BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To ...BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.展开更多
This work proposes the application of an iterative learning model predictive control(ILMPC)approach based on an adaptive fault observer(FOBILMPC)for fault-tolerant control and trajectory tracking in air-breathing hype...This work proposes the application of an iterative learning model predictive control(ILMPC)approach based on an adaptive fault observer(FOBILMPC)for fault-tolerant control and trajectory tracking in air-breathing hypersonic vehicles.In order to increase the control amount,this online control legislation makes use of model predictive control(MPC)that is based on the concept of iterative learning control(ILC).By using offline data to decrease the linearized model’s faults,the strategy may effectively increase the robustness of the control system and guarantee that disturbances can be suppressed.An adaptive fault observer is created based on the suggested ILMPC approach in order to enhance overall fault tolerance by estimating and compensating for actuator disturbance and fault degree.During the derivation process,a linearized model of longitudinal dynamics is established.The suggested ILMPC approach is likely to be used in the design of hypersonic vehicle control systems since numerical simulations have demonstrated that it can decrease tracking error and speed up convergence when compared to the offline controller.展开更多
Traffic forecasting with high precision aids Intelligent Transport Systems(ITS)in formulating and optimizing traffic management strategies.The algorithms used for tuning the hyperparameters of the deep learning models...Traffic forecasting with high precision aids Intelligent Transport Systems(ITS)in formulating and optimizing traffic management strategies.The algorithms used for tuning the hyperparameters of the deep learning models often have accurate results at the expense of high computational complexity.To address this problem,this paper uses the Tree-structured Parzen Estimator(TPE)to tune the hyperparameters of the Long Short-term Memory(LSTM)deep learning framework.The Tree-structured Parzen Estimator(TPE)uses a probabilistic approach with an adaptive searching mechanism by classifying the objective function values into good and bad samples.This ensures fast convergence in tuning the hyperparameter values in the deep learning model for performing prediction while still maintaining a certain degree of accuracy.It also overcomes the problem of converging to local optima and avoids timeconsuming random search and,therefore,avoids high computational complexity in prediction accuracy.The proposed scheme first performs data smoothing and normalization on the input data,which is then fed to the input of the TPE for tuning the hyperparameters.The traffic data is then input to the LSTM model with tuned parameters to perform the traffic prediction.The three optimizers:Adaptive Moment Estimation(Adam),Root Mean Square Propagation(RMSProp),and Stochastic Gradient Descend with Momentum(SGDM)are also evaluated for accuracy prediction and the best optimizer is then chosen for final traffic prediction in TPE-LSTM model.Simulation results verify the effectiveness of the proposed model in terms of accuracy of prediction over the benchmark schemes.展开更多
Model predictive control(MPC)has been deemed as an attractive control method in motor drives by virtue of its simple structure,convenient multi-objective optimization,and satisfactory dynamic performance.However,the s...Model predictive control(MPC)has been deemed as an attractive control method in motor drives by virtue of its simple structure,convenient multi-objective optimization,and satisfactory dynamic performance.However,the strong reliance on mathematical models seriously restrains its practical application.Therefore,improving the robustness of MPC has attained significant attentions in the last two decades,followed by which,model-free predictive control(MFPC)comes into existence.This article aims to reveal the current state of MFPC strategies for motor drives and give the categorization from the perspective of implementation.Based on this review,the principles of the reported MFPC strategies are introduced in detail,as well as the challenges encountered in technology realization.In addition,some of typical and important concepts are experimentally validated via case studies to evaluate the performance and highlight their features.Finally,the future trends of MFPC are discussed based on the current state and reported developments.展开更多
Fluctuating voltage levels in power grids necessitate automatic voltage regulators(AVRs)to ensure stability.This study examined the modeling and control of AVR in hydroelectric power plants using model predictive cont...Fluctuating voltage levels in power grids necessitate automatic voltage regulators(AVRs)to ensure stability.This study examined the modeling and control of AVR in hydroelectric power plants using model predictive control(MPC),which utilizes an extensive mathe-matical model of the voltage regulation system to optimize the control actions over a defined prediction horizon.This predictive feature enables MPC to minimize voltage deviations while accounting for operational constraints,thereby improving stability and performance under dynamic conditions.Thefindings were compared with those derived from an optimal proportional integral derivative(PID)con-troller designed using the artificial bee colony(ABC)algorithm.Although the ABC-PID method adjusts the PID parameters based on historical data,it may be difficult to adapt to real-time changes in system dynamics under constraints.Comprehensive simulations assessed both frameworks,emphasizing performance metrics such as disturbance rejection,response to load changes,and resilience to uncertainties.The results show that both MPC and ABC-PID methods effectively achieved accurate voltage regulation;however,MPC excelled in controlling overshoot and settling time—recording 0.0%and 0.25 s,respectively.This demonstrates greater robustness compared to conventional control methods that optimize PID parameters based on performance criteria derived from actual system behavior,which exhibited settling times and overshoots exceeding 0.41 s and 5.0%,respectively.The controllers were implemented using MATLAB/Simulink software,indicating a significant advancement for power plant engineers pursuing state-of-the-art automatic voltage regulations.展开更多
Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and ca...Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most prevalent and lethal malignant tumors worldwide.Currently,surgical intervention was the primary treatment modality for CRC.However,increasing studies have revealed t...BACKGROUND Colorectal cancer(CRC)is one of the most prevalent and lethal malignant tumors worldwide.Currently,surgical intervention was the primary treatment modality for CRC.However,increasing studies have revealed that CRC patients may experience postoperative cognitive dysfunction(POCD).AIM To establish a risk prediction model for POCD in CRC patients and investigate the preventive value of dexmedetomidine(DEX).METHODS A retrospective analysis was conducted on clinical data from 140 CRC patients who underwent surgery at the People’s Hospital of Qian Nan from February 2020 to May 2024.Patients were allocated into a modeling group(n=98)and a validation group(n=42)in a 7:3 ratio.General clinical data were collected.Additionally,in the modeling group,patients who received DEX preoperatively were incorporated into the observation group(n=54),while those who did not were placed in the control group(n=44).The incidence of POCD was recorded for both cohorts.Data analysis was performed using statistical product and service solutions 20.0,with t-tests orχ^(2) tests employed for group comparisons based on the data type.Least absolute shrinkage and selection operator regression was applied to identify influencing factors and reduce the impact of multicollinear predictors among variables.Multivariate analysis was carried out using Logistic regression.Based on the identified risk factors,a risk prediction model for POCD in CRC patients was developed,and the predictive value of these risk factors was evaluated.RESULTS Significant differences were observed between the cognitive dysfunction group and the non-cognitive dysfunction group in diabetes status,alcohol consumption,years of education,anesthesia duration,intraoperative blood loss,intraoperative hypoxemia,use of DEX during surgery,intraoperative use of vasoactive drugs,surgical time,systemic inflammatory response syndrome(SIRS)score(P<0.05).Multivariate Logistic regression analysis identified that diabetes[odds ratio(OR)=4.679,95%confidence interval(CI)=1.382-15.833],alcohol consumption(OR=5.058,95%CI:1.255-20.380),intraoperative hypoxemia(OR=4.697,95%CI:1.380-15.991),no use of DEX during surgery(OR=3.931,95%CI:1.383-11.175),surgery duration≥90 minutes(OR=4.894,95%CI:1.377-17.394),and a SIRS score≥3(OR=4.133,95%CI:1.323-12.907)were independent risk factors for POCD in CRC patients(P<0.05).A risk prediction model for POCD was constructed using diabetes,alcohol consumption,intraoperative hypoxemia,non-use of DEX during surgery,surgery duration,and SIRS score as factors.A receiver operator characteristic curve analysis of these factors revealed the model’s predictive sensitivity(88.56%),specificity(70.64%),and area under the curve(AUC)(AUC=0.852,95%CI:0.773-0.919).The model was validated using 42 CRC patients who met the inclusion criteria,demonstrating sensitivity(80.77%),specificity(81.25%),and accuracy(80.95%),and AUC(0.805)in diagnosing cognitive impairment,with a 95%CI:0.635-0.896.CONCLUSION Logistic regression analysis identified that diabetes,alcohol consumption,intraoperative hypoxemia,non-use of DEX during surgery,surgery duration,and SIRS score vigorously influenced the occurrence of POCD.The risk prediction model based on these factors demonstrated good predictive performance for POCD in CRC individuals.This study offers valuable insights for clinical practice and contributes to the prevention and management of POCD under CRC circumstances.展开更多
This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et...This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et al developed a robust predictive model demonstrating high accuracy(area under the curve 0.92 in the training cohort)by integrating venous phase radiomic features with alphafetoprotein levels.This noninvasive approach enables early identification of patients unlikely to benefit from transarterial chemoembolization,allowing a timely transition to alternative therapies such as targeted agents or immunotherapy.Such precision strategies may improve clinical outcomes,optimize resource utilization,and increase survival in advanced hepatocellular carcinoma management.Future studies should emphasize external validation and broader clinical adoption.展开更多
Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential S...Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.展开更多
BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk...BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.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
BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a prom...BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.展开更多
