Risk prediction models including the Prostate Health Index(phi)for prostate cancer have been well established and evaluated in the Western population.The aim of this study is to build phi-based risk calculators in a p...Risk prediction models including the Prostate Health Index(phi)for prostate cancer have been well established and evaluated in the Western population.The aim of this study is to build phi-based risk calculators in a prostate biopsy population and evaluate their performanee in predicting prostate cancer(PCa)and high-grade PCa(Gleason score 27)in the Chinese population.We developed risk calculators based on 635 men who underwent initial prostate biopsy.Then,we validated the performance of prostate-specific antigen(PSA),phi,and the risk calculators in an additional observational cohort of 1045 men.We observed that the phi-based risk calculators(risk calculators 2 and 4)outperformed the PSA-based risk calculator for predicting PCa and high-grade PCa in the training cohort.In the validation study,the area under the receiver operating characteristic curve(AUC)for risk calculators 2 and 4 reached 0.91 and 0.92,respectively,for predicting PCa and high-grade PCa,respectively;the AUC values were better than those for risk calculator 1(PSA-based model with an AUC of 0.81 and 0.82,respectively)(all P<0.001).Such superiority was also observed in the stratified population with PSA ranging from 2.0 ng ml^-1 to 10.0 ng ml^-1.Decision curves confirmed that a considerable proportion of unnecessary biopsies could be avoided while applying phi-based risk calculators.In this study,we showed that,compared to risk calculators without phi,phi-based risk calculators exhibited superior discrimination and calibration for PCa in the Chinese biopsy population.Applying these risk calculators also considerably reduced the number of unnecessary biopsies for PCa.展开更多
The performances of the Prostate Cancer Prevention Trial （PCPT） risk calculator and other risk calculators for prostate cancer （PCa） prediction in Chinese populations were poorly understood. We performed this stud...The performances of the Prostate Cancer Prevention Trial （PCPT） risk calculator and other risk calculators for prostate cancer （PCa） prediction in Chinese populations were poorly understood. We performed this study to build risk calculators （Huashan risk calculators） based on Chinese population and validated the performance of prostate-specific antigen （PSA）, PCPT risk calculator, and Huashan risk calculators in a validation cohort. We built Huashan risk calculators based on data from 1059 men who underwent initial prostate biopsy from January 2006 to December 2010 in a training cohort. Then, we validated the performance of PSA, PCPT risk calculator, and Huashan risk calculators in an observational validation study from January 2011 to December 2014. All necessary clinical information were collected before the biopsy. The results showed that Huashan risk calculators 1 and 2 outperformed the PCPT risk calculator for predicting PCa in both entire training cohort and stratified population （with PSA from 2.0 ng ml^-1 to 20.0 ng ml^-1）. In the validation study, Huashan risk calculator 1 still outperformed the PCPT risk calculator in the entire validation cohort （0.849 vs 0.779 in area under the receiver operating characteristic curve [AUC]） and stratified population. A considerable reduction of unnecessary biopsies （approximately 30%） was also observed when the Huashan risk calculators were used. Thus, we believe that the Huashan risk calculators （especially Huashan risk calculator 1） may have added value for predicting PCa in Chinese population. However, these results still needed further evaluation in larger populations.展开更多
Risk calculators are widely used in many clinical fields, and integrate several important risk factors through the conversion of a risk function into a single measure of risk. Several studies have been carried out to ...Risk calculators are widely used in many clinical fields, and integrate several important risk factors through the conversion of a risk function into a single measure of risk. Several studies have been carried out to create risk calculators for the prediction of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Most of them were hospital-based, with limited sample sizes and insufficient external validation. These study groups collaborated to establish the REACH-B risk score, which incorporated five clinical variables to predict HCC risk. This risk score was then validated in international clinical cohorts. Evidence suggests that quantitative serum HBsAg level provides additional predictability of HCC, especially in patients with low levels of hepatitis B virus DNA. This novel marker was incorporated into a risk calculator and was internally validated. This tool will hopefully be externally validated in the near future. Risk calculators can be used to support clinical practice, and to establish preventive measures; several “off-label” extension usages have also been implemented. Albeit beneficial, several precautions and discussions should be noted in using the risk calculators. The future development of risk calculators for CHB patients can be extended by applying them to additional CHB-related outcomes, and by incorporating emerging risk parameters.展开更多
BACKGROUND Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms(PCNs)are lacking.AIM To establish a nomogram-based online calculator for predicting the ris...BACKGROUND Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms(PCNs)are lacking.AIM To establish a nomogram-based online calculator for predicting the risk of malignancy in patients with PCNs.METHODS In this study,the clinicopathological data of target patients in three medical centers were analyzed.The independent sample t-test,Mann–Whitney U test or chi-squared test were used as appropriate for statistical analysis.After univariable and multivariable logistic regression analysis,five independent factors were screened and incorporated to develop a calculator for predicting the risk of malignancy.Finally,the concordance index(C-index),calibration,area under the curve,decision curve analysis and clinical impact curves were used to evaluate the performance of the calculator.RESULTS Enhanced mural nodules[odds ratio(OR):4.314;95%confidence interval(CI):1.618–11.503,P=0.003],tumor diameter≥40 mm(OR:3.514;95%CI:1.138–10.849,P=0.029),main pancreatic duct dilatation(OR:3.267;95%CI:1.230–8.678,P=0.018),preoperative neutrophil-to-lymphocyte ratio≥2.288(OR:2.702;95%CI:1.008–7.244,P=0.048],and preoperative serum CA19-9 concentration≥34 U/mL(OR:3.267;95%CI:1.274–13.007,P=0.018)were independent risk factors for a high risk of malignancy in patients with PCNs.In the training cohort,the nomogram achieved a C-index of 0.824 for predicting the risk of malignancy.The predictive ability of the model was then validated in an external cohort(C-index:0.893).Compared with the risk factors identified in the relevant guidelines,the current model showed better predictive performance and clinical utility.CONCLUSION The calculator demonstrates optimal predictive performance for identifying the risk of malignancy,potentially yielding a personalized method for patient selection and decision-making in clinical practice.展开更多
