Accurately distinguishing between indolent and aggressive tumors is a crucial unmet need in the clinical management of prostate cancer (PCa). The traditional Gleason grading system has been utilized for this purpose; however, there is often ambiguity in classifying tumors with a Gleason grade of 7. Clinicians commonly resort to using secondary Gleason grades, such as 3+4 or 4+3, to classify these tumors as indolent or aggressive, respectively. Unfortunately, such classifications are prone to misinterpretation, leading to erroneous diagnoses and prognoses. To address this challenge, we investigated the application of Machine Learning (ML) techniques to classify PCa patients based on gene expression data sourced from The Cancer Genome Atlas. By comparing gene expression levels between indolent and aggressive tumors, we sought to identify distinctive features for developing and validating a range of ML algorithms and stacking techniques. The stacking based model achieved an impressive accuracy of 96% for all samples encompassing primary Gleason grades 6 to 10. Notably, when excluding Gleason grade 7 from the analysis, the accuracy further improved to 97%. This study underscores the effectiveness of the stacked ML algorithm for accurately classifying indolent versus aggressive PCa. Leveraging gene expression data and employing a combination of classifiers, this approach offers a powerful solution to address the unmet need in robustly distinguishing between different types of PCa tumors. Future implementation of this methodology may significantly impact clinical decision-making and patient outcomes in the management of prostate cancer.

Aggressive angiomyxoma (AAM) is a rare and benign mesenchymal tumor, localized predominantly in the female pelvis. Its invasive growth and local recurrence are challenging for professionals. Histologically, AAM is a tumor with a myxoid, highly vascularized stroma. The diagnosis is made relatively late due to nonspecific symptoms. Treatment of AAM is extensive local surgical excision. Gonadotropin-releasing hormone agonists are added postoperatively. The prognosis is good and metastasis is rare. We present a case of an AAM located in the left greater labial area in a 50-year-old woman initially diagnosed as left inguinal hernia. The tumor was extirpated under epidural anaesthesia on the date of the patient's informed consent. The patient was prescribed postoperative therapy with Zoladex 3,6 mg according to the schedule. The patient was subjected to monthly gynecological check-ups for one year after the surgical intervention. To date, no recurrence of the underlying disease has been detected. Long-term results show a good trend. In conclusion, we can say that the optimal treatment of AAM is wide local excision. Рadicality is not recommended because of the risk of postoperative complications. Postoperative administration of GnRH-a is advisable to avoid recurrences. All patients undergo regular follow-up examinations for long-term.

ADHD is a neurodevelopmental disorder that children and also adults can develop. A complex interplay of genetic and environmental factors may underlie interindividual variability in ADHD and potentially related aggressive behavior. Using high-resolution molecular biology techniques, we investigated the impact of some MAOA and SLC6A4 variations on ADHD and aggressive behavior in a group of 80 Italian children with ADHD and in 80 healthy controls.We found that homozygous genotypes of MAOA rs6323 and rs1137070 were associated with an increased risk of ADHD (p=0.02 and p=0.03, respectively), instead the heterozygous genotypes (GT of rs6323 and CT of rs1137030) (p=0.0002 and p=0.0006) were strongly linked to a lower risk of developing this disorder. In patients with aggressive behavior, we highligted only a weak negative association of both MAOA polymorphisms (heterozygous genotypes) with aggressiveness then, suggesting that these genotypes maybe protective towards specific changes in behavior (p=0.05). Interestingly, an increase of the GG genotype of rs6323 (p=0.01) and a decrease of GT genotype (p=0.0005) was also found in patients without aggressive behavior compared with controls. Regarding 5HTT gene genotyping, no allele and genotype differences have been detected among patients and controls. Our work shows that defining a genetic profile of ADHD may help to early detect those patients who are more vulnerable to ADHD and/or antisocial and aggressive behavior and to design precision-targeted therapies.

Antisocial behavior is a behavior disorder inherited according to the inheritance of X-linked chromosome. This disorder derives from mutations in the MAOA gene. One of the mutations results in the MAOA-L allele activity. The MAOA-L allele activity can cause antisocial behavior in both healthy and unhealthy people. Antisocial behavior from healthy males can originate from maltreatment during childhood. Currently, MAOA inhibitor can reverse antisocial behavior to normal behavior in animal models. However, this disorder cannot be treated permanently; to treat it permanently in the future, technologies such as CRISPR/Cas9, iPSCs and ssODN are required. These technologies have succeeded to correct erroneous segments in the F8 gene and F9 gene. Both genes occupy the X chromosome. The MAOA gene also occupies the X chromosome. Therefore, it is reasonable to state that CRISPR/Cas9 and iPSCs technique for instance can be beneficial tools to edit the MAOA gene to treat antisocial behavior. CRISPR/Cas9 can be used in combination with iPSCs or ssODN for instance. This combination can greatly help the permanent healing of antisocial behavioral disorders.

