Objectives
To evaluate the diagnostic performance of the LI-RADS (v2014) on gadoxetate-enhanced MRI prospectively applied in actual practice.
Methods
We retrospectively reviewed the prospectively ...written radiology reports of 143 treatment-naïve at-risk patients who underwent gadoxetate-enhanced liver MRI from January to December 2014, and identified 202 hepatic observations categorized using the LI-RADS. The diagnostic performances of LI-RADS categories for hepatocellular carcinoma (HCC) and hepatic malignancy were calculated.
Results
Twenty (69.0 %) of 29 LR-4, 73 (97.3 %) of 75 LR-5, and all of five (100 %) LR-5V observations were HCCs. The remaining two (2.7 %) LR-5 observations were combined hepatocellular-cholangiocarcinomas, while 10 (76.9 %) of 13 LR-M observations were HCCs. The sensitivity and specificity of LR-5/5V for HCC were 60.5 % and 97.3 %, respectively. Including LR-M in the diagnostic criteria for HCC increased sensitivity (68.2 %,
p
= 0.002) but decreased specificity without statistical significance (93.2 %,
p
= 0.154). LR-5/5V/M yielded sensitivity of 68.9 % and specificity of 100.0 % for hepatic malignancy.
Conclusions
LI-RADS v2014 was successfully applied on gadoxetate-enhanced MRI in clinical practice. LR-5/5V was the most specific diagnostic measure for HCC, but most LR-M observations were HCCs and a considerable portion of non-HCC malignancies were categorized as LR-4 or LR-5.
Key Points
•
LR-5/5V provided a highly specific diagnosis for HCC
.
•
Half of non-HCC malignancies were categorized as LR-4 or LR-5
.
•
The majority of LR-M observations were finally diagnosed as HCCs
.
•
More sensitive diagnosis of HCC was feasible with LR-5/5V/M on gadoxetate-enhanced MRI
.
•
Observations in either LR-5/5V or LR-M categories were definitely malignant
.
The literature on perceived novelty and product evaluation has diverged into two disparate streams of research. The first stream builds on theories of curiosity and argues that the perceived novelty ...of a new product benefits product evaluation because it induces curiosity and provides evaluators (e.g., customers) with positive experiences in learning new features of the product and in resolving their curiosity. In contrast, the second stream adopts theories of expectation violations and argues that perceived novelty decreases product evaluation because it violates evaluators' expectations of a new product and requires burdensome efforts to make sense of the product. The main goal of our research is to resolve this theoretical inconsistency by offering an integrative model of new product evaluation that proposes an inverted U-shaped curvilinear relationship between perceived novelty and product evaluation. Based on this model, we further examine whether a producer's reputation plays an ironic moderating role in this curvilinear relationship. Utilizing content analysis and big data approaches with a large sample of 49,835 reviews of 147 movies in the movie industry, we found that an evaluator's perception of the novelty of a new movie benefited product evaluation but only when that perceived novelty was moderate; at higher levels of perceived novelty, the product evaluation decreased. In addition, we compared the curves of high vs. low reputation producers and found that perceived novelty penalized product evaluation of new movies created by high reputation producers.
Sustained agonist-induced production of the second messengers InsP3 and diacylglycerol requires steady delivery of phosphatidylinositol (PtdIns) from its site of synthesis in the ER to the plasma ...membrane (PM) to maintain PtdIns(4,5)P2 levels. Similarly, phosphatidic acid (PtdOH), generated from diacylglycerol in the PM, has to reach the ER for PtdIns resynthesis. Here, we show that the Drosophila RdgB homolog, Nir2, a presumed PtdIns transfer protein, not only transfers PtdIns from the ER to the PM but also transfers PtdOH to the opposite direction at ER-PM contact sites. PtdOH delivery to the ER is impaired in Nir2-depleted cells, leading to limited PtdIns synthesis and ultimately to loss of signaling from phospholipase C-coupled receptors. These studies reveal a unique feature of Nir2, namely its ability to serve as a highly localized lipid exchanger that ensures that PtdIns synthesis is matched with PtdIns(4,5)P2 utilization so that cells maintain their signaling competence.
Display omitted
•Nir2 protein supports phosphatidic acid transfer from the plasma membrane (PM) to the ER•Nir2 translocates to ER-PM contact sites during PLC activation•Nir2 delivers phosphatidic acid to the ER for PtdIns synthesis•Accelerated phosphoinositide turnover is confined to ER-PM contact zones
Kim et al. identify the Nir2 protein as a lipid transporter that moves phosphatidylinositol from the ER to the plasma membrane while transferring phosphatidic acid in the other direction. Therefore, Nir2 helps maintain plasma membrane lipid identity when phosphoinositides are rapidly consumed during receptor-mediated activation of phospholipase C enzymes.