Millions of men each year are faced with a clinical suspicion of prostate cancer （PCa） but the prostate biopsy fails to detect the disease. For the urologists, how to select the appropriate candidate for repeat biop...Millions of men each year are faced with a clinical suspicion of prostate cancer （PCa） but the prostate biopsy fails to detect the disease. For the urologists, how to select the appropriate candidate for repeat biopsy is a significant clinical dilemma. Traditional risk-stratification tools in this setting such as prostate-specific antigen （PSA） related markers and histopathology findings have met with limited correlation with cancer diagnosis or with significant disease. Thus, an individualized approach using predictive models such as an online risk calculator （RC） or updated biomarkers is more suitable in counseling men about their risk of harboring clinically significant prostate cancer, This review will focus on the available risk-stratification tools in the population of men with prior negative biopsies and persistent suspicion of PCa. The underlying methodology and platforms of the available tools are reviewed to better understand the development and validation of these models. The index patient is then assessed with different RCs to determine the range of heterogeneity among various RCs. This should allow the urologists to better incorporate these various risk-stratification tools into their clinical practice and improve patient counseling.展开更多
BACKGROUND No single endoscopic feature can reliably predict the pathological nature of colorectal tumors(CRTs).AIM To establish and validate a simple online calculator to predict the pathological nature of CRTs based...BACKGROUND No single endoscopic feature can reliably predict the pathological nature of colorectal tumors(CRTs).AIM To establish and validate a simple online calculator to predict the pathological nature of CRTs based on white-light endoscopy.METHODS This was a single-center study.During the identification stage,530 consecutive patients with CRTs were enrolled from January 2015 to December 2021 as the derivation group.Logistic regression analysis was performed.A novel online calculator to predict the pathological nature of CRTs based on white-light images was established and verified internally.During the validation stage,two series of 110 images obtained using white-light endoscopy were distributed to 10 endoscopists[five highly experienced endoscopists and five less experienced endoscopists(LEEs)]for external validation before and after systematic training.RESULTS A total of 750 patients were included,with an average age of 63.6±10.4 years.Early colorectal cancer(ECRC)was detected in 351(46.8%)patients.Tumor size,left semicolon site,rectal site,acanthosis,depression and an uneven surface were independent risk factors for ECRC.The C-index of the ECRC calculator prediction model was 0.906(P=0.225,Hosmer-Lemeshow test).For the LEEs,significant improvement was made in the sensitivity,specificity and accuracy(57.6%vs 75.5%;72.3%vs 82.4%;64.2%vs 80.2%;P<0.05),respectively,after training with the ECRC online calculator prediction model.CONCLUSION A novel online calculator including tumor size,location,acanthosis,depression,and uneven surface can accurately predict the pathological nature of ECRC.展开更多
The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning syste...The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning system (TPS) and the fast dose calculation method (FDC) for single-field optimization (SFO) and multi-field optimization (MFO) IMPT plans. In addition, because some authors have reported dosimetric benefit of a proton arc therapy with ultimate multi-fields in recent years, we wanted to evaluate how the number of fields and beam angles affect the differences for IMPT plans. Therefore, for one brain cancer patient with a large heterogeneity, SFO and MFO IMPT plans with various multi-angle beams were planned by the TPS. Dose distributions for each IMPT plan were calculated by both the TPS’s conventional pencil beam algorithm and the FDC. The dosimetric parameters were compared between the two algorithms. The TPS overestimated 400 - 500 cGy (RBE) for minimum dose to the CTV relative to the dose calculated by the FDC. These differences indicate clinically relevant effect on clinical results. In addition, we observed that the maximum difference in dose calculated between the TPS and the FDC was about 900 cGy (RBE) for the right optic nerve, and this quantity also has a possibility to have a clinical effect. The major difference was not seen in calculations for SFO IMPT planning and those for MFO IMPT planning. Differences between the TPS and the FDC in SFO and MFO IMPT plans depend strongly on beam arrangement and the presence of a heterogeneous body. We advocate use of a Monte Carlo method in proton treatment planning to deliver the most precise proton dose in IMPT.展开更多
Risk calculators have offered a viable tool for clinicians to stratify patients at risk of prostate cancer(PCa)and to mitigate the low sensitivity and specificity of screening prostate specific antigen(PSA).While init...Risk calculators have offered a viable tool for clinicians to stratify patients at risk of prostate cancer(PCa)and to mitigate the low sensitivity and specificity of screening prostate specific antigen(PSA).While initially based on clinical and demographic data,incorporation of multiparametric magnetic resonance imaging(MRI)and the validated prostate imaging reporting and data system suspicion scoring system has standardized and improved risk stratification beyond the use of PSA and patient parameters alone.Biopsy-naïve patients with lower risk profiles for harboring clinically significant PCa are often subjected to uncomfortable,invasive,and potentially unnecessary prostate biopsy procedures.Incorporating risk calculator data into prostate MRI reports can broaden the role of radiologists,improve communication with clinicians primarily managing these patients,and help guide clinical care in directing the screening,detection,and risk stratification of PCa.展开更多