In pig production, pigs often show more aggressive behavior after mixing, which adversely affects animal welfare and growth performance. The Jumonji and structural domain-rich AT interaction domain 2 (JARID2) gene plays an important role in neurodevelopment in mice and various psychiatric disorders in humans. The JARID2 gene may impact the aggressive behavior of pigs. By observing the behavior of 500 weaned pigs during the first 72 hours after mixing, the ear tissue samples of the 12 most aggressive and 12 least aggressive pigs were selected for DNA resequencing based on the intensity of their aggressive behavior. Large group correlation analysis indicated that the rs3262221458 site located in the 3'-UTR region of the porcine JARID2 gene has a strong relationship with aggressive behavior of weaned pigs. Pigs with the mutant TT genotype of rs3262221458 have more aggressive behavior than those pigs with the GG and GT genotypes. The dual luciferase assay indicated that the luciferase activity of the plasmids containing the G allele of rs326221458 was significantly less than plasmids conaining the T allele of rs326221458 and control groups. The binding abiltiy of miR-9828-3p to sequences containing the T allele was less than sequences containing the G allele. The overexpression of miR-9828-3p in porcine neuroglial cells (PNGCs) and PK15 cells significantly decreased the mRNA and protein levels of the JARID2 gene. In addition, miR-9828-3p inhibited the proliferation of PNGCs. After inhibiting miR-9828-3p, the mRNA and protein expression levels of JARID2 increased, and the proliferation of PNGCs showed an opposite trend to the cells that forced expression of miR-9828-3p. In addition, interference with the JARID2 gene by siRNA can effectively inhibit the proliferation of PNGCs. In summary, we found that the rs326221458 locus regulates the expression of the JARID2 gene by affecting the binding of miR-9828-3p and the JARID2 gene, thereby affecting the aggressive behavior of weaned pigs after mixing.

Aggressive behavior in adolescence is influenced by a diversity of individual, family and social variables. The purpose of this study was to analyze the relationship between family functioning, emotional intelligence and values for development of different types of aggression, as well as to establish profiles according to the predictor variables of aggression. To do this, a sample of 317 high school students aged 13 to 18 were administered the Peer Conflict Scale, the Family Functionality Scale, the Brief Emotional Intelligence Inventory for Senior Citizens and the Values for Adolescent Development Scales. The study showed that stress management, positive adolescent development and family functioning predominated in nonaggressive subjects with higher scores than aggressors. There was also a negative relationship between the different types of aggression and emotional intelligence, positive values and family functioning. In addition, two different profiles were found. The first had low scores on all the variables, while the second profile had higher scores on all the variables except family functioning which was higher.

Developing effective trend estimators is a main method to solve the online portfolio selection problem. Although the existing portfolio strategies have demonstrated good performance through the development of various trend estimators, it is still challenging to determine in advance which estimator will yield the maximum final cumulative wealth in online portfolio selection tasks. This paper studies an online ensemble approach for online portfolio selection by leveraging the strengths of multiple trend estimators. Specifically, a return-based loss function and a cross-entropy-based loss function are first designed to evaluate the adaptiveness of different trend estimators in a financial environment. On this basis, a passive aggressive ensemble model is proposed to weigh these trend estimators within a unit simplex according to their adaptiveness. Extensive experiments are conducted on benchmark datasets from various real-world stock markets to evaluate the performance. The results show that the proposed strategy achieves the state-of-the-art performance including efficiency and cumulative return.

Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma with variable aggressive clinical behavior. In this retrospective study we aimed to investigate prognostic factors based on clinicopathologic findings in a molecular/immunohistochemical confirmed nationwide multicenter cohort of 57 EHE. Patients had unifocal disease (n=29), multifocal disease (n=5), lymph node metastasis (n=8) and/or distant metastasis (n=15) at the time of diagnosis. The overall survival rate was 69.6% at 1 year and 50.5% at 5 years. Survival did not correlate with sex, age or histo-pathological parameters. No survival differences were observed between multifocal and metastatic disease suggesting that multifocality represents early metastases and treatment options are limited in comparison to unifocal disease. In unifocal tumors, survival could be predicted using the risk stratification model of Shibayama et al. dividing the cases into low (n=4), intermediate (n=15) and high (n=3) risk-groups. Larger tumor size (>3cm) and higher mitotic count (>1/10HPF) was asso-ciated with progressive unifocal disease course. Lymph node metastases at time of diagnosis oc-curred in 14.0% of the cases and was mainly associated with tumor localization in the head and neck area proposing lymph node dissection. In conclusion, our results demonstrate the aggressive behavior of EHE, emphasize the prognostic value of a previous described risk stratification model and may provide new insights regarding tumor focality, therapeutic strategies and prognosis.

Self-regulatory Self-efficacy belief (i.e., SRSE) represents a fundamental factor for adjustment in adolescence, as a vehicle to promote positive behaviors and protect youths from transgressions and maladjustment Bandura et al., 2003; LaRose et al., 2010). Research attested that, during adolescence, boys are more vulnerable to externalizing behaviors than girls, especially when they perceive themselves as scarcely capable of managing and orienting their behaviors, and when they possess impairments in impulsivity (Bandura et al., 2001; Muris, 2006). Previous studies firmly supported the key role of SRSE especially in the offline context in adolescence, but very few studies investigated its impact in the online context, although nowadays Internet represents one of the most significant environments for youths’ daily lives (LaRose et al., 2010; Favini et al., 2023). Thus, we aimed to examine the protective moderating role of SRSE in online and offline aggressive behaviors, beyond youths’ temperamental vulnerabilities, such as high levels of impulsivity. A sample of 318 Italian adolescents (Mage=15.21; SD=.51; 57% boys; 40% girls; 3% third gender) were asked to complete the Impulsivity Scale at Wave1, online and offline aggressive behaviors scales at Wave 2, and SRSE at Wave 2. Multiple-group-by-gender moderation model evidenced that, for what concerns online aggression, beyond the direct effects of impulsivity in boys and girls, SRSE directly affected online aggression and mediated the effect of impulsivity in girls. In contrast, impulsivity significantly affected offline aggressive behaviors only indirectly through the effects of SRSE, and SRSE directly influenced these behaviors in both genders. These results hold for the effects of youth’s age, sexual orientation, socioeconomic status, and years of education completed. This work preliminary evidenced that, contrary to previous studies which focused especially on the vulnerability of boys to aggressive conduct, impulsivity had direct effects on online aggressive behaviors in girls, and SRSE can protect adolescents of both genders in the online context, by predicting low online aggression, and represent a protective factor from the indirect effects that im-pulsivity impairments can have also in the offline context.

Stage IV grade C localized periodontitis (pre-puberal localized aggressive periodontitis/LPP), an extremely rare form of periodontal disease, occurs in otherwise healthy individuals (no signs of dental plaque/calculus) due a hyper-aggressive auto-immune response to high periodontopathic bacteria levels. Methods: A 4-year-old Caucasian girl with unusual high mobility of temporary lower left canine and localized gingival inflammation was misrecognized by multiple clinicians (initially diagnosed with hypophosphatasia, genetic and metabolic disorders, all turning negative), over a period of 4-6 month, despite initial radiographs showing clear pathognomonic signs. LPP diagnostic was made by the last clinician, but by now the tooth was lost. Similar inflammation signs appeared around the lower temporary right canine. X-ray examination showed similar bone and periodontal loss as previously seen, while periodontopathic bacteria tested highly positive. The patient received both mechanical cleaning and ten days systemic antibiotic treatment (Augmentin and Metronidazole). Results: Two months after, inflammation signs disappeared, with periodontal regeneration radiologically present, and only small periodontopathic bacteria precursors concentrations. Conclusions: Despite initial periodontal loss, an adequate treatment can keep under control an LPP disease. Moreover, bone and periodontal regeneration appears if periodontopathic bacteria scores are kept lower, showing the importance of fast adequate diagnostic and treatment.

