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NExON-Bayes: a Bayesian approach to network estimation informed by ordinal covariates.

MOTIVATION: In heterogeneous disease settings, accounting for intrinsic sample variability is crucial for obtaining reliable and interpretable omic network estimates. However, most graphical model analyses of biomedical data assume homogeneous conditional dependence structures, potentially leading to misleading conclusions. To address this, we propose a joint Gaussian graphical model that leverages sample-level ordinal covariates (e.g. disease stage) to account for heterogeneity and improve the estimation of partial correlation structures. RESULTS: Our modelling framework, called NExON-Bayes, extends the graphical spike-and-slab framework to account for ordinal covariates, jointly estimating their relevance to the graph structure and leveraging them to improve the accuracy of network estimation. To scale to high-dimensional omic settings, we develop an efficient variational inference algorithm tailored to our model. Through simulations, we demonstrate that our method outperforms the vanilla graphical spike-and-slab (with no covariate information), as well as other state-of-the-art network approaches which exploit covariate information. Applying our method to reverse phase protein array data from patients diagnosed with stage I, II or III breast carcinoma, we estimate the behaviour of proteomic networks as cancer progresses. Our model provides insights not only through inspection of the estimated proteomic networks, but also of the estimated ordinal covariate dependencies of key groups of proteins within those networks, offering a comprehensive understanding of how biological pathways shift across disease stages. AVAILABILITY AND IMPLEMENTATION: A user-friendly R package for NExON-Bayes with tutorials is available on Github at github.com/jf687/NExON, and archived at https://doi.org/10.5281/zenodo.20312938. The source of the dataset used is cited in the relevant section.

Bayes Theorem↗

Trends in the stage of cancer at the time of diagnosis.

The stage of cancers at the time of diagnosis for 10 major sites of disease from patients treated at two Medical College of Wisconsin teaching hospitals was analyzed from tumor registry data and compared from the years 1983, 1987, and 1991. A trend toward earlier stages of cancer of major sites was noted, with patients having in situ or localized disease increasing from 35% in 1983 to 48% in 1991. Patients with breast cancer demonstrated the strongest trend, with 44% of the cases representing in situ or localized disease in 1983 compared to 61% in 1991 (p = 0.03). A shift toward earlier stage of cancer at diagnosis was also noted for other major sites including: lung, trachea and bronchus; colon and rectum; and prostate cancers. Trends toward an earlier stage of cancer may result from patient and physician education, local practice patterns, as well as proper use of screening programs. Information on such trends from hospital tumor registries may be helpful in the appropriate and efficient allocation of local health care resources.

Humans↗

The relationship of HRV to sleep EEG and sleep rhythm.

Previous studies have shown that there exists a cycle of NREM (non-rapid eye movement)-REM (rapid eye movement) during normal human sleep, and heart rate variability (HRV) has a close relationship to sleep stages and sleep cycle. This article reports the relationship between the electroencephalographic activity and the HRV spectral power in several specific frequency bands. The authors discovered that relationships do exist between HRV and electroencephalogram (EEG) during sleep. In particular, it was found that, prior to the changes of EEG, the changes of HRV usually indicate the shift of sleep stages. HRV frequency analysis indicates that the very-low-frequency components of HRV are closely related to sleep EEG. Results show that the rhythm of the spectral power oscillations in some specific frequency bands of HRV is almost the same as the sleep cycle, which reflects the rhythm of sleep to a certain extent.

Adolescent↗

Histopathologic subtyping of cervical adenocarcinoma reveals increasing incidence rates of endometrioid tumors in all age groups: a population based study with review of all nonsquamous cervical carcinomas in Norway from 1966 to 1970, 1976 to 1980, and 1986 to 1990.

