BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
BACKGROUND Gastric cancer is one of the most common malignant tumors in the digestive system,ranking sixth in incidence and fourth in mortality worldwide.Since 42.5%of metastatic lymph nodes in gastric cancer belong t...BACKGROUND Gastric cancer is one of the most common malignant tumors in the digestive system,ranking sixth in incidence and fourth in mortality worldwide.Since 42.5%of metastatic lymph nodes in gastric cancer belong to nodule type and peripheral type,the application of imaging diagnosis is restricted.AIM To establish models for predicting the risk of lymph node metastasis in gastric cancer patients using machine learning(ML)algorithms and to evaluate their pre-dictive performance in clinical practice.METHODS Data of a total of 369 patients who underwent radical gastrectomy at the Depart-ment of General Surgery of Affiliated Hospital of Xuzhou Medical University(Xuzhou,China)from March 2016 to November 2019 were collected and retro-spectively analyzed as the training group.In addition,data of 123 patients who underwent radical gastrectomy at the Department of General Surgery of Jining First People’s Hospital(Jining,China)were collected and analyzed as the verifi-cation group.Seven ML models,including decision tree,random forest,support vector machine(SVM),gradient boosting machine,naive Bayes,neural network,and logistic regression,were developed to evaluate the occurrence of lymph node metastasis in patients with gastric cancer.The ML models were established fo-llowing ten cross-validation iterations using the training dataset,and subsequently,each model was assessed using the test dataset.The models’performance was evaluated by comparing the area under the receiver operating characteristic curve of each model.RESULTS Among the seven ML models,except for SVM,the other ones exhibited higher accuracy and reliability,and the influences of various risk factors on the models are intuitive.CONCLUSION The ML models developed exhibit strong predictive capabilities for lymph node metastasis in gastric cancer,which can aid in personalized clinical diagnosis and treatment.展开更多
Objective:This study aimed to establish a nomogram model to predict the mortality risk of patients with dangerous upper gastrointestinal bleeding(DUGIB),and identify high-risk patients who require emergent therapy.Met...Objective:This study aimed to establish a nomogram model to predict the mortality risk of patients with dangerous upper gastrointestinal bleeding(DUGIB),and identify high-risk patients who require emergent therapy.Methods:From January 2020 to April 2022,the clinical data of 256 DUGIB patients who received treatments in the intensive care unit(ICU)were retrospectively collected from Renmin Hospital of Wuhan University(n=179)and the Eastern Campus of Renmin Hospital of Wuhan University(n=77).The 179 patients were treated as the training cohort,and 77 patients as the validation cohort.Logistic regression analysis was used to calculate the independent risk factors,and R packages were used to construct the nomogram model.The prediction accuracy and identification ability were evaluated by the receiver operating characteristic(ROC)curve,C index and calibration curve.The nomogram model was also simultaneously externally validated.Decision curve analysis(DCA)was then used to demonstrate the clinical value of the model.Results:Logistic regression analysis showed that hematemesis,urea nitrogen level,emergency endoscopy,AIMS65,Glasgow Blatchford score and Rockall score were all independent risk factors for DUGIB.The ROC curve analysis indicated the area under curve(AUC)of the training cohort was 0.980(95%CI:0.962-0.997),while the AUC of the validation cohort was 0.790(95%CI:0.685-0.895).The calibration curves were tested for Hosmer-Lemeshow goodness of fit for both training and validation cohorts(P=0.778,P=0.516).Conclusion:The developed nomogram is an effective tool for risk stratification,early identification and intervention for DUGIB patients.展开更多
Neuromyelitis optica spectrum disorders are neuroinflammatory demyelinating disorders that lead to permanent visual loss and motor dysfunction.To date,no effective treatment exists as the exact causative mechanism rem...Neuromyelitis optica spectrum disorders are neuroinflammatory demyelinating disorders that lead to permanent visual loss and motor dysfunction.To date,no effective treatment exists as the exact causative mechanism remains unknown.Therefore,experimental models of neuromyelitis optica spectrum disorders are essential for exploring its pathogenesis and in screening for therapeutic targets.Since most patients with neuromyelitis optica spectrum disorders are seropositive for IgG autoantibodies against aquaporin-4,which is highly expressed on the membrane of astrocyte endfeet,most current experimental models are based on aquaporin-4-IgG that initially targets astrocytes.These experimental models have successfully simulated many pathological features of neuromyelitis optica spectrum