Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Obje...Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Objective:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery required.Methods:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference methods.Six models were trained to make individualized treatment recommendations.Patients who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the recommendations.Inverse probability weighting(IPW)was used to minimize bias.The effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal inference.Results:In total,5269 female patients with MBC were included.DSME was an independent protective factor,outperforming other models in recommend-ing surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving surgery.The debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also quantified.Conclusions:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery needed.This method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.展开更多
Trace elements in atmospheric particulate matter play a significant role in air quality,human health,and biogeochemical cycles.In this study,the trace elements(Ca,Al,K,Fe,Na,Mg,Zn,Pb,Mn,Ti,Cu,Cr,Sr,Ni)in PM2.5samples ...Trace elements in atmospheric particulate matter play a significant role in air quality,human health,and biogeochemical cycles.In this study,the trace elements(Ca,Al,K,Fe,Na,Mg,Zn,Pb,Mn,Ti,Cu,Cr,Sr,Ni)in PM2.5samples collected at the summit of Mt.Lushan were analyzed to quantify their abundance,source,transport,and health risks.During the whole sampling period,the major trace elements was Ca,Al,and K.While the trace metals with the lowest concentrations were Sr,Ni,Rb,and Cd.The trace elements were influenced by air mass transport routes,exhibiting an increasing trend of crustal elements in the northwesterly airmass and anthropogenic elements(Zn,Mn,Cu,and Ni)in the easterly air masses.Construction dust,coal+biomass burning,vehicle emission,urban nitrate-rich+urban waste incineration emissions,and soil dust+industry emissions were common sources of PM2.5on Mt.Lushan.Different air mass transport routes had various source contribution patterns.These results indicate that trace elements at Mt.Lushan are influenced by regional anthropogenic emissions and monsoon-dominated trace element transport.The total resulting cancer risk value that these elements posed were below the acceptable risk value of 1×10^(-6),while the non-carcinogenic risk value(1.72)was higher than the safety level,suggesting that non-carcinogenic effects due to these trace elements inhalation were likely to occur.Vehicle emission and coal+biomass burning were the common dominant sources of non-cancer risks posed by trace elements at Mt.Lushan.展开更多
目的:探讨沙库巴曲缬沙坦对持续性心房颤动(房颤)导管消融术后中远期预后的影响。方法:回顾性分析我院2019年1月—2022年11月因持续性房颤行导管消融术的患者210例,分为沙库巴曲缬沙坦组(ARNI组,93例)和ACEI/ARB组(117例)。采用1∶1倾...目的:探讨沙库巴曲缬沙坦对持续性心房颤动(房颤)导管消融术后中远期预后的影响。方法:回顾性分析我院2019年1月—2022年11月因持续性房颤行导管消融术的患者210例,分为沙库巴曲缬沙坦组(ARNI组,93例)和ACEI/ARB组(117例)。采用1∶1倾向性匹配评分,比较匹配后两组手术相关参数(手术时间、术式、单圈隔离率、左心房基质、手术前后左心房脉冲压、平均左心房压)、手术并发症、复合终点事件和左心功能指标的差异。结果:倾向性评分后ARNI组和ACEI/ARB组共有72对匹配成功,两组手术时间、单圈隔离率、电复律率、手术前后左心房脉冲压、平均左心房压和术后并发症比较均差异无统计学意义。与ACEI/ARB组相比,ARNI组术后6个月的房颤复发率显著降低(25.00%vs 11.11%,P=0.048),心力衰竭加重比例明显减少(11.11%vs 2.78%,P=0.044);两组心血管死亡率和再住院率比较差异无统计学意义。亚组分析中,基质标测显示,两组存在低电压区域比例比较差异无统计学意义(65.28%vs 72.22%);与ACEI/ARB组相比,ARNI组存在左心房基质不良的患者6个月房颤复发率显著降低(33.33%vs 12.00%,P=0.017)。6个月左心功能和生化指标随访发现,与ACEI/ARB组相比,ARNI组左心房直径(LAD)显著降低[(43.08±6.54) mm vs (40.71±4.50) mm,P=0.017],N末端脑钠肽前体(NT-proBNP)水平显著降低[333.00(121.00,870.00) pg/mL vs 195.00(88.50,429.50) pg/mL,P=0.018],纽约心功能分级显著减小(P=0.025)。多因素logistic回归分析显示,沙库巴曲缬沙坦为左心房基质不良的持续性房颤患者导管消融术后6个月无房颤复发的保护性因素(OR=0.291,95%CI:0.094~0.904,P=0.033)。结论:沙库巴曲缬沙坦可有效减少持续性房颤导管消融术后6个月的复发率,改善其左心功能,获益可能主要来自对左心房不良基质的改善作用。展开更多
