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
Over the last few decades,the evolution of liver resection has progressed through numerous milestones in peri-operative management,operative techniques and novel technologies that have dramatically improved patient sa...Over the last few decades,the evolution of liver resection has progressed through numerous milestones in peri-operative management,operative techniques and novel technologies that have dramatically improved patient safety and outcomes(1).Consequently,such developments have enabled surgeons to embark on liver resections of lesions in technically challenging locations,whereby extended resection or bilovascular reconstruction may be required to ensure oncologic clearance.In the context of extended resections or resection of lesions from heavily diseased livers,concerns remain regarding the adequacy of the remnant future liver remnant(FLR)and liver function,placing patients at risk of the clinical phenomenon known as post-hepatectomy liver failure(PHLF).Although relatively uncommon,PHLF has a reported incidence of up to 32%in the literature and remains an important cause of post-hepatectomy morbidity and mortality(2).Presently,several definitions have been proposed to describe PHLF,the most recent of which was proposed by the International Study Group of Liver Surgery(ISGLS).In this definition,PHLF was defined as an increased international normalized ratio(INR)or hyperbilirubinemia on or after post-operative day 5,with further stratification of severity grades(A,B or C)based on the extent of clinical management(3).While definitions in PHLF assist in providing a common diagnostic framework among physicians,establishing predictors in PHLF is conceivably more helpful as it allows surgeons to have important decision-making details prior to planned liver resection.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
The defect regulation and p-n heterojunction of composites have gained significant attention due to their potential applications.Nitrogen(N)as doping heteroatoms and perylene-3,4,9,10-tetracarboximide(PDINH)as an appr...The defect regulation and p-n heterojunction of composites have gained significant attention due to their potential applications.Nitrogen(N)as doping heteroatoms and perylene-3,4,9,10-tetracarboximide(PDINH)as an appropriate n-type semiconductor were innovatively and reasonably selected to enhance the photocatalytic performance of pristine p-type cuprous oxide(Cu_(2)O).In this study,the defect regula-tion of N doping(1)achieved the small-size effect of Cu_(2)O,(2)optimized the electron features,and(3)improved the kinetics of reactive oxygen species.The p-n heterojunction with PDINH was developed to sharply improve the light utilization of Cu_(2)O,from the UV region to the near-infrared region.As expected,the optimized Cu_(2)N_(x)O_(1–x)/PDINH(x=0.02)exhibited excellent long-term photocatalytic antibacterial ac-tivities,with antibacterial rates exceeding 91%against Staphylococcus aureus and Pseudomonas aeruginosa.Defect regulation and p-n heterojunction of Cu_(2)O-based composites thus provide a great deal of potential for future advancements in photocatalysis.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
Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-depo...Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-deposited and remelted were developed to refine the microstructure and enhance the oxidation resistance of refractory high entropy alloy using electron beam freeform fabrication(EBF3).Finer and short-range ordering structures were observed in the remelted sample,whereas the Al-deposited sample showcased the formation of silicide and intermetallic phases.High-temperature cyclic and isothermal oxidation tests at 1000℃ were carried out.The total weight gain after 60 h of cyclic oxidation decreased by 17.49%and 30.46%for the remelted and deposited samples,respectively,compared to the as-cast state.Oxidation kinetics reveal an evident lower mass gain and oxidation rate in the treated samples.A multilayer oxide consisting of TiO_(2)+Al_(2)O_(3)+SiO_(2)+AlNbO_(4) was studied for its excellent oxidation resistance.The oxidation behavior of rutile,corundum and other oxides was analyzed using first principles calculations and chemical defect analysis.Overall,this research,which introduces novel treatments,offers promising insights for enhancing the inherent oxidation resistance of refractory high entropy alloys.展开更多
Nitrogen-doping of carbon support(N-C)for platinum(Pt)nanoparticles to form Pt/N-C catalyst represents an effective strategy to promote the electrocatalysis of cathodic oxygen reduction reaction(ORR)in proton exchange...Nitrogen-doping of carbon support(N-C)for platinum(Pt)nanoparticles to form Pt/N-C catalyst represents an effective strategy to promote the electrocatalysis of cathodic oxygen reduction reaction(ORR)in proton exchange membrane fuel cells.For fundamental understanding,clearly identifying the metalsupport effect on enhancement mechanisms of ORR electrocatalysis is definitely needed.In this work,the impact of Pt-support interaction via interfacial Pt-N coordination on electrocatalytic ORR activity and stability in Pt/N-C catalyst is deeply studied through structural/compositional characterizations,electrochemical measurements and theoretical DFT-calculations/AIMD-simulations.The resulting Pt/N-C catalyst exhibits a superior electrocatalytic performance compared to the commercial Pt/C catalyst in both half-cell and H_(2)-O_(2)fuel cell.Experimental and theoretical results reveal that the interfacial Pt-N coordination enables electron transfer from N-C support to Pt nanoparticles,which can weaken the adsorption strength of oxygen intermediates on Pt surface to improve ORR activity and induce the strong Pt-support interaction to enhance electrochemical stability.展开更多
