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1.
Environ Res ; 260: 119779, 2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39142459

RESUMO

Lanthanum nickelate (LaNiO3), known for its high visible-light absorption, is a promising photocatalyst for water purification. However, the low conduction band position and high photogenerated carrier complexation rate of pure LaNiO3 limit its photocatalytic activity. To address this issue, we investigated the synergistic effects of doping and constructing heterojunctions. A La0.9Sr0.1NiO3 (20%)/g-C3N4 (L2CN8) heterojunction was successfully created. In addition, various characterisation techniques were then employed to analyse the structure-performance relationships of these heterojunction photocatalysts in degrading organic dyes. Results revealed that at a 10% Sr doping level, the oxygen vacancy content was 0.68, which is significantly higher than that of LaNiO3 (0.05). The increased number of oxygen vacancies enhanced the electron capture ability and improved the separation efficiency of photogenerated carriers. Furthermore, the optimised L2CN8 (20 mg) achieved 81.2% and 73.8% removal of methylene blue (50.0 mL, 10 mg L-1) and tetracycline (50.0 mL, 10 mg L-1) under simulated visible-light irradiation (λ > 420 nm). Furthermore, an active species capture experiment confirmed the significant role of superoxide radicals (·O2-) in the degradation process. Based on these experimental findings, we proposed a rational Z-type charge transfer mechanism. This study holds great importance for water pollution control and environmental protection.


Assuntos
Lantânio , Luz , Poluentes Químicos da Água , Poluentes Químicos da Água/química , Poluentes Químicos da Água/análise , Catálise , Lantânio/química , Níquel/química , Azul de Metileno/química , Fotólise , Processos Fotoquímicos , Compostos de Nitrogênio/química , Tetraciclina/química , Nitrilas/química , Grafite
2.
World J Surg Oncol ; 22(1): 183, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39010087

RESUMO

BACKGROUND: Minimal access breast surgery (MABS) is commonly employed in the management of breast cancer, but there is limited research on the postoperative immune function associated with MABS. OBJECTIVE: This study aimed to assess the postoperative immune function in breast patients who underwent MABS or conventional open breast surgery (COBS). METHODS: We retrospectively analyzed the medical records of 829 breast cancer patients treated with either MABS or COBS at a single hospital between January 2020 and June 2023. Among them, 116 matched pairs were obtained through 1:1 propensity score matching (PSM). Flow cytometry was used to measure the percentages of CD3+, CD4+, and CD8+ cells, as well as the CD4+/CD8+ ratio, on three different time points: preoperative day 1 (PreD1), postoperative day 1 (PostD1), and postoperative day 7 (PostD7). RESULTS: Both the MABS and COBS groups demonstrated a significant reduction in the percentages of CD3+, CD4+, and CD8+ cells, along with the CD4+/CD8+ ratio, from PreD1 to PostD1. Interestingly, the MABS group showed a reversal of these parameters, returning to preoperative levels by PostD7. Conversely, the COBS group showed an increase in these parameters from PostD1 to PostD7, but they still remained significantly lower than preoperative levels at PostD7. CONCLUSION: MABS treatment may result in reduced postoperative immune suppression and faster recovery of preoperative immune function compared to COBS in patients.


Assuntos
Neoplasias da Mama , Mastectomia , Pontuação de Propensão , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/imunologia , Neoplasias da Mama/patologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Prognóstico , Seguimentos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Período Pós-Operatório , Adulto , Idoso
3.
J Transl Med ; 21(1): 91, 2023 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-36750951