Ferroptosis,an iron-dependent form of programmed cell death,has garnered significant attention in tumor research in recent years.Its core characteristics include aberrant accumulation of lipid peroxides and impairment...Ferroptosis,an iron-dependent form of programmed cell death,has garnered significant attention in tumor research in recent years.Its core characteristics include aberrant accumulation of lipid peroxides and impairment of antioxidant defense mechanisms,such as dysfunction of glutathione peroxidase 4.These fea-tures are closely intertwined with the initiation,progression,and therapeutic resistance of hepatocellular carcinoma(HCC).This review presents a systematic overview of the fundamental molecular mechanisms underlying ferroptosis,en-compassing iron metabolism,lipid metabolism,and the antioxidant system.Fur-thermore,it summarizes the potential applications of targeting ferroptosis in liver cancer treatment,including the mechanisms of action of anticancer agents(e.g.,sorafenib)and relevant ferroptosis-related enzymes.Against the backdrop of the growing potential of artificial intelligence(AI)in liver cancer research,various AI-based predictive models for liver cancer are being increasingly developed.On the one hand,this review examines the mechanisms of ferroptosis in HCC to explore novel early detection markers for liver cancer,to provide new insights for the development of AI-based early diagnostic models.On the other hand,it syn-thesizes the current research progress of existing liver cancer predictive models while summarizing key challenges that AI predictive models may encounter in the diagnosis and treatment of HCC.展开更多
BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barr...BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barriers,and professional challenges.Compared to other age groups,they have higher recurrence rates,lower survival rates,and increased risk of depression.Research is lacking on factors influencing depressive symptoms and predictive models for this age group.AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province,China from November 2023 to April 2024 were included in the study.Participants were surveyed using a general information questionnaire,the patient health questionnaire depression scale,the visual analog scale for pain,the revised family support scale,and the long form of the international physical activity questionnaire.Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients,and a predictive model for depression risk was developed based on these findings.RESULTS Among the 360 middle-aged and young BC patients,the incidence rate of depressive symptoms was 38.61%(139/360).Multivariate analysis revealed that tumor grade,patient’s monthly income,pain score,family support score,and physical activity score were factors influencing depression in this patient group(P<0.05).The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852,with a maximum Youden index of 0.973,sensitivity of 86.80%,specificity of 89.50%,and a diagnostic odds ratio of 0.552.The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit(χ^(2)=0.360,P=0.981).CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.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
This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk facto...This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.展开更多
Objective This study aimed to develop a prediction model to assess the risk of sepsis-induced coagulopathy(SIC)in sepsis patients.Methods We conducted a retrospective study of septic patients admitted to the Intensive...Objective This study aimed to develop a prediction model to assess the risk of sepsis-induced coagulopathy(SIC)in sepsis patients.Methods We conducted a retrospective study of septic patients admitted to the Intensive Care Units of Shandong Provincial Hospital(Central Campus and East Campus),and Shenxian People’s Hospital from January 2019 to September 2024.We used Kaplan-Meier analysis to assess survival outcomes.LASSO regression identified predictive variables,and logistic regression was employed to analyze risk factors for pre-SIC.A nomogram prediction model was developed via R software and evaluated via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).Results Among 309 patients,236 were in the training set,and 73 were in the test set.The pre-SIC group had higher mortality(44.8%vs.21.3%)and disseminated intravascular coagulation(DIC)incidence(56.3%vs.29.1%)than the non-SIC group.LASSO regression identified lactate,coagulation index,creatinine,and SIC scores as predictors of pre-SIC.The nomogram model demonstrated good calibration,with an AUC of 0.766 in the development cohort and 0.776 in the validation cohort.DCA confirmed the model’s clinical utility.Conclusion SIC is associated with increased mortality,with pre-SIC further increasing the risk of death.The nomogram-based prediction model provides a reliable tool for early SIC identification,potentially improving sepsis management and outcomes.展开更多
BACKGROUND Gastric cancer is one of the most common malignant tumors of the digestive system globally,with a generally poor prognosis for patients with advanced dis-ease.In recent years,immune checkpoint inhibitors ha...BACKGROUND Gastric cancer is one of the most common malignant tumors of the digestive system globally,with a generally poor prognosis for patients with advanced dis-ease.In recent years,immune checkpoint inhibitors have made significant advan-cements in gastric cancer treatment,with some HER-2 negative advanced gastric cancer patients benefiting from the combination of immunotherapy and chemo-therapy.However,significant biological heterogeneity exists among patients,resulting in a lack of effective tools to predict the benefits of immunotherapy and survival outcomes.Therefore,there is an urgent need to develop a scientific and precise survival prediction model to provide robust support for personalized treatment decisions.AIM To develop and validate a novel survival