基于改进Ratio统计量的重尾AR(p)时间序列均值变点检验

文章提出两个改进的Ratio统计量来研究重尾AR(p)时间序列均值变点检验问题,在原假设下推导了统计量的渐近分布,且在备择假设下证明了其一致性。由于重尾指数未知且难以估计,因此结合Wild Bootstrap重抽样方法来确定渐近分布的临界值;在均值变点存在的情形下,给出了变点位置的一致估计量。数值模拟结果表明:统计量的临界值均不受重尾指数和自回归系数的影响,其经验水平和经验势均取得满意的效果;尤其在原假设下,积分型Ratio统计量的经验水平表现出更好的稳健性,而在备择假设下,最值型Ratio统计量则具备更好的显著性。最后,基于一组股票数据,从实际应用角度进一步阐明所提方法的有效性和可行性。

Thermally insulating and fire-retardant bio-mimic structural composites with a negative Poisson's ratio for battery protection

Battery safety has attracted considerable attention worldwide due to the rapid development of wearable electronics and the steady increase in the production and use of electric vehicles.As battery failures are often associated with mechanical-thermal coupled behaviors,protective shielding materials with excellent mechanical robustness and flame-retardant properties are highly desired to mitigate thermal runaway.However,most of the thermal insulating materials are not strong enough to protect batteries from mechanical abuse,which is one of the most critical scenarios with catastrophic consequences.Here,inspired by wood,we have developed an effective approach to engineer a hierarchical nanocomposite via self-assembly of calcium silicate hydrate and polyvinyl alcohol polymer chains(referred as CSH wood).The versatile protective material CSH wood demonstrates an unprecedented combination of light weight(0.018 g cm-3),high stiffness(204 MPa in the axial direction),negative Poisson's ratio(-0.15),remarkable toughness(6.67×105 J m-3),superior thermal insulation(0.0204 W m-1 K-1 in the radial direction),and excellent fire retardancy(UL94-V0).When applied as a protective cover or a protective layer within battery packages,the tough CSH wood can resist high-impact load and block heat diffusion to block or delay the spread of fire,therefore significantly reducing the risk of property damage or bodily injuries caused by battery explosions.This work provides new pathways for fabricating advanced thermal insulating materials with large scalability and demonstrates great potential for the protection of electronic devices.

Statics, vibration, and buckling of sandwich plates with metamaterial cores characterized by negative thermal expansion and negative Poisson's ratio

This paper proposes a three-dimensional(3D)Maltese cross metamaterial with negative Poisson’s ratio(NPR)and negative thermal expansion(NTE)adopted as the core layers in sandwich plates,and aims to explore the relations between the mechanical responses of sandwich composites and the NPR or NTE of the metamaterial.First,the NPR and NTE of the metamaterial are derived analytically based on energy conservation.The effective elastic modulus and mass density of the 3D metamaterial are obtained and validated by the finite element method(FEM).Subsequently,the general governing equation of the 3D sandwich plate under thermal environments is established based on Hamilton’s principle with the consideration of the von Kármán nonlinearity.The differential quadrature(DQ)FEM(DQFEM)is utilized to obtain the numerical solutions.It is shown that NPR and NTE can enhance the global stiffness of sandwich structures.The geometric parameters of the Maltese cross metamaterial significantly affect the responses of the thermal stress,natural frequency,and critical buckling load.

A new strategy for ionospheric remote sensing using the 130.4/135.6 nm airglow intensity ratios