RESUMO

BACKGROUND: Length of stay (LOS) is an important metric for evaluating the management of inpatients. This study aimed to explore the factors impacting the LOS of inpatients with type-2 diabetes mellitus (T2DM) and develop a predictive model for the early identification of inpatients with prolonged LOS. METHODS: A 13-year multicenter retrospective study was conducted on 83,776 patients with T2DM to develop and validate a clinical predictive tool for prolonged LOS. Least absolute shrinkage and selection operator regression model and multivariable logistic regression analysis were adopted to build the risk model for prolonged LOS, and a nomogram was taken to visualize the model. Furthermore, receiver operating characteristic curves, calibration curves, and decision curve analysis and clinical impact curves were used to respectively validate the discrimination, calibration, and clinical applicability of the model. RESULTS: The result showed that age, cerebral infarction, antihypertensive drug use, antiplatelet and anticoagulant use, past surgical history, past medical history, smoking, drinking, and neutrophil percentage-to-albumin ratio were closely related to the prolonged LOS. Area under the curve values of the nomogram in the training, internal validation, external validation set 1, and external validation set 2 were 0.803 (95% CI [confidence interval] 0.799-0.808), 0.794 (95% CI 0.788-0.800), 0.754 (95% CI 0.739-0.770), and 0.743 (95% CI 0.722-0.763), respectively. The calibration curves indicated that the nomogram had a strong calibration. Besides, decision curve analysis, and clinical impact curves exhibited that the nomogram had favorable clinical practical value. Besides, an online interface ( https://cytjt007.shinyapps.io/prolonged_los/ ) was developed to provide convenient access for users. CONCLUSION: In sum, the proposed model could predict the possible prolonged LOS of inpatients with T2DM and help the clinicians to improve efficiency in bed management.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Fatores de Risco , Albuminas
4.
BMC Gastroenterol ; 23(1): 310, 2023 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-37704966

RESUMO

OBJECTIVES: To appraise effective predictors for infection in patients with decompensated cirrhosis (DC) by using XGBoost algorithm in a retrospective case-control study. METHODS: Clinical data were retrospectively collected from 6,648 patients with DC admitted to five tertiary hospitals. Indicators with significant differences were determined by univariate analysis and least absolute contraction and selection operator (LASSO) regression. Further multi-tree extreme gradient boosting (XGBoost) machine learning-based model was used to rank importance of features selected from LASSO and subsequently constructed infection risk prediction model with simple-tree XGBoost model. Finally, the simple-tree XGBoost model is compared with the traditional logical regression (LR) model. Performances of models were evaluated by area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. RESULTS: Six features, including total bilirubin, blood sodium, albumin, prothrombin activity, white blood cell count, and neutrophils to lymphocytes ratio were selected as predictors for infection in patients with DC. Simple-tree XGBoost model conducted by these features can predict infection risk accurately with an AUROC of 0.971, sensitivity of 0.915, and specificity of 0.900 in training set. The performance of simple-tree XGBoost model is better than that of traditional LR model in training set, internal verification set, and external feature set (P < 0.001). CONCLUSIONS: The simple-tree XGBoost predictive model developed based on a minimal amount of clinical data available to DC patients with restricted medical resources could help primary healthcare practitioners promptly identify potential infection.


Assuntos
Albuminas , Algoritmos , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Área Sob a Curva
5.
BMC Geriatr ; 23(1): 698, 2023 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-37891456

RESUMO

BACKGROUND: This study aimed to construct a risk prediction model to estimate the odds of osteoporosis (OP) in elderly patients with type 2 diabetes mellitus (T2DM) and evaluate its prediction efficiency. METHODS: This study included 21,070 elderly patients with T2DM who were hospitalized at six tertiary hospitals in Southwest China between 2012 and 2022. Univariate logistic regression analysis was used to screen for potential influencing factors of OP and least absolute shrinkage. Further, selection operator regression (LASSO) and multivariate logistic regression analyses were performed to select variables for developing a novel predictive model. The area under the receiver operating characteristic curve (AUROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were used to evaluate the performance and clinical utility of the model. RESULTS: The incidence of OP in elderly patients with T2DM was 7.01% (1,476/21,070). Age, sex, hypertension, coronary heart disease, cerebral infarction, hyperlipidemia, and surgical history were the influencing factors. The seven-variable model displayed an AUROC of 0.713 (95% confidence interval [CI]:0.697-0.730) in the training set, 0.716 (95% CI: 0.691-0.740) in the internal validation set, and 0.694 (95% CI: 0.653-0.735) in the external validation set. The optimal decision probability cut-off value was 0.075. The calibration curve (bootstrap = 1,000) showed good calibration. In addition, the DCA and CIC demonstrated good clinical practicality. An operating interface on a webpage ( https://juntaotan.shinyapps.io/osteoporosis/ ) was developed to provide convenient access for users. CONCLUSIONS: This study constructed a highly accurate model to predict OP in elderly patients with T2DM. This model incorporates demographic characteristics and clinical risk factors and may be easily used to facilitate individualized prediction.


