showed no significant difference between the two groups (surgery-MRI interval <3 years vs. ≥ 3 years). Two node-positive second breast cancers were detected in the group with <3 years interval. BRCA mutation status, receipt of breast-conserving surgery, and adjuvant chemotherapy (all p <.05) were significant factors associated with the development of second breast cancers. Conclusion: Outcomes following a negative surveillance MRI did not differ by surgery-MRI interval. BRCA mutation status, receipt of breast-conserving surgery and adjuvant chemotherapy were independently associated with the risk of developing second breast cancers after negative surveillance MRI. [ABSTRACT FROM AUTHOR]

In this study, we employed various machine learning models to predict metabolic phenotypes, focusing on thyroid function, using a dataset from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. Our analysis utilized laboratory parameters relevant to thyroid function or metabolic dysregulation in addition to demographic features, aiming to uncover potential associations between thyroid function and metabolic phenotypes by various machine learning methods. Multinomial Logistic Regression performed best to identify the relationship between thyroid function and metabolic phenotypes, achieving an area under receiver operating characteristic curve (AUROC) of 0.818, followed closely by Neural Network (AUROC: 0.814). Following the above, the performance of Random Forest, Boosted Trees, and K Nearest Neighbors was inferior to the first two methods (AUROC 0.811, 0.811, and 0.786, respectively). In Random Forest, homeostatic model assessment for insulin resistance, serum uric acid, serum albumin, gamma glutamyl transferase, and triiodothyronine/thyroxine ratio were positioned in the upper ranks of variable importance. These results highlight the potential of machine learning in understanding complex relationships in health data. However, it's important to note that model performance may vary depending on data characteristics and specific requirements. Furthermore, we emphasize the significance of accounting for sampling weights in complex survey data analysis and the potential benefits of incorporating additional variables to enhance model accuracy and insights. Future research can explore advanced methodologies combining machine learning, sample weights, and expanded variable sets to further advance survey data analysis. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the impact of intravenous palonosetron compared to ondansetron on hypotension induced by spinal anesthesia in women undergoing cesarean section. Methods: Fifty-four women scheduled for elective cesarean section were, randomly allocated to ondansetron group (n = 27) or palonosetron group (n = 27). Ten minutes prior to the administration of spinal anesthesia, participants received an intravenous injection of either ondansetron or palonosetron. A prophylactic phenylephrine infusion was initiated immediately following the intrathecal administration of bupivacaine and fentanyl. The infusion rate was titrated to maintain adequate blood pressure until the time of fetal delivery. The primary outcome was total dose of phenylephrine administered. The secondary outcomes were nausea or vomiting, the need for rescue antiemetics, hypotension, bradycardia, and shivering. Complete response rate, defined as the absence of postoperative nausea and vomiting and no need for additional antiemetics, were assessed for up to 24 hours post-surgery. Results: No significant differences were observed in the total dose of phenylephrine used between the ondansetron and palonosetron groups (387.5 μg [interquartile range, 291.3–507.8 μg versus 428.0 μg [interquartile range, 305.0–507.0 μg], P = 0.42). Complete response rates also showed no significant differences between the groups both within two hours post-spinal anesthesia (88.9% in the ondansetron group versus 100% in the palonosetron group; P = 0.24) and at 24 hours post-surgery (81.5% in the ondansetron group versus 88.8% in the palonosetron group; P = 0.7). In addition, there was no difference in other secondary outcomes. Conclusion: Prophylactic administration of palonosetron did not demonstrate a superior effect over ondansetron in mitigating hemodynamic changes or reducing phenylephrine requirements in patients undergoing spinal anesthesia with bupivacaine and fentanyl for cesarean section. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the common CT findings of high-grade (HG) PanIN and clinical effects in the remnant pancreas in patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Materials and methods: Two hundred fifty-one patients with surgically confirmed IPMNs (118 malignant [invasive carcinoma/high-grade dysplasia] and 133 benign [low-grade dysplasia]) were retrospectively enrolled. The grade of PanIN (233 absent/low-grade and 18 high-grade) was recorded, and all patients underwent serial CT follow-up before and after surgery. Two radiologists analyzed CT findings of high-risk stigmata or worrisome features according to 2017 international consensus guidelines. They also analyzed tumor recurrence on serial follow-up CT after surgery. Statistical analyses were performed to identify significant predictors and clinical impact on postoperative outcomes of HG PanIN. Results: PanIN grade showed a significant association with IPMN grade (p = 0.012). Enhancing mural nodules ≥5 mm, abrupt main pancreatic duct (MPD) changes with distal pancreatic atrophy, increased mural nodule size and MPD diameter were common findings in HG PanIN (P<0.05). In multivariate analysis, abrupt MPD change with distal pancreatic atrophy (odds ratio (OR) 6.59, 95% CI: 2.32–18.72, <0.001) and mural nodule size (OR, 1.05; 95% CI, 1.02–1.08, 0.004) were important predictors for HG PanIN. During postoperative follow-up, HG PanIN (OR, 4.98; 95% CI, 1.22–20.33, 0.025) was significantly associated with cancer recurrence in the remnant pancreas. Conclusion: CT can be useful for predicting HG PanIN using common features, such as abrupt MPD changes and mural nodules. In HG PanIN, extra caution is needed to monitor postoperative recurrence during follow-up. [ABSTRACT FROM AUTHOR]