We demonstrate here that global-scale determination of a key ionospheric parameter,the peak height of the F_(2)region(h_(m)F_(2)),can be obtained by making a simple ratio measurement of the atomic oxygen 130.4 and 135.6 nm emissions in the far-ultraviolet nightglow with a nadir-viewing system such as a pair of photometers suitable for flight on a CubeSat.We further demonstrate that measurements from an altitude that is within the typical range of nighttime h_(m)F_(2)250−450 km can provide the ratios that are needed for retrieval of the h_(m)F_(2).Our study is conducted mostly through numerical simulations by using radiative transfer models of the two emissions coupled with empirical models of the atmosphere and ionosphere.Modeling results show that the relationship between the h_(m)F_(2)and the intensity ratio is sensitive to the altitude from which the emissions are observed,primarily because of the distinctly different degrees of resonant scattering of the two emissions in the atmosphere.A roughly quadratic relationship can be established for observations from an orbit of~400 km,which enables h_(m)F_(2)retrieval.Parametric analysis indicates that the relationship can be affected by the ambient atmospheric conditions through resonant scattering and O2 absorption.For typical nighttime conditions with h_(m)F_(2)250−450 km,retrieval of the h_(m)F_(2)from synthetic observations shows that the typical errors are only a few kilometers(up to~20 km),depending on the accuracy of the ambient conditions predicted by the empirical models.Our findings pave the way for use of the 130.4/135.6 nm intensity ratios for global-scale monitoring of the nighttime ionosphere at mid to low latitudes.

ASTER Data Processing by Discrete Wavelets Transform and Band Ratio Techniques for the Identification of Lineaments and Hydrothermal Alteration Zones in Poli, North Cameroon

The aim of this study is to carry out hydrothermal alteration mapping and structural mapping using ASTER images in order to identify indices that could guide mining exploration work in the Poli area and its surroundings. To achieve this, the ASTER images were first preprocessed to correct atmospheric effects and remove vegetation influence. Secondly, a lineament mapping was conducted by applying Discrete Wavelet Transform (DWT) algorithms to the First Principal Component Analysis (PCA1) of Visible Near-Infrared (VNIR) and Shortwave Infrared (SWIR) bands. Lastly, band ratio methods were applied to the VNIR, SWIR, and Thermal Infrared (TIR) bands to determine indices of iron oxides/hydroxides (hematite and limonite), hydroxyl-bearing minerals (chlorite, epidote, and muscovite), and the quartz index. The results obtained showed that the lineaments were mainly oriented NE-SW, ENE-WSW, and E-W, with NE-SW being the most predominant direction. Concerning hydrothermal alteration, the identified indices covered almost the entire study area and showed a strong correlation with lithological data. Overlaying the obtained lineaments with the hydrothermal alteration indices revealed a significant correlation between existing mining indices and those observed in the field. Mineralized zones generally coincided with areas of high lineament density exhibiting significant hydrothermal alteration. Based on the correlation between existing mining indices and the results of hydrothermal and structural mapping, the results obtained can then be used as a reference document for any mining exploration in the study area.

The Most Irrational Number that Shows up Everywhere: The Golden Ratio

Since the time of the ancient Greeks, humans have been aware of this mathematical idea. Golden ratio is an irrational number that is symbolized by the Greek numeral phi (φ). One can find this ratio everywhere. It is in nature, art, architecture, human body, etc. But this symbolism can result in a strong connection with mathematical nature. In this paper we will be discussing the connection between Fibonacci sequence (a series of numbers where every number is equal to the sum of two numbers before it) and Golden ratio. Secondly, how this mathematical idea shows up in a nature, such as sunflower and human DNA.

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.

Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer:A meta-analysis and systematic review

Objective: To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic diseases.Methods: A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect model.Results: Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: −0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24).Conclusion: The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.

Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

Optimal scheduling of a township integrated-energy system using the adjustable heat-electricity ratio model

With the expansion and implementation of rural revitalization strategies,there is a constant need for new energy sources for the construction of new townships.Consequently,integrated energy systems with the interconnection and interaction of multiple energy sources are developing rapidly.Biomass energy,a renewable green energy source with low pollution and wide distribution,has significant application potential in integrated energy systems.Considering the application of biomass energy in townships,this study established an integrated biomass energy system and proposed a model to optimize its operation.Lowest economic cost and highest clean energy utilization rate were considered as the objective functions.In addition,a plan was suggested to adjust the heat-electricity ratio based on the characteristics of the combined heat and power of the biomass.Finally,a simulation analysis conducted for a town in China was discussed,demonstrating that the construction of a township integrated-energy system and the use of biomass can significantly reduce operating costs and improve the energy utilization rate.Moreover,by adjusting the heat-electricity ratio,the economic cost was further reduced by 6.70%,whereas the clean energy utilization rate was increased by 5.14%.

