为了寻求合理简化的流域地形指数水文模型TOPMODEL(Topographic Index model)用于大尺度的陆面模式,推导了土壤表层饱和导水率k0、衰减因子f和地下水补给速率R空间都可变的扩展的TOPMODEL,并将f空间非均匀分布的TOPMODEL与陆面模式SSiB...为了寻求合理简化的流域地形指数水文模型TOPMODEL(Topographic Index model)用于大尺度的陆面模式,推导了土壤表层饱和导水率k0、衰减因子f和地下水补给速率R空间都可变的扩展的TOPMODEL,并将f空间非均匀分布的TOPMODEL与陆面模式SSiB4耦合(SSiB4/GTOP)。通过耦合模型在f空间非均匀条件下进行实际流域的水文模拟,分析f空间非均匀对流域土壤湿度、蒸散发、地表径流、基流和总径流的影响。主要结论有:(1)k0和R的空间变化并不改变经典TOPMODEL原有关系式,只要定义新的地形指数,k0和R空间非均匀TOPMODEL与空间均匀的TOPMODEL并无区别;(2) f空间变化条件下由于局地的地下水埋深还与局地的f值有关,地形指数相同的区域具有水文相似性这一结论不再成立;(3)与f空间均匀的模拟结果相比较,f随海拔高度h i增加而线性减小使模拟的流域土壤湿度、地表径流和流域蒸散减小但使基流和总径流增加;(4) f空间非均匀对流域水文模拟结果有影响,但其影响明显小于流域地形因子的影响。展开更多
Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen r...Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen receptor protein,characterized by polyglutamine expansion,is prone to misfolding and forms aggregates in both the nucleus and cytoplasm in the brain in spinal and bulbar muscular atrophy patients.These aggregates alter protein-protein interactions and compromise transcriptional activity.In this study,we reported that in both cultured N2a cells and mouse brain,mutant androgen receptor with polyglutamine expansion causes reduced expression of mesencephalic astrocyte-de rived neurotrophic factor.Overexpressio n of mesencephalic astrocyte-derived neurotrophic factor amelio rated the neurotoxicity of mutant androgen receptor through the inhibition of mutant androgen receptor aggregation.Conversely.knocking down endogenous mesencephalic astrocyte-derived neurotrophic factor in the mouse brain exacerbated neuronal damage and mutant androgen receptor aggregation.Our findings suggest that inhibition of mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor is a potential mechanism underlying neurodegeneration in spinal and bulbar muscular atrophy.展开更多
BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram...BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.展开更多
BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for e...BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for early detection of stomal complications is important to improve the outcome.A model including patients and disease related factors,intraoperative surgical techniques and biochemical markers would be a better determinant to anticipate early stomal complications.Incorporation of emerging tools and technology such as artificial intelligence(AI),will further improve the prediction.AIM To identify various risk factors and models for prediction of early post operative stomal complications in colorectal cancer(CRC)surgery.METHODS Published literatures on early postoperative stomal complications in CRC surgery were systematically reviewed between 1995 and 2024 from online search engines PubMed and MEDLINE.RESULTS Twenty-four observational studies focused on identifying various risk factors for early post operative stomal complications in CRC surgery were analyzed.Stomal complications in CRC are influenced by several factors such as disease factors,patient-specific characteristics,and surgical techniques.There are some biomarkers and tools loke AI which may play significant roles in early detection.CONCLUSION Careful analysis of these factors,changes in biochemical parameters,and application of AI,a predictive model for stomal complications can be generated,to help in early detection,prompt action to achieve better outcomes.展开更多
Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondri...Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondrial,or nuclear transcriptomes/genomes and increased taxon sampling have provided unprecedent resolution into the phylogeny of flowering plants.However,owing to ancient rapid radiations,the interrelationships among the five lineages of Mesangiospermae,the vast majority of angiosperms,remain contentious.Here we show that,although plastid and mitochondrial genomes lack sufficient phylogenetic signal for resolving deeper phylogeny,the relationships among five mesangiosperm lineages can be confidently resolved under better-fitting models using genome-scale data.According to our Bayesian cross-validation and model test in a maximum likelihood framework,siteheterogeneous models(e.g.,CAT-GTR+G4,LG+C20+F+G)outperform site-homogeneous or partition models often used in previous studies.Under site-heterogeneous models,the approximately unbiased test favored our preferred tree recovered from various datasets:Ceratophyllales(coontails)are robustly recovered as sister to monocots,and they together are sister to the clade comprising magnoliids,Chloranthales,and eudicots.Our phylogenomic analyses resolve the last enigma of the deeper phylogeny of angiosperms and emphasize the efficacy of modeling compositional heterogeneity in resolving rapid radiations of plants.展开更多
