Garg incontinence scores: New scoring system on the horizon to evaluate fecal incontinence. Will it make a difference?

The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.

Comparison of different severity scores in correlating hemoglobin levels with the severity of hepatic decompensation: An observational study

BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.

Improving gastrointestinal scoring systems for predicting short-term mortality in critically ill patients

Shen et al’s retrospective study aims to compare the utility of two separate scoring systems for predicting mortality attributable to gastrointestinal(GI)injury in critically ill patients[the GI Dysfunction Score(GIDS)and the Acute Gastroin-testinal Injury(AGI)grade].The authors note that this study is the first proposal that suggests an equivalence between the ability of both scores to predict mor-tality at 28 days from intensive care unit(ICU)admission.Shen et al retrospec-tively analysed an ICU cohort of patients utilising two physicians administering both the AGI grade and GIDS score,using electronic healthcare records and ICU flowsheets.Where these physicians disagreed about the scores,the final decision as to the scores was made by an associate chief physician,or chief physician.We note that the primary reason for the development of GIDS was to create a clear score for GI dysfunction,with minimal subjectivity or inter-operator variability.The subjectivity inherent to the older AGI grading system is what ultimately led to the development of GIDS in 2021.By ensuring consensus between physicians administering the AGI,Shen et al have controlled for one of this grading systems biggest issues.We have concerns,however,that this does not represent the real-world challenges associated with applying the AGI compared to the newer GIDS,and wonder if this arbitration process had not been instituted,would the two scoring systems remain equivalent in terms of predicted mortality?

GATIS score:An innovative prognostic score for rectal neuroendocrine neoplasms

In this article,we discussed the article by Zeng et al,published in a recent issue of the World Journal of Gastroenterology.The publication represents a significant advancement in the prognostic evaluation of rectal neuroendocrine neoplasms.The GATIS score is a single nomogram model that incorporates five key progno-stic factors:Tumor grade;T stage;tumor size;age;and the prognostic nutritional index.This innovation optimizes the prognostic process,delivering more accurate predictions of overall survival and progression-free survival compared to tradi-tional TNM staging and World Health Organization classification systems.The findings of the study were based on a retrospective analysis spanning 12 years and involving 1408 patients from 17 reference centers in China.In this editorial,we specifically examined the strengths and limitations of the study,the clinical implications of the GATIS score,and the questions arising from its conclusions.

Predicting post-hepatectomy liver failure using a nomogram based on portal vein width,inflammatory indices,and the albumin-bilirubin score

BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identify potential high-risk PHLF patients as early as possible through preoperative evaluation.AIM To identify risk factors for PHLF and develop a prediction model.METHODS This study included 248 patients with HCC at The Second Affiliated Hospital of Air Force Medical University between January 2014 and December 2023;these patients were divided into a training group(n=164)and a validation group(n=84)via random sampling.The independent variables for the occurrence of PHLF were identified by univariate and multivariate analyses and visualized as nomograms.Ultimately,comparisons were made with traditional models via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS In this study,portal vein width[odds ratio(OR)=1.603,95%CI:1.288-1.994,P≤0.001],the preoperative neutrophil-to-lymphocyte ratio(NLR)(OR=1.495,95%CI:1.126-1.984,P=0.005),and the albumin-bilirubin(ALBI)score(OR=8.868,95%CI:2.144-36.678,P=0.003)were independent risk factors for PHLF.A nomogram prediction model was developed using these factors.ROC and DCA analyses revealed that the predictive efficacy and clinical value of this model were better than those of traditional models.CONCLUSION A new Nomogram model for predicting PHLF in HCC patients was successfully established based on portal vein width,the NLR,and the ALBI score,which outperforms the traditional model.

Scoring system supporting suture decision-making for duodenal submucosal tumors

BACKGROUND In recent years,endoscopic resection(ER)has been employed for the excision of submucosal tumors(SMTs).Nonetheless,ER in the duodenum is linked to ele-vated risks of both immediate and delayed hemorrhagic complications and perforations.Satisfactory suturing is crucial for reducing the occurrence of complications.AIM To establish a clinical score model for supporting suture decision-making of duodenal SMTs.METHODS This study included 137 individuals diagnosed with duodenal SMTs who under-went ER.Participants were evenly divided into two groups:A training cohort(TC)comprising 95 cases and an internal validation cohort(VC)with 42 cases.Subsequently,a scoring system was formulated utilizing multivariate logistic regression analysis within the TC,which was then subjected to evaluation in the VC.RESULTS The clinical scoring system incorporated two key factors:Extraluminal growth,which was assigned 2 points,and endoscopic full-thickness resection,which was given 3 points.This model demonstrated strong predictive accuracy,as evidenced by the area under the receiver operating characteristic curve of 0.900(95%confidence interval:0.823-0.976).Additionally,the model’s goodness-of-fit was validated by the Hosmer-Lemeshow test(P=0.404).The probability of purse-string suturing in low(score 0-2)and high(score>3)categories were 3.0%and 64.3%in the TC,and 6.1%and 88.9%in the VC,respectively.CONCLUSION This scoring system may function as a beneficial instrumentality for medical practitioners,facilitating the decision-making process concerning suture techniques in the context of duodenal SMTs.