Assuntos
Diabetes Mellitus Tipo 2 , Osteoporose , Idoso , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Retrospectivos , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Fatores de Risco , Infarto Cerebral
6.
Compr Psychiatry ; 107: 152235, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33765493

RESUMO

OBJECTIVE: The study aims to investigate public awareness of coronavirus disease 2019 (COVID-19) and measure levels of anxiety during the outbreak. METHOD: A total of 2115 subjects from 34 provinces in China were evaluated. A questionnaire was designed, which covers demographic characteristics, knowledge of COVID-19, and factors that influenced anxiety during the outbreak to test public awareness and determine the impact of the outbreak on people's lives. In addition, a generalized anxiety disorder (GAD) scale was utilized to assess anxiety levels during the outbreak. Lastly, the chi-square test and multiple logistic regression analysis were used to identify factors associated with levels of public anxiety. RESULTS: A majority of respondents reported high levels of awareness of COVID-19. A total of 1107 (52.3%), 707 (33.4%), 154 (7.3%), and 147 (7%) respondents exhibited no, mild, moderate, and severe levels of anxiety, respectively. Results of the chi-square test and multiple logistic regression analysis demonstrated that respondents (a) with no college education, (b) are unaware of neighbors who may have been infected, (c) who spent considerable time collecting information and browsing negative information related to the virus, (d) are unhealthy, and (e) displayed low levels of awareness of the transmission routes were highly likely to be anxious. CONCLUSION: During the outbreak, the majority of people exhibited high levels of awareness and knowledge regarding preventive measures from COVID-19. The absence of psychological anxiety was observed in more than half of the respondents. Adaptive responses to anxiety and high levels of awareness about COVID-19 may have protected the public during the outbreak.


Assuntos
COVID-19 , Epidemias , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão , Humanos , SARS-CoV-2 , Inquéritos e Questionários
7.
Chaos ; 30(8): 083118, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32872797

RESUMO

The connectivity of complex networks is usually determined by a small fraction of key nodes. Earlier works successfully identify an influential single node, yet have some problems for the case of multiple ones. In this paper, based on the matrix spectral theory, we propose the collective influence of multiple nodes. An interesting finding is that some traditionally influential nodes have strong internal coupling interactions that reduce their collective influence. We then propose a greedy algorithm to dismantle complex networks by optimizing the collective influence of multiple nodes. Experimental results show that our proposed method outperforms the state of the art methods in terms of the principal eigenvalue and the giant component of the remaining networks.

8.
J Nanosci Nanotechnol ; 18(8): 5155-5170, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-29458567

RESUMO

Nanotechnology for early diagnosis and treatment of malignant tumor is a forefront topic in the international field of biotechnology and medicine. In order to improve the effect of cancer therapy, the timely and accurate detection of the cancer is important and necessary. Graphene and its derivatives have various excellent characteristics. For example, biological sensors based on graphene are good at amplifying detection signals, and its derivatives play an important role in the early diagnosis and cancer therapy. In view of this, we discussed the biological sensor application based on graphene and its derivatives in the detection and therapy of cancer.


Assuntos
Grafite , Nanoestruturas , Nanotecnologia , Técnicas Biossensoriais , Biotecnologia , Neoplasias/diagnóstico , Neoplasias/terapia
9.
World J Surg ; 41(5): 1274-1280, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27909771

RESUMO

BACKGROUND: Whether body mass index (BMI) is a significant risk factor for recurrence of primary spontaneous pneumothorax (PSP) remains controversial. The purpose of this study was to examine whether BMI and other factors are linked to risk of PSP recurrence. METHODS: A consecutive cohort of 273 patients was retrospectively evaluated. Patients were divided into those who experienced recurrence (n = 81) and those who did not (n = 192), as well as into those who had low BMI (n = 75) and those who had normal or elevated BMI (n = 198). The two pairs of groups were compared in terms of baseline data, and Cox proportional hazards modeling was used to identify predictors of PSP recurrence. RESULTS: Rates of recurrence among all 273 patients were 20.9% at 1 year, 23.8% at 2 years, and 28.7% at 5 years. Univariate analysis identified the following significant predictors of PSP recurrence: height, weight, BMI, size of pneumothorax, and treatment modality. Multivariate analyses identified several risk factors for PSP recurrence: low BMI, pneumothorax size ≥50%, and non-surgical treatment. Kaplan-Meier survival analysis indicated that patients with low BMI showed significantly lower recurrence-free survival than patients with normal or elevated BMI (P < 0.001). CONCLUSIONS: Low BMI, pneumothorax size ≥50%, and non-surgical treatment were risk factors for PSP recurrence in our cohort. Low BMI may be a clinically useful predictor of PSP recurrence.