Background and Aims: Of all primary liver tumors, primary hepatic angiosarcoma (PHA) is a rare and aggressive malignant vascular tumor. The standard therapeutic care for hepatic angiosarcoma remains unclear. This study compared the survival outcomes of aggressive treatment (resection and liver transplant) and nonaggressive treatment (chemotherapy, transarterial chemoembolization [TACE], and conservative treatments) for patients with PHA and analyzed the prognostic factors influencing survival. Materials and Methods: Data of patients diagnosed as having PHA at our facility were retrospectively reviewed. The primary outcome was survival time. The secondary outcome was calculated baseline characteristics. Results: We included a total of 19 patients, who were divided into 2 treatment groups: aggressive (8 patients had undergone resection or transplants) and nonaggressive (11 patients had undergone TACE, chemotherapy, or conservative treatment). The mean survival time was 233.1 ± 189.7 days in the aggressive treatment group and 146.5 ± 115.8 days in the nonaggressive treatment group. A Kaplan-Meier plot revealed no significant difference in survival time between the 2 treatment groups (P = .3256). Conclusions: The survival time of patients receiving aggressive treatment was longer than that of those receiving nonaggressive treatment. The long term survival time in some selective cases of aggressive treatment will be achieved. Thought a difference was not significant between the groups. Because the number of patients was limited, more cases are required to confirm these findings.

This review focuses on social play, a complex behavior that is often difficult to categorize. Although play has been typically associated with positive emotions, emerging research indicates that it relates to various emotional systems, ranging from attachment to conflict. Play oscillates between compe-tition and cooperation, and includes a spectrum in-between, thus quantitatively identifying and demonstrating the emotional nature of play remains challenging. We examined some examples from human and non-human animal studies and explored the emotional and neuro-hormonal systems involved in play. We considered ethological data possibly indicating the emotional states underlying play and we focused on the cooperative and competitive elements of play. We investigated the relationship between play and affiliative/aggressive behaviours, the communicative meaning of play signals (especially primate play faces), and the motor and possibly emotional contagion func-tion of rapid motor mimicry during play. Of all the literature on play, this review selects and com-bines the studies in an innovative way, to present the methods, tools, and evidence indicative of the emotional nature underlying play, which is much more complex than previously thought.

Harsh parenting could be regarded as a harsh form of behavior, feelings and attitude towards children in the process of parenting. According to the theory of intergenerational transmission of violence, harsh parenting is an important factor affecting children's aggressive behavior, but the theory does not clarify the specific action path between the harsh parenting and aggressive behavior. In order to reveal the relationship between harsh parenting and aggressive behavior of juvenile delinquents, 604 male juvenile delinquents (N=604, Mage=16.57 years, SD=0.612 years) were investigated using Harsh Parenting Questionnaire, Buss-Perry Aggression Questionnaire, Multidimensional Peer-Victimization Scale, and the Word Sentence Association Paradigm for Hostility in Chinese version. Analysis using structural equation modeling procedures showed that (a) all variables were positively associated with each others; (b) the partial indirect effect of harsh parenting on aggressive behaviors was realized through the mediator of peer victimization and hostile attribution bias independently, (c) as well as the partial indirect effect through the mediator of peer victimization and hostile attribution bias sequentially. The results suggested that harsh parenting can explain the high aggressive behavior of male juvenile delinquents. Moreover, harsh parenting may also lead to the formation of hostile attribution bias by increasing the risk of peer victimization, and ultimately lead to the formation of highly aggressive behaviors.

Background: Periodontitis is a disease that leads to serious functional and aesthetic dysfunctions resulting in impairment of life quality; it exists in different forms and its etiology is related with multiple component causes. Angiogenesis, together with inflammatory infiltrate, are two key processes in the evolution of inflammatory processes involving gingival tissues. The aim of this study was to evaluate their alterations in relation to some important periodontal diseases-associated factors (i.e. smoke, sex, age, plaque, pus, probing pocket depth) in patients with diagnosis of Generalized Aggressive Periodontitis (GAP). Methods: Eighteen subjects with GAP were enrolled for this study. Percentage of inflammatory cells and vascular area were measured and evaluated in relation with each periodontal diseases-associated factor. Results: The results showed a significant decrease of the percentage of vascular area in association with almost all the periodontal diseases-related factors (smoke, age, PPD, plaque) and not significant differences in the percentage of inflammatory cells. Conclusions: Data suggest that, even if these factors are often commonly related to worsening of periodontal status, they did not affect inflammatory and vascular pattern, as we can assume. For the future, additional studies, aimed to evaluated each singular factor in a wider sample size, should be planned.

