Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Predictive Ability of Hypertriglyceridemic Waist,Hypertriglyceridemic Waist-to-Height Ratio,and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents

Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio:Markers predicting immune-checkpoint inhibitor efficacy and immune-related adverse events

We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.

Clinical study of neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio in hypertriglyceridemia-induced acute pancreatitis and acute biliary pancreatitis with persistent organ failure

BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute pancreatitis by etiology into acute biliary pancreatitis(ABP)and hypertriglyceridemia-induced acute pancreatitis(HTGP).AIM To investigate the clinical significance of NLR and PLR in assessing persistent organ failure(POF)in HTGP and ABP.METHODS A total of 1450 patients diagnosed with acute pancreatitis(AP)for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled.The patients were categorized into two groups according to the etiology of AP:ABP in 530 patients and HTGP in 241 patients.We collected and compared the clinical data of the patients,including NLR,PLR,and AP prognostic scoring systems,within 48 h of hospital admission.RESULTS The NLR(9.1 vs 6.9,P<0.001)and PLR(203.1 vs 160.5,P<0.001)were significantly higher in the ABP group than in the HTGP group.In the HTGP group,both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score≥3.Likewise,in the ABP group,NLR and PLR were significantly elevated in patients with severe AP,modified computed tomography severity index score≥4,Japanese Severity Score≥3,and modified Marshall score≥2.Moreover,NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups.CONCLUSION NLR and PLR vary between ABP and HTGP,are strongly associated with AP prognostic scoring systems,and have predictive potential for the occurrence of POF in both ABP and HTGP.

Experimental Study of Local Scour Around Four Piles Under Different Attack Angles and Gap Ratios

In an effort to investigate and quantify the patterns of local scour,researchers embarked on an in-depth study using a systematic experimental approach.The research focused on the effects of local scour around a set of four piles,each subjected to different hydromechanical conditions.In particular,this study aimed to determine how different attack angles—the angles at which the water flow impinges on the piles,and gap ratios—the ratios of the spacing between the piles to their diameters,influence the extent and nature of scour.A comprehensive series of 35 carefully designed experiments were orchestrated,each designed to dissect the nuances in how the gap ratio and attack angle might contribute to changes in the local scour observed at the base of pile groups.During these experimental trials,a wealth of local scour data were collected to support the analysis.These data included precise topographic profiles of the sediment bed around the pile groups,as well as detailed scour time histories showing the evolution of scour at strategic feature points throughout the test procedure.The analysis of the experimental data provided interesting insights.The study revealed that the interplay between the gap ratio and the attack angle had a pronounced influence on the scouring dynamics of the pile groups.One of the key observations was that the initial phases of scour,particularly within the first hour of water flow exposure,were characterized by a sharp increase in the scour depth occurring immediately in front of the piles.After this initial rapid development,the scour depth transitioned to a more gradual change rate.In contrast,the scour topography around the piles continuously evolved.This suggests that sediment displacement and the associated sculpting of the seabed around pile foundations are sustained and progressive processes,altering the underwater landscape over time.The results of this empirical investigation have significant implications for the design and construction of offshore multi-pile foundations,providing a critical reference for engineers and designers to estimate the expected scour depth around such structures,which is an integral part of decisions regarding foundation design,selection of structural materials,and implementation of scour protection measures.

Effect of length-width ratio of rounded rectangle aquaculture tank in dual-diagonal-inlet layout on hydrodynamics

To adapt to the change of aquaculture workshop site,optimize the shape of aquaculture tanks and improve the utilization rate of breeding space,it is necessary to determine the appropriate length width ratio parameters of aquaculture tanks.In this paper,computational fluid dynamics(CFD)technology is adopted to study the flow field performance of aquaculture tanks with different L/B ratios(L:the length;B:the width,of aquaculture tank)and different jet direction conditions(lengthways jet and widthways jet).A three-dimensional numerical calculation model of turbulence in rounded rectangle aquaculture tanks in dual-diagonal-inlet layout was established.Jet directions are arranged lengthways and widthways,and the water flow velocity,resistance coefficient change,vorticity,etc.are analyzed under two working conditions.Results show that the flow field performance in aquaculture tank decreases with the increase of the L/B ratio.The flow field performed well when L/B was 1.0-1.3,sharply dropped at 1.4-1.6,and poor at 1.7-1.9.The results provided a theoretical basis for the design and optimization in flow field performance of the industrialized circulating aquaculture tanks.