disorders,such as aquaporin-4 loss,astrocytopathy,granulocyte and macrophage infiltration,complement activation,demyelination,and neuronal loss;however,they do not fully capture the pathological process of human neuromyelitis optica spectrum disorders.In this review,we summarize the currently known pathogenic mechanisms and the development of associated experimental models in vitro,ex vivo,and in vivo for neuromyelitis optica spectrum disorders,suggest potential pathogenic mechanisms for further investigation,and provide guidance on experimental model choices.In addition,this review summarizes the latest information on pathologies and therapies for neuromyelitis optica spectrum disorders based on experimental models of aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders,offering further therapeutic targets and a theoretical basis for clinical trials.展开更多
This study was aimed to prepare landslide susceptibility maps for the Pithoragarh district in Uttarakhand,India,using advanced ensemble models that combined Radial Basis Function Networks(RBFN)with three ensemble lear...This study was aimed to prepare landslide susceptibility maps for the Pithoragarh district in Uttarakhand,India,using advanced ensemble models that combined Radial Basis Function Networks(RBFN)with three ensemble learning techniques:DAGGING(DG),MULTIBOOST(MB),and ADABOOST(AB).This combination resulted in three distinct ensemble models:DG-RBFN,MB-RBFN,and AB-RBFN.Additionally,a traditional weighted method,Information Value(IV),and a benchmark machine learning(ML)model,Multilayer Perceptron Neural Network(MLP),were employed for comparison and validation.The models were developed using ten landslide conditioning factors,which included slope,aspect,elevation,curvature,land cover,geomorphology,overburden depth,lithology,distance to rivers and distance to roads.These factors were instrumental in predicting the output variable,which was the probability of landslide occurrence.Statistical analysis of the models’performance indicated that the DG-RBFN model,with an Area Under ROC Curve(AUC)of 0.931,outperformed the other models.The AB-RBFN model achieved an AUC of 0.929,the MB-RBFN model had an AUC of 0.913,and the MLP model recorded an AUC of 0.926.These results suggest that the advanced ensemble ML model DG-RBFN was more accurate than traditional statistical model,single MLP model,and other ensemble models in preparing trustworthy landslide susceptibility maps,thereby enhancing land use planning and decision-making.展开更多
This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV i...This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.展开更多
BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized p...BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.展开更多
Rare neurological diseases,while individually are rare,collectively impact millions globally,leading to diverse and often severe neurological symptoms.Often attributed to genetic mutations that disrupt protein functio...Rare neurological diseases,while individually are rare,collectively impact millions globally,leading to diverse and often severe neurological symptoms.Often attributed to genetic mutations that disrupt protein function or structure,understanding their genetic basis is crucial for accurate diagnosis and targeted therapies.To investigate the underlying pathogenesis of these conditions,researchers often use non-mammalian model organisms,such as Drosophila(fruit flies),which is valued for their genetic manipulability,cost-efficiency,and preservation of genes and biological functions across evolutionary time.Genetic tools available in Drosophila,including CRISPR-Cas9,offer a means to manipulate gene expression,allowing for a deep exploration of the genetic underpinnings of rare neurological diseases.Drosophila boasts a versatile genetic toolkit,rapid generation turnover,and ease of large-scale experimentation,making it an invaluable resource for identifying potential drug candidates.Researchers can expose flies carrying disease-associated mutations to various compounds,rapidly pinpointing promising therapeutic agents for further investigation in mammalian models and,ultimately,clinical trials.In this comprehensive review,we explore rare neurological diseases where fly research has significantly contributed to our understanding of their genetic basis,pathophysiology,and potential therapeutic implications.We discuss rare diseases associated with both neuron-expressed and glial-expressed genes.Specific cases include mutations in CDK19 resulting in epilepsy and developmental delay,mutations in TIAM1 leading to a neurodevelopmental disorder with seizures and language delay,and mutations in IRF2BPL causing seizures,a neurodevelopmental disorder with regression,loss of speech,and abnormal movements.And we explore mutations in EMC1 related to cerebellar atrophy,visual impairment,psychomotor retardation,and gain-of-function mutations in ACOX1 causing Mitchell syndrome.Loss-of-function mutations in ACOX1 result in ACOX1 deficiency,characterized by