Efficacy-cost analysis of endoscopic mucosal resection and cold snare polypectomy:A propensity score matching analysis

BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.

Laparoscopic hepatectomy using indocyanine green attenuates postoperative inflammatory response for hepatocellular carcinoma:A propensity score matching analysis

BACKGROUND Improving the intraoperative and postoperative performance of laparoscopic hepatectomy was quite a challenge for liver surgeons.AIM To determine the benefits of indocyanine green(ICG)fluorescence imaging in patients with hepatocellular carcinoma(HCC)who underwent laparoscopic hepatectomy during and after surgery.METHODS We retrospectively collected the clinicopathological data of 107 patients who successfully underwent laparoscopic hepatectomy at Zhongshan Hospital(Xiamen),Fudan University from June 2022 to June 2023.Whether using the ICG fluorescence imaging technique,we divided them into the ICG and non-ICG groups.To eliminate statistical bias,a 1:1 propensity score matching analysis was conducted.The comparison of perioperative outcomes,including inflammationrelated markers and progression-free survival,was analyzed statistically.RESULTS Intraoperatively,the ICG group exhibited lower blood loss,a shorter surgical time,lower hepatic inflow occlusion(HIO)frequency,and a shorter total HIO time.Postoperatively,the participation of ICG resulted in a shorter duration of hospitalization(6.5 vs 7.6 days,P=0.03)and postoperative inflammatory response attenuation(lower neutrophil-lymphocyte ratio on the first day after surgery and platelet-lymphocyte ratio on the third day,P<0.05).Although the differences were not significant,the levels of all inflammation-related markers were lower in the ICG group.The rates of postoperative complications and the survival analyses,including progression-free and overall survivals showed no significant difference between the groups.CONCLUSION The involvement of ICG fluorescence imaging may lead to improved perioperative outcomes,especially postoperative inflammatory response attenuation,and ultimately improve HCC patients’recovery after surgery.

Radiomics-based predictive risk score: A scoring system for preoperatively predicting risk of lymph node metastasis in patients with resectable non-small cell lung cancer

Objective: To develop and validate a radiomics-based predictive risk score(RPRS) for preoperative prediction of lymph node(LN) metastasis in patients with resectable non-small cell lung cancer(NSCLC).Methods: We retrospectively analyzed 717 who underwent surgical resection for primary NSCLC with systematic mediastinal lymphadenectomy from October 2007 to July 2016. By using the method of radiomics analysis, 591 computed tomography(CT)-based radiomics features were extracted, and the radiomics-based classifier was constructed. Then, using multivariable logistic regression analysis, a weighted score RPRS was derived to identify LN metastasis. Apparent prediction performance of RPRS was assessed with its calibration,discrimination, and clinical usefulness.Results: The radiomics-based classifier was constructed, which consisted of 13 selected radiomics features.Multivariate models demonstrated that radiomics-based classifier, age group, tumor diameter, tumor location, and CT-based LN status were independent predictors. When we assigned the corresponding score to each variable,patients with RPRSs of 0-3, 4-5, 6, 7-8, and 9 had distinctly very low(0%-20%), low(21%-40%), intermediate(41%-60%), high(61%-80%), and very high(81%-100%) risks of LN involvement, respectively. The developed RPRS showed good discrimination and satisfactory calibration (C-index: 0.785, 95% confidence interval(95% CI):0.780-0.790)Additionally, RPRS outperformed the clinicopathologic-based characteristics model with net reclassification index(NRI) of 0.711(95% CI: 0.555-0.867).Conclusions: The novel clinical scoring system developed as RPRS can serve as an easy-to-use tool to facilitate the preoperatively individualized prediction of LN metastasis in patients with resectable NSCLC. This stratification of patients according to their LN status may provide a basis for individualized treatment.

Validation of a new scoring system: Rapid assessment faecal incontinence score

AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between "state" and "leaks" was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r " for the different subscales of the questionnaire were: "lifestyle" r =-0.87, "coping/behaviour" r =-0.91, "depression" r =-0.36 and "embarrassment" r =-0.90,(P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high.CONCLUSION: RAFIS is a valid and reliable tool to assess Faecal Incontinence.