A carbon footprint(CF)calculator was developed to apply to a Portuguese touristic accommodation to contribute to a sustainable touristic activity.Although some calculators are available online,they are related to the ...A carbon footprint(CF)calculator was developed to apply to a Portuguese touristic accommodation to contribute to a sustainable touristic activity.Although some calculators are available online,they are related to the country reality or use outdated emission factors.A calculator based on national emission factors is important.The calculator was developed in Microsoft Excel(version 365)and is based on the CO2e emissions resulting from electricity,water,fuels and food use,laundry and waste production.The calculator development involved:study the accommodation emission sources,selection the environmental indicators,determination of the emission factors and development of the CF formulas.Total CF calculation was made considering the partial CF per component,a monthly and annual comparison of each indicator’s emissions contribution using graphs.The emissions amount per overnight stay,per room,per area,were also assessed and these values were transformed into global hectare(gha).Avoided emissions calculation gives the information about the efforts in CF reduction,and two indicators were considered:electricity production from renewable energy sources and the amount of separated waste for recycling.It was considered reforestation measures to achieve carbon neutrality.This calculator incorporates four components not often used:water,laundry,waste,food,and avoided emissions.展开更多
Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-posi...Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-positive infants retrospectively in infants born in the last 10 years in our hospital.Methods In a retrospective cohort study,the comparison groups were divided into Group A(no antibiotics recommended by KSC)and Group B(antibiotics recommended).Results Overall,17/24(71%)infants would have been started on antibiotics per KSC but 7/24(29%)would not.The initial EOS risk was not significantly different between the groups(Group A vs.Group B:0.44 vs.0.76,P=0.41),but the final risk score was(0.33 vs.9.41,P<0.001).In Group A(no antibiotics),3/7 infants became symptomatic between 9 and 42 hours.Conclusion There may be a potential delay in starting antibiotics in infants that are asymptomatic at birth while using KSC.展开更多
Background： Aspirin is widely used for the prevention of cardiovascular and cerebrovascular diseases for the past few years. However, much attention has been paid to the adverse effects associated with aspirin such a...Background： Aspirin is widely used for the prevention of cardiovascular and cerebrovascular diseases for the past few years. However, much attention has been paid to the adverse effects associated with aspirin such as gastrointestinal bleeding. How to weigh the benefits and hazards？ The current study aimed to assess the feasibility of a cardiovascular/gastrointestinal risk calculator, AsaRiskCalculator, in predicting gastrointestinal events in Chinese patients with myocardial infarction （MI）, determining unique risk factor（s） for gastrointestinal events to be considered in the calculator. Methods： The MI patients who visited Shapingba District People＇s Hospital between January 2012 and January 2016 were retrospectively reviewed. Based on gastroscopic data, the patients were divided into two groups： gastrointestinal and nongastrointestinal groups. Demographic and clinical data of the patients were then retrieved for statistical analysis. Univariate and multiple logistic regression analyses were used to identify independent risk factors for gastrointestinal events. The receiver operating characteristic （ROC） curves were used to assess the predictive value of AsaRiskCalculator for gastrointestinal events. Results： A total of 400 MI patients meeting the eligibility criteria were analyzed, including 94 and 306 in the gastrointestinal and nongastrointestinal groups, respectively. The data showed that age, male gender, predicted gastrointestinal events, and Helicobacterpylori （HP） infection were positively correlated with gastrointestinal events. In multiple logistic regression analysis, predicted gastrointestinal events and HP infection were identified as risk factors for actual gastrointestinal events. HP infection was highly predictive in Chinese patients; the ROC curve indicated an area under the curve of 0.822 （95% confidence interval： 0.774-0.870）. The best diagnostic cutoff point of predicted gastrointestinal events was 68.0%0, yielding sensitivity and specificity of 60.6% and 93.1%, respectively, for predicting gastrointestinal events in Chinese patients with MI. Conclusions： AsaRiskCalculator had a predictive value for gastrointestinal events in Chinese patients with MI. HP infection seemed to be an independent risk factor for gastrointestinal events caused by long-term aspirin treatment in Chinese patients with MI, and it should be included in the risk calculator adapted for Chinese patients.展开更多
Reed-Solomon （RS） codes have been widely adopted in many modern communication systems. This paper describes a new method for error detection in the syndrome calculator block of RS decoders. The main feature of this ...Reed-Solomon （RS） codes have been widely adopted in many modern communication systems. This paper describes a new method for error detection in the syndrome calculator block of RS decoders. The main feature of this method is to prove that it is possible to compute only a few syndrome coeffi- cients -- less than half-- to detect whether the codeword is correct. The theoretical estimate of the prob- ability that the new algorithm failed is shown to depend on the number of syndrome coefficients computed. The algorithm is tested using the RS（204,188） code with the first four coefficients. With a bit error rate of 1 ~ 104, this method reduces the power consumption by 6% compared to the basic RS（204,188） decoder. The error detection algorithm for the syndrome calculator block does not require modification of the basic hardware implementation of the syndrome coefficients computation. The algorithm significantly reduces the computation complexity of the syndrome calculator block, thus lowering the power needed.展开更多
The efficiency and stability of catalysts for photocatalytic hydrogen evolution(PHE)are largely governed by the charge transfer behaviors across the heterojunction interfaces.In this study,CuO,a typical semiconductor ...The efficiency and stability of catalysts for photocatalytic hydrogen evolution(PHE)are largely governed by the charge transfer behaviors across the heterojunction interfaces.In this study,CuO,a typical semiconductor featuring a broad spectral absorption range,is successfully employed as the electron acceptor to combine with CdS for constructing a S-scheme heterojunction.The optimized photocatalyst(CdSCuO2∶1)delivers an exceptional hydrogen evolution rate of 18.89 mmol/(g·h),4.15-fold higher compared with bare CdS.X-ray photoelectron spectroscopy(XPS)and ultraviolet-visible diffuse reflection absorption spectroscopy(UV-vis DRS)confirmed the S-scheme band structure of the composites.Moreover,the surface photovoltage(SPV)and electron paramagnetic resonance(EPR)indicated that the photogenerated electrons and photogenerated holes of CdS-CuO2∶1 were respectively transferred to the conduction band(CB)of CdS with a higher reduction potential and the valence band(VB)of CuO with a higher oxidation potential under illumination,as expected for the S-scheme mechanism.Density-functional-theory calculations of the electron density difference(EDD)disclose an interfacial electric field oriented from CdS to CuO.This built-in field suppresses charge recombination and accelerates carrier migration,rationalizing the markedly enhanced PHE activity.This study offers a novel strategy for designing S-scheme heterojunctions with high light harvesting and charge utilization toward sustainable solar-tohydrogen conversion.展开更多