BACKGROUND: The effect of histopathologic review and subclassification on incidence rates for nonsquamous cell carcinoma (non-SCC) of the uterine cervix in the Norwegian population was evaluated. METHODS: All non-SCC from three 5-year periods (1966-70, 1976-80, and 1986-90) were reviewed, classified, and graded. RESULTS: Incidence rates were 1.2, 1.2, and 1.7 per 100,000 for adenocarcinoma and 0.1, 0.3, and 0.5 per 100,000 for other carcinomas in the three periods. Adenocarcinomas increased in all age groups, most markedly in women younger than 35 years. Incidence rates for both major subgroups of endocervical (EC) and endometrioid (EM) carcinomas increased for women younger than 55 years. After 1976-80, the incidence rate for EC, but not for EM, decreased in women older than 55 years. Endometrioid carcinoma became the dominant histologic subtype in 1986-90. Shifts toward lower clinical stages and younger age were found for EC, EM, and carcinoma not otherwise specified (NOS). Patients with NOS, clear cell, serous, or glassy cell/undifferentiated carcinoma were older, and their disease was diagnosed at higher stages. Distribution of International Federation of Gynecology and Obstetrics (FIGO) stages was: Stage I: 62%; Stage II: 21%; Stage III: 12%; and Stage IV: 5%. Distribution of histologic subgroups was: EC:, 24%; EM: 21%; NOS: 16%; clear cell: 7%; adenosquamous: 7%; small cell: 6%; serous: 4%; undifferentiated: 3%; and villoglandular carcinoma: 2%. Other subgroups were seen only sporadically. CONCLUSIONS: Incidence rates of non-SCC of the uterine cervix are increasing in Norway. Improvements in diagnostic procedures may explain shifts toward lower stage and age of patients but not the observed differences between histologic subgroups.

Adenocarcinoma↗

CT screening for lung cancer: the first ten years.

This article reviews the current state of knowledge regarding computed tomography (CT) screening for lung cancer. The initial 3 studies have demonstrated the superiority of CT-based screening for lung cancer over traditional radiography. Furthermore, false-positive tests common on baseline screening were manageable without notable excess of biopsies or thoracotomies. Differences and similarities of various screening regimens are discussed in relation to reported study results. When comparing the various studies, the focus should be placed on the diagnostic distribution achieved under annual repeat screening, as it is this distribution which is obtained year after year of repeat screening and this distribution and the curability of these repeat screen-diagnosed lung cancer which determine the usefulness of the screening regimen. To date, these studies demonstrate a consistent shift to over 80% of the cancer being diagnosed in Stage IA. This marked shift suggest that the curability of screen-detected lung cancers will be markedly improved.

Follow-Up Studies↗

Cigarette smoking and nocturnal sleep architecture.

Cigarette smoking has been associated with a high prevalence of sleep-related complaints. However, its effects on sleep architecture have not been fully examined. The primary objective of this investigation was to assess the impact of cigarette smoking on sleep architecture. Polysomnography was used to characterize sleep architecture among 6,400 participants of the Sleep Heart Health Study (United States, 1994-1999). Sleep parameters included total sleep time, latency to sleep onset, sleep efficiency, and percentage of time in each sleep stage. The study sample consisted of 2,916 never smokers, 2,705 former smokers, and 779 current smokers. Compared with never smokers, current smokers had a longer initial sleep latency (5.4 minutes, 95% confidence interval (CI): 2.9, 7.9) and less total sleep time (14.0 minutes, 95% CI: 6.4, 21.7). Furthermore, relative to never smokers, current smokers also had more stage 1 sleep (relative proportion = 1.24, 95% CI: 1.14, 1.33) and less slow wave sleep (relative proportion = 0.86, 95% CI: 0.78, 0.95). Finally, no differences in sleep architecture were noted between former and never smokers. The results of this study show that cigarette smoking is independently associated with disturbances in sleep architecture, including a longer latency to sleep onset and a shift toward lighter stages of sleep. Nicotine in cigarette smoke and acute withdrawal from it may contribute to disturbances in sleep architecture.

Aged↗

The quest for customer focus.

Companies have poured enormous amounts of money into customer relationship management, but in many cases the investment hasn't really paid off. That's because getting closer to customers isn't about building an information technology system. It's a learning journey-one that unfolds over four stages, requiring people and business units to coordinate in progressively more sophisticated ways. The journey begins with the creation of a companywide repository containing each interaction a customer has with the company, organized not by product, purchase, or location, but by customer. Communal coordination is what's called for at this stage, as each group contributes its information to the data pool separately from the others and then taps into it as needed. In the second stage, one-way serial coordination from centralized IT through analytical units and out to the operating units allows companies to go beyond just assembling data to drawing inferences. In stage three, companies shift their focus from past relationships to future behavior. Through symbiotic coordination, information flows back and forth between central analytic units and various organizational units like marketing, sales, and operations, as together they seek answers to questions like "How can we prevent customers from switching to a competitor?" and "Who would be most likely to buy a new product in the future"? In stage four, firms begin to move past discrete, formal initiatives and, through integral coordination, bring an increasingly sophisticated understanding oftheir customers to bear in all day-to-day operations. Skipping stages denies organizations the sure foundation they need to build a lasting customer-focused mind-set. Those that recognize this will invest their customer relationship dollars much more wisely-and will see their customer-focusing efforts pay offon the bottom line.