prediction model for assessing the survival risk of advanced HER-2 negative gastric cancer patients receiving immunotherapy combined with chemotherapy,thereby enhancing the accuracy of prognostic evaluation and its clinical guidance value.METHODS This retrospective study included 200 advanced HER-2 negative gastric cancer patients who received programmed cell death protein 1 inhibitors combined with chemotherapy.Independent prognostic factors for progression-free survival(PFS)and overall survival(OS)were identified using multivariable Cox regression analysis,and a nomogram model was constructed based on these factors.The variables included in the regression analysis were selected based on their clinical relevance,routine application in gastric cancer evaluation,and availability within our dataset.The model’s discrimination and calibration were assessed using the concordance index(C-index),the area under the receiver operating characteristic curve(AUC),and calibration plots.RESULTS Among the 200 advanced HER-2 negative gastric cancer patients,multivariable Cox regression analysis identified programmed death-ligand 1 expression level,microsatellite status,tumor-node-metastasis stage,tumor differen-tiation,neutrophil-to-lymphocyte ratio,and C-reactive protein-albumin-lymphocyte index as independent prognostic factors for PFS and OS(all P values<0.05).Based on these variables,nomogram models for PFS and OS were constructed.In the training set,the C-index for the PFS model was 0.82[95%confidence interval(CI):0.77-0.87],and in the internal validation set,it was 0.78(95%CI:0.70-0.87),indicating good discrimination ability.For AUC evaluation,the PFS model’s 3-month and 6-month prediction AUCs in the training set were 0.79(95%CI:0.65-0.92)and 0.89(95%CI:0.83-0.94),respectively.In the validation set,they were 0.82(95%CI:0.68-0.97)and 0.80(95%CI:0.68-0.92),respectively.For OS prediction,the C-index in the training set and validation set were 0.81(95%CI:0.76-0.86)and 0.78(95%CI:0.69-0.87),respectively.The nomogram also showed high accuracy in predicting OS at 12,15,and 18 months.In the training set,the AUCs were 0.82(95%CI:0.75-0.89),0.91(95%CI:0.86-0.97),and 0.89(95%CI:0.83-0.95),respectively.In the validation set,they were 0.79(95%CI:0.66-0.91),0.84(95%CI:0.73-0.96),and 0.81(95%CI:0.69-0.93),respectively.Furthermore,calibration curves demonstrated that the predicted probabilities of the model were highly consistent with the actual observed values at different time points,suggesting that the model has good reliability and adaptability for clinical application.CONCLUSION The nomogram model developed in this study effectively predicts the survival outcomes of advanced HER-2 negative gastric cancer patients receiving immunotherapy combined with chemotherapy,demonstrating good discrimination and consistency,and providing robust support for personalized clinical treatment decisions.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 In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer ce...BACKGROUND In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer cells,and increases the risk of tumor recurrence.At present,analyses and evaluation tools for factors influencing early postoperative recurrence in patients with CRC and obstruction are limited.AIM To explore the influencing factors and construct a predictive model of the early postoperative recurrence of CRC with obstruction.METHODS Data from 181 patients with CRC and obstruction who underwent surgery in the Department of Gastrointestinal Surgery,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2017 and May 2023 were retrospectively collected.Patients with CRC and obstruction were divided into a recurrence group and a non-recurrence group based on whether recurrence occurred during the 2-year follow-up after surgery.Datasets from the two groups were compared.Subsequently,multiple logistic regression was employed to analyze the influencing factors of the early postoperative recurrence of CRC with obstruction.The nomogram prediction model was drawn using R software,and its performance was evaluated by the goodness of fit test and receiver operating characteristic(ROC)curve analysis.The clinical benefit rate of the model was evaluated by decision curves.RESULTS Among the 181 patients with CRC and obstruction,52(28.73%)experienced tumor recurrence within 2 years after surgery.Significant differences were observed in preoperative carcinoembryonic antigen(CEA),preoperative systemic immuneinflammation index(SII),tumor,node,and metastasis(TNM)stage,differentiation degree,nerve infiltration,and Ki-67 expression between the recurrence and non-recurrence groups(P<0.05).Multivariate logistic regression analysis showed that high preoperative CEA(OR=2.094,P=0.008),high preoperative SII(OR=2.795,P<0.001),TNM stage III(OR=1.644,P=0.027),poor differentiation(OR=1.861,P=0.035),and high Ki-67 expression(OR=2.467,P=0.001)were all influencing factors for early postoperative recurrence of CRC with obstruction.The area under the ROC curve of the nomograph model constructed based on this was 0.890,the goodness of fit deviation test was conducted(χ^(2)=3.903,P=0.866),and the decision curve display model demonstrated practical value in clinical practice.CONCLUSION The early recurrence rate of CRC with obstruction is high.CEA,SII,TNM staging,differentiation degree,and Ki-67 expression are factors related to early postoperative recurrence.A nomogram prediction model incorporating these factors can effectively evaluate the risk of early postoperative recurrence in patients with CRC.展开更多
基金Supported by the National Key Research and Development Program of China,No.2022YFC2503600。
文摘BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.
基金supported by the National Natural Science Foundation of China(12072090).