Background The role of adjuvant transarterial chemoembolisation(TACE)to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma(HCC).Person...Background The role of adjuvant transarterial chemoembolisation(TACE)to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma(HCC).Personalised predictive tool to select which patients may benefit from adjuvant TACE is lacking.This study aimed to develop and validate an online calculator for estimating the reduced risk of early recurrence from adjuvant TACE for patients with HCC.Methods From a multi-institutional database,2590 eligible patients undergoing curative-intent hepatectomy for HCC were enrolled,and randomly assigned to the training and validation cohorts.Independent predictors of early recurrence within 1 year of surgery were identified in the training cohort,and subsequently used to construct a model and corresponding prediction calculator.The predictive performance of the model was validated using concordance indexes(C-indexes)and calibration curves,and compared with conventional HCC staging systems.The reduced risk of early recurrence when receiving adjuvant TACE was used to estimate the expected benefit from adjuvant TACE.Results The prediction model was developed by integrating eight factors that were independently associated with risk of early recurrence:alpha-fetoprotein level,maximum tumour size,tumour number,macrovascular and microvascular invasion,satellite nodules,resection margin and adjuvant TACE.The model demonstrated good calibration and discrimination in the training and validation cohorts(C-indexes:0.799 and 0.778,respectively),and performed better among the whole cohort than four conventional HCC staging systems(C-indexes:0.797 vs 0.562–0.673,all p<0.001).An online calculator was built to estimate the reduced risk of early recurrence from adjuvant TACE for patients with resected HCC.Conclusions The proposed calculator can be adopted to assist decision-making for clinicians and patients to determine which patients with resected HCC can significantly benefit from adjuvant TACE.WHAT IS ALREADY KNOWN ON THIS TOPIC⇒Previous studies have indicated that adjuvant transarterial chemoembolisation(TACE)may im-prove long-term survival in certain subgroups of patients with hepatocellular carcinoma(HCC)after hepatectomy.⇒However,these studies did not provide personalised risk assessment or net benefit estimation for indi-vidual patients,highlighting the need for a more refined prediction model.WHAT THIS STUDY ADDS⇒This study developed a risk prediction model in-corporating eight independent factors associat-ed with early recurrence after hepatectomy for HCC,demonstrating good predictive accuracy and discrimination.⇒The model outperformed four commonly used con-ventional HCC staging systems and facilitated the development of an online calculator to estimate in-dividual patient’s reduced risk of early recurrence using adjuvant TACE.HOW THIS STUDY MIGHT AFFECT RESEARCH,PRACTICE OR POLICY⇒The study’s findings may assist clinicians in decid-ing whether to use adjuvant TACE after hepatectomy for HCC,potentially improving patient outcomes.⇒Further research should validate the model with larger cohorts or those from other centres to assess its broader applicability.展开更多
While there are many online data dashboards on COVID-19,there are few analytics available to the public and non-epidemiologists to help them gain a deeper insight into the COVID-19 pandemic and evaluate the effectiven...While there are many online data dashboards on COVID-19,there are few analytics available to the public and non-epidemiologists to help them gain a deeper insight into the COVID-19 pandemic and evaluate the effectiveness of social intervention measures.To address the issue,this study describes the methods underlying the development of a realtime,data-driven online Epidemic Calculator for tracking COVID-19 growth parameters.From publicly available infection case and death data,the calculator is used to estimate the effective reproduction number,final epidemic size,and death toll.As a case study,we analyzed the results for Singapore during the"Circuit Breaker"period from April 7,2020 to the end of May 2020.The calculator shows that the stringent measures imposed have an immediate effect of rapidly slowing down the spread of the coronavirus.After about two weeks,the effective reproduction number reduced to about 1.0.Since then,the number has been fluctuating around 1.0 for more than a month.The COVID-19 Epidemic Calculator is available in the form of an online Google Sheet and the results are presented as Tableau Public dashboards at www.cv19.one.By making the calculator readily accessible online,the public can have a tool to assess the effectiveness of measures to control the pandemic meaningfully.展开更多
Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,b...Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,UK.SRC projections were obtained using its virtual risk estimator.Results:Sixty infants received PAb within the first 72 h of birth during the study period.Of these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven sepsis.Based on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>3.Birth below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>3.Interpretation:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.展开更多
Interfacial superconductivity(IS)has been a topic of intense interest in condensed matter physics,due to its unique properties and exotic photoelectrical performance.However,there are few reports about IS systems cons...Interfacial superconductivity(IS)has been a topic of intense interest in condensed matter physics,due to its unique properties and exotic photoelectrical performance.However,there are few reports about IS systems consisting of two insulators.Here,motivated by the emergence of an insulator-metal transition in type-Ⅲ heterostructures and the superconductivity in some“special”two-dimensional(2D)semiconductors via electron doping,we predict that the 2D heterostructure SnSe_(2)/PtTe_(2) is a model system for realizing IS by using firstprinciples calculations.Our results show that due to slight but crucial interlayer charge transfer,SnSe_(2)/PtTe_(2) turns to be a type-Ⅲ heterostructure with metallic properties and shows a superconducting transition with the critical temperature(T_(c))of 3.73 K.Similar to the enhanced electron–phonon coupling(EPC)in the electrondoped SnSe_(2) monolayer,the IS in the SnSe_(2)/PtTe_(2) heterostructure mainly originates from the metallized SnSe_(2) layer.Furthermore,we find that its superconductivity is sensitive to tensile lattice strain,forming a domeshaped superconducting phase diagram.Remarkably,at 7%biaxial tensile strain,the superconducting T_(c) can increase more than twofold(8.80 K),resulting from softened acoustic phonons at the𝑀point and enhanced EPC strength.Our study provides a concrete example for realizing IS in type-Ⅲ heterostructures,which waits for future experimental verification.展开更多