Commerce↗

[Stress on cardiac activity of students during course and national examinations].

Stress of the activity of the cardio-vascular system was studied in students at different stages of course and graduation examinations, by recording the changes in the pulse rate, systolic and diastolic pressure, pulse pressure, minute blood volume and peripheral resistance. The greatest stress on the cardiac activity was revealed before and after receiving the examination paper as well as during the answer. After the answer the cardiac activity rapidly reverted to the rest level. Graduation examinations caused more drastic and rapid functional shifts at decisive stages and at the same time a faster recovery than course examinations.

Adult↗

Epstein-Barr virus LMP1 initiates cell proliferation and apoptosis inhibition via regulating expression of Survivin in nasopharyngeal carcinoma.

UNLABELLED: Pathways controling cell proliferation and cell survival require flexible adaptation to environmental stress. Our previous studies showed that latent membrane protein1 (LMP1) encoded by Epstein-Barr virus (EBV) could trigger the expression of Survivin, an apoptosis inhibitor and essential regulator of mitosis. The aim of the work was to analyze the role of Survivin signal pathway in mediating effects triggered by LMP1. METHODS: Tet-on LMP1 HNE2, a tetracycline-regulated LMP1-expression nasopharyngeal carcinoma cell line, was used as cell model. The subcellular location of Survivin was detected by indirect immunofluorescence and Western-blotting assay. Using Ab-knock-out and gene transfection, we introduced anti-sense PS-ODN-Survivin and anti-body to Survivin into the Tet-on LMP1 HNE2, and then the apoptosis and the proliferation of cells were analyzed by flow cytometry, cell colony formation and detection of caspase-3. The results show that upon induction of LMP1 expression, the expression of Survivin in nucleus, level of phosphorylated retinoblastoma gene (Rb), the number of cells in S stage of cell cycle, and the cell colony formation rate were higher than those without LMP1 induction; if the expression of Survivin and the nucleus translocation of Survivin were knocked by introduction of anti-sense PS-ODN-Survivin and anti-Survivin-antibodies respectively, apoptosis rates and the activity of caspase-3 increased. CONCLUSION: LMP1 could trigger the nucleus translocation of Survivin, which led to the shift of S stage and cell proliferation. LMP1 may promote cell proliferation and inhibits apoptosis via Survivin signal pathway.

Apoptosis↗

Use of lower prostate specific antigen cutoffs for prostate cancer screening in black and white men.

PURPOSE: We evaluated differences in the prostate cancer detection rate among black and white men with serum prostate specific antigen (PSA) levels between 2.6 and 4.0 ng./ml., and benign findings on digital rectal examination. MATERIALS AND METHODS: From May 1995 through June 1997 we screened 14,209 white and 1,004 black men 50 years old or older with serum PSA and rectal examinations at 6-month intervals. If PSA was greater than 2.5 ng./ml. or the rectal examination was suspicious for cancer, we recommended an ultrasound guided sextant biopsy of the prostate. We compared differences in clinical characteristics, compliance with the recommendation for biopsy, cancer detection rate, and stage and grade of tumors detected for 924 white and 57 black men. RESULTS: Black men were younger (60 versus 63 years old, p = 0.005) and presented with slightly higher PSA levels (3.3 versus 3.1 ng./ml., p = 0.03) than white men. Overall cancer detection rate was 27% (106 of 391 patients), with cancer detection 2-fold higher among black (13 of 29, 45%) than among white (93 of 362, 26%) men (p = 0.03, odds ratio 2.4, 95% confidence interval 1.1 to 5.1). Controlling for age, total PSA, PSA density, percent free PSA and number of prior screening visits, race remained a significant predictor of cancer (adjusted odds ratio 3.4, confidence interval 1.4 to 8.4). We found trends for worse pathological stage and grade among black men but these differences did not reach statistical significance. CONCLUSIONS: Black race was an independent predictor of prostate cancer even at lower PSA cutoffs (2.6 to 4.0 ng./ml.). Although the positive predictive value for cancer detection was relatively high in black men, long-term outcomes studies are necessary to determine whether the use of lower PSA cutoffs would result in favorable shifts in cancer stage and grade, and a reduction in racial differences in prostate cancer mortality rates.

Aged↗

[Immunochemical characteristics of the population structure of antibody-producing cells in experimental influenza].