Dear Editor,This letter presents a novel latent factorization model for high dimensional and incomplete (HDI) tensor, namely the neural Tucker factorization (Neu Tuc F), which is a generic neural network-based latent-...Dear Editor,This letter presents a novel latent factorization model for high dimensional and incomplete (HDI) tensor, namely the neural Tucker factorization (Neu Tuc F), which is a generic neural network-based latent-factorization-of-tensors model under the Tucker decomposition framework.展开更多
BACKGROUND Sepsis is a severe complication in hospitalized patients with diabetic foot(DF),often associated with high morbidity and mortality.Despite its clinical significance,limited tools exist for early risk predic...BACKGROUND Sepsis is a severe complication in hospitalized patients with diabetic foot(DF),often associated with high morbidity and mortality.Despite its clinical significance,limited tools exist for early risk prediction.AIM To identify key risk factors and evaluate the predictive value of a nomogram model for sepsis in this population.METHODS This retrospective study included 216 patients with DF admitted from January 2022 to June 2024.Patients were classified into sepsis(n=31)and non-sepsis(n=185)groups.Baseline characteristics,clinical parameters,and laboratory data were analyzed.Independent risk factors were identified through multivariable logistic regression,and a nomogram model was developed and validated.The model's performance was assessed by its discrimination(AUC),calibration(Hosmer-Lemeshow test,calibration plots),and clinical utility[decision curve analysis(DCA)].RESULTS The multivariable analysis identified six independent predictors of sepsis:Diabetes duration,DF Texas grade,white blood cell count,glycated hemoglobin,Creactive protein,and albumin.A nomogram integrating these factors achieved excellent diagnostic performance,with an AUC of 0.908(95%CI:0.865-0.956)and robust internal validation(AUC:0.906).Calibration results showed strong agreement between predicted and observed probabilities(Hosmer-Lemeshow P=0.926).DCA demonstrated superior net benefit compared to extreme intervention scenarios,highlighting its clinical utility.CONCLUSION The nomogram prediction model,based on six key risk factors,demonstrates strong predictive value,calibration,and clinical utility for sepsis in patients with DF.This tool offers a practical approach for early risk stratification,enabling timely interventions and improved clinical management in this high-risk population.展开更多
Background:Lung cancer is the leading cause of cancer-related mortality,and while low-dose computed tomography screening may reduce mortality,emerging prognostic models show superior discriminative efficacy compared t...Background:Lung cancer is the leading cause of cancer-related mortality,and while low-dose computed tomography screening may reduce mortality,emerging prognostic models show superior discriminative efficacy compared to age-and smoking history-based screening.However,further research is needed to assess their reliability in predicting lung cancer risk in high-risk patients.Methods:This study evaluated the predictive performance and quality of existing lung cancer prognostic models through a systematic review and meta-analysis.A comprehensive search was conducted in PubMed,Cochrane,Web of Science,CNKI,and Wanfang for articles published between January 1,2000,and February 13,2025,identifying population-basedmodels incorporating all available modeling data.Results:Among 72 analyzed studies,models were developed from Asian(28 studies,including 23 Chinese cohorts)and European/American(48 studies)populations,with only 6 focusing on nonsmokers.Twenty-one models included genetic markers,15 used clinical factors,and 40 integrated epidemiological predictors.Although 37 models underwent external validation,only 4 demonstrated minimal bias and clinical applicability.A meta-analysis of 11 repeatedly validated models revealed calibration and discrimination,though some lacked calibration data.Conclusions:Few lung cancer prognostic models exist for nonsmokers.Most models exhibit poor predictive performance in external validations,with significant bias and limited application scope.Widespread external validation,standardized model development,and reporting techniques are needed to accurately identify high-risk individuals and ensure applicability across diverse populations.展开更多
Rip currents are a significant threat to swimmers worldwide,responsible for numerous drowning incidents each year.In Vietnam,Bai Dai Beach in Cam Ranh Bay,Khanh Hoa Province,has experienced an increase in drowning eve...Rip currents are a significant threat to swimmers worldwide,responsible for numerous drowning incidents each year.In Vietnam,Bai Dai Beach in Cam Ranh Bay,Khanh Hoa Province,has experienced an increase in drowning events due to rip currents in recent years.To address this issue,a comprehensive study was conducted based on developing a depth-averaged 2D hydrodynamic model to simulate rip currents in the Bai Dai-Cam Ranh coast.The HYDIST-2D numerical model was applied to simulate the rip current evolution in space and time for the study area.The results showed