The quest for high-energy-density magnesium-air batteries is hindered by the efficiency-voltage trade-off,ultimately leading to an unsatisfactory energy density.Here,we effectively mitigate the inherent efficiency-vol...The quest for high-energy-density magnesium-air batteries is hindered by the efficiency-voltage trade-off,ultimately leading to an unsatisfactory energy density.Here,we effectively mitigate the inherent efficiency-voltage trade-off by introducing a novel anode material,specifically,Mg-0.5Sn-0.5In-0.5Ga.This anode demonstrates exceptional anodic efficiency,achieving 60.5±2.5%at 1 mA cm^(-2),65.3±2.7%at 10 mA cm^(-2),and 71.4±1.2%at 20 mA cm^(-2).Furthermore,the discharge voltage is significantly enhanced,reaching 1.76±0.01 V at 1 mA cm^(-2),1.44±0.02 V at 10 mA cm^(-2),and 1.21±0.08 V at 20 mA cm^(-2).Consequently,our newly developed anode exhibits a remarkable energy density of 2312±98 W h kg^(-1),placing it among the top-performing magnesium anodes documented in the literature.Density functional theory calculations and experimental investigations have unveiled that the exceptional performance can be attributed to the inhibition of water reduction,facilitated by the hybridization between solute atoms and neighboring Mg atoms.Furthermore,the activation of the second phase,introducing additional galvanic couples,significantly contributes to this performance.This study presents valuable insights that can guide the design of novel anodes,contributing to the advancement of high-performance magnesium-air batteries.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Over the last few decades,the evolution of liver resection has progressed through numerous milestones in peri-operative management,operative techniques and novel technologies that have dramatically improved patient safety and outcomes(1).Consequently,such developments have enabled surgeons to embark on liver resections of lesions in technically challenging locations,whereby extended resection or bilovascular reconstruction may be required to ensure oncologic clearance.In the context of extended resections or resection of lesions from heavily diseased livers,concerns remain regarding the adequacy of the remnant future liver remnant(FLR)and liver function,placing patients at risk of the clinical phenomenon known as post-hepatectomy liver failure(PHLF).Although relatively uncommon,PHLF has a reported incidence of up to 32%in the literature and remains an important cause of post-hepatectomy morbidity and mortality(2).Presently,several definitions have been proposed to describe PHLF,the most recent of which was proposed by the International Study Group of Liver Surgery(ISGLS).In this definition,PHLF was defined as an increased international normalized ratio(INR)or hyperbilirubinemia on or after post-operative day 5,with further stratification of severity grades(A,B or C)based on the extent of clinical management(3).While definitions in PHLF assist in providing a common diagnostic framework among physicians,establishing predictors in PHLF is conceivably more helpful as it allows surgeons to have important decision-making details prior to planned liver resection.
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 Natural Science Foundation Joint Fund(Nos.U1806223 and U2106226)the National Natural Science Foundation of China(No.52371081)the Key Technology Research and Development Program of Shandong Province(No.2020CXGC010703).
文摘The defect regulation and p-n heterojunction of composites have gained significant attention due to their potential applications.Nitrogen(N)as doping heteroatoms and perylene-3,4,9,10-tetracarboximide(PDINH)as an appropriate n-type semiconductor were innovatively and reasonably selected to enhance the photocatalytic performance of pristine p-type cuprous oxide(Cu_(2)O).In this study,the defect regula-tion of N doping(1)achieved the small-size effect of Cu_(2)O,(2)optimized the electron features,and(3)improved the kinetics of reactive oxygen species.The p-n heterojunction with PDINH was developed to sharply improve the light utilization of Cu_(2)O,from the UV region to the near-infrared region.As expected,the optimized Cu_(2)N_(x)O_(1–x)/PDINH(x=0.02)exhibited excellent long-term photocatalytic antibacterial ac-tivities,with antibacterial rates exceeding 91%against Staphylococcus aureus and Pseudomonas aeruginosa.Defect regulation and p-n heterojunction of Cu_(2)O-based composites thus provide a great deal of potential for future advancements in photocatalysis.