Numerical analysis for the free-boundary current reversal equilibrium in the AC plasma current operation in a tokamak

In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.

Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis

BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.

Elliptical vibration chiseling:a novel process for texturing ultra-high-aspect-ratio microstructures on the metallic surface

High-aspect-ratio metallic surface microstructures are increasingly demanded in breakthrough applications,such as high-performance heat transfer enhancement and surface plasmon devices.However,the fast and cost-effective fabrication of high-aspect-ratio microstructures on metallic surfaces remains challenging for existing techniques.This study proposes a novel cutting-based process,namely elliptical vibration chiseling(EV-chiseling),for the high-efficiency texturing of surface microstructures with an ultrahigh aspect ratio.Unlike conventional cutting,EV-chiseling superimposes a microscale EV on a backward-moving tool.The tool chisels into the material in each vibration cycle to generate an upright chip with a high aspect ratio through material deformation.Thanks to the tool’s backward movement,the chip is left on the material surface to form a microstructure rather than falling off.Since one microstructure is generated in one vibration cycle,the process can be highly efficient using ultrafast(>1 kHz)tool vibration.A finite element analysis model is established to explore the process mechanics of EV-chiseling.Next,a mechanistic model of the microstructured surface generation is developed to describe the microstructures’aspect ratio dependency on the process parameters.Then,surface texturing tests are performed on copper to verify the efficacy of EV-chiseling.Uniformed micro ribs with a spacing of 1–10μm and an aspect ratio of 2–5 have been successfully textured on copper.Compared with the conventional EV-cutting that uses a forward-moving tool,EV-chiseling can improve the aspect ratio of textured microstructure by up to 40 times.The experimental results also verify the accuracy of the developed surface generation model of microstructures.Finally,the effects of elliptical trajectory,depth of cut,tool shape,and tool edge radius on the surface generation of micro ribs have been discussed.

Effect of height-diameter ratio on the mechanical characteristics of shale with different bedding orientations

Geological exploration cores obtained from shale gas wells several kilometers deep often show different height-diameter ratios(H/D)because of complex geological conditions(core disking or developed fractures),which makes further standard specimen preparation for mechanical evaluation of reservoirs difficult.In multi-cluster hydraulic fracturing,shale reservoirs between planes of hydraulic fractures with different lengths could be simplified to have different H/D ratios.Discovering the effect of H/D on the mechanical characteristics of shale specimens with different bedding orientations will support mechanical evaluation tests of reservoirs based on disked geological cores and help to optimize multicluster fracturing programs.In this study,we performed uniaxial compression tests and acoustic emission(AE)monitoring on cylindrical Longmaxi shale specimens under five bedding orientations and four H/D ratios.The experimental results showed that both the H/D-dependent mechanical properties and AE parameters demonstrated significant anisotropy.Increasing H/D did not change the uniaxial compressive strength(UCS)evolution versus bedding orientation,demonstrating a V-shaped relationship,but enhanced the curve shape.The stress level of crack damage for the specimens significantly increased with increasing H/D,excluding the specimens with a bedding orientation of 0°.With increasing H/D,the cumulative AE counts of the specimens with each bedding orientation tended to exhibit a stepped jump against the loading time.The proportion of low-average-frequency AE signals(below 100 kHz)in specimens with bedding orientations of 45°and 60°increased to over 70%by increasing H/D,but it only increased to 40%in specimens with bedding orientations of 0°,30°,and 90°.Finally,an empirical model that can reveal the effect of H/D on anisotropic UCS of shale reservoir was proposed,the anisotropic proportion of tensile and shear failure cracks in specimens under four H/D ratios was classified based on the AE data,and the effect of H/D on the anisotropic crack growth of specimens was discussed.