very-long-chain fatty acid accumulation and glial degeneration.Notably,this review highlights how modeling these diseases in Drosophila has provided valuable insights into their pathophysiology,offering a platform for the rapid identification of potential therapeutic interventions.Rare neurological diseases involve a wide range of expression systems,and sometimes common phenotypes can be found among different genes that cause abnormalities in neurons or glia.Furthermore,mutations within the same gene may result in varying functional outcomes,such as complete loss of function,partial loss of function,or gain-of-function mutations.The phenotypes observed in patients can differ significantly,underscoring the complexity of these conditions.In conclusion,Drosophila represents an indispensable and cost-effective tool for investigating rare neurological diseases.By facilitating the modeling of these conditions,Drosophila contributes to a deeper understanding of their genetic basis,pathophysiology,and potential therapies.This approach accelerates the discovery of promising drug candidates,ultimately benefiting patients affected by these complex and understudied diseases.展开更多
To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral cortex.However,these me...To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral cortex.However,these methods often require complex systems and the effect of age on cerebral embolism has not been adequately studied,although ischemic stroke is strongly age-related.In this study,we propose an optical-resolution photoacoustic microscopy-based visualized photothrombosis methodology to create and monitor ischemic stroke in mice simultaneously using a 532 nm pulsed laser.We observed the molding process in mice of different ages and presented age-dependent vascular embolism differentiation.Moreover,we integrated optical coherence tomography angiography to investigate age-associated trends in cerebrovascular variability following a stroke.Our imaging data and quantitative analyses underscore the differential cerebrovascular responses to stroke in mice of different ages,thereby highlighting the technique's potential for evaluating cerebrovascular health and unraveling age-related mechanisms involved in ischemic strokes.展开更多
The Internet of Things(IoT)has orchestrated various domains in numerous applications,contributing significantly to the growth of the smart world,even in regions with low literacy rates,boosting socio-economic developm...The Internet of Things(IoT)has orchestrated various domains in numerous applications,contributing significantly to the growth of the smart world,even in regions with low literacy rates,boosting socio-economic development.This study provides valuable insights into optimizing wireless communication,paving the way for a more connected and productive future in the mining industry.The IoT revolution is advancing across industries,but harsh geometric environments,including open-pit mines,pose unique challenges for reliable communication.The advent of IoT in the mining industry has significantly improved communication for critical operations through the use of Radio Frequency(RF)protocols such as Bluetooth,Wi-Fi,GSM/GPRS,Narrow Band(NB)-IoT,SigFox,ZigBee,and Long Range Wireless Area Network(LoRaWAN).This study addresses the optimization of network implementations by comparing two leading free-spreading IoT-based RF protocols such as ZigBee and LoRaWAN.Intensive field tests are conducted in various opencast mines to investigate coverage potential and signal attenuation.ZigBee is tested in the Tadicherla open-cast coal mine in India.Similarly,LoRaWAN field tests are conducted at one of the associated cement companies(ACC)in the limestone mine in Bargarh,India,covering both Indoor-toOutdoor(I2O)and Outdoor-to-Outdoor(O2O)environments.A robust framework of path-loss models,referred to as Free space,Egli,Okumura-Hata,Cost231-Hata and Ericsson models,combined with key performance metrics,is employed to evaluate the patterns of signal attenuation.Extensive field testing and careful data analysis revealed that the Egli model is the most consistent path-loss model for the ZigBee protocol in an I2O environment,with a coefficient of determination(R^(2))of 0.907,balanced error metrics such as Normalized Root Mean Square Error(NRMSE)of 0.030,Mean Square Error(MSE)of 4.950,Mean Absolute Percentage Error(MAPE)of 0.249 and Scatter Index(SI)of 2.723.In the O2O scenario,the Ericsson model showed superior performance,with the highest R^(2)value of 0.959,supported by strong correlation metrics:NRMSE of 0.026,MSE of 8.685,MAPE of 0.685,Mean Absolute Deviation(MAD)of 20.839 and SI of 2.194.For the LoRaWAN protocol,the Cost-231 model achieved the highest R^(2)value of 0.921 in the I2O scenario,complemented by the lowest metrics:NRMSE of 0.018,MSE of 1.324,MAPE of 0.217,MAD of 9.218 and SI of 1.238.In the O2O environment,the Okumura-Hata model achieved the highest R^(2)value of 0.978,indicating a strong fit with metrics NRMSE of 0.047,MSE of 27.807,MAPE of 27.494,MAD of 37.287 and SI of 3.927.This advancement in reliable communication networks promises to transform the opencast landscape into networked signal attenuation.These results support decision-making for mining needs and ensure reliable communications even in the face of formidable obstacles.展开更多
Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen r...Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen receptor protein,characterized by polyglutamine expansion,is prone to misfolding and forms aggregates in both the nucleus and cytoplasm in the brain in spinal and bulbar muscular atrophy patients.These aggregates alter protein-protein interactions and compromise transcriptional activity.In this study,we reported that in both cultured N2a cells and mouse brain,mutant androgen receptor with polyglutamine expansion causes reduced expression of mesencephalic astrocyte-de rived neurotrophic factor.Overexpressio n of mesencephalic astrocyte-derived neurotrophic factor amelio rated the neurotoxicity of mutant androgen receptor through the inhibition of mutant androgen receptor aggregation.Conversely.knocking down endogenous mesencephalic astrocyte-derived neurotrophic factor in the mouse brain exacerbated neuronal damage and mutant androgen receptor aggregation.Our findings suggest that inhibition of mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor is a potential mechanism underlying neurodegeneration in spinal and bulbar muscular atrophy.展开更多
BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To...BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.展开更多
Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important a...Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important and scarce network resources such as bandwidth and processing power.There have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial losses.This paper draws its motivation from such real network disaster incidents attributed to signaling storms.In this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and countermeasures.We provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding solutions.Another important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a table.This paper presents an update and an extension of our earlier conference publication.To our knowledge,no similar survey study exists on the subject.展开更多
安全生产事故往往由多组织交互、多因素耦合造成,事故原因涉及多个组织。为预防和遏制多组织生产安全事故的发生,基于系统理论事故建模与过程模型(Systems-Theory Accident Modeling and Process,STAMP)、24Model,构建一种用于多组织事...安全生产事故往往由多组织交互、多因素耦合造成,事故原因涉及多个组织。为预防和遏制多组织生产安全事故的发生,基于系统理论事故建模与过程模型(Systems-Theory Accident Modeling and Process,STAMP)、24Model,构建一种用于多组织事故分析的方法,并以青岛石油爆炸事故为例进行事故原因分析。结果显示:STAMP-24Model可以分组织,分层次且有效、全面、详细地分析涉及多个组织的事故原因,探究多组织之间的交互关系;对事故进行动态演化分析,可得到各组织不安全动作耦合关系与形成的事故失效链及管控失效路径,进而为预防多组织事故提供思路和参考。展开更多
The two-center problem,also known as Euler's three-body problem,is a classic example of integrable systems.Among its periodic solutions,planetary type solutions are periodic solutions which enclose both centers.In...The two-center problem,also known as Euler's three-body problem,is a classic example of integrable systems.Among its periodic solutions,planetary type solutions are periodic solutions which enclose both centers.Inspired by advances on n-body and n-center problems via variational techniques developed during the past two decades,a recent paper(Arch.Rat.Mech.Ana.2022)shows the minimizing property of planetary type solutions for any given masses of centers at fixed positions,as long as the period is above a mass-dependent threshold value.In this paper,we provide further discussions regarding this minimizing approach.In particular,we improve the above-mentioned mass-dependent threshold value by refining estimates for action values.展开更多
We theoretically investigate the two-center interference in high-order harmonics generated from the H2-+ in a combination of a mid-infrared laser and a terahertz field by numerically solving the time-dependent Schr &...We theoretically investigate the two-center interference in high-order harmonics generated from the H2-+ in a combination of a mid-infrared laser and a terahertz field by numerically solving the time-dependent Schr ¨odinger equation(TDSE).The interference minima in high-order harmonic generation(HHG) are effectively suppressed when a THz field is added.The contribution to HHG from the two separate nuclei is used to demonstrate the locating order of the harmonic minima.Furthermore, we also investigate the emission time of harmonics. The results show that the intensity of the short path around 60^th order after adding a THz field is stronger than that in the mid-infrared laser field, which further illustrates the suppression of the interference minima in HHG.展开更多