文摘This work proposes the application of an iterative learning model predictive control(ILMPC)approach based on an adaptive fault observer(FOBILMPC)for fault-tolerant control and trajectory tracking in air-breathing hypersonic vehicles.In order to increase the control amount,this online control legislation makes use of model predictive control(MPC)that is based on the concept of iterative learning control(ILC).By using offline data to decrease the linearized model’s faults,the strategy may effectively increase the robustness of the control system and guarantee that disturbances can be suppressed.An adaptive fault observer is created based on the suggested ILMPC approach in order to enhance overall fault tolerance by estimating and compensating for actuator disturbance and fault degree.During the derivation process,a linearized model of longitudinal dynamics is established.The suggested ILMPC approach is likely to be used in the design of hypersonic vehicle control systems since numerical simulations have demonstrated that it can decrease tracking error and speed up convergence when compared to the offline controller.
文摘Traffic forecasting with high precision aids Intelligent Transport Systems(ITS)in formulating and optimizing traffic management strategies.The algorithms used for tuning the hyperparameters of the deep learning models often have accurate results at the expense of high computational complexity.To address this problem,this paper uses the Tree-structured Parzen Estimator(TPE)to tune the hyperparameters of the Long Short-term Memory(LSTM)deep learning framework.The Tree-structured Parzen Estimator(TPE)uses a probabilistic approach with an adaptive searching mechanism by classifying the objective function values into good and bad samples.This ensures fast convergence in tuning the hyperparameter values in the deep learning model for performing prediction while still maintaining a certain degree of accuracy.It also overcomes the problem of converging to local optima and avoids timeconsuming random search and,therefore,avoids high computational complexity in prediction accuracy.The proposed scheme first performs data smoothing and normalization on the input data,which is then fed to the input of the TPE for tuning the hyperparameters.The traffic data is then input to the LSTM model with tuned parameters to perform the traffic prediction.The three optimizers:Adaptive Moment Estimation(Adam),Root Mean Square Propagation(RMSProp),and Stochastic Gradient Descend with Momentum(SGDM)are also evaluated for accuracy prediction and the best optimizer is then chosen for final traffic prediction in TPE-LSTM model.Simulation results verify the effectiveness of the proposed model in terms of accuracy of prediction over the benchmark schemes.
基金supported in part by the National Natural Science Foundation of China under Grant 52077002。
文摘Model predictive control(MPC)has been deemed as an attractive control method in motor drives by virtue of its simple structure,convenient multi-objective optimization,and satisfactory dynamic performance.However,the strong reliance on mathematical models seriously restrains its practical application.Therefore,improving the robustness of MPC has attained significant attentions in the last two decades,followed by which,model-free predictive control(MFPC)comes into existence.This article aims to reveal the current state of MFPC strategies for motor drives and give the categorization from the perspective of implementation.Based on this review,the principles of the reported MFPC strategies are introduced in detail,as well as the challenges encountered in technology realization.In addition,some of typical and important concepts are experimentally validated via case studies to evaluate the performance and highlight their features.Finally,the future trends of MFPC are discussed based on the current state and reported developments.
文摘Fluctuating voltage levels in power grids necessitate automatic voltage regulators(AVRs)to ensure stability.This study examined the modeling and control of AVR in hydroelectric power plants using model predictive control(MPC),which utilizes an extensive mathe-matical model of the voltage regulation system to optimize the control actions over a defined prediction horizon.This predictive feature enables MPC to minimize voltage deviations while accounting for operational constraints,thereby improving stability and performance under dynamic conditions.Thefindings were compared with those derived from an optimal proportional integral derivative(PID)con-troller designed using the artificial bee colony(ABC)algorithm.Although the ABC-PID method adjusts the PID parameters based on historical data,it may be difficult to adapt to real-time changes in system dynamics under constraints.Comprehensive simulations assessed both frameworks,emphasizing performance metrics such as disturbance rejection,response to load changes,and resilience to uncertainties.The results show that both MPC and ABC-PID methods effectively achieved accurate voltage regulation;however,MPC excelled in controlling overshoot and settling time—recording 0.0%and 0.25 s,respectively.This demonstrates greater robustness compared to conventional control methods that optimize PID parameters based on performance criteria derived from actual system behavior,which exhibited settling times and overshoots exceeding 0.41 s and 5.0%,respectively.The controllers were implemented using MATLAB/Simulink software,indicating a significant advancement for power plant engineers pursuing state-of-the-art automatic voltage regulations.
基金supported by the National Natural Science Foundation of China(82371709).