that the HYDIST-2D numerical model can accurately predict the location,magnitude,and microstructure of rip currents,including rip current speed,width,and length.The simulation results revealed that the rip current speed is greater during the low tide phase,with an average speed of 0.5 m s^(-1),while during high tide,the rip current speed is lower,around 0.1–0.8 m s^(-1).The width and length of the rip current also vary with the tide phase,with a wider and longer rip current observed during the low tide phase.The results also showed that the rip current speed and microstructure are influenced by the wave features,tide current,and bathymetry of the study area.The present study provides valuable insights into the dynamics of rip currents in the Bai Dai-Cam Ranh coast.The findings can be used to support the management of bathing activities and provide early warnings for potential risks associated with rip currents.展开更多
In this article,we comment on the article published by Yu et al.By employing LASSO regression and Cox proportional hazard models,the article identified nine significant variables affecting survival,including body mass...In this article,we comment on the article published by Yu et al.By employing LASSO regression and Cox proportional hazard models,the article identified nine significant variables affecting survival,including body mass index,Karnofsky performance status,and tumor-node-metastasis staging.We firmly concur with Yu et al regarding the vital significance of clinical prediction models(CPMs),including logistic regression and Cox regression for assessment in esophageal carcinoma(EC).However,the nomogram's limitations and the complexities of integrating genetic factors pose challenges.The integration of immunological data with advanced statistics offers new research directions.High-throughput sequencing and big data,facilitated by machine learning,have revolutionized cancer research but require substantial computational resources.The future of CPMs in EC depends on leveraging these technologies to improve predictive accuracy and clinical application,addressing the need for larger datasets,patientreported outcomes,and regular updates for clinical relevance.展开更多
BACKGROUND Low rectal cancer poses a significant surgical challenge because of its close proximity to the anal sphincter,often requiring radical resection with permanent colostomy to achieve oncological safety.Revisit...BACKGROUND Low rectal cancer poses a significant surgical challenge because of its close proximity to the anal sphincter,often requiring radical resection with permanent colostomy to achieve oncological safety.Revisited rectal anatomy,advances in surgical techniques and neoadjuvant therapies have enabled the possibility of sphincter-preserving procedures,however,it is uniformly not applicable.Selecting appropriate candidates for sphincter preservation is crucial,as an illadvised approach may compromise oncological outcome or lead to poor functional outcomes.Currently there is no consensus-which clinical,anatomical,or molecular factors most accurately predict the feasibility of sphincter-preserving surgery(SPS)in this subset of patients.By identifying these predictors,the study seeks to support improved patient selection,enhance surgical planning,and ultimately contribute to better functional and oncological outcomes in patients with low rectal cancer.AIM To identify predictive factors that determine the feasibility of SPS in patients with low rectal cancer.METHODS A comprehensive literature search was conducted using PubMed/MEDLINE databases.The search focused on various factors influencing the feasibility of SPS in low rectal cancer.These included patient-related factors,anatomical considerations,findings from different imaging modalities,advancements in diagnostic tools and techniques,and the role of neoadjuvant chemoradiotherapy.The relevance of each factor in predicting the potential for sphincter preservation was critically analyzed and presented based on the current evidence RESULTS Multiple studies have identified a range of predictive factors influencing the feasibility of SPS in low rectal cancer.Patient-related factors include age,sex,preoperative continence status,comorbidities,and body mass index.Anatomical considerations,such as tumor distance from the anal verge,involvement of the external anal sphincter,and levator ani muscles,also play a critical role.Additionally,a favourable response to neoadjuvant chemoradiotherapy has been associated with improved suitability for sphincter preservation.Several biomarkers,such as inflammatory markers like interleukins and C-reactive protein,as well as tumor markers like carcinoembryonic antigen,are important.Molecular markers,including BRAF and KRAS mutations and microsatellite instability status,have been linked to prognosis and may further guide decision-making regarding sphincter-preserving approaches.Artificial intelligence(AI)can further add in to select an ideal patient for sphincter preservation.CONCLUSION SPS is feasible in low rectal cancer and depends on patient factors,tumor anatomy and biology,preoperative treatment response,and biomarkers.In addition,tools and technology including AI can further help in selecting an ideal patient for long term optimal outcome.展开更多