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘BACKGROUND Gastric cancer is one of the most common malignant tumors in the digestive system,ranking sixth in incidence and fourth in mortality worldwide.Since 42.5%of metastatic lymph nodes in gastric cancer belong to nodule type and peripheral type,the application of imaging diagnosis is restricted.AIM To establish models for predicting the risk of lymph node metastasis in gastric cancer patients using machine learning(ML)algorithms and to evaluate their pre-dictive performance in clinical practice.METHODS Data of a total of 369 patients who underwent radical gastrectomy at the Depart-ment of General Surgery of Affiliated Hospital of Xuzhou Medical University(Xuzhou,China)from March 2016 to November 2019 were collected and retro-spectively analyzed as the training group.In addition,data of 123 patients who underwent radical gastrectomy at the Department of General Surgery of Jining First People’s Hospital(Jining,China)were collected and analyzed as the verifi-cation group.Seven ML models,including decision tree,random forest,support vector machine(SVM),gradient boosting machine,naive Bayes,neural network,and logistic regression,were developed to evaluate the occurrence of lymph node metastasis in patients with gastric cancer.The ML models were established fo-llowing ten cross-validation iterations using the training dataset,and subsequently,each model was assessed using the test dataset.The models’performance was evaluated by comparing the area under the receiver operating characteristic curve of each model.RESULTS Among the seven ML models,except for SVM,the other ones exhibited higher accuracy and reliability,and the influences of various risk factors on the models are intuitive.CONCLUSION The ML models developed exhibit strong predictive capabilities for lymph node metastasis in gastric cancer,which can aid in personalized clinical diagnosis and treatment.
基金supported by Wuhan Scientific Research Project(No.EX20B05)National Nature Science Foundation of China(No.82000521).
文摘Objective:This study aimed to establish a nomogram model to predict the mortality risk of patients with dangerous upper gastrointestinal bleeding(DUGIB),and identify high-risk patients who require emergent therapy.Methods:From January 2020 to April 2022,the clinical data of 256 DUGIB patients who received treatments in the intensive care unit(ICU)were retrospectively collected from Renmin Hospital of Wuhan University(n=179)and the Eastern Campus of Renmin Hospital of Wuhan University(n=77).The 179 patients were treated as the training cohort,and 77 patients as the validation cohort.Logistic regression analysis was used to calculate the independent risk factors,and R packages were used to construct the nomogram model.The prediction accuracy and identification ability were evaluated by the receiver operating characteristic(ROC)curve,C index and calibration curve.The nomogram model was also simultaneously externally validated.Decision curve analysis(DCA)was then used to demonstrate the clinical value of the model.Results:Logistic regression analysis showed that hematemesis,urea nitrogen level,emergency endoscopy,AIMS65,Glasgow Blatchford score and Rockall score were all independent risk factors for DUGIB.The ROC curve analysis indicated the area under curve(AUC)of the training cohort was 0.980(95%CI:0.962-0.997),while the AUC of the validation cohort was 0.790(95%CI:0.685-0.895).The calibration curves were tested for Hosmer-Lemeshow goodness of fit for both training and validation cohorts(P=0.778,P=0.516).Conclusion:The developed nomogram is an effective tool for risk stratification,early identification and intervention for DUGIB patients.
文摘Neuromyelitis optica spectrum disorders are neuroinflammatory demyelinating disorders that lead to permanent visual loss and motor dysfunction.To date,no effective treatment exists as the exact causative mechanism remains unknown.Therefore,experimental models of neuromyelitis optica spectrum disorders are essential for exploring its pathogenesis and in screening for therapeutic targets.Since most patients with neuromyelitis optica spectrum disorders are seropositive for IgG autoantibodies against aquaporin-4,which is highly expressed on the membrane of astrocyte endfeet,most current experimental models are based on aquaporin-4-IgG that initially targets astrocytes.These experimental models have successfully simulated many pathological features of neuromyelitis optica spectrum disorders,such as aquaporin-4 loss,astrocytopathy,granulocyte and macrophage infiltration,complement activation,demyelination,and neuronal loss;however,they do not fully capture the pathological process of human neuromyelitis optica spectrum disorders.In this review,we summarize the currently known pathogenic mechanisms and the development of associated experimental models in vitro,ex vivo,and in vivo for neuromyelitis optica spectrum disorders,suggest potential pathogenic mechanisms for further investigation,and provide guidance on experimental model choices.In addition,this review summarizes the latest information on pathologies and therapies for neuromyelitis optica spectrum disorders based on experimental models of aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders,offering further therapeutic targets and a theoretical basis for clinical trials.
