Frontiers in Medicine最新文献

{"title":"Meta-analysis of the efficiency and safety of neoadjuvant therapy with immune checkpoint inhibitors in resectable hepatocellular carcinoma.","authors":"Adili Tuersun, Yadikaer Yasen, Munire Mohetaer, Guanxin Hou, Gang Cheng, Xin Zhao","doi":"10.3389/fmed.2024.1511511","DOIUrl":"10.3389/fmed.2024.1511511","url":null,"abstract":"<p><strong>Purpose: </strong>Immunotherapy as a neoadjuvant treatment approach has achieved certain therapeutic effects in various types of cancer. However, in the specific cancer type of hepatocellular carcinoma (HCC), standardized protocols for neoadjuvant immunotherapy remain to be defined. This systematic review and meta-analysis focus on evaluating the efficacy and safety of neoadjuvant immunotherapy in the treatment of HCC, aiming to provide a robust basis for clinical decision-making.</p><p><strong>Methods: </strong>This study systematically searched databases such as PubMed, EMBASE, the Cochrane Library, and conference proceedings to identify clinical trials focusing on patients with HCC undergoing neoadjuvant immunotherapy. The Review Manager 5.4 software was applied to estimate the odds ratio (OR) of effect sizes and their corresponding 95% confidence intervals (CI).</p><p><strong>Results: </strong>Immune checkpoint inhibitors (ICIs) demonstrate significant efficacy in improving pathological outcomes and safety profiles in patients with resectable hepatocellular carcinoma (HCC). Specifically, ICIs significantly increase the pathological complete response (pCR) rate (OR = 0.23, 95% CI [0.14, 0.37], <i>p</i> < 0.00001) and major pathological response (MPR) rate (OR = 0.47, 95% CI [0.32, 0.70], <i>p</i> = 0.0002). They also markedly enhance the objective response rate (ORR) (OR = 0.42, 95% CI [0.28, 0.63], <i>p</i> < 0.0001). Furthermore, ICIs potentially improve the surgical resection rate (OR = 3.91, 95% CI [2.05, 7.45], <i>p</i> < 0.0001) and reduce the incidence of grade 3-4 treatment-related adverse events (TRAEs) (OR = 0.27, 95% CI [0.17, 0.44], <i>p</i> < 0.00001), indicating both therapeutic benefits and acceptable toxicity profiles.</p><p><strong>Conclusion: </strong>Neoadjuvant immunotherapy shows promise in the treatment of resectable HCC. Nonetheless, to further validate its efficacy, more large-scale, well-designed clinical trials are necessary to provide conclusive evidence.</p><p><strong>Systematic review registration: </strong>This comprehensive review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards and has been carried out as per a preregistered protocol (PROSPERO registration number: CRD42024560660).</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1511511"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical features and outcomes of diabetes patients infected with COVID-19: a systematic review and meta-analysis comprising 192,693 patients.","authors":"Kai Liu, Shu Liu, Ting-Ting Xu, Hong Qiao","doi":"10.3389/fmed.2025.1523139","DOIUrl":"10.3389/fmed.2025.1523139","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to explore the relevance of analyses that include critical laboratory parameters and drug treatment, clinical characteristics of diabetic patients who are infected with COVID-19, to the development of individualized treatment strategies for diabetic patients infected with COVID-19.</p><p><strong>Methods: </strong>We searched Cochrane, Embase, FMRS, Pubmed, Springer, Web of Science databases for systematic reviews and meta-analyses to estimate the clinical characteristics and prognosis of confirmed covid-19 infections in patients with and without diabetes.</p><p><strong>Results: </strong>Our meta-analysis included a total of 32 studies with 192,693 COVID-19 patients. Common comorbidities in the diabetic group were hypertension, cerebrovascular disease, chronic kidney disease and cardiovascular disease. We discovered that white blood cell count, neutrophil count, inflammatory marker levels, D-dimer, urea, precursor of the brain natriuretic peptide (Pro-BNP) increased and lymphocyte count, estimated glomerular filtration rate (eGFR), albumin decreased significantly in the diabetic group in laboratory test results. Compared with the non-diabetic group, the diabetic group had a higher incidence of complications in acute respiratory distress syndrome (ARDS), shock, acute heart injury, acute kidney injury and more regularly used oxygen therapy, invasive ventilation, non-invasive ventilation, continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO) treatment. Mortality and intensive care unit (ICU) hospitalization rates were highest in the diabetic group than in the non-diabetic group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Diabetic patients hospitalized with COVID-19 have an increased risk of death, lower discharge rates, and higher ICU admission rates. Their presence of hypertension, cerebrovascular disease, chronic kidney disease (CKD), higher levels of inflammatory markers. Multiple complications are all predictors of poor outcomes in people with diabetes. Our findings will help identify elevated risk factors in diabetics, which will benefit early prediction.