Assuntos
Índice de Massa Corporal , Pneumotórax , Adulto , Idoso , Estatura , Peso Corporal , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pneumotórax/mortalidade , Pneumotórax/patologia , Pneumotórax/terapia , Modelos de Riscos Proporcionais , Recidiva , Estudos Retrospectivos , Fatores de Risco
10.
Dis Esophagus ; 30(2): 1-8, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-27766708

RESUMO

This study aims to evaluate the effect of neoadjuvant chemoradiotherapy (NCRT) on perioperative immune function during surgery to treat resectable locally advanced esophageal cancer. Records were retrospectively analyzed for 220 patients with locally advanced esophageal cancer, of whom 112 received surgery alone and 98 received neoadjuvant NCRT plus surgery. The two groups were compared in terms of proportions of CD3+, CD4+, CD8+, and natural kill (NK) cells, as well as the ratio of CD4+ to CD8+ cells. These measurements were made using flow cytometry on preoperative day 1 and on postoperative days 1 and 7. Subgroup analysis were performed in terms of degrees of pathological response of NCRT. When the entire NCRT and no-NCRT (surgery alone) cohorts were compared, no significant differences in propocrtions of CD3+, CD4+, CD8+, or NK cells or in the CD4+/CD8+ ratio occurred at any of the three time points. Similar results were obtained using the subgroup of NCRT patients who were NCRT-sensitive, but the subgroup of NCRT-insensitive patients showed significantly lower CD4+ and NK proportions and lower CD4+/CD8+ ratio than the no-NCRT group. Our findings suggest that NCRT does not affect perioperative immune function in patients who are NCRT-sensitive, but it does significantly reduce such function in patients who are NCRT-insensitive.


Assuntos
Quimiorradioterapia Adjuvante/efeitos adversos , Neoplasias Esofágicas/imunologia , Neoplasias Esofágicas/terapia , Esofagectomia/métodos , Contagem de Linfócitos , Terapia Neoadjuvante/efeitos adversos , Adulto , Quimiorradioterapia Adjuvante/métodos , Neoplasias Esofágicas/patologia , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Período Pós-Operatório , Período Pré-Operatório , Estudos Retrospectivos , Linfócitos T , Resultado do Tratamento
11.
J Surg Oncol ; 114(8): 966-970, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27633143

RESUMO

AIM: The suitability of hepatic resection for older patients remains controversial. This study aimed to investigate whether age influences overall survival of patients with hepatocellular carcinoma (HCC) after resection. METHODS: Records of 1,132 patients with HCC after hepatic resection were retrospectively reviewed. Overall survival (OS) was compared between younger and older patients based on five cut-off ages (30, 40, 50, 60, and 70 years). RESULTS: Across all patients, OS was 89.7% at 1 year, 67.7% at 3 years, and 47.7% at 5 years. OS was similar between younger and older patients at all cut-off ages (all P > 0.1), but OS was marginally lower among patients >70 years old than those ≤70 (P = 0.090). Multivariate analyses identified several risk factors for lower OS: preoperative serum albumin <35 g/L, alanine aminotransferase >80 U/L, α-fetoprotein ≥400 ng/ml, presence of esophagogastric varices or macrovascular invasion, incomplete/absent tumor capsule, tumor size >10 cm, tumor number ≥3, and major hepatectomy. CONCLUSION: Age does not influence the prognosis of patients with HCC after hepatic resection. Older patients should be considered for curative resection if remnant liver volume and liver function are adequate. J. Surg. Oncol. 2016;114:966-970. © 2016 Wiley Periodicals, Inc.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/mortalidade , Feminino , Seguimentos , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
12.
Sci Rep ; 14(1): 15602, 2024 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971880