Monocyte to high-density lipoprotein cholesterol ratio as a predictor of the activity of thyroid-associated ophthalmopathy

AIM:To evaluate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the disease activity of thyroid-associated ophthalmopathy(TAO).METHODS:A total of 87 patients were classified into two groups based on clinical activity score(CAS)scoring criteria:high CAS group(n=62,the CAS score was≥3);low CAS group(n=25,the CAS score was<3).In addition,a group of healthy people(n=114)were included to compared the MHR.Proptosis,MHR,average signal intensity ratio(SIR),average lacrimal gland(LG)-SIR,average extraocular muscles(EOM)area from 87 patients with TAO were calculated in magnetic resonance imaging(MRI),and compared between these two groups.Correlation testing was utilized to evaluate the association of parameters among the clinical variables.RESULTS:Patients in high CAS group had a higher proptosis(P=0.041)and MHR(P=0.048).Compared to the healthy group,the MHR in the TAO group was higher(P=0.001).Correlation testing declared that CAS score was strongly associated with proptosis and average SIR,and MHR was positively associated with CAS score,average SIR,and average LG-SIR.The area under the receiver operating characteristic curve(AUC)of MHR was 0.6755.CONCLUSION:MHR,a novel inflammatory biomarker,has a significant association with CAS score and MRI imaging(average SIR and LG-SIR)and it can be a new promising predictor during the active phase of TAO.

Red cell distribution width-to-albumin ratio is a simple promising prognostic marker in acute cholangitis requiring biliary drainage

Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC.

Construction of a predictive model for acute liver failure after hepatectomy based on neutrophil-to-lymphocyte ratio and albuminbilirubin score

BACKGROUND Acute liver failure(ALF)is a common cause of postoperative death in patients with hepatocellular carcinoma(HCC)and is a serious threat to patient safety.The neutrophil-to-lymphocyte ratio(NLR)is a common inflammatory indicator that is associated with the prognosis of various diseases,and the albumin-bilirubin score(ALBI)is used to evaluate liver function in liver cancer patients.Therefore,this study aimed to construct a predictive model for postoperative ALF in HCC tumor integrity resection(R0)based on the NLR and ALBI,providing a basis for clinicians to choose appropriate treatment plans.AIM To construct an ALF prediction model after R0 surgery for HCC based on NLR and ALBI.METHODS In total,194 patients with HCC who visited The First People’s Hospital of Lianyungang to receive R0 between May 2018 and May 2023 were enrolled and divided into the ALF and non-ALF groups.We compared differences in the NLR and ALBI between the two groups.The risk factors of ALF after R0 surgery for HCC were screened in the univariate analysis.Independent risk factors were analyzed by multifactorial logistic regression.We then constructed a prediction model of ALF after R0 surgery for HCC.A receiver operating characteristic curve,calibration curve,and decision curve analysis(DCA)were used to evaluate the value of the prediction model.RESULTS Among 194 patients with HCC who met the standard inclusion criteria,46 cases of ALF occurred after R0(23.71%).There were significant differences in the NLR and ALBI between the two groups(P<0.05).The univariate analysis showed that alpha-fetoprotein(AFP)and blood loss volume(BLV)were significantly higher in the ALF group compared with the non-ALF group(P<0.05).The multifactorial analysis showed that NLR,ALBI,AFP,and BLV were independent risk factors for ALF after R0 surgery in HCC.The predictive efficacy of NLR,ALBI,AFP,and BLV in predicting the occurrence of ALT after R0 surgery for HCC was average[area under the curve(AUC)NLR=0.767,AUCALBI=0.755,AUCAFP=0.599,AUCBLV=0.718].The prediction model for ALF after R0 surgery for HCC based on NLR and ALBI had a better predictive efficacy(AUC=0.916).The calibration curve and actual curve were in good agreement.DCA showed a high net gain and that the model was safer compared to the curve in the extreme case over a wide range of thresholds.CONCLUSION The prediction model based on NLR and ALBI can effectively predict the risk of developing ALF after HCC R0 surgery,providing a basis for clinical prevention of developing ALF after HCC R0 surgery.

Consideration of the influence of supports in modeling the electromagnetic fields of 25 kV traction networks under emergency conditions