基金supported by the National Key R&D Program of China,No.2021YFA0805200(to SY)the National Natural Science Foundation of China,No.31970954(to SY)two grants from the Department of Science and Technology of Guangdong Province,Nos.2021ZT09Y007,2020B121201006(both to XJL)。
文摘Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen receptor protein,characterized by polyglutamine expansion,is prone to misfolding and forms aggregates in both the nucleus and cytoplasm in the brain in spinal and bulbar muscular atrophy patients.These aggregates alter protein-protein interactions and compromise transcriptional activity.In this study,we reported that in both cultured N2a cells and mouse brain,mutant androgen receptor with polyglutamine expansion causes reduced expression of mesencephalic astrocyte-de rived neurotrophic factor.Overexpressio n of mesencephalic astrocyte-derived neurotrophic factor amelio rated the neurotoxicity of mutant androgen receptor through the inhibition of mutant androgen receptor aggregation.Conversely.knocking down endogenous mesencephalic astrocyte-derived neurotrophic factor in the mouse brain exacerbated neuronal damage and mutant androgen receptor aggregation.Our findings suggest that inhibition of mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor is a potential mechanism underlying neurodegeneration in spinal and bulbar muscular atrophy.
基金Supported by Government Assignment,No.1023022600020-6RSF Grant,No.24-15-00549Ministry of Science and Higher Education of the Russian Federation within the Framework of State Support for the Creation and Development of World-Class Research Center,No.075-15-2022-304.
文摘BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.
文摘BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for early detection of stomal complications is important to improve the outcome.A model including patients and disease related factors,intraoperative surgical techniques and biochemical markers would be a better determinant to anticipate early stomal complications.Incorporation of emerging tools and technology such as artificial intelligence(AI),will further improve the prediction.AIM To identify various risk factors and models for prediction of early post operative stomal complications in colorectal cancer(CRC)surgery.METHODS Published literatures on early postoperative stomal complications in CRC surgery were systematically reviewed between 1995 and 2024 from online search engines PubMed and MEDLINE.RESULTS Twenty-four observational studies focused on identifying various risk factors for early post operative stomal complications in CRC surgery were analyzed.Stomal complications in CRC are influenced by several factors such as disease factors,patient-specific characteristics,and surgical techniques.There are some biomarkers and tools loke AI which may play significant roles in early detection.CONCLUSION Careful analysis of these factors,changes in biochemical parameters,and application of AI,a predictive model for stomal complications can be generated,to help in early detection,prompt action to achieve better outcomes.
基金supported by the National Natural Science Foundation of China(42222201,42288201)。
文摘Angiosperms experienced one of the most remarkable radiations of land plants and are now the dominant autotrophs in terrestrial ecosystems.Recent phylogenomic studies based on large-scale data from plastid,mitochondrial,or nuclear transcriptomes/genomes and increased taxon sampling have provided unprecedent resolution into the phylogeny of flowering plants.However,owing to ancient rapid radiations,the interrelationships among the five lineages of Mesangiospermae,the vast majority of angiosperms,remain contentious.Here we show that,although plastid and mitochondrial genomes lack sufficient phylogenetic signal for resolving deeper phylogeny,the relationships among five mesangiosperm lineages can be confidently resolved under better-fitting models using genome-scale data.According to our Bayesian cross-validation and model test in a maximum likelihood framework,siteheterogeneous models(e.g.,CAT-GTR+G4,LG+C20+F+G)outperform site-homogeneous or partition models often used in previous studies.Under site-heterogeneous models,the approximately unbiased test favored our preferred tree recovered from various datasets:Ceratophyllales(coontails)are robustly recovered as sister to monocots,and they together are sister to the clade comprising magnoliids,Chloranthales,and eudicots.Our phylogenomic analyses resolve the last enigma of the deeper phylogeny of angiosperms and emphasize the efficacy of modeling compositional heterogeneity in resolving rapid radiations of plants.