基金the University of Transport Technology under the project entitled“Application of Machine Learning Algorithms in Landslide Susceptibility Mapping in Mountainous Areas”with grant number DTTD2022-16.
文摘This study was aimed to prepare landslide susceptibility maps for the Pithoragarh district in Uttarakhand,India,using advanced ensemble models that combined Radial Basis Function Networks(RBFN)with three ensemble learning techniques:DAGGING(DG),MULTIBOOST(MB),and ADABOOST(AB).This combination resulted in three distinct ensemble models:DG-RBFN,MB-RBFN,and AB-RBFN.Additionally,a traditional weighted method,Information Value(IV),and a benchmark machine learning(ML)model,Multilayer Perceptron Neural Network(MLP),were employed for comparison and validation.The models were developed using ten landslide conditioning factors,which included slope,aspect,elevation,curvature,land cover,geomorphology,overburden depth,lithology,distance to rivers and distance to roads.These factors were instrumental in predicting the output variable,which was the probability of landslide occurrence.Statistical analysis of the models’performance indicated that the DG-RBFN model,with an Area Under ROC Curve(AUC)of 0.931,outperformed the other models.The AB-RBFN model achieved an AUC of 0.929,the MB-RBFN model had an AUC of 0.913,and the MLP model recorded an AUC of 0.926.These results suggest that the advanced ensemble ML model DG-RBFN was more accurate than traditional statistical model,single MLP model,and other ensemble models in preparing trustworthy landslide susceptibility maps,thereby enhancing land use planning and decision-making.
基金supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(grant number IMSIU-RP23066).
文摘This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.
基金Supported by National Natural Science Foundation of China,No.81874390 and No.81573948Shanghai Natural Science Foundation,No.21ZR1464100+1 种基金Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission,No.22S11901700the Shanghai Key Specialty of Traditional Chinese Clinical Medicine,No.shslczdzk01201.
文摘BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.
基金supported by Warren Alpert Foundation and Houston Methodist Academic Institute Laboratory Operating Fund(to HLC).
文摘Rare neurological diseases,while individually are rare,collectively impact millions globally,leading to diverse and often severe neurological symptoms.Often attributed to genetic mutations that disrupt protein function or structure,understanding their genetic basis is crucial for accurate diagnosis and targeted therapies.To investigate the underlying pathogenesis of these conditions,researchers often use non-mammalian model organisms,such as Drosophila(fruit flies),which is valued for their genetic manipulability,cost-efficiency,and preservation of genes and biological functions across evolutionary time.Genetic tools available in Drosophila,including CRISPR-Cas9,offer a means to manipulate gene expression,allowing for a deep exploration of the genetic underpinnings of rare neurological diseases.Drosophila boasts a versatile genetic toolkit,rapid generation turnover,and ease of large-scale experimentation,making it an invaluable resource for identifying potential drug candidates.Researchers can expose flies carrying disease-associated mutations to various compounds,rapidly pinpointing promising therapeutic agents for further investigation in mammalian models and,ultimately,clinical trials.In this comprehensive review,we explore rare neurological diseases where fly research has significantly contributed to our understanding of their genetic basis,pathophysiology,and potential therapeutic implications.We discuss rare diseases associated with both neuron-expressed and glial-expressed genes.Specific cases include mutations in CDK19 resulting in epilepsy and developmental delay,mutations in TIAM1 leading to a neurodevelopmental disorder with seizures and language delay,and mutations in IRF2BPL causing seizures,a neurodevelopmental disorder with regression,loss of speech,and abnormal movements.And we explore mutations in EMC1 related to cerebellar atrophy,visual impairment,psychomotor retardation,and gain-of-function mutations in ACOX1 causing Mitchell syndrome.Loss-of-function mutations in ACOX1 result in ACOX1 deficiency,characterized by very-long-chain fatty acid accumulation and glial degeneration.Notably,this review highlights how modeling these diseases in Drosophila has provided valuable insights into their pathophysiology,offering a platform for the rapid identification of potential therapeutic interventions.Rare neurological diseases involve a wide range of expression systems,and sometimes common phenotypes can be found among different genes that cause abnormalities in neurons or glia.Furthermore,mutations within the same gene may result in varying functional outcomes,such as complete loss of function,partial loss of function,or gain-of-function mutations.The phenotypes observed in patients can differ significantly,underscoring the complexity of these conditions.In conclusion,Drosophila represents an indispensable and cost-effective tool for investigating rare neurological diseases.By facilitating the modeling of these conditions,Drosophila contributes to a deeper understanding of their genetic basis,pathophysiology,and potential therapies.This approach accelerates the discovery of promising drug candidates,ultimately benefiting patients affected by these complex and understudied diseases.