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1523139"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted drug delivery in neurodegenerative diseases: the role of nanotechnology.","authors":"Rupal Dhariwal, Mukul Jain, Yaser Rafiq Mir, Abhayveer Singh, Bhavik Jain, Pankaj Kumar, Mohd Tariq, Devvret Verma, Khemraj Deshmukh, Virendra Kumar Yadav, Tabarak Malik","doi":"10.3389/fmed.2025.1522223","DOIUrl":"10.3389/fmed.2025.1522223","url":null,"abstract":"<p><p>Neurodegenerative diseases, characterized by progressive neuronal loss and cognitive impairments, pose a significant global health challenge. This study explores the potential of nanotherapeutics as a promising approach to enhance drug delivery across physiological barriers, particularly the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (B-CSFB). By employing nanoparticles, this research aims to address critical challenges in the diagnosis and treatment of conditions such as Alzheimer's, Parkinson's, and Huntington's diseases. The multifactorial nature of these disorders necessitates innovative solutions that leverage nanomedicine to improve drug solubility, circulation time, and targeted delivery while minimizing off-target effects. The findings underscore the importance of advancing nanomedicine applications to develop effective therapeutic strategies that can alleviate the burden of neurodegenerative diseases on individuals and healthcare systems.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1522223"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of acupuncture on mortality in patients with disabilities and newly diagnosed heart failure: a nationwide cohort study.","authors":"Hyungsun Jun, Dasol Park, Jae-Uk Sul, Moon Joo Cheong, Haerim Kim, Inae Youn, Jungtae Leem","doi":"10.3389/fmed.2025.1519588","DOIUrl":"10.3389/fmed.2025.1519588","url":null,"abstract":"<p><strong>Objective: </strong>People with disabilities have high rates of cardiovascular diseases and mortality, and heart failure can worsen their condition. Therefore, preventing and managing cardiovascular diseases is particularly important for this population. Although acupuncture has been used for heart failure, research on its impact on mortality is limited. Given the unique pathophysiological characteristics of people with disabilities, this study aimed to evaluate the effect of acupuncture on mortality in those newly diagnosed with heart failure.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Korean National Health Insurance Service, focusing on people with disabilities diagnosed with heart failure between 2014 and 2016. Acupuncture exposure within 1 year of diagnosis was assessed by dividing the participants into acupuncture-exposed and non-exposed groups. Propensity score matching (PSM) was used to adjust for group differences, and all-cause mortality was tracked for 3 years. Cox proportional hazard models were employed to calculate hazard ratios (HRs) and confidence intervals (CIs). Dose-response relationships were also analyzed by dividing acupuncture frequency into quartiles.</p><p><strong>Results: </strong>After PSM, 21,001 individuals were included in both groups. The acupuncture-exposed group had a 20% lower risk of all-cause mortality (adjusted HR 0.80, 95% CI 0.76-0.84) than those in the non-exposed group. Higher acupuncture doses were associated with a greater reduction in mortality, with the highest dose group showing a 36% lower risk (adjusted HR 0.64, 95% CI 0.58-0.69) than those in the non-exposed group. The subgroup analysis showed a consistent reduction in mortality across most groups, particularly in women, older adults, higher-income individuals, and those with severe disabilities.</p><p><strong>Conclusion: </strong>This study suggests that acupuncture exposure is associated with reduced mortality in people with disabilities who are newly diagnosed with heart failure. While several limitations exist, we highlight the potential role of acupuncture in managing cardiovascular diseases in this population and encourage further research to support healthcare policies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1519588"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostics of lung cancer by fragmentated blood circulating cell-free DNA based on machine learning methods.","authors":"Ivan O Meshkov, Alexander P Koturgin, Pavel V Ershov, Liubov A Safonova, Julia A Remizova, Valentina V Maksyutina, Ekaterina D Maralova, Vasilisa A