RESUMO

To establish and validate a predictive model for breast cancer-related lymphedema (BCRL) among Chinese patients to facilitate individualized risk assessment. We retrospectively analyzed data from breast cancer patients treated at a major single-center breast hospital in China. From 2020 to 2022, we identified risk factors for BCRL through logistic regression and developed and validated a nomogram using R software (version 4.1.2). Model validation was achieved through the application of receiver operating characteristic curve (ROC), a calibration plot, and decision curve analysis (DCA), with further evaluated by internal validation. Among 1485 patients analyzed, 360 developed lymphedema (24.2%). The nomogram incorporated body mass index, operative time, lymph node count, axillary dissection level, surgical site infection, and radiotherapy as predictors. The AUCs for training (N = 1038) and validation (N = 447) cohorts were 0.779 and 0.724, respectively, indicating good discriminative ability. Calibration and decision curve analysis confirmed the model's clinical utility. Our nomogram provides an accurate tool for predicting BCRL risk, with potential to enhance personalized management in breast cancer survivors. Further prospective validation across multiple centers is warranted.


Assuntos
Linfedema Relacionado a Câncer de Mama , Neoplasias da Mama , Nomogramas , Humanos , Feminino , Pessoa de Meia-Idade , Linfedema Relacionado a Câncer de Mama/diagnóstico , Linfedema Relacionado a Câncer de Mama/etiologia , Estudos Retrospectivos , Neoplasias da Mama/complicações , Fatores de Risco , Adulto , Curva ROC , Idoso , China/epidemiologia , Medição de Risco
13.
Sci Rep ; 14(1): 13842, 2024 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-38879651

RESUMO

To examine the influence of Body Mass Index (BMI) on laparoscopic gastrectomy (LG) short-term and long-term outcomes for gastric cancer. A retrospective analysis was conducted on gastric cancer patients undergoing LG at the Third Hospital of Nanchang City from January 2013 to January 2022. Based on WHO BMI standards, patients were categorized into normal weight, overweight, and obese groups. Factors such as operative time, intraoperative blood loss, postoperative complications, and overall survival were assessed. Across different BMI groups, it was found that an increase in BMI was associated with longer operative times (average times: 206.22 min for normal weight, 231.32 min for overweight, and 246.78 min for obese), with no significant differences noted in intraoperative blood loss, postoperative complications, or long-term survival among the groups. The impact of BMI on long-term survival following LG for gastric cancer was found to be insignificant, with no notable differences in survival outcome between different BMI groups. Although higher BMI is associated with increased operative time in LG for gastric cancer, it does not significantly affect intraoperative blood loss, postoperative complications, recovery, or long-term survival. LG is a feasible treatment choice for obese patients with gastric cancer.


Assuntos
Índice de Massa Corporal , Gastrectomia , Laparoscopia , Complicações Pós-Operatórias , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Gastrectomia/métodos , Gastrectomia/efeitos adversos , Masculino , Laparoscopia/métodos , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Resultado do Tratamento , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Duração da Cirurgia , Obesidade/complicações , Obesidade/cirurgia , Adulto , Perda Sanguínea Cirúrgica
14.
Sci Rep ; 14(1): 18738, 2024 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-39134566

RESUMO

To evaluate the impact of neoadjuvant chemotherapy on perioperative immune function in breast cancer patients, focusing on CD3+, CD4+, CD8+, and natural killer (NK) cells, as well as the CD4+/CD8+ ratio. We retrospectively reviewed medical records of breast cancer patients who underwent surgery with or without neoadjuvant chemotherapy at our medical center from January 2020 to December 2022. Patients were matched 1:1 based on propensity scores. Immune cell proportions and the CD4+/CD8+ ratio were compared on preoperative day one and postoperative days one and seven. Among matched patients, immune cell proportions and the CD4+/CD8+ ratio did not significantly differ between those who received neoadjuvant chemotherapy and those who did not at any of the three time points. Similar results were observed in chemotherapy-sensitive patients compared to the entire group of patients who did not receive neoadjuvant chemotherapy. However, chemotherapy-insensitive patients had significantly lower proportions of CD4+ and NK cells, as well as a lower CD4+/CD8+ ratio, at all three time points compared to patients who did not receive neoadjuvant chemotherapy. Neoadjuvant chemotherapy may impair immune function in chemotherapy-insensitive patients, but not in those who are sensitive to the treatment.