This study aimed to identify underlying demographic and clinical characteristics among individuals who had previously attempted suicide, utilizing the comprehensive Health Insurance Review and Assessment Service (HIRA) database. Data of patients aged 18 and above who had attempted suicide between January 1 and December 31, 2014, recorded in HIRA, were extracted. The index date was identified when a suicide attempt was made within the year 2014. The medical history of the three years before the index date and seven years of follow-up data after the index date were analyzed. Kaplan-Meier estimate was used to infer reattempt of the suicide attempters, and Cox-proportional hazard analysis was used to investigate risk factors associated with suicide reattempts. A total of 17,026 suicide attempters were identified, of which 1,853 (10.9%) reattempted suicide; 4,925 (28.9%) patients had been diagnosed with depressive disorder. Of the reattempters, 391 (21.1%) demonstrated a history of suicide attempts in the three years before the index date, and the mean number of prior attempts was higher compared to that of the non-reattempters (1.7 vs.1.3, p-value < 0.01). Prior psychiatric medication, polypharmacy, and an increase in the number of psychotropics were associated with suicide reattempt in overall suicide attempters. (Hazard ratio (HR) = 3.20, 95% confidence interval [CI] = 2.56–4.00; HR = 2.42, 95% CI = 1.87–3.14; HR = 19.66, 95% CI = 15.22–25.39 respectively). The risk of reattempt decreased in individuals receiving antidepressant prescriptions compared to those unmedicated, showing a reduction of 78% when prescribed by non-psychiatrists and 89% when prescribed by psychiatrists. Similar risk factors for suicide reattempts were observed in the depressive disorder subgroup, but the median time to reattempt was shorter (556.5 days) for this group compared to that for the overall attempters (578 days). Various risk factors including demographics, clinical characteristics, and medications should be considered to prevent suicide reattempts among suicide attempters, and patients with depressive disorder should be monitored more closely. [ABSTRACT FROM AUTHOR]

Verifying habitats, including the foraging and nesting areas for sea turtles, enables an understanding of their spatial ecology and successful planning of their conservation and management strategies. Recently, the observation frequency and bycatch of loggerhead (Caretta caretta) and green (Chelonia mydas) turtles have increased in the northern limit of their distribution range, in the northern part of the East China Sea and East (Japan) Sea. We conducted satellite tracking to investigate the habitat use of seven loggerhead and eight green turtles from June 2016 to August 2022 in this area, where little is known about their spatial ecology. We applied a 50 percent volume contour method to determine their main foraging areas and analyzed 6 environmental variables to characterize their habitats. Loggerhead turtles mainly stayed in and used the East China Sea as a foraging area during the tracking period, while two individuals among them also used the East Sea as a seasonal foraging area. Most green turtles also used the East China Sea as a foraging area, near South Korea and Japan, with one individual among them using the lower area of the East Sea as a seasonal foraging area. Notably, one green turtle traveled to Hainan Island in the South China Sea, a historical nesting area. Our results showed that the two sea turtle species included the East Sea as a seasonal foraging area, possibly owing to the abundance of food sources available, despite its relatively lower sea temperature. Considering that loggerhead and green sea turtles were observed using the northern part of the East China Sea and East Sea more frequently than previously known and that the sea temperature gradually increases due to climate change, conservation and management activities are required for sea turtles in these areas. [ABSTRACT FROM AUTHOR]

BackgroundMultiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation.MethodsWe constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures.ResultsOverall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together.ConclusionsThis model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM.