Astafieva, Alexey A Ivashechkin, Boris D Ignatiev, Antonida V Makhotenko, Ekaterina A Snigir, Valentin V Makarov, Vladimir S Yudin, Anton A Keskinov, Sergey M Yudin, Anna S Makarova, Veronika I Skvortsova","doi":"10.3389/fmed.2025.1435428","DOIUrl":"10.3389/fmed.2025.1435428","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive diagnostics based on liquid biopsy makes it possible early detection of lung cancer (LC). The blood plasma circulating cell-free DNA (cfDNA) fragments reflect the genome and chromatin status and are considered as integral cancer biomarkers and the biological entities for 'cancer-of-origin' prediction. The aim of this work is to create a method for processing next-generation sequencing (NGS) data and an interpretable binary classification model (CM), which analyzed cfDNA fragmentation features for distinguishing healthy subjects and subjects with LC.</p><p><strong>Methods: </strong>148 healthy subjects and 138 subjects with LC were included in the study. cfDNA fractions, isolated from blood plasma biospecimens, were used for DNA libraries preparations and NGS on the NovaSeq 6,000 Illumina system with a coverage of 100 million reads/sample. Twelve variables, describing the abundance and length distribution of cfDNA fragments within each genomic interval, and 40 variables based on the values of position-weight matrices, describing combinations of 5-bp-long terminal motifs of cfDNA fragments, were used to characterize genomic fragmentation. Classification models of the first phase of machine learning were based either on logistic regression with L1- and L2-regularization or were probabilistic CMs based on Gaussian processes. The second phase CM was based on kernel logistic regression.</p><p><strong>Results: </strong>The final CM can distinguish healthy subjects and subjects with LC with AUC values of 0.872-0.875. The performance of developed CM was evaluated using datum and testing sets for each LC stage category. Sensitivity values ranged from 66.7 to 85.7%, from 77.8 to 100%, and from 70 to 80% for LC stages I, II, and III, respectively. Specificity values ranged from 79.3 to 90.0%.</p><p><strong>Discussion: </strong>Thus, the CM has a good diagnostic value and does not require clinical or other data on tumor-associated biomarkers. The current method for LC detection has some advantages for future clinical implementation as a decision-making support system due to the performance of the CM requires data exclusively from NGS-analysis of blood plasma cfDNA fragmentation; the accuracy of the CM does not depend on any additional clinical data; the CM is highly interpretable and traceable; CM has appropriate modular architecture.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1435428"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of afzelin on inflammation and lipogenesis in particulate matter-stimulated <i>C. acnes-</i>treated SZ95 sebocytes.","authors":"Ji Yeon Hong, Yong Hee Choi, Yoon Jin Roh, Mi-Kyung Lee, Christos C Zouboulis, Kui Young Park","doi":"10.3389/fmed.2025.1518382","DOIUrl":"10.3389/fmed.2025.1518382","url":null,"abstract":"<p><strong>Background: </strong>Afzelin, a flavonoid (kaempferol 3-O-α-L-rhamnopyranoside) isolated from <i>Thesium chinense</i>, is known for its potent anti-inflammatory properties. However, its effects on the molecular aspects of inflammation and lipogenesis in SZ95 sebocytes has not been investigated.</p><p><strong>Objective: </strong>This study aimed to (i) investigate inflammatory and sebum secretion changes when a <i>Cutibacterium acnes</i>-treated immortalized human sebocyte cell line (SZ95) is exposed to particulate matter (PM) and (ii) examine the effects of afzelin on these.</p><p><strong>Methods: </strong>To investigate the effect of afzelin on PM- and <i>C. acnes</i>-treated SZ95 sebocytes, we injected heat-killed <i>C. acnes</i> into SZ95 cells to induce acne-like status. Thereafter, the SZ95 sebocytes were treated with PM and subsequently with afzelin. The gene expression profile was determined using real-time polymerase chain reaction analysis, and protein expression was confirmed via western blotting and immunofluorescence. Intracellular lipid droplet formation was investigated using Nile Red O staining.</p><p><strong>Results: </strong>PM treatment upregulated the mRNA and protein expression levels of inflammatory cytokine and lipogenic genes in <i>C. acnes</i>-treated SZ95 sebocytes. Furthermore, intracellular lipid-droplet accumulation increased when <i>C. acnes</i>-stimulated SZ95 cells were exposed to PM. Interestingly, the upregulated inflammatory and lipogenic gene expression induced by <i>C. acnes</i> and PM was attenuated by afzelin treatment.