BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling techn...BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.展开更多
Delirium,a complex neurocognitive syndrome,frequently emerges following surgery,presenting diverse manifestations and considerable obstacles,especially among the elderly.This editorial delves into the intricate phenom...Delirium,a complex neurocognitive syndrome,frequently emerges following surgery,presenting diverse manifestations and considerable obstacles,especially among the elderly.This editorial delves into the intricate phenomenon of postoperative delirium(POD),shedding light on a study that explores POD in elderly individuals undergoing abdominal malignancy surgery.The study examines pathophysiology and predictive determinants,offering valuable insights into this challenging clinical scenario.Employing the synthetic minority oversampling technique,a predictive model is developed,incorporating critical risk factors such as comorbidity index,anesthesia grade,and surgical duration.There is an urgent need for accurate risk factor identification to mitigate POD incidence.While specific to elderly patients with abdominal malignancies,the findings contribute significantly to understanding delirium pathophysiology and prediction.Further research is warranted to establish standardized predictive for enhanced generalizability.展开更多
This article presents two approaches for automated building of knowledge bases of soil resources mapping. These methods used decision tree and Bayesian predictive modeling, respectively to generate knowledge from tra...This article presents two approaches for automated building of knowledge bases of soil resources mapping. These methods used decision tree and Bayesian predictive modeling, respectively to generate knowledge from training data. With these methods, building a knowledge base for automated soil mapping is easier than using the conventional knowledge acquisition approach. The knowledge bases built by these two methods were used by the knowledge classifier for soil type classification of the Longyou area, Zhejiang Province, China using TM bi-temporal imageries and GIS data. To evaluate the performance of the resultant knowledge bases, the classification results were compared to existing soil map based on field survey. The accuracy assessment and analysis of the resultant soil maps suggested that the knowledge bases built by these two methods were of good quality for mapping distribution model of soil classes over the study area.展开更多
There has been evidence of crime in the US since colonization. In this article, we analyze the crime statistics of San Francisco and its resolution of crime recorded from January to September of the year 2018. We defi...There has been evidence of crime in the US since colonization. In this article, we analyze the crime statistics of San Francisco and its resolution of crime recorded from January to September of the year 2018. We define resolution of crime as a target variable and study its relationship with other variables. We make several classification models to predict resolution of crime using several data mining techniques and suggest the best model for predicting resolution.展开更多
Artificial intelligence(AI)and digital twin models of various systems have long been used in industry to test products quickly and efficiently.Use of digital twins in clinical medicine caught attention with the develo...Artificial intelligence(AI)and digital twin models of various systems have long been used in industry to test products quickly and efficiently.Use of digital twins in clinical medicine caught attention with the development of Archimedes,an AI model of diabetes,in 2003.More recently,AI models have been applied to the fields of cardiology,endocrinology,and undergraduate medical education.The use of digital twins and AI thus far has focused mainly on chronic disease management,their application in the field of critical care medicine remains much less explored.In neurocritical care,current AI technology focuses on interpreting electroencephalography,monitoring intracranial pressure,and prognosticating outcomes.AI models have been developed to interpret electroencephalograms by helping to annotate the tracings,detecting seizures,and identifying brain activation in unresponsive patients.In this mini-review we describe the challenges and opportunities in building an actionable AI model pertinent to neurocritical care that can be used to educate the newer generation of clinicians and augment clinical decision making.展开更多
In a competitive digital age where data volumes are increasing with time, the ability to extract meaningful knowledge from high-dimensional data using machine learning (ML) and data mining (DM) techniques and making d...In a competitive digital age where data volumes are increasing with time, the ability to extract meaningful knowledge from high-dimensional data using machine learning (ML) and data mining (DM) techniques and making decisions based on the extracted knowledge is becoming increasingly important in all business domains. Nevertheless, high-dimensional data remains a major challenge for classification algorithms due to its high computational cost and storage requirements. The 2016 Demographic and Health Survey of Ethiopia (EDHS 2016) used as the data source for this study which is publicly available contains several features that may not be relevant to the prediction task. In this paper, we developed a hybrid multidimensional metrics framework for predictive modeling for both model performance evaluation and feature selection to overcome the feature selection challenges and select the best model among the available models in DM and ML. The proposed hybrid metrics were used to measure the efficiency of the predictive models. Experimental results show that the decision tree algorithm is the most efficient model. The higher score of HMM (m, r) = 0.47 illustrates the overall significant model that encompasses almost all the user’s requirements, unlike the classical metrics that use a criterion to select the most appropriate model. On the other hand, the ANNs were found to be the most computationally intensive for our prediction task. Moreover, the type of data and the class size of the dataset (unbalanced data) have a significant impact on the efficiency of the model, especially on the computational cost, and the interpretability of the parameters of the model would be hampered. And the efficiency of the predictive model could be improved with other feature selection algorithms (especially hybrid metrics) considering the experts of the knowledge domain, as the understanding of the business domain has a significant impact.展开更多