Assuntos
Neoplasias da Mama , Células Matadoras Naturais , Terapia Neoadjuvante , Pontuação de Propensão , Humanos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/imunologia , Neoplasias da Mama/cirurgia , Feminino , Terapia Neoadjuvante/métodos , Estudos Retrospectivos , Pessoa de Meia-Idade , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/efeitos dos fármacos , Adulto , Idoso , Período Perioperatório , Relação CD4-CD8 , Quimioterapia Adjuvante/métodos
15.
Front Neurol ; 15: 1405096, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39148703

RESUMO

Background: This study aimed to identify the predictive factors for prolonged length of stay (LOS) in elderly type 2 diabetes mellitus (T2DM) patients suffering from cerebral infarction (CI) and construct a predictive model to effectively utilize hospital resources. Methods: Clinical data were retrospectively collected from T2DM patients suffering from CI aged ≥65 years who were admitted to five tertiary hospitals in Southwest China. The least absolute shrinkage and selection operator (LASSO) regression model and multivariable logistic regression analysis were conducted to identify the independent predictors of prolonged LOS. A nomogram was constructed to visualize the model. The discrimination, calibration, and clinical practicality of the model were evaluated according to the area under the receiver operating characteristic curve (AUROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC). Results: A total of 13,361 patients were included, comprising 6,023, 2,582, and 4,756 patients in the training, internal validation, and external validation sets, respectively. The results revealed that the ACCI score, OP, PI, analgesics use, antibiotics use, psychotropic drug use, insurance type, and ALB were independent predictors for prolonged LOS. The eight-predictor LASSO logistic regression displayed high prediction ability, with an AUROC of 0.725 (95% confidence interval [CI]: 0.710-0.739), a sensitivity of 0.662 (95% CI: 0.639-0.686), and a specificity of 0.675 (95% CI: 0.661-0.689). The calibration curve (bootstraps = 1,000) showed good calibration. In addition, the DCA and CIC also indicated good clinical practicality. An operation interface on a web page (https://xxmyyz.shinyapps.io/prolonged_los1/) was also established to facilitate clinical use. Conclusion: The developed model can predict the risk of prolonged LOS in elderly T2DM patients diagnosed with CI, enabling clinicians to optimize bed management.

16.
Pragmat Obs Res ; 15: 121-137, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39130528

RESUMO

Purpose: Hospitalized hypertensive patients rely on blood pressure medication, yet there is limited research on the sole use of amlodipine, despite its proven efficacy in protecting target organs and reducing mortality. This study aims to identify key indicators influencing the efficacy of amlodipine, thereby enhancing treatment outcomes. Patients and Methods: In this multicenter retrospective study, 870 hospitalized patients with primary hypertension exclusively received amlodipine for the first 5 days after admission, and their medical records contained comprehensive blood pressure records. They were categorized into success (n=479) and failure (n=391) groups based on average blood pressure control efficacy. Predictive models were constructed using six machine learning algorithms. Evaluation metrics encompassed the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). SHapley Additive exPlanations (SHAP) analysis assessed feature contributions to efficacy. Results: All six machine learning models demonstrated superior predictive performance. Following variable reduction, the model predicting amlodipine efficacy was reconstructed using these algorithms, with the light gradient boosting machine (LightGBM) model achieving the highest overall performance (AUC = 0.803). Notably, amlodipine showed enhanced efficacy in patients with low platelet distribution width (PDW) values, as well as high hematocrit (HCT) and thrombin time (TT) values. Conclusion: This study utilized machine learning to predict amlodipine's effectiveness in hypertension treatment, pinpointing key factors: HCT, PDW, and TT levels. Lower PDW, along with higher HCT and TT, correlated with enhanced treatment outcomes. This facilitates personalized treatment, particularly for hospitalized hypertensive patients undergoing amlodipine monotherapy.