基金supported by the National Natural Science Foundation of China(62272078)Chongqing Natural Science Foundation(CSTB2023NSCQ-LZX0069)the Science and Technology Research Program of Chongqing Municipal Education Commission(KJQN202300210)
文摘Dear Editor,This letter presents a novel latent factorization model for high dimensional and incomplete (HDI) tensor, namely the neural Tucker factorization (Neu Tuc F), which is a generic neural network-based latent-factorization-of-tensors model under the Tucker decomposition framework.
文摘BACKGROUND Sepsis is a severe complication in hospitalized patients with diabetic foot(DF),often associated with high morbidity and mortality.Despite its clinical significance,limited tools exist for early risk prediction.AIM To identify key risk factors and evaluate the predictive value of a nomogram model for sepsis in this population.METHODS This retrospective study included 216 patients with DF admitted from January 2022 to June 2024.Patients were classified into sepsis(n=31)and non-sepsis(n=185)groups.Baseline characteristics,clinical parameters,and laboratory data were analyzed.Independent risk factors were identified through multivariable logistic regression,and a nomogram model was developed and validated.The model's performance was assessed by its discrimination(AUC),calibration(Hosmer-Lemeshow test,calibration plots),and clinical utility[decision curve analysis(DCA)].RESULTS The multivariable analysis identified six independent predictors of sepsis:Diabetes duration,DF Texas grade,white blood cell count,glycated hemoglobin,Creactive protein,and albumin.A nomogram integrating these factors achieved excellent diagnostic performance,with an AUC of 0.908(95%CI:0.865-0.956)and robust internal validation(AUC:0.906).Calibration results showed strong agreement between predicted and observed probabilities(Hosmer-Lemeshow P=0.926).DCA demonstrated superior net benefit compared to extreme intervention scenarios,highlighting its clinical utility.CONCLUSION The nomogram prediction model,based on six key risk factors,demonstrates strong predictive value,calibration,and clinical utility for sepsis in patients with DF.This tool offers a practical approach for early risk stratification,enabling timely interventions and improved clinical management in this high-risk population.
基金funded by theGuangzhou Municipal Science and Tech-nology Bureau(No.2023A03J0507).
文摘Background:Lung cancer is the leading cause of cancer-related mortality,and while low-dose computed tomography screening may reduce mortality,emerging prognostic models show superior discriminative efficacy compared to age-and smoking history-based screening.However,further research is needed to assess their reliability in predicting lung cancer risk in high-risk patients.Methods:This study evaluated the predictive performance and quality of existing lung cancer prognostic models through a systematic review and meta-analysis.A comprehensive search was conducted in PubMed,Cochrane,Web of Science,CNKI,and Wanfang for articles published between January 1,2000,and February 13,2025,identifying population-basedmodels incorporating all available modeling data.Results:Among 72 analyzed studies,models were developed from Asian(28 studies,including 23 Chinese cohorts)and European/American(48 studies)populations,with only 6 focusing on nonsmokers.Twenty-one models included genetic markers,15 used clinical factors,and 40 integrated epidemiological predictors.Although 37 models underwent external validation,only 4 demonstrated minimal bias and clinical applicability.A meta-analysis of 11 repeatedly validated models revealed calibration and discrimination,though some lacked calibration data.Conclusions:Few lung cancer prognostic models exist for nonsmokers.Most models exhibit poor predictive performance in external validations,with significant bias and limited application scope.Widespread external validation,standardized model development,and reporting techniques are needed to accurately identify high-risk individuals and ensure applicability across diverse populations.
