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Adreno-cortical carcinoma (ACC) is an uncommon tumor, some of them may produce excessive steroid hormone. The prognosis of ACC is quite poor and current treatment options are relatively limited, especially for patients whose tumor is metastatic and difficult to remove by surgical operation. This makes the management of ACC challenging. Existing studies have shown that the mechanisms of ACC are complex. The molecular changes happen in adrenocortical development and homeostasis may explain the occurrence of ACC. This review focuses on recent studies and summarizes the genetic and molecular mechanism changes that potentially associated with ACC in the development process of the adrenal cortex and multi-omics studies, including genomic changes, epigenetic changes, differences in non-coding RNA, immune microenvironment and features found through multi-omics analysis. This information may support screening of therapeutic targets of ACC in future.

Background With the mature application of assisted reproductive technologies, the incidence of multiple pregnancies has increased dramatically, and complications including premature labor, fetal malformations, preeclampsia, and gestational diabetes have also increased. Perinatal prognosis and fetal survival quality can be improved through fetal reduction. Selective fetal reduction in the first trimester may result in a better prognosis than selective fetal reduction in the second trimester, suggesting that early assessment of pregnancy outcome in early pregnancy will provide a significant improvement in maternal and fetal prognosis. Objective To explore the relationship of ultrasonographic soft markers in early pregnancy and twin-specific markers with the pregnancy outcome of double chorionic double amniotic sac twins (DCDA) . Methods Pregnant women and fetuses with DCDA twin pregnancies in early pregnancy (11-13+6 weeks) attending the Department of Ultrasound Medicine of Longgang District Maternity&Child Healthcare Hospital of Shenzhen City from May 2018 to May 2022 were retrospectively selected for the study. The detection rates of ultrasonographic soft markers and twin-specific markers in DCDA twin pregnancies in early pregnancy and their association with adverse pregnancy outcomes. Ultrasonographic soft markers included thickened nuchal translucency (NT), choroid plexus cyst, nasal bone dysplasia, ventricular punctate strong echo, tricuspid regurgitation, absence or inversion of ductus venosus A wave, intestinal echo enhancement, mild dilatation of the renal pelvis, single umbilical artery and right subclavian artery vagus. Twin-specific markers included differences in twin crown-rump length (CRL), twin NT, and twin umbilical cord insertion (UCI). Adverse pregnancy outcomes included miscarriage, stillbirth, neonatal death, structural abnormalities, and genetic abnormalities, with the addition of positive weight gain (≥25% difference in twin weights) as a specific adverse pregnancy outcome. Logistic regression analysis was used to explore the correlation of ultrasonographic soft markers and twin-specific markers of DCDA twin pregnancies in early pregnancy with adverse fetal pregnancy outcomes. Results Finally, 418 cases pregnant women of DCDA twin pregnancies in the first trimester were included, of which 342 cases (81.82%) had normal pregnancy outcomes and 76 cases (18.18%) had adverse pregnancy outcomes. The total detection rate of positive ultrasonographic soft markers in twin pregnancies in the first trimester was 10.53% (53/418) ; a total of 61 ultrasonographic soft markers were detected in 53 fetuses with positive ultrasonographic soft markers, and the top three detection rates were NT thickening in 6.94% (29/418), choroid plexus cyst in 2.39% (10/418) and nasal bone dysplasia in 1.67% (7/418). The incidence rate of adverse pregnancy outcomes for fetuses with positive ultrasonographic soft markers was 30.19% (16/53), and the incidence rate of adverse pregnancy outcomes for fetuses with negative ultrasonographic soft markers was 16.44% (60/365) ; the incidence rate of adverse pregnancy outcomes for fetuses with positive ultrasonographic soft markers in the first trimester was higher than fetuses with negative ultrasonographic soft markers (χ2=5.882, P=0.015). Binary Logistic regression analysis results showed that a twin CRL difference≥15% was a risk factor for adverse pregnancy outcomes in twin pregnancy (OR=9.955, 95%CI=1.882-52.662, P=0.007), and a positive twin UCI difference was a risk factor for positive fetal weight in twin pregnancy (OR=3.733, 95%CI=1.300-10.720, P=0.014). The total detection rate of positive twin-specific markers in fetuses with twin pregnancies in early pregnancy was 27.27% (114/418), including 12 cases with a twin CRL difference≥15% and a negative twin UCI difference, 100 cases with a twin CRL difference

In this paper, a key node mining algorithm of entropy-CRITIC combined weighted GRA-TOPSIS method is proposed, which is based on the network structure features. First, the method obtained multi-dimensional data of students' identities, seating relationships, social relationships, and so on to build a database. Then, the seating similarity among students was used to construct the in-class social networks and analyze the structural characteristics of them. Finally, the CRITIC and entropy weight method was introduced for obtaining the combined weight values and the GRA-TOPSIS multi-decision fusion algorithm to mine the key student nodes that have negative impact. The experiments showed that the algorithm of this paper can evaluate students objectively based on their classroom social networks, providing technical support for process-oriented comprehensive quality education evaluation.

This article studied two methods to detect mode effects in two credentialing exams. In Study 1, we used a "modal scale comparison approach," where the same pool of items was calibrated separately, without transformation, within two TC cohorts (TC1 and TC2) and one OP cohort (OP1) matched on their pool-based scale score distributions. The calibrations from all three groups were used to score the TC2 cohort, designated the validation sample. The TC1 item parameters and TC1-based thetas and pass rates were more like the native TC2 values than the OP1-based values, indicating mode effects, but the score and pass/fail decision differences were small. In Study 2, we used a "cross-modal repeater approach" in which test takers who failed their first attempt in one modality took the test again in either the same or different modality. The two pairs of repeater groups (TC [right arrow] TC: TC [right arrow] OP, and OP [right arrow] OP: OP [right arrow] TC) were matched exactly on their first attempt scores. Results showed increased pass rate and greater score variability in all conditions involving OP, with mode effects noticeable in both the TC [right arrow] OP condition and less-strongly in the OP [right arrow] TC condition. Limitations of the study and implications for exam developers were discussed.

For any testing programs that administer multiple forms across multiple years, maintaining score comparability via equating is essential. With continuous testing and high-stakes results, especially with less secure online administrations, testing programs must consider the potential for cheating on their exams. This study used empirical and simulated data to examine the impact of item exposure and prior knowledge on the estimation of item difficulty and test taker's ability via pool-based IRT preequating. Raw-to-theta transformations were derived from two groups of test takers with and without possible prior knowledge of exposed items, and these were compared to a criterion raw to theta transformation. Results indicated that item exposure has a large impact on item difficulty, not only altering the difficulty of exposed items, but also altering the difficulty of unexposed items. Item exposure makes test takers with prior knowledge appear more able. Further, theta estimation bias for test takers without prior knowledge increases when more test takers with possible prior knowledge are in the calibration population. Score inflation occurs for test takers with and without prior knowledge, especially for those with lower abilities.