文摘Risk prediction models including the Prostate Health Index(phi)for prostate cancer have been well established and evaluated in the Western population.The aim of this study is to build phi-based risk calculators in a prostate biopsy population and evaluate their performanee in predicting prostate cancer(PCa)and high-grade PCa(Gleason score 27)in the Chinese population.We developed risk calculators based on 635 men who underwent initial prostate biopsy.Then,we validated the performance of prostate-specific antigen(PSA),phi,and the risk calculators in an additional observational cohort of 1045 men.We observed that the phi-based risk calculators(risk calculators 2 and 4)outperformed the PSA-based risk calculator for predicting PCa and high-grade PCa in the training cohort.In the validation study,the area under the receiver operating characteristic curve(AUC)for risk calculators 2 and 4 reached 0.91 and 0.92,respectively,for predicting PCa and high-grade PCa,respectively;the AUC values were better than those for risk calculator 1(PSA-based model with an AUC of 0.81 and 0.82,respectively)(all P<0.001).Such superiority was also observed in the stratified population with PSA ranging from 2.0 ng ml^-1 to 10.0 ng ml^-1.Decision curves confirmed that a considerable proportion of unnecessary biopsies could be avoided while applying phi-based risk calculators.In this study,we showed that,compared to risk calculators without phi,phi-based risk calculators exhibited superior discrimination and calibration for PCa in the Chinese biopsy population.Applying these risk calculators also considerably reduced the number of unnecessary biopsies for PCa.
文摘The performances of the Prostate Cancer Prevention Trial （PCPT） risk calculator and other risk calculators for prostate cancer （PCa） prediction in Chinese populations were poorly understood. We performed this study to build risk calculators （Huashan risk calculators） based on Chinese population and validated the performance of prostate-specific antigen （PSA）, PCPT risk calculator, and Huashan risk calculators in a validation cohort. We built Huashan risk calculators based on data from 1059 men who underwent initial prostate biopsy from January 2006 to December 2010 in a training cohort. Then, we validated the performance of PSA, PCPT risk calculator, and Huashan risk calculators in an observational validation study from January 2011 to December 2014. All necessary clinical information were collected before the biopsy. The results showed that Huashan risk calculators 1 and 2 outperformed the PCPT risk calculator for predicting PCa in both entire training cohort and stratified population （with PSA from 2.0 ng ml^-1 to 20.0 ng ml^-1）. In the validation study, Huashan risk calculator 1 still outperformed the PCPT risk calculator in the entire validation cohort （0.849 vs 0.779 in area under the receiver operating characteristic curve [AUC]） and stratified population. A considerable reduction of unnecessary biopsies （approximately 30%） was also observed when the Huashan risk calculators were used. Thus, we believe that the Huashan risk calculators （especially Huashan risk calculator 1） may have added value for predicting PCa in Chinese population. However, these results still needed further evaluation in larger populations.
基金Supported by The Department of Health,Executive Yuan,Taipei,Taiwan,Bristol-Myers Squibb Co.,United StatesAcademia Sinica,Taipei,Taiwan+1 种基金the National Science Council No.NSC101-2314-B-039-029-MY3,Taipei,Taiwanthe National Health Research Institutes(NHRI-EX98-9806PI),Chunan,Taiwan
文摘Risk calculators are widely used in many clinical fields, and integrate several important risk factors through the conversion of a risk function into a single measure of risk. Several studies have been carried out to create risk calculators for the prediction of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Most of them were hospital-based, with limited sample sizes and insufficient external validation. These study groups collaborated to establish the REACH-B risk score, which incorporated five clinical variables to predict HCC risk. This risk score was then validated in international clinical cohorts. Evidence suggests that quantitative serum HBsAg level provides additional predictability of HCC, especially in patients with low levels of hepatitis B virus DNA. This novel marker was incorporated into a risk calculator and was internally validated. This tool will hopefully be externally validated in the near future. Risk calculators can be used to support clinical practice, and to establish preventive measures; several “off-label” extension usages have also been implemented. Albeit beneficial, several precautions and discussions should be noted in using the risk calculators. The future development of risk calculators for CHB patients can be extended by applying them to additional CHB-related outcomes, and by incorporating emerging risk parameters.
基金University Natural Science Research Project of Anhui Province,No.KJ2021ZD0021.
文摘BACKGROUND Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms(PCNs)are lacking.AIM To establish a nomogram-based online calculator for predicting the risk of malignancy in patients with PCNs.METHODS In this study,the clinicopathological data of target patients in three medical centers were analyzed.The independent sample t-test,Mann–Whitney U test or chi-squared test were used as appropriate for statistical analysis.After univariable and multivariable logistic regression analysis,five independent factors were screened and incorporated to develop a calculator for predicting the risk of malignancy.Finally,the concordance index(C-index),calibration,area under the curve,decision curve analysis and clinical impact curves were used to evaluate the performance of the calculator.RESULTS Enhanced mural nodules[odds ratio(OR):4.314;95%confidence interval(CI):1.618–11.503,P=0.003],tumor diameter≥40 mm(OR:3.514;95%CI:1.138–10.849,P=0.029),main pancreatic duct dilatation(OR:3.267;95%CI:1.230–8.678,P=0.018),preoperative neutrophil-to-lymphocyte ratio≥2.288(OR:2.702;95%CI:1.008–7.244,P=0.048],and preoperative serum CA19-9 concentration≥34 U/mL(OR:3.267;95%CI:1.274–13.007,P=0.018)were independent risk factors for a high risk of malignancy in patients with PCNs.In the training cohort,the nomogram achieved a C-index of 0.824 for predicting the risk of malignancy.The predictive ability of the model was then validated in an external cohort(C-index:0.893).Compared with the risk factors identified in the relevant guidelines,the current model showed better predictive performance and clinical utility.CONCLUSION The calculator demonstrates optimal predictive performance for identifying the risk of malignancy,potentially yielding a personalized method for patient selection and decision-making in clinical practice.
