Development and Validation of a Novel Machine Learning Model to Predict the Survival of Patients with Gastrointestinal Neuroendocrine Neoplasms.

INTRODUCTION: Well-calibrated models for personalized prognostication of patients with gastrointestinal neuroendocrine neoplasms (GINENs) are limited. This study aimed to develop and validate a machine-learning model to predict the survival of patients with GINENs. METHODS: Oblique random survival forest (ORSF) model, Cox proportional hazard risk model, Cox model with least absolute shrinkage and selection operator penalization, CoxBoost, Survival Gradient Boosting Machine, Extreme Gradient Boosting survival regression, DeepHit, DeepSurv, DNNSurv, logistic-hazard model, and PC-hazard model were compared. We further tuned hyperparameters and selected variables for the best-performing ORSF. Then, the final ORSF model was validated. RESULTS: A total of 43,444 patients with GINENs were included. The median (interquartile range) survival time was 53 (19-102) months. The ORSF model performed best, in which age, histology, M stage, tumor size, primary tumor site, sex, tumor number, surgery, lymph nodes removed, N stage, race, and grade were ranked as important variables. However, chemotherapy and radiotherapy were not necessary for the ORSF model. The ORSF model had an overall C index of 0.86 (95% confidence interval, 0.85-0.87). The area under the receiver operation curves at 1, 3, 5, and 10 years were 0.91, 0.89, 0.87, and 0.80, respectively. The decision curve analysis showed superior clinical usefulness of the ORSF model than the American Joint Committee on Cancer Stage. A nomogram and an online tool were given. CONCLUSION: The machine learning ORSF model could precisely predict the survival of patients with GINENs, with the ability to identify patients at high risk for death and probably guide clinical practice.

A Systematic Review and Quality Assessment of Cardiovascular Disease-Specific Health-Related Quality-of-Life Instruments Part I: Instrument Development and Content Validity.

OBJECTIVES: Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. METHODS: The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. RESULTS: The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. CONCLUSIONS: The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing a HRQoL instrument in CVD clinical studies and health economic evaluations.

Analysis of causes and prognostic impact of tube occlusion during hyperthermic intraperitoneal chemotherapy for appendiceal pseudomyxoma peritonei.

BACKGROUND: Appendiceal pseudomyxoma peritonei (PMP), a rare tumor from mucinous appendiceal origins, is treated with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). However, tubing blockages during HIPEC treatment pose a common challenge, impeding the smooth progression of therapy. Few studies to date have explored the incidence and risk factors of tube occlusion during HIPEC in patients with appendiceal PMP, as well as its adverse impact on postoperative complications. METHODS: From October 2017 to June 2023, a total of 80 patients with appendiceal PMP undergoing combined CRS and HIPEC were included in this study. Tubing blockage events were strictly defined, with patients experiencing blockages during HIPEC treatment allocated to the study group, while those with unobstructed perfusion were assigned to the control group. A comparative analysis was conducted between the two groups regarding post-HIPEC health assessments and occurrence of complications. Risk factors for luminal occlusion during closed HIPEC procedures were identified through univariate and multivariate analysis of data from 303 HIPEC treatments. RESULTS: Tubing blockages occurred in 41 patients (51.3%). The study group experienced prolonged gastrointestinal decompression time (4.1 ± 3.0 vs. 2.5 ± 1.7 days, P = 0.003) and prolonged time to bowel movement (6.1 ± 2.3 vs. 5.1 ± 1.8 days, P = 0.022) compared to the control group. There was no significant difference in the incidence of complications between the two groups. The 1-year survival rate postoperatively was 97%, and the 3-year survival rate was 81%, with no association found between tubing blockage and poorer survival. Additionally, In 303 instances of HIPEC treatment among these 80 patients, tube occlusion occurred in 89 cases (89/303, 29.4%). Multivariable logistic regression analysis revealed age, diabetes, hypertension, and pathology as independent risk factors for tube occlusion. CONCLUSION: Tubing blockages are a common occurrence during HIPEC treatment, leading to prolonged postoperative gastrointestinal functional recovery time. When patients are elderly and have concomitant hypertension and diabetes, along with a histological type of low-grade mucinous tumor, the risk of tube occlusion increases. However, this study did not find a significant correlation between tubing blockage and the incidence of postoperative complications or overall patient survival.