文摘Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]
基金Supported by the Research Fund of Qiannan Medical College for Nationalities,No.Qnyz202222.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most prevalent and lethal malignant tumors worldwide.Currently,surgical intervention was the primary treatment modality for CRC.However,increasing studies have revealed that CRC patients may experience postoperative cognitive dysfunction(POCD).AIM To establish a risk prediction model for POCD in CRC patients and investigate the preventive value of dexmedetomidine(DEX).METHODS A retrospective analysis was conducted on clinical data from 140 CRC patients who underwent surgery at the People’s Hospital of Qian Nan from February 2020 to May 2024.Patients were allocated into a modeling group(n=98)and a validation group(n=42)in a 7:3 ratio.General clinical data were collected.Additionally,in the modeling group,patients who received DEX preoperatively were incorporated into the observation group(n=54),while those who did not were placed in the control group(n=44).The incidence of POCD was recorded for both cohorts.Data analysis was performed using statistical product and service solutions 20.0,with t-tests orχ^(2) tests employed for group comparisons based on the data type.Least absolute shrinkage and selection operator regression was applied to identify influencing factors and reduce the impact of multicollinear predictors among variables.Multivariate analysis was carried out using Logistic regression.Based on the identified risk factors,a risk prediction model for POCD in CRC patients was developed,and the predictive value of these risk factors was evaluated.RESULTS Significant differences were observed between the cognitive dysfunction group and the non-cognitive dysfunction group in diabetes status,alcohol consumption,years of education,anesthesia duration,intraoperative blood loss,intraoperative hypoxemia,use of DEX during surgery,intraoperative use of vasoactive drugs,surgical time,systemic inflammatory response syndrome(SIRS)score(P<0.05).Multivariate Logistic regression analysis identified that diabetes[odds ratio(OR)=4.679,95%confidence interval(CI)=1.382-15.833],alcohol consumption(OR=5.058,95%CI:1.255-20.380),intraoperative hypoxemia(OR=4.697,95%CI:1.380-15.991),no use of DEX during surgery(OR=3.931,95%CI:1.383-11.175),surgery duration≥90 minutes(OR=4.894,95%CI:1.377-17.394),and a SIRS score≥3(OR=4.133,95%CI:1.323-12.907)were independent risk factors for POCD in CRC patients(P<0.05).A risk prediction model for POCD was constructed using diabetes,alcohol consumption,intraoperative hypoxemia,non-use of DEX during surgery,surgery duration,and SIRS score as factors.A receiver operator characteristic curve analysis of these factors revealed the model’s predictive sensitivity(88.56%),specificity(70.64%),and area under the curve(AUC)(AUC=0.852,95%CI:0.773-0.919).The model was validated using 42 CRC patients who met the inclusion criteria,demonstrating sensitivity(80.77%),specificity(81.25%),and accuracy(80.95%),and AUC(0.805)in diagnosing cognitive impairment,with a 95%CI:0.635-0.896.CONCLUSION Logistic regression analysis identified that diabetes,alcohol consumption,intraoperative hypoxemia,non-use of DEX during surgery,surgery duration,and SIRS score vigorously influenced the occurrence of POCD.The risk prediction model based on these factors demonstrated good predictive performance for POCD in CRC individuals.This study offers valuable insights for clinical practice and contributes to the prevention and management of POCD under CRC circumstances.
文摘This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et al developed a robust predictive model demonstrating high accuracy(area under the curve 0.92 in the training cohort)by integrating venous phase radiomic features with alphafetoprotein levels.This noninvasive approach enables early identification of patients unlikely to benefit from transarterial chemoembolization,allowing a timely transition to alternative therapies such as targeted agents or immunotherapy.Such precision strategies may improve clinical outcomes,optimize resource utilization,and increase survival in advanced hepatocellular carcinoma management.Future studies should emphasize external validation and broader clinical adoption.
文摘Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.
文摘BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.
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 Shandong Province Traditional Chinese Medicine Technology Project,No.Q-2023147the Weifang Health Commission Research Project,No.WFWSJK-2023-033+3 种基金the Weifang City Science and Technology Development Plan(Medical Category),No.2023YX057the Weifang Medical University 2022 Campus Level Education and Teaching Reform and Research Project,No.2022YB051Norman Bethune Public Welfare Foundation,No.ezmr2023-037Special Research Project on Optimized Management of Acute Pain,Wu Jieping Medical Foundation.
文摘BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.
基金Supported by Henan Provincial Science and Technology Research Project,No.252102311168 and No.242102310066the Medical Education Research Project in Henan Province,No.WJLX2024153.