文摘Millions of men each year are faced with a clinical suspicion of prostate cancer （PCa） but the prostate biopsy fails to detect the disease. For the urologists, how to select the appropriate candidate for repeat biopsy is a significant clinical dilemma. Traditional risk-stratification tools in this setting such as prostate-specific antigen （PSA） related markers and histopathology findings have met with limited correlation with cancer diagnosis or with significant disease. Thus, an individualized approach using predictive models such as an online risk calculator （RC） or updated biomarkers is more suitable in counseling men about their risk of harboring clinically significant prostate cancer, This review will focus on the available risk-stratification tools in the population of men with prior negative biopsies and persistent suspicion of PCa. The underlying methodology and platforms of the available tools are reviewed to better understand the development and validation of these models. The index patient is then assessed with different RCs to determine the range of heterogeneity among various RCs. This should allow the urologists to better incorporate these various risk-stratification tools into their clinical practice and improve patient counseling.
基金Supported by Capital’s Funds for Health Improvement and Research,No.2020-4-2085Beijing Science and Technology Plan Project,No.Z211100002921028。
文摘BACKGROUND No single endoscopic feature can reliably predict the pathological nature of colorectal tumors(CRTs).AIM To establish and validate a simple online calculator to predict the pathological nature of CRTs based on white-light endoscopy.METHODS This was a single-center study.During the identification stage,530 consecutive patients with CRTs were enrolled from January 2015 to December 2021 as the derivation group.Logistic regression analysis was performed.A novel online calculator to predict the pathological nature of CRTs based on white-light images was established and verified internally.During the validation stage,two series of 110 images obtained using white-light endoscopy were distributed to 10 endoscopists[five highly experienced endoscopists and five less experienced endoscopists(LEEs)]for external validation before and after systematic training.RESULTS A total of 750 patients were included,with an average age of 63.6±10.4 years.Early colorectal cancer(ECRC)was detected in 351(46.8%)patients.Tumor size,left semicolon site,rectal site,acanthosis,depression and an uneven surface were independent risk factors for ECRC.The C-index of the ECRC calculator prediction model was 0.906(P=0.225,Hosmer-Lemeshow test).For the LEEs,significant improvement was made in the sensitivity,specificity and accuracy(57.6%vs 75.5%;72.3%vs 82.4%;64.2%vs 80.2%;P<0.05),respectively,after training with the ECRC online calculator prediction model.CONCLUSION A novel online calculator including tumor size,location,acanthosis,depression,and uneven surface can accurately predict the pathological nature of ECRC.
文摘The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning system (TPS) and the fast dose calculation method (FDC) for single-field optimization (SFO) and multi-field optimization (MFO) IMPT plans. In addition, because some authors have reported dosimetric benefit of a proton arc therapy with ultimate multi-fields in recent years, we wanted to evaluate how the number of fields and beam angles affect the differences for IMPT plans. Therefore, for one brain cancer patient with a large heterogeneity, SFO and MFO IMPT plans with various multi-angle beams were planned by the TPS. Dose distributions for each IMPT plan were calculated by both the TPS’s conventional pencil beam algorithm and the FDC. The dosimetric parameters were compared between the two algorithms. The TPS overestimated 400 - 500 cGy (RBE) for minimum dose to the CTV relative to the dose calculated by the FDC. These differences indicate clinically relevant effect on clinical results. In addition, we observed that the maximum difference in dose calculated between the TPS and the FDC was about 900 cGy (RBE) for the right optic nerve, and this quantity also has a possibility to have a clinical effect. The major difference was not seen in calculations for SFO IMPT planning and those for MFO IMPT planning. Differences between the TPS and the FDC in SFO and MFO IMPT plans depend strongly on beam arrangement and the presence of a heterogeneous body. We advocate use of a Monte Carlo method in proton treatment planning to deliver the most precise proton dose in IMPT.
文摘Risk calculators have offered a viable tool for clinicians to stratify patients at risk of prostate cancer(PCa)and to mitigate the low sensitivity and specificity of screening prostate specific antigen(PSA).While initially based on clinical and demographic data,incorporation of multiparametric magnetic resonance imaging(MRI)and the validated prostate imaging reporting and data system suspicion scoring system has standardized and improved risk stratification beyond the use of PSA and patient parameters alone.Biopsy-naïve patients with lower risk profiles for harboring clinically significant PCa are often subjected to uncomfortable,invasive,and potentially unnecessary prostate biopsy procedures.Incorporating risk calculator data into prostate MRI reports can broaden the role of radiologists,improve communication with clinicians primarily managing these patients,and help guide clinical care in directing the screening,detection,and risk stratification of PCa.
基金This work is funded by National Funds through the Foundation for Science and Technology(FCT),I.P.,within the scope of the project RefªUIDB/05583/2020.