Spatial pattern dynamics among co-dominant populations in early secondary forests in Southwest China

The canopy of subtropical natural forests usually consists of several co-dominant populations(CDPs),which play a crucial role in forest structure,formation of the forest environment,and ecological function.However,little attention has been given to changes in spatial patterns in CDPs during natural succession.Cyclobalanopsis glauca(Thunb.)Oerst.,Quercus variabilis Blume,and Pinus yunnanensis var.tenuifolia W.C.Cheng & Y.W.Law are canopy species that form CDPs in zonal forests along the Nanpan River in southwest China.We used the g(r) function and its bivariate distribution model,g_(12)(r),which is based on distances between pairs of points,to explore the dynamics of the three CDP species with respect to distribution patterns and spatial correlations in two secondary forests(one 30-year-old forest [30-YF] and one 57-year-old forest [57-YF]).The following key results were obtained:(1) there was a clumped pattern in the 30-YF,but the intensity of aggregation varied among populations and life stages.The distribution pattern gradually shifted to become random with longer succes sion time(i.e.,30-YF vs.57-YF),expansion of the observation scale(r=0-20 m),and at later life stages.(2) Aside from the mid-sized C.glauca trees and large P.yunnanensis trees,the trees repulsed each other at certain scales(r=0-2,5-6,11-12,14-16 m) in the 30-YF.Almost all of the life stages in the CDPs were independently correlated.This independent correlation was exacerbated by a longer succession time.(3) An increase in life stages and longer succession also promoted independent changes in intraspecific correlations.(4) Intraspecific correlations were stronger than interspecific correlations.Our results showed that reducing exclusive competition is essential to coexistence in CDPs.Inter-and intra-specific repulsion may occur at the same time,but intraspecific repulsion was the main driving force behind the random distributions and independent correlations.

基于Z-Score动态压缩的高效联邦学习算法

联邦学习作为一种具有隐私保护的新兴分布式计算范式,在一定程度上保护了用户隐私和数据安全。然而,由于联邦学习系统中客户端与服务器需要频繁地交换模型参数,造成了较大的通信开销。在带宽有限的无线通信场景中,这成为了限制联邦学习发展的主要瓶颈。针对这一问题,提出了一种基于Z-Score的动态稀疏压缩算法。通过引入Z-Score,对局部模型更新进行离群点检测,将重要的更新值视为离群点,从而将其挑选出来。在不需要复杂的排序算法以及原始模型更新的先验知识的情况下,实现模型更新的稀疏化。同时随着通信轮次的增加,根据全局模型的损失值动态地调整稀疏率,从而在保证模型精度的前提下最大程度地减少总通信量。通过实验证明,在I.I.D.数据场景下,该算法与联邦平均(FedAvg)算法相比可以降低95%的通信量,精度损失仅仅为1.6%,与FTTQ算法相比可以降低40%~50%的通信量,精度损失仅为1.29%,证明了该方法在保证模型性能的同时显著降低了通信成本。

基于F-score和二进制灰狼优化的肿瘤基因选择方法

针对肿瘤基因数据维度高、噪声多、冗余性高的现状,结合Spearman相关系数改进F-score算法,在此基础上优化二进制灰狼算法,提出了一种基于改进F-score和二进制灰狼算法的肿瘤基因选择算法.首先,考虑特征之间的相关性,计算每个特征的F-score值和特征之间的Spearman相关系数的绝对值;然后,计算权重系数得出各个特征的权重值,依据重要性进行排序,选出初选特征子集;最后,通过收敛因子的衰减曲线和初始化方法优化二进制灰狼算法,调整全局搜索和局部搜索所占比例,增强全局搜索能力并提高局部搜索速度,有效节省时间开销,提升特征选择的分类性能和效率,得到最优特征子集.在9个肿瘤基因数据集上测试所提算法,在分类准确率和筛选特征数目两个指标上进行仿真实验,并与4种其他算法进行对比,实验结果证明所提算法表现良好,可有效降低基因数据维度,并具有较好的分类精度.

引入ESG框架的Z-Score业绩评价模式研究

本文结合当前企业可持续高质量发展的目标导向,构建了引入ESG框架的Z-Score业绩评价模式,以弥补EVA评价中过于关注经济利润以及BSC评价中过于关注企业内部治理的视角局限性。通过主成分分析法测度的关键综合业绩指标,在案例分析中证明了引入ESG框架后的业绩评价模式在实际应用中具有必要性和合理性。在传统业绩指标评价模式的基础上引入ESG框架来进一步优化企业业绩评价体系,有助于企业培育或强化适应高质量发展的业绩观。

Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step

The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.