文摘Ferroptosis,an iron-dependent form of programmed cell death,has garnered significant attention in tumor research in recent years.Its core characteristics include aberrant accumulation of lipid peroxides and impairment of antioxidant defense mechanisms,such as dysfunction of glutathione peroxidase 4.These fea-tures are closely intertwined with the initiation,progression,and therapeutic resistance of hepatocellular carcinoma(HCC).This review presents a systematic overview of the fundamental molecular mechanisms underlying ferroptosis,en-compassing iron metabolism,lipid metabolism,and the antioxidant system.Fur-thermore,it summarizes the potential applications of targeting ferroptosis in liver cancer treatment,including the mechanisms of action of anticancer agents(e.g.,sorafenib)and relevant ferroptosis-related enzymes.Against the backdrop of the growing potential of artificial intelligence(AI)in liver cancer research,various AI-based predictive models for liver cancer are being increasingly developed.On the one hand,this review examines the mechanisms of ferroptosis in HCC to explore novel early detection markers for liver cancer,to provide new insights for the development of AI-based early diagnostic models.On the other hand,it syn-thesizes the current research progress of existing liver cancer predictive models while summarizing key challenges that AI predictive models may encounter in the diagnosis and treatment of HCC.
基金Supported by Jiangsu Provincial Cadre Healthcare Scientific Research Grant Project,No.BJ23019Jiangsu Provincial Association of Maternal and Child Healthcare Scientific Research Grant Project,No.FYX202350+2 种基金Special Fund for the Project of Enhancing Academic Capability of Integrative Nursing,No.ZXYJHHL-K-2023-M20Jiangsu Provincial Graduate Student Practice and Innovation Program Project,No.SJCX24_0833the Training Project for Backbone Talents in Traditional Chinese Medicine Nursing in Nanjing Region,No.Ningwei Zhongyi[2023]No.8.
文摘BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barriers,and professional challenges.Compared to other age groups,they have higher recurrence rates,lower survival rates,and increased risk of depression.Research is lacking on factors influencing depressive symptoms and predictive models for this age group.AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province,China from November 2023 to April 2024 were included in the study.Participants were surveyed using a general information questionnaire,the patient health questionnaire depression scale,the visual analog scale for pain,the revised family support scale,and the long form of the international physical activity questionnaire.Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients,and a predictive model for depression risk was developed based on these findings.RESULTS Among the 360 middle-aged and young BC patients,the incidence rate of depressive symptoms was 38.61%(139/360).Multivariate analysis revealed that tumor grade,patient’s monthly income,pain score,family support score,and physical activity score were factors influencing depression in this patient group(P<0.05).The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852,with a maximum Youden index of 0.973,sensitivity of 86.80%,specificity of 89.50%,and a diagnostic odds ratio of 0.552.The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit(χ^(2)=0.360,P=0.981).CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.
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.
文摘This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.
基金funded by the Shandong Provincial Natural Science Foundation(No.ZR2024MH008)Postdoctoral Innovation Program of Shandong Province(No.SDCX-ZG-202400043)Beijing iGandan Foundation(No.iGandanF-1082022-RGG007).
文摘Objective This study aimed to develop a prediction model to assess the risk of sepsis-induced coagulopathy(SIC)in sepsis patients.Methods We conducted a retrospective study of septic patients admitted to the Intensive Care Units of Shandong Provincial Hospital(Central Campus and East Campus),and Shenxian People’s Hospital from January 2019 to September 2024.We used Kaplan-Meier analysis to assess survival outcomes.LASSO regression identified predictive variables,and logistic regression was employed to analyze risk factors for pre-SIC.A nomogram prediction model was developed via R software and evaluated via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).Results Among 309 patients,236 were in the training set,and 73 were in the test set.The pre-SIC group had higher mortality(44.8%vs.21.3%)and disseminated intravascular coagulation(DIC)incidence(56.3%vs.29.1%)than the non-SIC group.LASSO regression identified lactate,coagulation index,creatinine,and SIC scores as predictors of pre-SIC.The nomogram model demonstrated good calibration,with an AUC of 0.766 in the development cohort and 0.776 in the validation cohort.DCA confirmed the model’s clinical utility.Conclusion SIC is associated with increased mortality,with pre-SIC further increasing the risk of death.The nomogram-based prediction model provides a reliable tool for early SIC identification,potentially improving sepsis management and outcomes.