</p><p><strong>Conclusions: </strong>This study's findings indicate that PM potentially aggravates acne by acting on both inflammation and sebum secretion. They also reveal afzelin's ability to suppress these phenomena by not only suppressing inflammatory cytokine expression but also inhibiting sebogenesis. These findings confirm afzelin's potential therapeutic role in improving PM-exacerbated acne.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1518382"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the landscape and research trend of imaging diagnosis in lymphoma: a bibliometric analysis from 1976 to 2024.","authors":"Yi Ma","doi":"10.3389/fmed.2025.1516817","DOIUrl":"10.3389/fmed.2025.1516817","url":null,"abstract":"<p><strong>Background: </strong>Over the past five decades, extensive research has been conducted on lymphoma imaging diagnostics; however, no bibliometric analysis has been performed in this area. Therefore, we undertook a bibliometric analysis to clarify the progress and current state of research in this field.</p><p><strong>Methods: </strong>We conducted a search of the Web of Science Core Collection database for articles related to imaging diagnosis and lymphoma, focusing exclusively on English-language publications up to June 20, 2024. We analyzed and visualized various aspects, including publication trends, journals, co-authorship networks, countries, institutions, and keywords. To examine research trends in this field, we utilized bibliometric analysis tools such as VOSviewer, CiteSpace, and R4.3.3.</p><p><strong>Results: </strong>From 1976 to 2024, a total of 10,410 publications were produced on this topic, with 2021 marking the peak in publication numbers. The most significant contributions in this research area were found in the fields of <i>Radiology</i>, <i>Nuclear Medicine & Medical Imaging</i>, <i>Oncology</i>, and <i>Hematology</i>. The United States, China, and Japan were the leading contributors. Zucca Emanuele ranked first among authors, followed closely by Meignan Michel. In terms of institutions, Assistance Publique Hôpitaux de Paris was the most prominent. The most frequently used keywords included positron emission tomography, computed tomography, and non-Hodgkin's lymphoma.</p><p><strong>Conclusion: </strong>This study presented a bibliometric analysis of lymphoma imaging diagnosis, highlight showcasing research trends, influential significant studies, and collaborative networks. The analysis identified key contributions to the field and provide insights for future research directions.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1516817"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low hydrostatic pressure promotes functional homeostasis of nucleus pulposus cells through the TRPV4/CRT/FA complex axis.","authors":"Junxian Hu, Yibo Zhu, Zeyu Pang, Xiaoxiao Li, Huilin Zhang, Xiangwei Li, Yongjian Gao, Yiyang Wang, Pei Li, Qiang Zhou","doi":"10.3389/fmed.2025.1531907","DOIUrl":"10.3389/fmed.2025.1531907","url":null,"abstract":"<p><p>The low hydrostatic pressure in the intervertebral disc plays a crucial role in maintaining the homeostasis of the disc environment, particularly in supporting the physiological functions of nucleus pulposus cells (NPCs). However, the underlying mechanisms remain poorly understood. TRPV4, a baroreceptor in the intervertebral disc, is primarily responsible for converting extracellular pressure signals into intracellular chemical signals. Upon activation, TRPV4 facilitates the influx of calcium ions, thereby regulating the physiological behavior of NP cells. Calreticulin (CRT), an endoplasmic reticulum retention protein, performs various physiological functions, including the regulation of intracellular calcium levels. CRT also exhibits distinct roles depending on its subcellular localization. In this study, we observed that under low hydrostatic pressure, TRPV4 activation and subsequent calcium influx led to an increase in CRT synthesis and a significant rise in its cytosolic expression. This was followed by the depolymerization of focal adhesion (FA) complexes, primarily consisting of FAK and integrin β1, which resulted in an increase in collagen type II (Col II) and a decrease in collagen type I (Col I). These changes in extracellular matrix (ECM) composition helped maintain the physiological function of NP cells. Furthermore, overexpression of CRT enhanced the ability of NP cells to resist partial functional damage caused by high hydrostatic pressure. Taken together, our findings suggested that low hydrostatic pressure enhanced NP cell function by regulating the TRPV4/CRT/FA complex signaling axis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1531907"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-stream disentangled model for microvascular extraction in five datasets from multiple OCTA instruments.","authors":"Xiaoyang Hu, Jinkui Hao, Quanyong Yi, Yitian Zhao, Jiong Zhang","doi":"10.3389/fmed.2025.1542737","DOIUrl":"10.3389/fmed.2025.1542737","url":null,"abstract":"<p><strong>Introduction: </strong>Optical Coherence Tomography Angiography (OCTA) is a cutting-edge imaging technique that captures retinal capillaries at micrometer resolution using optical instrument. Accurate segmentation of retinal vasculature is essential for eye related diseases measurement and diagnosis. However, noise and artifacts from different imaging instruments can interfere with segmentation, and most existing deep learning models struggle with segmenting small vessels and capturing low-dimensional structural information. These challenges typically results in less precise segmentation performance.