17.
Health Sci Rep ; 7(2): e1820, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38323124

RESUMO

Background and Aims: Influenza is one of the most widespread respiratory infections and poses a huge burden on health care worldwide. Vaccination is key to preventing and controlling influenza. Influenza vaccine hesitancy is an important reason for the low vaccination rate. In 2019, Vaccine hesitancy was identified as one of the top 10 threats to global health by the World Health Organization. However, there remains a glaring scarcity of bibliometric research in that regard. This study sought to identify research hotspots and future development trends on influenza vaccine hesitation and provide a new perspective and reference for future research. Methods: We retrieved publications on global influenza vaccine hesitancy from the Web of Science Core Collection database, Scopus, and PubMed databases from inception to 2022. This study used VOSviewer and CiteSpace for visualization analysis. Results: Influenza vaccine hesitancy-related publications increased rapidly from 2012 and peaked in 2022. One hundred and nine countries contributed to influenza vaccine hesitation research, and the United States ranked first with 541 articles and 7161 citations. Vaccines-Basel was the journal with the largest number of published studies on influenza vaccine hesitations. MacDonald was the most frequently cited author. The most popular research topics on influenza vaccine hesitancy were (1) determinants of influenza vaccination in specific populations, such as healthcare workers, children, pregnant women, and so on; (2) influenza and COVID-19 vaccine hesitancy during the COVID-19 pandemic. Conclusions: The trend in the number of annual publications related to influenza vaccine hesitancy indicating the COVID-19 pandemic will prompt researchers to increase their attention to influenza vaccine hesitancy. With healthcare workers as the key, reducing vaccine hesitancy and improving vaccine acceptance in high-risk groups will be the research direction in the next few years.

18.
Hepatol Int ; 18(2): 550-567, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37067674

RESUMO

BACKGROUND: Although the elderly constitute more than a third of hepatocellular carcinoma (HCC) patients, they have not been adequately represented in treatment and prognosis studies. Thus, there is not enough evidence to guide the treatment of such patients. The objective of this study is to identify the prognostic factors of older patients with HCC and to construct a new prognostic model for predicting their overall survival (OS). METHODS: 2,721 HCC patients aged ≥ 65 were extracted from the public database-Surveillance, Epidemiology, and End Results (SEER) and randomly divided into a training set and an internal validation set with a ratio of 7:3. 101 patients diagnosed from 2008 to 2017 in the First Affiliated Hospital of Zhejiang University School of Medicine were identified as the external validation set. Univariate cox regression analyses and multivariate cox regression analyses were adopted to identify these independent prognostic factors. A predictive nomogram-based risk stratification model was proposed and evaluated using area under the receiver operating characteristic curve (AUC), calibration curves, and a decision curve analysis (DCA). RESULTS: These attributes including age, sex, marital status, T stage, N stage, surgery, chemotherapy, tumor size, alpha-fetoprotein level, fibrosis score, bone metastasis, lung metastasis, and grade were the independent prognostic factors for older patients with HCC while predicting survival duration. We found that the nomogram provided a good assessment of OS at 1, 3, and 5 years in older patients with HCC (1-year OS: (training set: AUC = 0.823 (95%CI 0.803-0.845); internal validation set: AUC = 0.847 (95%CI 0.818-0.876); external validation set: AUC = 0.732 (95%CI 0.521-0.943)); 3-year OS: (training set: AUC = 0.813 (95%CI 0.790-0.837); internal validation set: AUC = 0.844 (95%CI 0.812-0.876); external validation set: AUC = 0.780 (95%CI 0.674-0.887)); 5-year OS: (training set: AUC = 0.839 (95%CI 0.806-0.872); internal validation set: AUC = 0.800 (95%CI 0.751-0.849); external validation set: AUC = 0.821 (95%CI 0.727-0.914)). The calibration curves showed that the nomogram was with strong calibration. The DCA indicated that the nomogram can be used as an effective tool in clinical practice. The risk stratification of all subgroups was statistically significant (p < 0.05). In the stratification analysis of surgery, larger resection (LR) achieved a better survival curve than local destruction (LD), but a worse one than segmental resection (SR) and liver transplantation (LT) (p < 0.0001). With the consideration of the friendship to clinicians, we further developed an online interface (OHCCPredictor) for such a predictive function ( https://juntaotan.shinyapps.io/dynnomapp_hcc/ ). With such an easily obtained online tool, clinicians will be provided helpful assistance in formulating personalized therapy to assess the prognosis of older patients with HCC. CONCLUSIONS: Age, sex, marital status, T stage, N stage, surgery, chemotherapy, tumor size, AFP level, fibrosis score, bone metastasis, lung metastasis, and grade were independent prognostic factors for elderly patients with HCC. The constructed nomogram model based on the above factors could accurately predict the prognosis of such patients. Besides, the developed online web interface of the predictive model provide easily obtained access for clinicians.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias Pulmonares , Idoso , Humanos , Medição de Risco , Fibrose , Prognóstico
19.
Front Public Health ; 11: 1120462, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36817929