Isotopic dependence of the yield ratios of light fragments from different projectiles and their unified neutron skin thicknesses

The yield ratios of neutron-proton(R(n/p))and^(3)H-^(3)He(R(^(3)H∕^(3)He))with reduced rapidity from 0 to 0.5 were simulated at 50 MeV/u even-even ^(36−56)Ca+^(40)Ca,even-even ^(48−78)Ni+^(58)Ni,and ^(100−139)Sn(every third isotopes)+112 Sn for full reduced impact parameters using the isospin-dependent quantum molecular dynamics(IQMD)model.The neutron and proton density distributions and root-mean-square radii of the reaction systems were obtained using the Skyrme-Hartree-Fock model,which was used for the phase space initialization of the projectile and target in IQMD.We defined the unified neutron skin thickness asΔRnp=<r^(2)>^(1∕2) n−<r^(2)>^(1∕2)p,which was negative for neutron-deficient nuclei.The unifiedΔRnp values for nuclei with the same relative neutron excess from different isotopic chains were nearly equal,except for extreme neutron-rich isotopes,which is a type of scaling behavior.The yield ratios of the three isotopic chain-induced reactions,which depended on the reduced impact parameter and unified neutron skin thickness,were studied.The results showed that both R(n/p)and R(^(3)H∕^(3)He)decreased with a reduced impact parameter for extreme neutron-deficient isotopes;however,they increased with reduced impact parameters for extreme neutron-rich isotopes,and increased with theΔRnp of the projectiles for all reduced impact parameters.In addition,a scaling phenomenon was observed betweenΔR np and the yield ratios in peripheral colli-sions from different isotopic chain projectiles(except for extreme neutron-rich isotopes).Thus,R(n/p)and R(^(3)H∕^(3)He)from peripheral collisions were suggested as experimental probes for extracting the neutron or proton skin thicknesses of non-extreme neutron-rich nuclei from different isotopic chains.

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.

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.

Topology Optimization of Metamaterial Microstructures for Negative Poisson’s Ratio under Large Deformation Using a Gradient-Free Method

Negative Poisson’s ratio(NPR)metamaterials are attractive for their unique mechanical behaviors and potential applications in deformation control and energy absorption.However,when subjected to significant stretching,NPR metamaterials designed under small strain assumption may experience a rapid degradation in NPR performance.To address this issue,this study aims to design metamaterials maintaining a targeted NPR under large deformation by taking advantage of the geometry nonlinearity mechanism.A representative periodic unit cell is modeled considering geometry nonlinearity,and its topology is designed using a gradient-free method.The unit cell microstructural topologies are described with the material-field series-expansion(MFSE)method.The MFSE method assumes spatial correlation of the material distribution,which greatly reduces the number of required design variables.To conveniently design metamaterials with desired NPR under large deformation,we propose a two-stage gradient-free metamaterial topology optimization method,which fully takes advantage of the dimension reduction benefits of the MFSE method and the Kriging surrogate model technique.Initially,we use homogenization to find a preliminary NPR design under a small deformation assumption.In the second stage,we begin with this preliminary design and minimize deviations in NPR from a targeted value under large deformation.Using this strategy and solution technique,we successfully obtain a group of NPR metamaterials that can sustain different desired NPRs in the range of[−0.8,−0.1]under uniaxial stretching up to 20% strain.Furthermore,typical microstructure designs are fabricated and tested through experiments.The experimental results show good consistency with our numerical results,demonstrating the effectiveness of the present gradientfree NPR metamaterial design strategy.

