Guiding post-pancreaticoduodenectomy interventions for pancreatic cancer patients utilizing decision tree models.

Background: Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed in advanced stages, necessitating pancreaticoduodenectomy (PD) as a primary therapeutic approach. However, PD surgery can engender intricate complications. Thus, understanding the factors influencing postoperative complications documented in electronic medical records and their impact on survival rates is crucial for improving overall patient outcomes. Methods: A total of 749 patients were divided into two groups: 598 (79.84%) chose the RPD (Robotic pancreaticoduodenectomy) procedure and 151 (20.16%) chose the LPD (Laparoscopic pancreaticoduodenectomy) procedure. We used correlation analysis, survival analysis, and decision tree models to find the similarities and differences about postoperative complications and prognostic survival. Results: Pancreatic cancer, known for its aggressiveness, often requires pancreaticoduodenectomy as an effective treatment. In predictive models, both BMI and surgery duration weigh heavily. Lower BMI correlates with longer survival, while patients with heart disease and diabetes have lower survival rates. Complications like delayed gastric emptying, pancreatic fistula, and infection are closely linked post-surgery, prompting conjectures about their causal mechanisms. Interestingly, we found no significant correlation between nasogastric tube removal timing and delayed gastric emptying, suggesting its prompt removal post-decompression. Conclusion: This study aimed to explore predictive factors for postoperative complications and survival in PD patients. Effective predictive models enable early identification of high-risk individuals, allowing timely interventions. Higher BMI, heart disease, or diabetes significantly reduce survival rates in pancreatic cancer patients post-PD. Additionally, there's no significant correlation between DGE incidence and postoperative extubation time, necessitating further investigation into its interaction with pancreatic fistula and infection.

Spatiotemporal variations in soil pollution by polycyclic aromatic hydrocarbons over a 20-year economic boom in different districts of a heavy industrial city in North China.

Urbanization-related human activities, such as population aggregation, rapid industrial expansion, and intensified traffic, are key factors that impact local polycyclic aromatic hydrocarbon emissions and their associated health risks. Consequently, regions with varying degrees of urbanization within a megacity may exhibit diverse spatiotemporal patterns in the presence and distribution of soil polycyclic aromatic hydrocarbons, resulting in different levels of ecological risks for local inhabitants following the same period of development. In this study, we measured the concentrations of 16 polycyclic aromatic hydrocarbons in soil samples collected from industrial district and rural district in Tianjin (China) in 2018, and compared with polycyclic aromatic hydrocarbon data in 2001 from a previous study to characterize these regional variations in occurrence, source, and human risk of polycyclic aromatic hydrocarbons induced by urbanization with time and space. The results indicate the 20-year rapid urbanization and industrialization has differentially affected the composition, distribution and sources of polycyclic aromatic hydrocarbons in soils from different economic functional zones in Tianjin. Additionally, its impact on health risks in rural district appeared to be more significant than that in industrial district.

Contamination Status, Environmental Factor and Risk Assessment of Polychlorinated Biphenyls and Hexachlorobutadiene in Greenhouse and Open-Field Agricultural Soils across China.

With the popularization and high-intensity utilization of greenhouse cultivation for crops growth, the pollution of greenhouse soils has been of concern. Therefore, a national-scale survey was conducted to investigate the contamination status, sources, influence factors and the risks of polychlorinated biphenyls (PCBs) and hexachlorobutadiene (HCBD) in greenhouse and nearby open-field soils. Contents of PCBs ranged from 10-6). This study provided a full insight on the contamination status and risks of PCBs and HCBD when guiding greenhouse agriculture activities.

Assessment of Multivariate Information Transmission in Space-Time-Frequency Domain: A Case Study for EEG Signals.