</p><p><strong>Methods: </strong>Therefore, we propose a novel and robust Dual-stream Disentangled Network (D2Net) for retinal OCTA microvascular segmentation. Specifically, the D2Net includes a dual-stream encoder that separately learns image artifacts and latent vascular features. By introducing vascular structure as a prior constraint and constructing auxiliary information, the network achieves disentangled representation learning, effectively minimizing the interference of noise and artifacts. The introduced vascular structure prior includes low-dimensional neighborhood energy from the Distance Correlation Energy (DCE) module, which helps to better perceive the structural information of continuous vessels.</p><p><strong>Results and discussion: </strong>To precisely evaluate our method on small vessels, we delicately establish OCTA microvascular labels by performing comprehensive and detailed annotations on the FOCA dataset, which includes data collected from different instruments, and evaluated the proposed D2Net effectively mitigates the challenges of microvasculature region recognition caused by noise and artifacts. The method achieves more refined segmentation performance. In addition, we validated the performance of D2Net on four OCTA datasets (OCTA-500, ROSE-O, ROSE-Z, and ROSE-H) acquired using different instruments, demonstrating its robustness and generalization capabilities in retinal vessel segmentation compared to other state-of-the-art methods.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1542737"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a prognostic nomogram for ocular melanoma: a SEER population-based study (2000-2021).","authors":"Miyun Zheng, Maodong Xu, Mengxing You, Zhiqing Huang","doi":"10.3389/fmed.2025.1494925","DOIUrl":"10.3389/fmed.2025.1494925","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular melanoma (OM) is a rare but lethal subtype of melanoma. This study develops a prognostic nomogram for OM using machine learning and internal validation techniques, aiming to improve prognosis prediction and clinical decision-making.</p><p><strong>Methods: </strong>Independent prognostic variables were identified using univariate and multivariate COX proportional hazard regression models. Significant variables were then incorporated into the nomogram. The predictive accuracy of the nomogram was evaluated using receiver operating characteristic (ROC) curves, calibration plots, decision curve analysis (DCA), and 10-fold cross-validation. The performance of the nomogram was compared with that of a machine learning model.</p><p><strong>Results: </strong>Thirteen variables, including age, sex, tumor site, histologic subtype, stage, basal diameter size, tumor thickness, liver metastasis, first malignant primary indicator, marital status, and treatment modalities (surgery/radiotherapy/chemotherapy) were identified as independent prognostic factors for overall survival (OS) and were included in the nomogram (all <i>P</i> < 0.05). The nomogram showed a concordance index of 0.712. The areas under the curve (AUC) for predicting 3-, 5-, and 10-year survival rates were 0.749, 0.734, and 0.730, respectively. Calibration plots for 3-, 5-, and 10-year survival were in close agreement with the ideal predictions, and DCA indicated a superior net benefit. The average AUC from 10-fold cross-validation was 0.725. The machine-learning model identified liver metastasis as the most significant predictor of survival, followed by age, radiotherapy, stage, and other factors that were incorporated into the nomogram. The machine-learning model achieved a predictive AUC score of 0.750.</p><p><strong>Conclusions: </strong>A robust nomogram incorporating 13 significant clinicopathological variables was developed. The combined use of ROC curve analysis, calibration plots, DCA, 10-fold cross-validation, and machine learning confirmed the strong predictive performance of the nomogram for survival outcomes in patients with OM.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1494925"},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}