基金supported by University of Macao,China,Nos.MYRG2022-00054-FHS and MYRG-GRG2023-00038-FHS-UMDF(to ZY)the Macao Science and Technology Development Fund,China,Nos.FDCT0048/2021/AGJ and FDCT0020/2019/AMJ and FDCT 0011/2018/A1(to ZY)Natural Science Foundation of Guangdong Province of China,No.EF017/FHS-YZ/2021/GDSTC(to ZY)。
文摘To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral cortex.However,these methods often require complex systems and the effect of age on cerebral embolism has not been adequately studied,although ischemic stroke is strongly age-related.In this study,we propose an optical-resolution photoacoustic microscopy-based visualized photothrombosis methodology to create and monitor ischemic stroke in mice simultaneously using a 532 nm pulsed laser.We observed the molding process in mice of different ages and presented age-dependent vascular embolism differentiation.Moreover,we integrated optical coherence tomography angiography to investigate age-associated trends in cerebrovascular variability following a stroke.Our imaging data and quantitative analyses underscore the differential cerebrovascular responses to stroke in mice of different ages,thereby highlighting the technique's potential for evaluating cerebrovascular health and unraveling age-related mechanisms involved in ischemic strokes.
文摘The Internet of Things(IoT)has orchestrated various domains in numerous applications,contributing significantly to the growth of the smart world,even in regions with low literacy rates,boosting socio-economic development.This study provides valuable insights into optimizing wireless communication,paving the way for a more connected and productive future in the mining industry.The IoT revolution is advancing across industries,but harsh geometric environments,including open-pit mines,pose unique challenges for reliable communication.The advent of IoT in the mining industry has significantly improved communication for critical operations through the use of Radio Frequency(RF)protocols such as Bluetooth,Wi-Fi,GSM/GPRS,Narrow Band(NB)-IoT,SigFox,ZigBee,and Long Range Wireless Area Network(LoRaWAN).This study addresses the optimization of network implementations by comparing two leading free-spreading IoT-based RF protocols such as ZigBee and LoRaWAN.Intensive field tests are conducted in various opencast mines to investigate coverage potential and signal attenuation.ZigBee is tested in the Tadicherla open-cast coal mine in India.Similarly,LoRaWAN field tests are conducted at one of the associated cement companies(ACC)in the limestone mine in Bargarh,India,covering both Indoor-toOutdoor(I2O)and Outdoor-to-Outdoor(O2O)environments.A robust framework of path-loss models,referred to as Free space,Egli,Okumura-Hata,Cost231-Hata and Ericsson models,combined with key performance metrics,is employed to evaluate the patterns of signal attenuation.Extensive field testing and careful data analysis revealed that the Egli model is the most consistent path-loss model for the ZigBee protocol in an I2O environment,with a coefficient of determination(R^(2))of 0.907,balanced error metrics such as Normalized Root Mean Square Error(NRMSE)of 0.030,Mean Square Error(MSE)of 4.950,Mean Absolute Percentage Error(MAPE)of 0.249 and Scatter Index(SI)of 2.723.In the O2O scenario,the Ericsson model showed superior performance,with the highest R^(2)value of 0.959,supported by strong correlation metrics:NRMSE of 0.026,MSE of 8.685,MAPE of 0.685,Mean Absolute Deviation(MAD)of 20.839 and SI of 2.194.For the LoRaWAN protocol,the Cost-231 model achieved the highest R^(2)value of 0.921 in the I2O scenario,complemented by the lowest metrics:NRMSE of 0.018,MSE of 1.324,MAPE of 0.217,MAD of 9.218 and SI of 1.238.In the O2O environment,the Okumura-Hata model achieved the highest R^(2)value of 0.978,indicating a strong fit with metrics NRMSE of 0.047,MSE of 27.807,MAPE of 27.494,MAD of 37.287 and SI of 3.927.This advancement in reliable communication networks promises to transform the opencast landscape into networked signal attenuation.These results support decision-making for mining needs and ensure reliable communications even in the face of formidable obstacles.