The authors presented the results of population study of specific IgG-antibody-forming cells (AFC) in the pool of mice splenocytes performed in the time-course of simulated influenza with the help of experimental mathematical approach which permitted making a detailed observation of the functional structure of the population and analysing the changes in the spectrum of the AFC subpopulations in the time-course of viral disease. Mathematical simulation of the main stage of immunopointed identification of AFC on +nitrocellulose filters (NCF) permitted the verification of the ratio between the characteristic features of the spots on the NCF and the number and affinity of cell-secreting IgG antibodies. New data are obtained on the formation of the population of +virus-specific IgG-AFC which are featured by discreteness of the AFC +affinity ++ spectrum, cyclic changes in their activity and shifts in the stages of the AFC subpopulation activity. The authors substantiated the necessity to revise the existing theoretical models of the formation of humoral immune response to viral infections.

Animals↗

Early diagnosis of cervical cancers. Our experience at the Rural Cancer Registry, Barshi, India.

In the cervical cancer cases registered at the Cancer Hospital at Barshi, India during 1988-90, 99 of the 105 cases were clinically staged (Total number of cases registered: 136). The annual number of cases were too few for a comparison of stage distribution between the registry years. However, comparison of the proportions of early cases (FIGO Ib, IIa & IIb) in each year, with the corresponding proportion in a large series at the Tata Memorial Hospital (TMH) in Bombay in 1988, showed that the proportions of early cases in 1988 & 1989 (0.31 and 0.35 respectively) were similar to that (0.30) in TMH but in 1990, it (0.50) was significantly higher (P < 0.01). The shift to early stages observed three years after the inception of the Registry is most likely due to the registry activity which involved inter-personal contact with the community and motivation of the symptomatics to undergo a medical investigation. These activities were designed to overcome the adverse conditions for cancer registration prevailing in the rural population. It is suggested that to achieve early diagnosis similar activities be incorporated in the initial phase of a cervical cancer control programme in the country, where cervical cancer is not only the predominant cancer in women but also the cases generally present themselves in advanced stages.

Adult↗

Modeling stage-sequential change in ordered categorical responses.

Although few would dispute the usefulness of looking at behavioral change from a stage-sequential perspective, until recently the lack of appropriate modeling techniques has hampered rigorous empirical tests of stage theories. In particular, for behavioral measurements that are ordinal, there is a need for methods that represent the underlying change processes in the form of qualitative and discontinuous shifts. This article introduces a stage-sequential ordinal model by postulating that at any point in time there are a finite number of latent stages. Panel members may shift among these stages over time. The authors show that the stage-sequential model provides a general approach for both the analysis of ordinal time-dependent data and tests of various competing theories and hypotheses about psychological change processes. An analysis of a 5-year study concerning attitudes toward alcohol consumption by teenagers is presented to illustrate the modeling approach.

Adolescent↗

Gene expression profiling for molecular staging and prognosis prediction in colorectal cancer.

A key issue for patients undergoing surgery for colorectal cancer is the accurate prediction of treatment outcome. Currently, classification of a tumor by histopathologic stage is the most accurate prognostic factor for the risk assessment of treatment failure. However, despite improved histologic techniques and the application of novel immunohistochemical and molecular techniques, it is still not possible to delineate the underlying biochemical and genetic events that predict clinical outcome for individual cancer patients. One reason for this lack of progress is that the factors which determine the metastatic potential of a primary tumor are still unknown. This reality, coupled to dramatic technological developments in the field of expression profiling, has started a paradigm shift in the staging of colorectal cancers. It has raised expectations that genetic and/or transcriptome profiling of the primary tumor will result in the identification of prognostic determinants relevant to the individual patient. In turn, this may allow a clinically relevant definition of patient subgroups based on individual molecular parameters for rational decision making regarding choice of therapy.

Biomarkers, Tumor↗

[Effect of emotional stress on sleep dynamics in cats].

Emotional stress was developed in cats by putting them in one cage with dogs for 24 hours. Then the 24 hours sleep-walking cycles records revealed prolonged REM stage in day time or at night in five animals out of seven, and in six animals a general increase of REM sleep duration over 24 hours. Simultaneously, in six animals the length of drowsiness and of deep slow-wave sleep stages was reduced. Increased overall sleep duration in the 24 hours was recorded in five cats. Sleep changes dynamics analysis reveals three stages: 1) sharp shift of all sleep parameters--27%, 2) deviation in sleep parameters--34% and 3) returning to basic sleep parameters--in 38%. The conclusion is drawn that sleep disorders may be used as an index of higher nervous activity disturbance in waking state.

Animals↗

Maternal redd1 mRNA decline triggers mTORC1 activation during the blastula-gastrula transition in zebrafish embryos.