文摘A carbon footprint(CF)calculator was developed to apply to a Portuguese touristic accommodation to contribute to a sustainable touristic activity.Although some calculators are available online,they are related to the country reality or use outdated emission factors.A calculator based on national emission factors is important.The calculator was developed in Microsoft Excel(version 365)and is based on the CO2e emissions resulting from electricity,water,fuels and food use,laundry and waste production.The calculator development involved:study the accommodation emission sources,selection the environmental indicators,determination of the emission factors and development of the CF formulas.Total CF calculation was made considering the partial CF per component,a monthly and annual comparison of each indicator’s emissions contribution using graphs.The emissions amount per overnight stay,per room,per area,were also assessed and these values were transformed into global hectare(gha).Avoided emissions calculation gives the information about the efforts in CF reduction,and two indicators were considered:electricity production from renewable energy sources and the amount of separated waste for recycling.It was considered reforestation measures to achieve carbon neutrality.This calculator incorporates four components not often used:water,laundry,waste,food,and avoided emissions.
文摘Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-positive infants retrospectively in infants born in the last 10 years in our hospital.Methods In a retrospective cohort study,the comparison groups were divided into Group A(no antibiotics recommended by KSC)and Group B(antibiotics recommended).Results Overall,17/24(71%)infants would have been started on antibiotics per KSC but 7/24(29%)would not.The initial EOS risk was not significantly different between the groups(Group A vs.Group B:0.44 vs.0.76,P=0.41),but the final risk score was(0.33 vs.9.41,P<0.001).In Group A(no antibiotics),3/7 infants became symptomatic between 9 and 42 hours.Conclusion There may be a potential delay in starting antibiotics in infants that are asymptomatic at birth while using KSC.
文摘Background： Aspirin is widely used for the prevention of cardiovascular and cerebrovascular diseases for the past few years. However, much attention has been paid to the adverse effects associated with aspirin such as gastrointestinal bleeding. How to weigh the benefits and hazards？ The current study aimed to assess the feasibility of a cardiovascular/gastrointestinal risk calculator, AsaRiskCalculator, in predicting gastrointestinal events in Chinese patients with myocardial infarction （MI）, determining unique risk factor（s） for gastrointestinal events to be considered in the calculator. Methods： The MI patients who visited Shapingba District People＇s Hospital between January 2012 and January 2016 were retrospectively reviewed. Based on gastroscopic data, the patients were divided into two groups： gastrointestinal and nongastrointestinal groups. Demographic and clinical data of the patients were then retrieved for statistical analysis. Univariate and multiple logistic regression analyses were used to identify independent risk factors for gastrointestinal events. The receiver operating characteristic （ROC） curves were used to assess the predictive value of AsaRiskCalculator for gastrointestinal events. Results： A total of 400 MI patients meeting the eligibility criteria were analyzed, including 94 and 306 in the gastrointestinal and nongastrointestinal groups, respectively. The data showed that age, male gender, predicted gastrointestinal events, and Helicobacterpylori （HP） infection were positively correlated with gastrointestinal events. In multiple logistic regression analysis, predicted gastrointestinal events and HP infection were identified as risk factors for actual gastrointestinal events. HP infection was highly predictive in Chinese patients; the ROC curve indicated an area under the curve of 0.822 （95% confidence interval： 0.774-0.870）. The best diagnostic cutoff point of predicted gastrointestinal events was 68.0%0, yielding sensitivity and specificity of 60.6% and 93.1%, respectively, for predicting gastrointestinal events in Chinese patients with MI. Conclusions： AsaRiskCalculator had a predictive value for gastrointestinal events in Chinese patients with MI. HP infection seemed to be an independent risk factor for gastrointestinal events caused by long-term aspirin treatment in Chinese patients with MI, and it should be included in the risk calculator adapted for Chinese patients.
基金Supported by the National High-Tech Research and Development (863) Program of China (No. 2007AA01Z2B3)
文摘Reed-Solomon （RS） codes have been widely adopted in many modern communication systems. This paper describes a new method for error detection in the syndrome calculator block of RS decoders. The main feature of this method is to prove that it is possible to compute only a few syndrome coeffi- cients -- less than half-- to detect whether the codeword is correct. The theoretical estimate of the prob- ability that the new algorithm failed is shown to depend on the number of syndrome coefficients computed. The algorithm is tested using the RS（204,188） code with the first four coefficients. With a bit error rate of 1 ~ 104, this method reduces the power consumption by 6% compared to the basic RS（204,188） decoder. The error detection algorithm for the syndrome calculator block does not require modification of the basic hardware implementation of the syndrome coefficients computation. The algorithm significantly reduces the computation complexity of the syndrome calculator block, thus lowering the power needed.
文摘The efficiency and stability of catalysts for photocatalytic hydrogen evolution(PHE)are largely governed by the charge transfer behaviors across the heterojunction interfaces.In this study,CuO,a typical semiconductor featuring a broad spectral absorption range,is successfully employed as the electron acceptor to combine with CdS for constructing a S-scheme heterojunction.The optimized photocatalyst(CdSCuO2∶1)delivers an exceptional hydrogen evolution rate of 18.89 mmol/(g·h),4.15-fold higher compared with bare CdS.X-ray photoelectron spectroscopy(XPS)and ultraviolet-visible diffuse reflection absorption spectroscopy(UV-vis DRS)confirmed the S-scheme band structure of the composites.Moreover,the surface photovoltage(SPV)and electron paramagnetic resonance(EPR)indicated that the photogenerated electrons and photogenerated holes of CdS-CuO2∶1 were respectively transferred to the conduction band(CB)of CdS with a higher reduction potential and the valence band(VB)of CuO with a higher oxidation potential under illumination,as expected for the S-scheme mechanism.Density-functional-theory calculations of the electron density difference(EDD)disclose an interfacial electric field oriented from CdS to CuO.This built-in field suppresses charge recombination and accelerates carrier migration,rationalizing the markedly enhanced PHE activity.This study offers a novel strategy for designing S-scheme heterojunctions with high light harvesting and charge utilization toward sustainable solar-tohydrogen conversion.