Background
Sarcopenia has been underscored as a significant predictor of poor prognosis in cancer patients undergoing immunotherapy with programmed death-1 (PD-1) inhibitors. We aimed to investigate ...the prognostic significance of computed tomography (CT)-determined sarcopenia in patients with microsatellite-stable (MSS) gastric cancer (GC) treated with PD-1 inhibitors.
Methods
We retrospectively assessed patients with MSS GC who had been treated with PD-1 inhibitors from March 2016 to June 2019. Pre-treatment sarcopenic status was determined by analyzing L3 skeletal muscle index with abdominal CT. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, and the differences in survival probability according to sarcopenic status were compared using the log-rank test. Cox proportional hazards regression analyses were performed to identify predictors of PFS and OS.
Results
Of 149 patients with MSS GC (mean age, 57.0 ± 12.3 years; 93 men), 79 (53.0%) had sarcopenia. Patients with sarcopenia had significantly shorter PFS than patients without sarcopenia (median, 1.4 months vs. 2.6 months;
P
= 0.026). Sarcopenia was independently associated with shorter PFS (adjusted hazard ratio HR, 1.79; 95% confidence interval CI, 1.10−2.93;
P
= 0.020). Patients with sarcopenia had shorter OS than patients without sarcopenia (median, 3.6 months vs. 4.9 months;
P
= 0.052), but sarcopenia itself was not a significant prognostic factor for OS (adjusted HR, 1.01; 95% CI, 0.58−1.75;
P
= 0.974).
Conclusions
CT-determined sarcopenia is an independent prognostic factor for PFS in patients with MSS GC treated with PD-1 inhibitors.
Polyphosphoinositides are lipid signaling molecules generated from phosphatidylinositol (PtdIns) with critical roles in vesicular trafficking and signaling. It is poorly understood where PtdIns is ...located within cells and how it moves around between membranes. Here we identify a hitherto-unrecognized highly mobile membrane compartment as the site of PtdIns synthesis and a likely source of PtdIns of all membranes. We show that the PtdIns-synthesizing enzyme PIS associates with a rapidly moving compartment of ER origin that makes ample contacts with other membranes. In contrast, CDP-diacylglycerol synthases that provide PIS with its substrate reside in the tubular ER. Expression of a PtdIns-specific bacterial PLC generates diacylglycerol also in rapidly moving cytoplasmic objects. We propose a model in which PtdIns is synthesized in a highly mobile lipid distribution platform and is delivered to other membranes during multiple contacts by yet-to-be-defined lipid transfer mechanisms.
Display omitted
► PtdIns synthesis takes place in a highly mobile organelle ► The PtdIns-synthesizing organelle is ER derived ► The PtdIns-synthesizing organelle is the ultimate source of polyphosphoinositides ► PtdIns depletion at the plasma membrane but not the ER impacts PtdIns(4,5)P2 pools
Programmed cell death-1 (PD-1) inhibitor treatment can cause hyperprogressive disease (HPD), but the incidence, outcome, and predictive factors of HPD are unknown in patients with hepatocellular ...carcinoma (HCC). Herein, we assessed the existence and factors predictive of HPD in patients with advanced HCC treated with nivolumab.
We enrolled 189 patients with advanced HCC treated with nivolumab. Occurrence of HPD was investigated using tumour growth dynamics based on tumour growth kinetics (TGK) and tumour growth rate (TGR) before and after treatment, or time to treatment failure. We additionally analysed patients treated with regorafenib (n = 95) or best supportive care (BSC)/placebo (n = 103) after progression on sorafenib to compare tumour growth dynamics.
Flare-up of tumour growth was observed in a fraction of patients upon PD-1 blockade, indicating the occurrence of HPD. Based on distinct patterns of disease progression exclusively observed in the nivolumab-treated cohort, but not in the regorafenib- or BSC/placebo-treated cohorts, 4-fold increases in TGK and TGR ratios as well as a 40% increase in TGR were the cut-off values used to define HPD; 12.7% of the patients (24/189) treated with nivolumab met all these criteria. Patients with HPD had worse progression-free survival (hazard ratio HR 2.194; 95% CI 1.214–3.964) and overall survival (HR 2.238; 95% CI 1.233–4.062) compared to patients with progressive disease without HPD. More than 90% of patients with HPD missed the opportunity for subsequent treatment because of rapid clinical deterioration. An elevated neutrophil-to-lymphocyte ratio (>4.125) was associated with HPD and an inferior survival rate.
HPD occurs in a fraction of patients with HCC who receive PD-1 inhibitor treatment. Analyses of the baseline immune profile and on-treatment tumour growth dynamics could enable optimal patient selection and earlier identification of HPD.
Hyperprogressive disease is an unexpected response pattern observed in patients treated with an immune checkpoint inhibitor. This study revealed that hyperprogressive disease occurs in a fraction of patients with advanced hepatocellular carcinoma treated with an anti-PD-1 antibody, providing evidence to encourage careful monitoring of patients to prevent clinical deterioration induced by PD-1 blockade.