中医药团体标准评价体系(SCORE-TCM)解读

本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容、推广应用和实施效益等几方面特征的综合评价工具。文中详述了SCORE-TCM的构建目的、定义和构建过程,解释了评价指标体系中的各项指标,并对每项指标的评价材料进行介绍。本文旨在帮助中医药团体标准的制定者、第三方评价机构和其他相关方更好地理解SCORE-TCM各评价条目的含义,更有效地运用于中医药团体标准的自评价或第三方评价,SCORE-TCM将为《中医药团体标准管理办法》的贯彻实施,以及中医药团体标准的高质量发展提供技术支持。

A Scoring System to Assess Patients with Diabetes: Nutech Functional Score

Background: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The symptoms of hyperglycemia include polyuria, polydypsia, polyphagia, blurred vision and weight loss. Various diagnostic tests are used for the diagnosis of DM in patients, but the findings of these tests cannot be assumed to be completely valid. This study aimed at developing a novel scoring system to assess the patients suffering from DM. Method: We assessed the patients based on various diagnostic tests available for DM and prepared a single list of these tests. The tests were categorized and graded based on the World Health Organization (WHO) criteria. Further, we coverted the grades into numeric values for easy use. Results: NFS for diabetes is an 11-point scoring system that assesses the patient’s condition before and after therapy. To facilitate the conduct of probability based studies, we have converted the scores into numeric values in the range of (0, 1). Each symptom is graded as (1, 2, 3, 4, 5) that runs in BAD → GOOD direction. Conclusion: NFS is a beneficial scoring system that can be used worldwide to assess the patients with DM.

Gustave Roussy Immune Score——结直肠癌患者的新型预后评分

目的探讨Gustave Roussy Immune Score(GRIm评分)在结直肠癌(CRC)根治术后患者预后评估中的价值。方法本研究共纳入2004年6月至2019年8月271例CRC根治术后患者。分析GRIm评分与CRC临床病理特征的关系。采用Kaplan-Meier法绘制CRC患者无病生存时间(DFS)曲线,生存差异行Log-rank检验;Cox风险比例回归模型分析影响CRC患者预后的因素;校准曲线和受试者工作特征(ROC)曲线检验基于GRIm评分的列线图的预测效能。结果GRIm评分与性别、肿瘤部位、神经侵犯、N分期、美国癌症联合委员会(AJCC)分期、白蛋白(ALB)评分和乳酸脱氢酶(LDH)评分有关(P<0.05);GRIm简化评分与肿瘤部位、肿瘤直径、癌栓、ALB评分和LDH评分有关(P<0.05)。Cox风险比例回归模型显示,GRIm评分是影响CRC患者DFS的独立因素(HR=2.546,95%CI:1.644~3.943,P<0.05)。包括GRIm评分的列线图对CRC患者DFS的预测能力优于第8版AJCC分期系统。结论GRIm评分是影响CRC患者DFS的独立因素,基于GRIm评分的列线图可以帮助临床医师有效评估CRC患者的预后,制定个体化治疗方案。

基于中心偏移的Fisher score与直觉邻域模糊熵的多标记特征选择

现有多标记Fisher score模型中边缘样本会影响算法分类效果。鉴于邻域直觉模糊熵处理不确定信息时具有更强的表达能力与分辨能力的优势,文中提出了一种基于中心偏移的Fisher score与邻域直觉模糊熵的多标记特征选择方法。首先,根据标记将多标记论域划分为多个样本集,计算样本集的特征均值作为标记下样本的原始中心点,以最远样本的距离乘以距离系数,去除边缘样本集,定义了新的有效样本集,计算中心偏移处理后的标记下每个特征的得分以及标记集的特征得分,进而建立了基于中心偏移的多标记Fisher score模型,预处理多标记数据。然后,引入多标记分类间隔作为自适应模糊邻域半径参数,定义了模糊邻域相似关系和模糊邻域粒,由此构造了多标记模糊邻域粗糙集的上、下近似集;在此基础上提出了多标记邻域粗糙直觉隶属度函数和非隶属度函数,定义了多标记邻域直觉模糊熵。最后,给出了特征的外部和内部重要度的计算公式,设计了基于邻域直觉模糊熵的多标记特征选择算法,筛选出最优特征子集。在多标记K近邻分类器下、9个多标记数据集上的实验结果表明,所提算法选择的最优子集具有良好的分类性能。

Role of albumin-bilirubin score in non-malignant liver disease

The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary cholangitis,liver cirrhosis,hepatitis,liver transplantation,and liver injury.The ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction models.It is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection indicators.An increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease;additionally,it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases,such as decompensation events.This article presents a review of the application of ALBI scores in various non-malignant liver diseases.