基金supported by the National Natural Science Foundation of China(no.82273074)Dawn Project Foundation of Shanghai(no.21SG36)+2 种基金Adjunct Talent Fund of Zhejiang Provincial People’s Hospital(no.2021-YT)the Natural Science Foundation of Shanghai(no.22ZR1477900)Shanghai Science and Technology Committee Rising-Star Programme(no.22QA1411600).
文摘Background The role of adjuvant transarterial chemoembolisation(TACE)to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma(HCC).Personalised predictive tool to select which patients may benefit from adjuvant TACE is lacking.This study aimed to develop and validate an online calculator for estimating the reduced risk of early recurrence from adjuvant TACE for patients with HCC.Methods From a multi-institutional database,2590 eligible patients undergoing curative-intent hepatectomy for HCC were enrolled,and randomly assigned to the training and validation cohorts.Independent predictors of early recurrence within 1 year of surgery were identified in the training cohort,and subsequently used to construct a model and corresponding prediction calculator.The predictive performance of the model was validated using concordance indexes(C-indexes)and calibration curves,and compared with conventional HCC staging systems.The reduced risk of early recurrence when receiving adjuvant TACE was used to estimate the expected benefit from adjuvant TACE.Results The prediction model was developed by integrating eight factors that were independently associated with risk of early recurrence:alpha-fetoprotein level,maximum tumour size,tumour number,macrovascular and microvascular invasion,satellite nodules,resection margin and adjuvant TACE.The model demonstrated good calibration and discrimination in the training and validation cohorts(C-indexes:0.799 and 0.778,respectively),and performed better among the whole cohort than four conventional HCC staging systems(C-indexes:0.797 vs 0.562–0.673,all p<0.001).An online calculator was built to estimate the reduced risk of early recurrence from adjuvant TACE for patients with resected HCC.Conclusions The proposed calculator can be adopted to assist decision-making for clinicians and patients to determine which patients with resected HCC can significantly benefit from adjuvant TACE.WHAT IS ALREADY KNOWN ON THIS TOPIC⇒Previous studies have indicated that adjuvant transarterial chemoembolisation(TACE)may im-prove long-term survival in certain subgroups of patients with hepatocellular carcinoma(HCC)after hepatectomy.⇒However,these studies did not provide personalised risk assessment or net benefit estimation for indi-vidual patients,highlighting the need for a more refined prediction model.WHAT THIS STUDY ADDS⇒This study developed a risk prediction model in-corporating eight independent factors associat-ed with early recurrence after hepatectomy for HCC,demonstrating good predictive accuracy and discrimination.⇒The model outperformed four commonly used con-ventional HCC staging systems and facilitated the development of an online calculator to estimate in-dividual patient’s reduced risk of early recurrence using adjuvant TACE.HOW THIS STUDY MIGHT AFFECT RESEARCH,PRACTICE OR POLICY⇒The study’s findings may assist clinicians in decid-ing whether to use adjuvant TACE after hepatectomy for HCC,potentially improving patient outcomes.⇒Further research should validate the model with larger cohorts or those from other centres to assess its broader applicability.
文摘While there are many online data dashboards on COVID-19,there are few analytics available to the public and non-epidemiologists to help them gain a deeper insight into the COVID-19 pandemic and evaluate the effectiveness of social intervention measures.To address the issue,this study describes the methods underlying the development of a realtime,data-driven online Epidemic Calculator for tracking COVID-19 growth parameters.From publicly available infection case and death data,the calculator is used to estimate the effective reproduction number,final epidemic size,and death toll.As a case study,we analyzed the results for Singapore during the"Circuit Breaker"period from April 7,2020 to the end of May 2020.The calculator shows that the stringent measures imposed have an immediate effect of rapidly slowing down the spread of the coronavirus.After about two weeks,the effective reproduction number reduced to about 1.0.Since then,the number has been fluctuating around 1.0 for more than a month.The COVID-19 Epidemic Calculator is available in the form of an online Google Sheet and the results are presented as Tableau Public dashboards at www.cv19.one.By making the calculator readily accessible online,the public can have a tool to assess the effectiveness of measures to control the pandemic meaningfully.
文摘Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,UK.SRC projections were obtained using its virtual risk estimator.Results:Sixty infants received PAb within the first 72 h of birth during the study period.Of these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven sepsis.Based on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>3.Birth below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>3.Interpretation:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.
基金supported by the National Key R&D Program of China (Grant Nos.2022YFA1403103 and 2019YFA0308603)the National Natural Science Foundation of China (Grant No.12304167)the Shandong Provincial Natural Science Foundation of China (Grant No.ZR2023QA020)。
文摘Interfacial superconductivity(IS)has been a topic of intense interest in condensed matter physics,due to its unique properties and exotic photoelectrical performance.However,there are few reports about IS systems consisting of two insulators.Here,motivated by the emergence of an insulator-metal transition in type-Ⅲ heterostructures and the superconductivity in some“special”two-dimensional(2D)semiconductors via electron doping,we predict that the 2D heterostructure SnSe_(2)/PtTe_(2) is a model system for realizing IS by using firstprinciples calculations.Our results show that due to slight but crucial interlayer charge transfer,SnSe_(2)/PtTe_(2) turns to be a type-Ⅲ heterostructure with metallic properties and shows a superconducting transition with the critical temperature(T_(c))of 3.73 K.Similar to the enhanced electron–phonon coupling(EPC)in the electrondoped SnSe_(2) monolayer,the IS in the SnSe_(2)/PtTe_(2) heterostructure mainly originates from the metallized SnSe_(2) layer.Furthermore,we find that its superconductivity is sensitive to tensile lattice strain,forming a domeshaped superconducting phase diagram.Remarkably,at 7%biaxial tensile strain,the superconducting T_(c) can increase more than twofold(8.80 K),resulting from softened acoustic phonons at the𝑀point and enhanced EPC strength.Our study provides a concrete example for realizing IS in type-Ⅲ heterostructures,which waits for future experimental verification.