Single-phase 25 kV traction networks of electrified alternating current(AC)railways create electromagnetic fields(EMFs)with significant levels of intensity.The most intense magnetic fields occur when short circuits exist between the contact wire and rails or ground.Despite the short duration of exposure,they can adversely affect electronic devices and induce significant voltages in adjacent power lines,which is dangerous for operating personnel.Although numerous investigations have focused on modeling the EMF of traction networks and power lines,the challenge of determining the three-dimensional electromagnetic fields near metal supports during the flow of a short-circuit current through them is yet to be resolved.In this case,the field has a complex spatial structure that significantly complicates the calculations of intensities.This study proposes a methodology,algorithms,software,and digital models for determining the EMF in the described emergency scenarios.During the modeling process,the objects being studied were represented by segments of thin wires to analyze the distribution of the electric charge and calculate the intensities of the electric and magnetic fields.This approach was implemented in the Fazonord software,and the modeling results show a substantial increase in EMF levels close to the support,with a noticeable decrease in the levels as the distance from it increases.The procedure implemented in the commercial software Fazonord is universal and can be used to determine electromagnetic fields at any electrical power facility that includes live parts of limited length.Based on the proposed procedure,the EMF near the supports of overhead power lines and traction networks of various designs could be determined,the EMF levels at substations can be calculated,and the influence of metal structures located near traction networks,such as pedestrian crossings at railway stations,can be considered.

Effect of NaCl Concentration on the Cumulative Strain and Pore Distribution of Clay under Cyclic Loading

Clay,as the most common soil used for foundationfill,is widely used in various infrastructure projects.The phy-sical and mechanical properties of clay are influenced by the pore solution environment.This study uses a GDS static/dynamic triaxial apparatus and nuclear magnetic resonance experiments to investigate the effects of cyclic loading on clay foundations.Moreover,the development of cumulative strain in clay is analyzed,and afitting model for cumulative plastic strain is introduced by considering factors such as NaCl solution concentration,con-solidation stress ratio,and cycle number.In particular,the effects of the NaCl solution concentration and con-solidation stress ratio on the pore distribution of the test samples before and after cyclic loading are examined,and the relationship between microscopic pore size and macroscopic cumulative strain is obtained accordingly.Our results show that as the consolidation stress ratio grows,an increasing number of large pores in the soil samples are transformed into small pores.As the NaCl solution concentration becomes higher,the number of small pores gradually decreases,while the number of large pores remains unchanged.Cyclic loading causes the disappearance of the large pores in the samples,and the average pore size before cyclic loading is posi-tively correlated with the axial cumulative strain after cyclic loading.The cumulative strain produced by the soil under cyclic loading is inversely proportional to the NaCl solution concentration and consolidation stress ratio.

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

Prediction of lime utilization ratio of dephosphorization in BOF steelmaking based on online sequential extreme learning machine with forgetting mechanism

The machine learning models of multiple linear regression(MLR),support vector regression(SVR),and extreme learning ma-chine(ELM)and the proposed ELM models of online sequential ELM(OS-ELM)and OS-ELM with forgetting mechanism(FOS-ELM)are applied in the prediction of the lime utilization ratio of dephosphorization in the basic oxygen furnace steelmaking process.The ELM model exhibites the best performance compared with the models of MLR and SVR.OS-ELM and FOS-ELM are applied for sequential learning and model updating.The optimal number of samples in validity term of the FOS-ELM model is determined to be 1500,with the smallest population mean absolute relative error(MARE)value of 0.058226 for the population.The variable importance analysis reveals lime weight,initial P content,and hot metal weight as the most important variables for the lime utilization ratio.The lime utilization ratio increases with the decrease in lime weight and the increases in the initial P content and hot metal weight.A prediction system based on FOS-ELM is applied in actual industrial production for one month.The hit ratios of the predicted lime utilization ratio in the error ranges of±1%,±3%,and±5%are 61.16%,90.63%,and 94.11%,respectively.The coefficient of determination,MARE,and root mean square error are 0.8670,0.06823,and 1.4265,respectively.The system exhibits desirable performance for applications in actual industrial pro-duction.

Enhanced entropy generation and heat transfer characteristics of magnetic nano-encapsulated phase change materials in latent heat thermal energy storage systems

The objective of the current study is to investigate the importance of entropy generation and thermal radiation on the patterns of velocity,isentropic lines,and temperature contours within a thermal energy storage device filled with magnetic nanoencapsulated phase change materials(NEPCMs).The versatile finite element method(FEM)is implemented to numerically solve the governing equations.The effects of various parameters,including the viscosity parameter,ranging from 1 to 3,the thermal conductivity parameter,ranging from 1 to 3,the Rayleigh parameter,ranging from 102 to 3×10^(2),the radiation number,ranging from 0.1 to 0.5,the fusion temperature,ranging from 1.0 to 1.2,the volume fraction of NEPCMs,ranging from 2%to 6%,the Stefan number,ranging from 1 to 5,the magnetic number,ranging from 0.1 to 0.5,and the irreversibility parameter,ranging from 0.1 to 0.5,are examined in detail on the temperature contours,isentropic lines,heat capacity ratio,and velocity fields.Furthermore,the heat transfer rates at both the cold and hot walls are analyzed,and the findings are presented graphically.The results indicate that the time taken by the NEPCMs to transition from solid to liquid is prolonged inside the chamber region as the fusion temperatureθf increases.Additionally,the contours of the heat capacity ratio Cr decrease with the increase in the Stefan number Ste.