Students' performance is an important factor for the evaluation of teaching quality in colleges. The prediction and analysis of students' performance can guide students' learning in time. Aiming at the low accuracy problem of single model in students' performance prediction, a combination prediction method is put forward based on ant colony algorithm. First, considering the characteristics of students' learning behavior and the characteristics of the models, decision tree (DT), support vector regression (SVR) and BP neural network (BP) are selected to establish three prediction models. Then, an ant colony algorithm (ACO) is proposed to calculate the weight of each model of the combination prediction model. The combination prediction method was compared with the single Machine learning (ML) models and other methods in terms of accuracy and running time. The combination prediction model with mean square error (MSE) of 0.0089 has higher performance than DT with MSE of 0.0326, SVR with MSE of 0.0229 and BP with MSE of 0.0148. To investigate the efficacy of the combination prediction model, other prediction models are used for a comparative study. The combination prediction model with MSE of 0.0089 has higher performance than GS-XGBoost with MSE of 0.0131, PSO-SVR with MSE of 0.0117 and IDA-SVR with MSE of 0.0092. Meanwhile, the running speed of the combination prediction model is also faster than the above three methods. [ABSTRACT FROM AUTHOR]

BackgroundEven when phenotypic differences are large between natural or domesticated strains, the underlying genetic basis is often complex, and causal genomic regions need to be identified by quantitative trait locus (QTL) mapping. Unfortunately, QTL positions typically have large confidence intervals, which can, for example, lead to one QTL being masked by another, when two closely linked loci are detected as a single QTL. One strategy to increase the power of precisely localizing small effect QTL, is the use of an intercross approach before inbreeding to produce Advanced Intercross RILs (AI-RILs).Methodology/principal findingsWe present two new AI-RIL populations of Arabidopsis thaliana genotyped with an average intermarker distance of 600 kb. The advanced intercrossing design led to expansion of the genetic map in the two populations, which contain recombination events corresponding to 50 kb/cM in an F(2) population. We used the AI-RILs to map QTL for light response and flowering time, and to identify segregation distortion in one of the AI-RIL populations due to a negative epistatic interaction between two genomic regions.Conclusions/significanceThe two new AI-RIL populations, EstC and KendC, derived from crosses of Columbia (Col) to Estland (Est-1) and Kendallville (Kend-L) provide an excellent resource for high precision QTL mapping. Moreover, because they have been genotyped with over 100 common markers, they are also excellent material for comparative QTL mapping.

Macrophage inhibitory cytokine 1 (MIC-1), which is overproduced in various human cancers and associated with cachexia, acts on the hypothalamus to suppress appetite and reduce body weight. We investigated the mechanisms through which MIC-1 affects bile acid metabolism and gallstone formation, which are poorly understood. Over 6 weeks, male C57BL/6 mice fed either standard chow or a lithogenic diet were intraperitoneally injected with phosphate-buffered saline (PBS) or MIC-1 (200 μg/kg/week). Among lithogenic diet–fed mice, MIC-1 treatment resulted in increased gallstone formation compared with PBS treatment. Compared with PBS treatment, MIC-1 treatment decreased hepatic cholesterol and bile acid levels and reduced expression of HMG-CoA reductase (HMGCR), the master cholesterol metabolism regulator sterol regulatory element-binding protein 2, cholesterol 7α-hydroxylase (CYP7A1), mitochondrial sterol 27-hydroxylase, and oxysterol 7α-hydroxylase. Compared with PBS treatment, MIC-1 treatment had no effect on small heterodimer partner, farnesoid X receptor, or pregnane X receptor expression, and extracellular signal–related kinase and c-Jun N-terminal kinase phosphorylation decreased, suggesting that these factors do not contribute to the MIC-1–induced reduction in CYP7A1 expression. Compared with PBS treatment, MIC-1 treatment increased AMP-activated protein kinase (AMPK) phosphorylation. Treatment with the AMPK activator 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR) reduced CYP7A1 and HMGCR expression, whereas the AMPK inhibitor Compound C reversed MIC-1-induced reductions in CYP7A1 and HMGCR expression. Furthermore, in MIC-1-treated mice, total biliary cholesterol levels increased together with increased ATP-binding cassette subfamily G (ABCG)5 and ABCG8 expression. Compared with PBS treatment, MIC-1 treatment did not affect expression of liver X receptors α and β, liver receptor homolog 1, hepatocyte nuclear factor 4α, or NR1I3 (also known as constitutive androstane receptor), which are upstream of ABCG5/8; however, MIC-1 treatment increased ABCG5/8 expression and promoter activities. Our study indicates that MIC-1 influences gallstone formation by increasing AMPK phosphorylation, reducing CYP7A1 and HMGCR expression, and increasing ABCG5 and ABCG8 expression. [ABSTRACT FROM AUTHOR]

This document is a correction notice for a study titled "Risk factors for critical COVID-19 illness during Delta- and Omicron-predominant period in Korea; using K-COV-N cohort in the National health insurance service." The correction pertains to the funding statement, which was published incorrectly. The correct funding statement acknowledges that the study was conducted as part of a public-private joint research effort on COVID-19, co-hosted by the KDCA (Korea Disease Control and Prevention Agency) and the NHIS (National Health Insurance Service) in South Korea. The study also received support from the Korea National Institute of Health. The funders did not have any involvement in the study design, data collection and analysis, decision to publish, or manuscript preparation. [Extracted from the article]