Mesoporous superacids S2O82–-Fe2O3/SBA-15(SFS)with active nanoparticles are prepared by ultrasonic adsorption method.This method is adopted to ensure a homo-dispersed nanoparticle active phase,large specific surface ...Mesoporous superacids S2O82–-Fe2O3/SBA-15(SFS)with active nanoparticles are prepared by ultrasonic adsorption method.This method is adopted to ensure a homo-dispersed nanoparticle active phase,large specific surface area and many acidic sites.Compared with bulk S2O82–-Fe2O3,Br?nsted acid catalysts and other reported catalysts,SFS with an Fe2O3 loading of 30%(SFS-30)exhibits an outstanding activity in the probe reaction of alcoholysis of styrene oxide by methanol with 100%yield.Moreover,SFS-30 also shows a more excellent catalytic performance than bulk S2O82–-Fe2O3 towards the alcoholysis of other ROHs(R=C2H5-C4H9).Lewis and Bronsted acid sites on the SFS-30 surfaces are confirmed by pyridine adsorbed infrared spectra.The highly efficient catalytic activity of SFS-30 may be attributed to the synergistic effect from the nano-effect of S2O82–-Fe2O3 nanoparticles and the mesostructure of SBA-15.Finally,SFS-30 shows a good catalytic reusability,providing an 84.1%yield after seven catalytic cycles.展开更多
基金Tianjin Key Medical Discipline(Specialty)Construction Project,Grant/Award Number:TJYXZDXK-029ANational Natural Science Foundation of China,Grant/Award Numbers:82170327,82370332。
文摘Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Objective:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery required.Methods:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference methods.Six models were trained to make individualized treatment recommendations.Patients who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the recommendations.Inverse probability weighting(IPW)was used to minimize bias.The effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal inference.Results:In total,5269 female patients with MBC were included.DSME was an independent protective factor,outperforming other models in recommend-ing surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving surgery.The debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also quantified.Conclusions:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery needed.This method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.
基金supported by the National Natural Science Foundation of China(No.42065007)supported by the Natural Science Foundation of Hebei Province(No.D2021501004)。
文摘Trace elements in atmospheric particulate matter play a significant role in air quality,human health,and biogeochemical cycles.In this study,the trace elements(Ca,Al,K,Fe,Na,Mg,Zn,Pb,Mn,Ti,Cu,Cr,Sr,Ni)in PM2.5samples collected at the summit of Mt.Lushan were analyzed to quantify their abundance,source,transport,and health risks.During the whole sampling period,the major trace elements was Ca,Al,and K.While the trace metals with the lowest concentrations were Sr,Ni,Rb,and Cd.The trace elements were influenced by air mass transport routes,exhibiting an increasing trend of crustal elements in the northwesterly airmass and anthropogenic elements(Zn,Mn,Cu,and Ni)in the easterly air masses.Construction dust,coal+biomass burning,vehicle emission,urban nitrate-rich+urban waste incineration emissions,and soil dust+industry emissions were common sources of PM2.5on Mt.Lushan.Different air mass transport routes had various source contribution patterns.These results indicate that trace elements at Mt.Lushan are influenced by regional anthropogenic emissions and monsoon-dominated trace element transport.The total resulting cancer risk value that these elements posed were below the acceptable risk value of 1×10^(-6),while the non-carcinogenic risk value(1.72)was higher than the safety level,suggesting that non-carcinogenic effects due to these trace elements inhalation were likely to occur.Vehicle emission and coal+biomass burning were the common dominant sources of non-cancer risks posed by trace elements at Mt.Lushan.