This narrative review challenges the recent World Workshop Consensus (WWC) conferences failure to classify aggressive periodontitis (AP) in young adults as distinct from adult periodontitis. Deficiencies in the consensus process, results of these deficiencies, and their impact on disease classification are presented. Support for retaining localized aggressive periodontitis (LAgP) in adolescents as a unique disease, focuses on the; 1) age of onset, 2) rate of bone loss in those affected, and 3) unique microbiological etiological associations. Examples of, 1) unique clinical signs and symptoms of LAgP are presented, and 2) the microbial subgingival consortia that precedes these clinical signs and symptoms are described. Tables show, 1) decreased publications for AP since publication of WWC guidelines and 2) Bradford-Hill guidelines that support the unique etiological consortia replicated in clinically well-defined longitudinal studies. The review describes major deficiencies in the WWC as compared to other medically-related well-run consensus conferences that, 1) set pre-conference standards for 70 – 80% agreement of expert participants, and 2) published the dissenting point of view. In contrast, the WWC conference was decided by a mere majority, and never presented the dissenting view. The review concludes that averaging of mean pocket depth reduction, or attachment gain can misrepresent disease and/or success of treatment in aggressive diseases. In contrast, clinical assessment of time to recurrence of subgingival re-infection with possible translocation of oral microbes to distant sites is presented as an alternative measurement of success. Other questions and future directions are presented.

Background: Molecular genetic events are among the numerous factors affecting the clinical course of papillary thyroid carcinoma (PTC). Recent studies have demonstrated that aberrant expression of miRNA, as well as different thyroid-related genes, correlate with the aggressive clinical course of PTC and unfavorable treatment outcome, which opens up new avenues for using them in personalization of the treatment strategy for patients with PTC. In the present work, our goal was to assess the applicability of molecular markers in preoperative diagnosis of aggressive variants of papillary thyroid cancer. Methods: The molecular genetic profile (expression levels of 34 different markers and BRAF mutation) was studied for 108 cytology specimens collected by fine-needle aspiration biopsy in patients with PTC having different clinical manifestations. Results: Statistically significant differences with adjustment for multiple comparisons (p < 0.0015) for clinically aggressive variants of PTC were obtained for four markers: miRNA-146b, miRNA-221, FN1, and CDKN2A. Weak statistical correlation (0.0015< р<0.05) was observed for miRNA-31, -375, -551b, -148b, -125b, mtDNA, CITED1, TPO, HMGA2, CLU, NIS, SERPINA1, TFF3, and TMPRSS4. Conclusions: The recurrence risk of papillary thyroid carcinoma can be preoperatively predicted using miRNA-221, the fibronectin and cyclin-dependent kinase inhibitor 2A genes.

(1) Background: This case presents a rare and challenging clinical scenario involving a 50-year-old female patient diagnosed with Inflammatory Carcinoma, a particularly aggressive and rapidly growing form of breast cancer. The disease is characterized by heat, redness, swelling and noticeable changes in the breast's skin texture, resembling the skin of an orange (peau d'orange). This case is important because it contributes to the limited clinical literature on such aggressive forms of breast cancer.; (2) Methods: The multidisciplinary approach was employed. Diagnostic procedures such as imaging tests, biopsy, and histopathological examination were performed to confirm the diagnosis of Inflammatory Carcinoma and assess the extent of the disease. The presence of the HER2 protein on the tumor cells supported the selection of a combination therapy involving systemic chemotherapy and targeted biological therapy.; (3) Results: The patient responded positively to the combination therapy consisting of systemic chemotherapy and targeted biological therapy. The aggressive nature of Inflammatory Carcinoma, characterized by rapid growth and distinct skin changes, was effectively addressed. The presence of the HER2 protein on the tumor cells indicated the potential efficacy of the combination therapy in aggressive forms of breast cancer.; (4) Conclusions: This case highlights the critical importance of a multidisciplinary approach in managing complex cases of breast cancer, especially rare and aggressive subtypes like Inflammatory Carcinoma. The positive response of the patient to the combination therapy involving systemic chemotherapy and targeted biological therapy demonstrates the potential for favorable outcomes in aggressive disease presentations.

The aim of this article is to evaluate and compare, retrospectively, the efficacy of two regenerative periodontal procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from multiple intra-bony defects (IBD); that were treated by one of two regenerative modalities of periodontal therapy randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of enamel matrix derivatives (EMD) combined with DBX. The monitoring of the treated sites included recordings of probing depth (PD), clinical attachment level (CAL), and gingival recession. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PD and CAL values, however, not between subject groups. CAL values decreased in all sites. At EMD group (44 sites) CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p<0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1-10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.