Ding an sich是康德哲学的核心概念之一,曾引发广泛争议,这种争议也反映在其中译上。在康德哲学东渐过程中,该概念的中译名主要有物自身、物自体、自在之物三种。通过对这三种译名的历史演进过程进行考察,并结合《哲学历史辞典》和康德...Ding an sich是康德哲学的核心概念之一,曾引发广泛争议,这种争议也反映在其中译上。在康德哲学东渐过程中,该概念的中译名主要有物自身、物自体、自在之物三种。通过对这三种译名的历史演进过程进行考察,并结合《哲学历史辞典》和康德对Ding an sich的论述,辨析了三种译法的优劣,在此基础上主张将其译为“自在之物”。展开更多
Background and aim Recently,long-term outcomes in patients with spontaneous intracerebral haemorrhage(sICH)have gained increasing attention besides acute-phase characteristics.Predictive models for long-term outcomes ...Background and aim Recently,long-term outcomes in patients with spontaneous intracerebral haemorrhage(sICH)have gained increasing attention besides acute-phase characteristics.Predictive models for long-term outcomes are valuable for risk stratification and treatment strategies.This study aimed to develop and validate an explainable model for predicting long-term recurrence and all-cause death in patients with ICH,using clinical and imaging markers of cerebral small vascular diseases from MRI.Method We retrospectively analysed data from a prospectively collected large-scale cohort of patients with acute ICH admitted to the Neurology Department of The Second Affiliated Hospital of Zhejiang University between November 2016 and April 2023.After comprehensive variable selection using least absolute shrinkage and selection operator and stepwise Cox regression,we constructed Cox proportional hazards models to predict recurrence and all-cause death.Model performance was evaluated using the concordance index,integrated Brier score and time-dependent area under the curve.Global and local interpretability were assessed using variable importance calculated as SurvSHAP(t)and SurvLIME methods for the entire training set and individual patients,respectively.Results A total of 842 eligible patients were included.Over a median follow-up of 36 months(IQR:12-51),86 patients(9.1%)died,and 62 patients(6.6%)experienced recurrence of ICH.The concordance indexes for the all-cause death and recurrence models were 0.841(95%CI 0.767 to 0.913)and 0.759(95%CI 0.651 to 0.867),respectively,with integrated Brier scores of 0.079 and 0.063.The interpretability maps highlighted age,aetiology of ICH and low haemoglobin as key predictors of long-term death,while cortical superficial siderosis and previous haemorrhage were crucial for predicting recurrence.Conclusions This model demonstrates high predictive accuracy and emphasises the crucial factors in predicting long-term outcomes of patients with sICH.展开更多
文摘Ding an sich是康德哲学的核心概念之一,曾引发广泛争议,这种争议也反映在其中译上。在康德哲学东渐过程中,该概念的中译名主要有物自身、物自体、自在之物三种。通过对这三种译名的历史演进过程进行考察,并结合《哲学历史辞典》和康德对Ding an sich的论述,辨析了三种译法的优劣,在此基础上主张将其译为“自在之物”。
基金supported by the Zhejiang Provincial Medical and Health Science and Technology Project(2022KY174)the‘Pioneer’R&D Program of Zhejiang(2024C03006).
文摘Background and aim Recently,long-term outcomes in patients with spontaneous intracerebral haemorrhage(sICH)have gained increasing attention besides acute-phase characteristics.Predictive models for long-term outcomes are valuable for risk stratification and treatment strategies.This study aimed to develop and validate an explainable model for predicting long-term recurrence and all-cause death in patients with ICH,using clinical and imaging markers of cerebral small vascular diseases from MRI.Method We retrospectively analysed data from a prospectively collected large-scale cohort of patients with acute ICH admitted to the Neurology Department of The Second Affiliated Hospital of Zhejiang University between November 2016 and April 2023.After comprehensive variable selection using least absolute shrinkage and selection operator and stepwise Cox regression,we constructed Cox proportional hazards models to predict recurrence and all-cause death.Model performance was evaluated using the concordance index,integrated Brier score and time-dependent area under the curve.Global and local interpretability were assessed using variable importance calculated as SurvSHAP(t)and SurvLIME methods for the entire training set and individual patients,respectively.Results A total of 842 eligible patients were included.Over a median follow-up of 36 months(IQR:12-51),86 patients(9.1%)died,and 62 patients(6.6%)experienced recurrence of ICH.The concordance indexes for the all-cause death and recurrence models were 0.841(95%CI 0.767 to 0.913)and 0.759(95%CI 0.651 to 0.867),respectively,with integrated Brier scores of 0.079 and 0.063.The interpretability maps highlighted age,aetiology of ICH and low haemoglobin as key predictors of long-term death,while cortical superficial siderosis and previous haemorrhage were crucial for predicting recurrence.Conclusions This model demonstrates high predictive accuracy and emphasises the crucial factors in predicting long-term outcomes of patients with sICH.
文摘目的:分析糖化血红蛋白(Glycosylated Hemoglobin,HbA1c)联合纤维蛋白原(Fibrinogen,FIB)评估急性脑梗死(Acute Cerebral Infarct,ACI)患者溶栓后症状性脑出血(symptomatic intracranial hemorrhage,sICH)的临床价值。方法:选取2021年4月至2023年5月期间本院确诊ACI并接受溶栓手术的97例患者作为研究对象。根据是否发生sICH将患者分为出血组(46例)和未出血组(51例)。收集两组的基线资料,对比两组HbA1c和FIB的水平,并运用多因素Logistic模型分析ACI患者溶栓后sICH的相关因素,运用ROC曲线分析HbA1c联合FIB对患者溶栓后sICH的评估效能。结果:出血组溶栓前血糖水平、NIHSS评分高于未出血组(P<0.05)。出血组的HbA1c高于未出血组,FIB显著低于未出血组(P<0.05)。经多因素Logistic模型分析可知,溶栓前美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、溶栓前血糖、HbA1c、FIB均为ACI患者溶栓后sICH的危险因素。经ROC曲线分析,HbA1c、FIB单独评估ACI患者溶栓后sICH的AUC分别为0.768、0.736,两者联合评估的AUC为0.879,灵敏度、特异度分别为78.3%、82.4%,均高于单独评估灵敏度与特异度。结论:HbA1c、FIB可有效评估ACI患者溶栓后sICH的发生,联合评估效能最高。