Influence of Trailing-Edge Wear on the Vibrational Behavior of Wind Turbine Blades

To study the impact of the trailing-edge wear on the vibrational behavior of wind-turbine blades,unworn blades and trailing-edge worn blades have been assessed through relevant modal tests.According to these experiments,the natural frequencies of trailing-edge worn blades-1,-2,and-3 increase the most in the second to fourth order,thefifth order increases in the middle,and thefirst order increases the least.The damping ratio data indi-cate that,in general,thefirstfive-order damping ratios of trailing-edge worn blades-1 and trailing-edge worn blades-2 are reduced,and thefirstfive-order damping ratios of trailing-edge worn blades-3 are slightly improved.The mode shape diagram shows that the trailing-edge worn blades-1 and-2 have a large swing in the tip and the blade,whereas the second-and third-order vibration shapes of the trailing edge-worn blade-3 tend to be improved.Overall,all these results reveal that the blade’s mass and the wear area are the main fac-tors affecting the vibration characteristics of wind turbine blades.

A gated recurrent unit model to predict Poisson’s ratio using deep learning

Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.

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.

Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.

Prognostic value of circulating tumor cells combined with neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma

BACKGROUND Circulating tumor cell(CTC)count and neutrophil-to-lymphocyte ratio(NLR)are both closely associated with the prognosis of hepatocellular carcinoma(HCC).AIM To investigate the prognostic value of combining these two indicators in HCC.METHODS Clinical data were collected from patients with advanced HCC who received im-mune therapy combined with targeted therapy at the Department of Oncology,the Affiliated Hospital of Southwest Medical University,Sichuan,China,from 2021 to 2023.The optimal cutoff values for CTC programmed death-ligand 1(PD-L1)(+)>1 or CTC PD-L1(+)≤1 and NLR>3.89 or NLR≤3.89 were evaluated using X-Tile software.Patients were categorized into three groups based on CTC PD-L1(+)counts and NLR:CTC-NLR(0),CTC-NLR(1),and CTC-NLR(2).The relationship between CTC-NLR and clinical variables as well as survival rates was assessed.RESULTS Patients with high CTC PD-L1(+)expression or NLR at baseline had shorter median progression-free survival(m-PFS)and median overall survival(mOS)than those with low levels of CTC PD-L1(+)or NLR(P<0.001).Mean-while,patients in the CTC-NLR(2)group showed a significant decrease in mPFS and mOS.Cox regression analysis revealed that alpha-fetoprotein(AFP),CTC PD-L1(+),and CTC-NLR were independent predictors of OS.The time-dependent receiver operating characteristic curve showed that the area under the curve of CTC-NLR at 12 months(0.821)and 18 months(0.821)was superior to that of AFP and CTC PD-L1(+).CONCLUSION HCC patients with high CTC PD-L1(+)or NLR expression tend to exhibit poor prognosis,and a high baseline CTC-NLR score may indicate low survival.CTC-NLR may serve as an effective prognostic indicator for patients with advanced HCC receiving immunotherapy combined with targeted therapy.

Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

BACKGROUND Traditional lymph node stage(N stage)has limitations in advanced gastric remnant cancer(GRC)patients;therefore,establishing a new predictive stage is necessary.AIM To explore the predictive value of positive lymph node ratio(LNR)according to clinicopathological characteristics and prognosis of locally advanced GRC.METHODS Seventy-four patients who underwent radical gastrectomy and lymphadenectomy for locally advanced GRC were retrospectively reviewed.The relationship between LNR and clinicopathological characteristics was analyzed.The survival analysis was performed using Kaplan-Meier survival curves and Cox regression model.RESULTS Number of metastatic LNs,tumor diameter,depth of tumor invasion,Borrmann type,serum tumor biomarkers,and tumor-node-metastasis(TNM)stage were correlated with LNR stage and N stage.Univariate analysis revealed that the factors affecting survival included tumor diameter,anemia,serum tumor biomarkers,vascular or neural invasion,combined resection,LNR stage,N stage,and TNM stage(all P<0.05).The median survival time for those with LNR0,LNR1,LNR2 and LNR3 stage were 61,31,23 and 17 mo,respectively,and the differences were significant(P=0.000).Anemia,tumor biomarkers and LNR stage were independent prognostic factors for survival in multivariable analysis(all P<0.05).CONCLUSION The new LNR stage is uniquely based on number of metastatic LNs,with significant prognostic value for locally advanced GRC,and could better differentiate overall survival,compared with N stage.