During early metazoan development, maternal mRNAs and proteins stored in the egg sustain initial cellular functions. After the blastula stage, developmental control shifts to zygotic gene expression, and maternal transcripts are progressively degraded. Although mTORC1 is a central regulator of global mRNA translation and cell growth, its role in controlling maternal mRNA translation prior to gastrulation remains poorly understood. In zebrafish embryos, the mTORC1 inhibitor redd1 is abundantly expressed after fertilization but decreases following the maternal-to-zygotic transition (MZT), inversely correlating with mTORC1 activity. Overexpression of redd1 suppresses mTORC1, impairs gastrulation, and reduces translation of 5'TOP mRNAs and key regulatory genes, underscoring the necessity of relieving mTORC1 inhibition after the blastula stage. To investigate redd1 translation under conditions of low mTORC1 activity, we injected reporter mRNAs containing its 5' and 3' UTRs. The 3'UTR promoted polyadenylation and enhanced translation, while both UTRs enabled efficient reporter expression despite mTORC1 suppression, indicating that redd1 mRNA is translated independently of canonical mTORC1 pathways. Similarly, maternal mRNAs such as nanog, myca, pou5f3, and ccnb1, as well as the early zygotic transcript dharma, are translated through mTORC1-independent mechanisms. Together, these findings reveal a transient phase of mTORC1 suppression in early zebrafish embryos and demonstrate that select maternal and zygotic mRNAs bypass this regulation to ensure proper developmental progression.

Animals↗

Altering the position of the first horizontal cleavage furrow of the amphibian (Xenopus) egg reduces embryonic survival.

The animal/vegetal cleavage ratio (AVCR), defined as the ratio of the height of the animal blastomere to the height of the Xenopus embryo at the 8 cell stage, can be shifted by placing embryos in novel gravitational fields: clinostating (microgravity simulation) increases AVCR, and centrifugation (hypergravity simulation) reduces AVCR. This report contributes to an understanding of the subcellular mechanism responsible for the furrow relocation and assesses its significance. Embryo inversion and D2O immersion were found to increase AVCR, and cold shock was found to reduce AVCR. Based on the additive or antagonistic effects of combined treatments, it is postulated that the primary cause of AVCR changes is an alteration in the distribution of yolk platelets and the rearrangement of microtubule arrays. Embryos with a decreased AVCR exhibited reduced survival in early developmental stages, indicating serious difficulties in cleavage, blastulation and/or gastrulation. Cold-shocked embryos with a reduced AVCR could be rescued by D2O pretreatment or clinostating, an observation which supports the notion that changes accompanying AVCR modifications represent the primary cause of the reduction in percent survival.

Animals↗

Association of prediagnosis endoscopy with stage and survival in adenocarcinoma of the esophagus and gastric cardia.

BACKGROUND: Barrett esophagus, a consequence of chronic gastroesophageal reflux disease, is a premalignant condition for adenocarcinoma of the esophagus and, possibly, the gastric cardia. However, the actual use and clinical impact of upper gastrointestinal endoscopy in screening and surveillance for Barrett esophagus are unknown. METHODS: A cohort included 1633 patients with adenocarcinoma (777 esophagus, 856 cardia) who were 70 years or older. They were diagnosed between 1993 and 1996 and were identified from the Surveillance, Epidemiology and End Results program registry. All claims for upper endoscopy and a diagnosis of Barrett esophagus from 1991 through 1 year before diagnosis were identified from linked Medicare files. RESULTS: One or more upper endoscopies before diagnosis were performed in 9.7% of patients (13.0% esophagus, 6.8% cardia) and a diagnosis of Barrett esophagus was present in only 3.7% of patients. A shift toward earlier stage at diagnosis was observed in patients with previous endoscopy or Barrett diagnosis. For example, 62% of patients with esophageal and 49% of patients with cardia tumors who underwent previous endoscopy presented with in situ or local stage carcinoma, compared with 35% and 27% of other patients, respectively. Receipt of endoscopy was also associated with a reduced risk of death for esophageal adenocarcinoma (relative hazard 0.73, 95% confidence interval 0.57-0.93; P = 0.01), but not for adenocarcinoma of the cardia. CONCLUSIONS: Receipt of upper endoscopy at least 1 year before diagnosis of adenocarcinoma, which may reflect prediagnosis screening, was associated with an earlier tumor stage and improved survival. These data support the role of endoscopic screening and surveillance for Barrett esophagus and highlight the underdiagnosis of populations at risk.

Adenocarcinoma↗