基金supported by the National Key R&D Program of China,No.2021YFA0805200(to SY)the National Natural Science Foundation of China,No.31970954(to SY)two grants from the Department of Science and Technology of Guangdong Province,Nos.2021ZT09Y007,2020B121201006(both to XJL)。
文摘Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen receptor protein,characterized by polyglutamine expansion,is prone to misfolding and forms aggregates in both the nucleus and cytoplasm in the brain in spinal and bulbar muscular atrophy patients.These aggregates alter protein-protein interactions and compromise transcriptional activity.In this study,we reported that in both cultured N2a cells and mouse brain,mutant androgen receptor with polyglutamine expansion causes reduced expression of mesencephalic astrocyte-de rived neurotrophic factor.Overexpressio n of mesencephalic astrocyte-derived neurotrophic factor amelio rated the neurotoxicity of mutant androgen receptor through the inhibition of mutant androgen receptor aggregation.Conversely.knocking down endogenous mesencephalic astrocyte-derived neurotrophic factor in the mouse brain exacerbated neuronal damage and mutant androgen receptor aggregation.Our findings suggest that inhibition of mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor is a potential mechanism underlying neurodegeneration in spinal and bulbar muscular atrophy.
文摘BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.
基金the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2024-9/1).
文摘Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important and scarce network resources such as bandwidth and processing power.There have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial losses.This paper draws its motivation from such real network disaster incidents attributed to signaling storms.In this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and countermeasures.We provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding solutions.Another important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a table.This paper presents an update and an extension of our earlier conference publication.To our knowledge,no similar survey study exists on the subject.
文摘安全生产事故往往由多组织交互、多因素耦合造成,事故原因涉及多个组织。为预防和遏制多组织生产安全事故的发生,基于系统理论事故建模与过程模型(Systems-Theory Accident Modeling and Process,STAMP)、24Model,构建一种用于多组织事故分析的方法,并以青岛石油爆炸事故为例进行事故原因分析。结果显示:STAMP-24Model可以分组织,分层次且有效、全面、详细地分析涉及多个组织的事故原因,探究多组织之间的交互关系;对事故进行动态演化分析,可得到各组织不安全动作耦合关系与形成的事故失效链及管控失效路径,进而为预防多组织事故提供思路和参考。
文摘The two-center problem,also known as Euler's three-body problem,is a classic example of integrable systems.Among its periodic solutions,planetary type solutions are periodic solutions which enclose both centers.Inspired by advances on n-body and n-center problems via variational techniques developed during the past two decades,a recent paper(Arch.Rat.Mech.Ana.2022)shows the minimizing property of planetary type solutions for any given masses of centers at fixed positions,as long as the period is above a mass-dependent threshold value.In this paper,we provide further discussions regarding this minimizing approach.In particular,we improve the above-mentioned mass-dependent threshold value by refining estimates for action values.
基金supported by the National Natural Science Foundation of China(Grant Nos.61575077,11574117,and 11271158)the Graduate Innovation Fund of Jilin University,China(Grant No.2016153)
文摘We theoretically investigate the two-center interference in high-order harmonics generated from the H2-+ in a combination of a mid-infrared laser and a terahertz field by numerically solving the time-dependent Schr ¨odinger equation(TDSE).The interference minima in high-order harmonic generation(HHG) are effectively suppressed when a THz field is added.The contribution to HHG from the two separate nuclei is used to demonstrate the locating order of the harmonic minima.Furthermore, we also investigate the emission time of harmonics. The results show that the intensity of the short path around 60^th order after adding a THz field is stronger than that in the mid-infrared laser field, which further illustrates the suppression of the interference minima in HHG.