文摘BACKGROUND Gastric cancer is one of the most common malignant tumors of the digestive system globally,with a generally poor prognosis for patients with advanced dis-ease.In recent years,immune checkpoint inhibitors have made significant advan-cements in gastric cancer treatment,with some HER-2 negative advanced gastric cancer patients benefiting from the combination of immunotherapy and chemo-therapy.However,significant biological heterogeneity exists among patients,resulting in a lack of effective tools to predict the benefits of immunotherapy and survival outcomes.Therefore,there is an urgent need to develop a scientific and precise survival prediction model to provide robust support for personalized treatment decisions.AIM To develop and validate a novel survival prediction model for assessing the survival risk of advanced HER-2 negative gastric cancer patients receiving immunotherapy combined with chemotherapy,thereby enhancing the accuracy of prognostic evaluation and its clinical guidance value.METHODS This retrospective study included 200 advanced HER-2 negative gastric cancer patients who received programmed cell death protein 1 inhibitors combined with chemotherapy.Independent prognostic factors for progression-free survival(PFS)and overall survival(OS)were identified using multivariable Cox regression analysis,and a nomogram model was constructed based on these factors.The variables included in the regression analysis were selected based on their clinical relevance,routine application in gastric cancer evaluation,and availability within our dataset.The model’s discrimination and calibration were assessed using the concordance index(C-index),the area under the receiver operating characteristic curve(AUC),and calibration plots.RESULTS Among the 200 advanced HER-2 negative gastric cancer patients,multivariable Cox regression analysis identified programmed death-ligand 1 expression level,microsatellite status,tumor-node-metastasis stage,tumor differen-tiation,neutrophil-to-lymphocyte ratio,and C-reactive protein-albumin-lymphocyte index as independent prognostic factors for PFS and OS(all P values<0.05).Based on these variables,nomogram models for PFS and OS were constructed.In the training set,the C-index for the PFS model was 0.82[95%confidence interval(CI):0.77-0.87],and in the internal validation set,it was 0.78(95%CI:0.70-0.87),indicating good discrimination ability.For AUC evaluation,the PFS model’s 3-month and 6-month prediction AUCs in the training set were 0.79(95%CI:0.65-0.92)and 0.89(95%CI:0.83-0.94),respectively.In the validation set,they were 0.82(95%CI:0.68-0.97)and 0.80(95%CI:0.68-0.92),respectively.For OS prediction,the C-index in the training set and validation set were 0.81(95%CI:0.76-0.86)and 0.78(95%CI:0.69-0.87),respectively.The nomogram also showed high accuracy in predicting OS at 12,15,and 18 months.In the training set,the AUCs were 0.82(95%CI:0.75-0.89),0.91(95%CI:0.86-0.97),and 0.89(95%CI:0.83-0.95),respectively.In the validation set,they were 0.79(95%CI:0.66-0.91),0.84(95%CI:0.73-0.96),and 0.81(95%CI:0.69-0.93),respectively.Furthermore,calibration curves demonstrated that the predicted probabilities of the model were highly consistent with the actual observed values at different time points,suggesting that the model has good reliability and adaptability for clinical application.CONCLUSION The nomogram model developed in this study effectively predicts the survival outcomes of advanced HER-2 negative gastric cancer patients receiving immunotherapy combined with chemotherapy,demonstrating good discrimination and consistency,and providing robust support for personalized clinical treatment decisions.
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 In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer cells,and increases the risk of tumor recurrence.At present,analyses and evaluation tools for factors influencing early postoperative recurrence in patients with CRC and obstruction are limited.AIM To explore the influencing factors and construct a predictive model of the early postoperative recurrence of CRC with obstruction.METHODS Data from 181 patients with CRC and obstruction who underwent surgery in the Department of Gastrointestinal Surgery,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2017 and May 2023 were retrospectively collected.Patients with CRC and obstruction were divided into a recurrence group and a non-recurrence group based on whether recurrence occurred during the 2-year follow-up after surgery.Datasets from the two groups were compared.Subsequently,multiple logistic regression was employed to analyze the influencing factors of the early postoperative recurrence of CRC with obstruction.The nomogram prediction model was drawn using R software,and its performance was evaluated by the goodness of fit test and receiver operating characteristic(ROC)curve analysis.The clinical benefit rate of the model was evaluated by decision curves.RESULTS Among the 181 patients with CRC and obstruction,52(28.73%)experienced tumor recurrence within 2 years after surgery.Significant differences were observed in preoperative carcinoembryonic antigen(CEA),preoperative systemic immuneinflammation index(SII),tumor,node,and metastasis(TNM)stage,differentiation degree,nerve infiltration,and Ki-67 expression between the recurrence and non-recurrence groups(P<0.05).Multivariate logistic regression analysis showed that high preoperative CEA(OR=2.094,P=0.008),high preoperative SII(OR=2.795,P<0.001),TNM stage III(OR=1.644,P=0.027),poor differentiation(OR=1.861,P=0.035),and high Ki-67 expression(OR=2.467,P=0.001)were all influencing factors for early postoperative recurrence of CRC with obstruction.The area under the ROC curve of the nomograph model constructed based on this was 0.890,the goodness of fit deviation test was conducted(χ^(2)=3.903,P=0.866),and the decision curve display model demonstrated practical value in clinical practice.CONCLUSION The early recurrence rate of CRC with obstruction is high.CEA,SII,TNM staging,differentiation degree,and Ki-67 expression are factors related to early postoperative recurrence.A nomogram prediction model incorporating these factors can effectively evaluate the risk of early postoperative recurrence in patients with CRC.