Prosocial Behavior and Well-Being: An Empirical Review of the Role of Basic Psychological Need Satisfaction.

Although prosocial behavior is positively associated with one's well-being, researchers have yet to reach a consensus on the role played by basic psychological need satisfaction (BPNS) in this association. A systematic review of the existing empirical literature is conducted in this article to summarize and synthesize the relationship between prosocial behavior and well-being, with a special emphasis on the multifaceted role of BPNS (i.e. mediation, moderation, and concurrent mediation and moderation). Nineteen articles have been identified that meet the criteria of the research focus, being empirical and peer-reviewed. Results suggest that BPNS can act as a mediator, moderator, and differing mediation and moderation roles. Prosocial behavior can both individually and jointly satisfy the three needs for autonomy, competence, and relatedness, thus enhancing well-being. Moreover, the positive correlation between prosocial behavior and well-being can be augmented by a high level of satisfaction of one or multiple needs. Furthermore, those who have higher satisfaction of autonomy, competence, or relatedness display a greater increase in well-being after engaging in prosocial behavior, which can be mediated by BPNS. Drawing on these findings, the current body of work is evaluated in terms of its strengths and weaknesses, and potential future directions are explored.

Bioinspired Thermal Conductive Cellulose Nanofibers/Boron Nitride Coating Enabled by Co-Exfoliation and Interfacial Engineering.

Thermal conductive coating materials with combination of mechanical robustness, good adhesion and electrical insulation are in high demand in the electronics industry. However, very few progresses have been achieved in constructing a highly thermal conductive composites coating that can conformably coat on desired subjects for efficient thermal dissipation, due to their lack of materials design and structure control. Herein, we report a bioinspired thermal conductive coating material from cellulose nanofibers (CNFs), boron nitride (BN), and polydopamine (PDA) by mimicking the layered structure of nacre. Owing to the strong interfacial strength, mechanical robustness, and high thermal conductivity of CNFs, they do not only enhance the exfoliation and dispersion of BN nanoplates, but also bridge BN nanoplates to achieve superior thermal and mechanical performance. The resulting composites coating exhibits a high thermal conductivity of 13.8 W/(m·K) that surpasses most of the reported thermal conductive composites coating owing to the formation of an efficient thermal conductive pathway in the layered structure. Additionally, the coating material has good interface adhesion to conformably wrap around various substrates by scalable spray coating, combined with good mechanical robustness, sustainability, electrical insulation, low-cost, and easy processability, which makes our materials attractive for electronic packaging applications.

Flexible CNT-Interpenetrating Hierarchically Porous Sulfurized Polyacrylonitrile (CIHP-SPAN) Electrodes for High-Rate Lithium-Sulfur (Li-S) Batteries.

Sulfurized polyacrylonitrile (SPAN) is a promising cathode material for lithium-sulfur batteries owing to its reversible solid-solid conversion for high-energy-density batteries. However, the sluggish reaction kinetics of SPAN cathodes significantly limit their output capacity, especially at high cycling rates. Herein, a CNT-interpenetrating hierarchically porous SPAN electrode is developed by a simple phase-separation method. Flexible self-supporting SPAN cathodes with fast electron/ion pathways are synthesized without additional binders, and exceptional high-rate cycling performances are obtained even with substantial sulfur loading. For batteries assembled with this special cathode, an impressive initial discharge capacity of 1090 mAh g-1 and a retained capacity of 800 mAh g-1 are obtained after 1000 cycles at 1 C with a sulfur loading of 1.5 mg cm-2. Furthermore, by incorporating V2O5 anchored carbon fiber as an interlayer with adsorption and catalysis function, a high initial capacity of 614.8 mAh g-1 and a notable sustained capacity of 500 mAh g-1 after 500 cycles at 5 C are achieved, with an ultralow decay rate of 0.037% per cycle with a sulfur loading of 1.5 mg cm-2. The feasible construction of flexible SPAN electrodes with enhanced cycling performance enlists the current processing as a promising strategy for novel high-rate lithium-sulfur batteries and other emerging battery electrodes.