RESUMO

Background: Since severe fever with thrombocytopenia syndrome virus (SFTSV) was first reported in 2009, a large number of relevant studies have been published. However, no bibliometrics analysis has been conducted on the literature focusing on SFTSV. This study aims to evaluate the research hotspots and future development trends of SFTSV research through bibliometric analysis, and to provide a new perspective and reference for future SFTSV research and the prevention of SFTSV. Methods: We retrieved global publications on SFTSV from the Web of Science Core Collection (WoSCC) and Scopus databases from inception of the database until 2022 using VOSviewer software and CiteSpace was used for bibliometric analysis. Results: The number of SFTSV-related publications has increased rapidly since 2011, peaking in 2021. A total of 45 countries/regions have published relevant publications, with China topping the list with 359. The Viruses-Basel has published the most papers on SFTSV. In addition, Yu et al. have made the greatest contribution to SFTSV research, with their published paper being the most frequently cited. The most popular SFTSV study topics included: (1) pathogenesis and symptoms, (2) characteristics of the virus and infected patients, and (3) transmission mechanism and risk factors for SFTSV. Conclusions: In this study, we provide a detailed description of the research developments in SFTSV since its discovery and summarize the SFTSV research trends. SFTSV research is in a phase of explosive development, and a large number of publications have been published in the past decade. There is a lack of collaboration between countries and institutions, and international collaboration and exchanges should be strengthened in the future. The current research hotpots of SFTSV is antiviral therapy, immunotherapy, virus transmission mechanism and immune response.


Assuntos
Febre Grave com Síndrome de Trombocitopenia , Humanos , Bibliometria , China , Bases de Dados Factuais , Imunoterapia
20.
Immun Inflamm Dis ; 11(9): e1013, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37773718

RESUMO

BACKGROUND: Influenza-related encephalopathy is a rapidly progressive encephalopathy that usually presents during the early phase of influenza infection and primarily manifests as central nervous system dysfunction. This study aimed to analyze the current research status and hotspots of influenza-related encephalopathy since 2000 through bibliometrics analysis. METHODS: The Web of Science Core Collection (WOSCC) was used to extract global papers on influenza-related encephalopathy from 2000 to 2022. Meanwhile, the VOSviewer and CiteSpace software were used for data processing and result visualization. RESULTS: A total of 561 published articles were included in the study. Japan was the country that published the most articles, with 205 articles, followed by the United States and China. Okayama University and Tokyo Medical University published the most articles, followed by Nagoya University, Tokyo University, and Juntendo University. Based on the analysis of keywords, four clusters with different research directions were identified: "Prevalence of H1N1 virus and the occurrence of neurological complications in different age groups," "mechanism of brain and central nervous system response after influenza virus infection," "various acute encephalopathy" and "diagnostic indicators of influenza-related encephalopathy." CONCLUSIONS: The research progress, hotspots, and frontiers on influenza-related encephalopathy after 2000 were described through the visualization of bibliometrics. The findings will lay the groundwork for future studies and provide a reference for influenza-related encephalopathy. Research on influenza-related encephalopathy is basically at a stable stage, and the number of research results is related to outbreaks of the influenza virus.


Assuntos
Encefalopatias , Vírus da Influenza A Subtipo H1N1 , Influenza Humana , Humanos , Influenza Humana/complicações , Influenza Humana/epidemiologia , Encefalopatias/epidemiologia , Encefalopatias/etiologia , Bibliometria , Encéfalo
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