文摘Rip currents are a significant threat to swimmers worldwide,responsible for numerous drowning incidents each year.In Vietnam,Bai Dai Beach in Cam Ranh Bay,Khanh Hoa Province,has experienced an increase in drowning events due to rip currents in recent years.To address this issue,a comprehensive study was conducted based on developing a depth-averaged 2D hydrodynamic model to simulate rip currents in the Bai Dai-Cam Ranh coast.The HYDIST-2D numerical model was applied to simulate the rip current evolution in space and time for the study area.The results showed that the HYDIST-2D numerical model can accurately predict the location,magnitude,and microstructure of rip currents,including rip current speed,width,and length.The simulation results revealed that the rip current speed is greater during the low tide phase,with an average speed of 0.5 m s^(-1),while during high tide,the rip current speed is lower,around 0.1–0.8 m s^(-1).The width and length of the rip current also vary with the tide phase,with a wider and longer rip current observed during the low tide phase.The results also showed that the rip current speed and microstructure are influenced by the wave features,tide current,and bathymetry of the study area.The present study provides valuable insights into the dynamics of rip currents in the Bai Dai-Cam Ranh coast.The findings can be used to support the management of bathing activities and provide early warnings for potential risks associated with rip currents.
基金Supported by the Scientific Research Program of Hunan Provincial Health Commission,No.B202313018450.
文摘In this article,we comment on the article published by Yu et al.By employing LASSO regression and Cox proportional hazard models,the article identified nine significant variables affecting survival,including body mass index,Karnofsky performance status,and tumor-node-metastasis staging.We firmly concur with Yu et al regarding the vital significance of clinical prediction models(CPMs),including logistic regression and Cox regression for assessment in esophageal carcinoma(EC).However,the nomogram's limitations and the complexities of integrating genetic factors pose challenges.The integration of immunological data with advanced statistics offers new research directions.High-throughput sequencing and big data,facilitated by machine learning,have revolutionized cancer research but require substantial computational resources.The future of CPMs in EC depends on leveraging these technologies to improve predictive accuracy and clinical application,addressing the need for larger datasets,patientreported outcomes,and regular updates for clinical relevance.
文摘BACKGROUND Low rectal cancer poses a significant surgical challenge because of its close proximity to the anal sphincter,often requiring radical resection with permanent colostomy to achieve oncological safety.Revisited rectal anatomy,advances in surgical techniques and neoadjuvant therapies have enabled the possibility of sphincter-preserving procedures,however,it is uniformly not applicable.Selecting appropriate candidates for sphincter preservation is crucial,as an illadvised approach may compromise oncological outcome or lead to poor functional outcomes.Currently there is no consensus-which clinical,anatomical,or molecular factors most accurately predict the feasibility of sphincter-preserving surgery(SPS)in this subset of patients.By identifying these predictors,the study seeks to support improved patient selection,enhance surgical planning,and ultimately contribute to better functional and oncological outcomes in patients with low rectal cancer.AIM To identify predictive factors that determine the feasibility of SPS in patients with low rectal cancer.METHODS A comprehensive literature search was conducted using PubMed/MEDLINE databases.The search focused on various factors influencing the feasibility of SPS in low rectal cancer.These included patient-related factors,anatomical considerations,findings from different imaging modalities,advancements in diagnostic tools and techniques,and the role of neoadjuvant chemoradiotherapy.The relevance of each factor in predicting the potential for sphincter preservation was critically analyzed and presented based on the current evidence RESULTS Multiple studies have identified a range of predictive factors influencing the feasibility of SPS in low rectal cancer.Patient-related factors include age,sex,preoperative continence status,comorbidities,and body mass index.Anatomical considerations,such as tumor distance from the anal verge,involvement of the external anal sphincter,and levator ani muscles,also play a critical role.Additionally,a favourable response to neoadjuvant chemoradiotherapy has been associated with improved suitability for sphincter preservation.Several biomarkers,such as inflammatory markers like interleukins and C-reactive protein,as well as tumor markers like carcinoembryonic antigen,are important.Molecular markers,including BRAF and KRAS mutations and microsatellite instability status,have been linked to prognosis and may further guide decision-making regarding sphincter-preserving approaches.Artificial intelligence(AI)can further add in to select an ideal patient for sphincter preservation.CONCLUSION SPS is feasible in low rectal cancer and depends on patient factors,tumor anatomy and biology,preoperative treatment response,and biomarkers.In addition,tools and technology including AI can further help in selecting an ideal patient for long term optimal outcome.