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.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF0609000)National Natural Science Foundation of China(Grant Nos.52171034 and 52101037)Postdoctoral Fellowship Program of CPSFara(No.GZB20230944).
文摘Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-deposited and remelted were developed to refine the microstructure and enhance the oxidation resistance of refractory high entropy alloy using electron beam freeform fabrication(EBF3).Finer and short-range ordering structures were observed in the remelted sample,whereas the Al-deposited sample showcased the formation of silicide and intermetallic phases.High-temperature cyclic and isothermal oxidation tests at 1000℃ were carried out.The total weight gain after 60 h of cyclic oxidation decreased by 17.49%and 30.46%for the remelted and deposited samples,respectively,compared to the as-cast state.Oxidation kinetics reveal an evident lower mass gain and oxidation rate in the treated samples.A multilayer oxide consisting of TiO_(2)+Al_(2)O_(3)+SiO_(2)+AlNbO_(4) was studied for its excellent oxidation resistance.The oxidation behavior of rutile,corundum and other oxides was analyzed using first principles calculations and chemical defect analysis.Overall,this research,which introduces novel treatments,offers promising insights for enhancing the inherent oxidation resistance of refractory high entropy alloys.
基金supported by the National Natural Science Foundation of China(Nos.22272105 and 22002110)Natural Science Foundation of Shanghai(No.23ZR1423900)。
文摘Nitrogen-doping of carbon support(N-C)for platinum(Pt)nanoparticles to form Pt/N-C catalyst represents an effective strategy to promote the electrocatalysis of cathodic oxygen reduction reaction(ORR)in proton exchange membrane fuel cells.For fundamental understanding,clearly identifying the metalsupport effect on enhancement mechanisms of ORR electrocatalysis is definitely needed.In this work,the impact of Pt-support interaction via interfacial Pt-N coordination on electrocatalytic ORR activity and stability in Pt/N-C catalyst is deeply studied through structural/compositional characterizations,electrochemical measurements and theoretical DFT-calculations/AIMD-simulations.The resulting Pt/N-C catalyst exhibits a superior electrocatalytic performance compared to the commercial Pt/C catalyst in both half-cell and H_(2)-O_(2)fuel cell.Experimental and theoretical results reveal that the interfacial Pt-N coordination enables electron transfer from N-C support to Pt nanoparticles,which can weaken the adsorption strength of oxygen intermediates on Pt surface to improve ORR activity and induce the strong Pt-support interaction to enhance electrochemical stability.
基金the R&D Program of Beijing Municipal Education Commission(No.KM202310005010)the National Natural Science Foundation of China(No.52001015)for their financial support.
文摘The quest for high-energy-density magnesium-air batteries is hindered by the efficiency-voltage trade-off,ultimately leading to an unsatisfactory energy density.Here,we effectively mitigate the inherent efficiency-voltage trade-off by introducing a novel anode material,specifically,Mg-0.5Sn-0.5In-0.5Ga.This anode demonstrates exceptional anodic efficiency,achieving 60.5±2.5%at 1 mA cm^(-2),65.3±2.7%at 10 mA cm^(-2),and 71.4±1.2%at 20 mA cm^(-2).Furthermore,the discharge voltage is significantly enhanced,reaching 1.76±0.01 V at 1 mA cm^(-2),1.44±0.02 V at 10 mA cm^(-2),and 1.21±0.08 V at 20 mA cm^(-2).Consequently,our newly developed anode exhibits a remarkable energy density of 2312±98 W h kg^(-1),placing it among the top-performing magnesium anodes documented in the literature.Density functional theory calculations and experimental investigations have unveiled that the exceptional performance can be attributed to the inhibition of water reduction,facilitated by the hybridization between solute atoms and neighboring Mg atoms.Furthermore,the activation of the second phase,introducing additional galvanic couples,significantly contributes to this performance.This study presents valuable insights that can guide the design of novel anodes,contributing to the advancement of high-performance magnesium-air batteries.