Display omitted
•HPD occurs in a fraction of patients with HCC treated with PD-1 inhibitors.•HPD is associated with worse PFS and OS, depriving patients of the chance to receive subsequent treatments.•Elevated neutrophil-to-lymphocyte ratio predicts the occurrence of HPD and inferior survival rate after PD-1 blockade.
Objective
Along with rapid economic growth, the United Arab Emirates (UAE) has undergone enormous sociocultural changes. Consequently, sociocultural and psychological factors, along with malnutrition ...and physical inactivity, have contributed to the high obesity rate. The objective of this study is to assess the long‐term impact of these new emerging factors on obesity among women in the UAE via mathematical modeling.
Methods
A differential equation model was developed considering psychological/social factors in population dynamics. It predicts the long‐term prevalence of obesity among women in the UAE under these factors by 2070. Computer simulations and a sensitivity analysis of the model were conducted to measure the impact of these factors on obesity.
Results
The model predicts the following: 80.07% of female UAE nationals will become overweight or have obesity and 60.19% will have obesity by 2070, and the population with abnormal eating behavior will increase to 15% by 2070. Psychological/social factors aggravate the obesity problems and can cause abnormal eating behavior to develop with little effect on weight reduction.
Conclusions
The obesity rate of female UAE nationals will continue to rise by 2070. Rising abnormal eating behavior caused by psychological/social factors is an emerging issue and should be recognized as a sign of escalating obesity problems in the UAE.
Background
The Liver Imaging Reporting and Data System (LI‐RADS) is a comprehensive system for standardizing liver imaging in patients at risk for hepatocellular carcinoma (HCC).
Purpose
To ...systematically compare the performance of computed tomography (CT)/MRI LI‐RADS category 5 (LR‐5) for diagnosing HCC between versions 2017 and 2018.
Study Type
Systematic review and meta‐analysis.
Subjects
Six articles with 1181 lesions.
Field Strength/Sequence
1.5 T and 3.0 T.
Assessment
Data extraction was independently performed by two reviewers who identified and reviewed articles comparing the performance of LR‐5 for diagnosing HCC between CT/MRI LI‐RADS versions 2017 and 2018. Study and patient characteristics, index test characteristics, reference standards, and study outcomes were extracted from included studies. Risk of bias and concerns regarding applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool.
Statistical Tests
Bivariate random‐effects models were used to calculate the pooled per‐observation sensitivity and specificity of LR‐5 using both versions. The summary receiver operating characteristic curves were plotted. Meta‐regression analysis was performed to explore heterogeneity. A P‐value <0.05 was considered to be statistically significant for all analyses other than heterogeneity, where the significance threshold was 0.1.
Results
The pooled per‐observation sensitivity of LR‐5 for diagnosing HCC did not show statistically significant difference between versions 2017 (60%; 95% confidence interval CI, 49%–70%) and 2018 (67%; 95% CI, 56%–76%; P = 0.381). The pooled per‐observation specificities of LR‐5 were not significantly different between versions 2017 (92%; 95% CI, 90%–95%) and 2018 (91%; 95% CI, 88%–93%; P = 0.332). Meta‐regression analyses revealed that the most common underlying liver disease (hepatitis B or hepatitis C) was a significant factor contributing to the heterogeneity of sensitivities among studies for both versions.
Data Conclusion
In this meta‐analysis using intraindividual paired comparisons, the pooled sensitivity and pooled specificity of LR‐5 were not significantly different between 2017 and 2018 LI‐RADS versions.
Level of Evidence
3
Technical Efficacy
Stage 2
Emotion information represents a user's current emotional state and can be used in a variety of applications, such as cultural content services that recommend music according to user emotional states ...and user emotion monitoring. To increase user satisfaction, recommendation methods must understand and reflect user characteristics and circumstances, such as individual preferences and emotions. However, most recommendation methods do not reflect such characteristics accurately and are unable to increase user satisfaction. In this paper, six human emotions (neutral, happy, sad, angry, surprised, and bored) are broadly defined to consider user speech emotion information and recommend matching content. The "genetic algorithms as a feature selection method" (GAFS) algorithm was used to classify normalized speech according to speech emotion information. We used a support vector machine (SVM) algorithm and selected an optimal kernel function for recognizing the six target emotions. Performance evaluation results for each kernel function revealed that the radial basis function (RBF) kernel function yielded the highest emotion recognition accuracy of 86.98%. Additionally, content data (images and music) were classified based on emotion information using factor analysis, correspondence analysis, and Euclidean distance. Finally, speech information that was classified based on emotions and emotion information that was recognized through a collaborative filtering technique were used to predict user emotional preferences and recommend content that matched user emotions in a mobile application.
PDF