OBJECTIVE: Multivariate signal (MS) analysis, especially the assessment of its information transmission (for example, from the perspective of network science), is the key to our understanding of various phenomena in biology, physics and economics. Although there is a large amount of literature demonstrating that MS can be decomposed into space-time-frequency domain information, there seems to be no research confirming that multivariate information transmission (MIT) in these three domains can be quantified. Therefore, in this study, we attempted to combine dynamic mode decomposition (DMD) and parallel communication model (PCM) together to realize it. METHODS: We first regarded MS as a large-scale system and then used DMD to decompose it into specific subsystems with their own intrinsic oscillatory frequencies. At the same time, the transition probability matrix (TPM) of information transmission within and between MS at two consecutive moments in each subsystem can also be calculated. Then, communication parameters (CPs) derived from each TPM were calculated in order to quantify the MIT in the space-time-frequency domain. In this study, multidimensional electroencephalogram (EEG) signals were used to illustrate our method. RESULTS: Compared with traditional EEG brain networks, this method shows greater potential in EEG analysis to distinguish between patients and healthy controls. CONCLUSION: This study demonstrates the feasibility of measuring MIT in the space-time-frequency domain simultaneously. SIGNIFICANCE: This study shows that MIT analysis in the space-time-frequency domain is not only completely different from the MS decomposition in these three domains, but also can reveal many new phenomena behind MS that have not yet been discovered.

Emission Characteristics of Air Pollutants and CO2 from 11 Cities with Different Economic Development around the Bohai Sea in China from 2008-2017.

Cities around the Bohai Sea are one of the main population cluster areas in China, which are characterized by high levels of sustainability performance and human capital, as well as resource-intensive industries. In this study, levels of economic development metrics and emissions of air pollutants (BC, CO, NH3, NOx, OC, PM2.5, PM10, and SO2) and CO2 across eleven cities around the Bohai Sea from 2008 to 2017 were compared to illustrate the potential relationships between air pollutants/carbon emissions and socioeconomic developments. Meanwhile, the associations between the levels of economic development metrics (GDP per capita), emissions, and energy use per GDP have also been examined. Large differences across these 11 cities presenting different economic development levels and energy consumption characteristics have been observed. Cities with development dependable on the consumption of fossil fuels and the development of resource-intensive industries have emitted large amounts of air pollutants and CO2. Furthermore, the emissions and energy use per GDP for all the cities follow environmental Kuznets curves. The comparison results suggested that the developing cities dependable on resource-intensive industries around the Bohai Sea would obtain greater socioeconomic benefits owing to the interregional cooperation policies under top-down socioeconomic development plans and bottom-up technology development, accompanied by reduced emissions of air pollutants and CO2.

Perioperative Risk Assessment for Surgery of Consecutive Cases with Ventricular Septal Rupture: Seeking A Novel and Comprehensive Method.

BACKGROUND: Ventricular septal rupture (VSR) is a rare but lethal complication occurring after acute myocardial infarction. The aim of our study was to review the single-center experience of surgery for VSR and seek a comprehensive evaluation process for early mortality. METHODS: Patients undergoing surgical repair for postinfarction VSR in our institution retrospectively were evaluated from Jan. 2006 to Dec. 2019. The endpoint of the study was mortality within 30 days after VSR surgery, which was divided into survivors and nonsurvivors. The calibration and discrimination of two risk evaluation systems (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons (STS) risk score) in total were compared by Hosmer-Lemeshow, and the area under the receiver operating characteristic curve (AUC). Risk factors in subsets were assessed by logistic regression analysis. RESULTS: Twenty-three patients undergoing surgery for VSR repair were reviewed, and the early mortality after surgery was 34.8% (N = 8). The expected mortality predicted by EuroSCORE II was 24.3%, and that of the STS score was 12.2%. Both the EuroSCORE II and STS risk evaluation systems showed positive calibration in predicting mortality (H-L: P = 0.117 and P = 0.346, respectively) but poor discriminative power (AUC=0.633 and 0.575). Significant predictors determined by univariate analysis were concomitant coronary artery bypass grafting (CABG) (P = 0.035) and postoperative continuous renal replacement therapy (CRRT) (P = 0.008). CONCLUSION: Early mortality of VSR after surgery remains high, and the evaluation process is complicated. The performances of the two risk evaluation systems were not optimal, but EuroSCORE II was more accurate than STS. Patients with lower preoperation EuroSCORE II, concomitant CABG during repair, and no need for CRRT after surgery may have a better early survival rate.