Efficient removal of Al(Ⅲ)and P507 from high concentration MgCl_(2)solution based on in-situ reaction strategy

For a highly efficient recycling of a wastewater containing a high concentration of MgCl_(2),Al(Ⅲ)and P507 were scheduled to be removed in advance.In this study,the in-situ removal of Al(Ⅲ)and P507 from a high concentration MgCl_(2)solution at different pH values and Al/P molar ratios was investigated.The results showed that P507 formed organic complexes of Al_(x)(OH)_y^(Z+)-P507 at pH of 2.0-4.0.At pH of 4.0-5.0,Al(Ⅲ)precipitated and transferred into Al(OH)_(3)with a flocculent amorphous morphology.Active sites on the Al(OH)_(3)surface enhanced the removal efficiency of P507.At pH of 6.0-6.5,Al(Ⅲ)and Mg(Ⅱ)formed layered crystalline Al(OH)_(3)and MgAl_(2)(OH)_(8with)small pore channels and fewer active sites,resulting in a reduced removal efficiency of P507.When the Al/P molar ratio exceeded 13 and the pH was between 4.0 and 5.0,the removal rates of both Al(Ⅲ)and P507 were higher than98%,while the concentration loss of Mg(Ⅱ)was only 0.2%-0.9%.

Oils with different degree of saturation:effects on ileal digestibility of fat and corresponding additivity and bacterial community in growing pigs

Background Oils are important sources of energy in pig diets.The combination of oils with different degree of saturation contributes to improve the utilization efficiency of the mixed oils and may reduce the cost of oil supplemented.An experiment was conducted to evaluate the effects of oils with different degree of saturation on the fat digestibility and corresponding additivity and bacterial community in growing pigs.Methods Eighteen crossbred(Duroc×Landrace×Yorkshire)barrows(initial body weight:29.3±2.8 kg)were surgically fitted with a T-cannula in the distal ileum.The experimental diets included a fat-free basal diet and 5 oil-added diets.The 5 oil-added diets were formulated by adding 6%oil with different ratio of unsaturated to saturated fatty acids(U:S)to the basal diet.The 5 oils were palm oil(U:S=1.2),canola oil(U:S=12.0),and palm oil and canola oil were mixed in different proportions to prepare a combination of U:S of 2.5,3.5 and 4.5,respectively.Results The apparent and standardized ileal digestibility(AID and SID)of fat and fatty acids increased linearly(P<0.05)as the U:S of dietary oils increased except for SID of fat and C18:2.The AID and SID of fat and fatty acids differed among the dietary treatments(P<0.05)except for SID of unsaturated fatty acids(UFA)and C18:2.Fitted one-slope broken-line analyses for the SID of fat,saturated fatty acids(SFA)and UFA indicated that the breakpoint for U:S of oil was 4.14(R^(2)=0.89,P<0.01),2.91(R^(2)=0.98,P<0.01)and 3.84(R^(2)=0.85,P<0.01),respectively.The determined SID of fat,C18:1,C18:2 and UFA in the mixtures was not different from the calculated SID of fat,C18:1,C18:2 and UFA.However,the determined SID of C16:0,C18:0 and SFA in the mixtures were greater than the calculated SID values(P<0.05).The abundance of Romboutsia and Turicibacter in pigs fed diet containing palm oil was greater than that in rapeseed oil treatment group,and the two bacteria were negatively correlated with SID of C16:0,C18:0 and SFA(P<0.05).Conclusions The optimal U:S for improving the utilization efficiency of mixed oil was 4.14.The SID of fat and UFA for palm oil and canola oil were additive in growing pigs,whereas the SID of SFA in the mixture of two oils was greater than the sum of the values of pure oils.Differences in fat digestibility caused by oils differing in degree of saturation has a significant impact on bacterial community in the foregut.