文摘目的:探讨沙库巴曲缬沙坦对持续性心房颤动(房颤)导管消融术后中远期预后的影响。方法:回顾性分析我院2019年1月—2022年11月因持续性房颤行导管消融术的患者210例,分为沙库巴曲缬沙坦组(ARNI组,93例)和ACEI/ARB组(117例)。采用1∶1倾向性匹配评分,比较匹配后两组手术相关参数(手术时间、术式、单圈隔离率、左心房基质、手术前后左心房脉冲压、平均左心房压)、手术并发症、复合终点事件和左心功能指标的差异。结果:倾向性评分后ARNI组和ACEI/ARB组共有72对匹配成功,两组手术时间、单圈隔离率、电复律率、手术前后左心房脉冲压、平均左心房压和术后并发症比较均差异无统计学意义。与ACEI/ARB组相比,ARNI组术后6个月的房颤复发率显著降低(25.00%vs 11.11%,P=0.048),心力衰竭加重比例明显减少(11.11%vs 2.78%,P=0.044);两组心血管死亡率和再住院率比较差异无统计学意义。亚组分析中,基质标测显示,两组存在低电压区域比例比较差异无统计学意义(65.28%vs 72.22%);与ACEI/ARB组相比,ARNI组存在左心房基质不良的患者6个月房颤复发率显著降低(33.33%vs 12.00%,P=0.017)。6个月左心功能和生化指标随访发现,与ACEI/ARB组相比,ARNI组左心房直径(LAD)显著降低[(43.08±6.54) mm vs (40.71±4.50) mm,P=0.017],N末端脑钠肽前体(NT-proBNP)水平显著降低[333.00(121.00,870.00) pg/mL vs 195.00(88.50,429.50) pg/mL,P=0.018],纽约心功能分级显著减小(P=0.025)。多因素logistic回归分析显示,沙库巴曲缬沙坦为左心房基质不良的持续性房颤患者导管消融术后6个月无房颤复发的保护性因素(OR=0.291,95%CI:0.094~0.904,P=0.033)。结论:沙库巴曲缬沙坦可有效减少持续性房颤导管消融术后6个月的复发率,改善其左心功能,获益可能主要来自对左心房不良基质的改善作用。
文摘Mesoporous superacids S2O82–-Fe2O3/SBA-15(SFS)with active nanoparticles are prepared by ultrasonic adsorption method.This method is adopted to ensure a homo-dispersed nanoparticle active phase,large specific surface area and many acidic sites.Compared with bulk S2O82–-Fe2O3,Br?nsted acid catalysts and other reported catalysts,SFS with an Fe2O3 loading of 30%(SFS-30)exhibits an outstanding activity in the probe reaction of alcoholysis of styrene oxide by methanol with 100%yield.Moreover,SFS-30 also shows a more excellent catalytic performance than bulk S2O82–-Fe2O3 towards the alcoholysis of other ROHs(R=C2H5-C4H9).Lewis and Bronsted acid sites on the SFS-30 surfaces are confirmed by pyridine adsorbed infrared spectra.The highly efficient catalytic activity of SFS-30 may be attributed to the synergistic effect from the nano-effect of S2O82–-Fe2O3 nanoparticles and the mesostructure of SBA-15.Finally,SFS-30 shows a good catalytic reusability,providing an 84.1%yield after seven catalytic cycles.