Laser surface hardening is a very promising hardening process for ferrous alloys where transformations occur during cooling after laser heating in the solid state. The characteristics of the hardened surface depend on...Laser surface hardening is a very promising hardening process for ferrous alloys where transformations occur during cooling after laser heating in the solid state. The characteristics of the hardened surface depend on the physicochemical properties of the material as well as the heating system parameters. To exploit the benefits presented by the laser hardening process, it is necessary to develop an integrated strategy to control the process parameters in order to produce desired hardened surface attributes without being forced to use the traditional and fastidious trial and error procedures. This study presents a comprehensive modelling approach for predicting the hardened surface physical and geometrical attributes. The laser surface transformation hardening of cylindrical AISI 4340 steel workpieces is modeled using the conventional regression equation method as well as artificial neural network method. The process parameters included in the study are laser power, beam scanning speed, and the workpiece rotational speed. The upper and the lower limits for each parameter are chosen considering the start of the transformation hardening and the maximum hardened zone without surface melting. The resulting models are able to predict the depths representing the maximum hardness zone, the hardness drop zone, and the overheated zone without martensite transformation. Because of its ability to model highly nonlinear problems, the ANN based model presents the best modelling results and can predict the hardness profile with good accuracy.展开更多
Objective:To determine the most influential data features and to develop machine learning approaches that best predict hospital readmissions among patients with diabetes.Methods:In this retrospective cohort study,we s...Objective:To determine the most influential data features and to develop machine learning approaches that best predict hospital readmissions among patients with diabetes.Methods:In this retrospective cohort study,we surveyed patient statistics and performed feature analysis to identify the most influential data features associated with readmissions.Classification of all-cause,30-day readmission outcomes were modeled using logistic regression,artificial neural network,and Easy Ensemble.F1 statistic,sensitivity,and positive predictive value were used to evaluate the model performance.Results:We identified 14 most influential data features(4 numeric features and 10 categorical features)and evaluated 3 machine learning models with numerous sampling methods(oversampling,undersampling,and hybrid techniques).The deep learning model offered no improvement over traditional models(logistic regression and Easy Ensemble)for predicting readmission,whereas the other two algorithms led to much smaller differences between the training and testing datasets.Conclusions:Machine learning approaches to record electronic health data offer a promising method for improving readmission prediction in patients with diabetes.But more work is needed to construct datasets with more clinical variables beyond the standard risk factors and to fine-tune and optimize machine learning models.展开更多
To optimize cutting control parameters and provide scientific evidence for controlling cutting forces,cutting force modeling and cutting control parameter optimization are researched with one tool adopted to orbital d...To optimize cutting control parameters and provide scientific evidence for controlling cutting forces,cutting force modeling and cutting control parameter optimization are researched with one tool adopted to orbital drill holes in aluminum alloy 6061.Firstly,four cutting control parameters(tool rotation speed,tool revolution speed,axial feeding pitch and tool revolution radius)and affecting cutting forces are identified after orbital drilling kinematics analysis.Secondly,hybrid level orthogonal experiment method is utilized in modeling experiment.By nonlinear regression analysis,two quadratic prediction models for axial and radial forces are established,where the above four control parameters are used as input variables.Then,model accuracy and cutting control parameters are analyzed.Upon axial and radial forces models,two optimal combinations of cutting control parameters are obtained for processing a13mm hole,corresponding to the minimum axial force and the radial force respectively.Finally,each optimal combination is applied in verification experiment.The verification experiment results of cutting force are in good agreement with prediction model,which confirms accracy of the research method in practical production.展开更多
Predictive microbiology was utilized to model Staphylococcus aureus （S. aureus） growth and staphylococcal enterotoxin A （SEA） production in milk in this study. The modifed logistic model, modifed Gompertz model an...Predictive microbiology was utilized to model Staphylococcus aureus （S. aureus） growth and staphylococcal enterotoxin A （SEA） production in milk in this study. The modifed logistic model, modifed Gompertz model and Baranyi model were applied to model growth data of S. aureus between 15℃ and 37℃. Model comparisons indicated that Baranyi model described the growth data more accurately than two others with a mean square error of 0.0129. Growth rates generated from Baranyi model matched the observed ones with a bias factor of 0.999 and an accuracy factor of 1.01, and ft a square root model with respect to temperature; other two modifed models both overestimated the observed ones. SEA amount began to be detected when the cell number reached106.4 cfu ？ mL-1, and showed the linear correlation with time. Besides, the rate of SEA production ftted an exponential relationship as a function of temperature. Predictions based on the study could be applied to indicate possible growth of S. aureus and prevent the occurrence of staphylococcal food poisoning.展开更多
Sources of uncertainty or error that arise in attempting to scale up the results of laboratory-scale sediment transport studies for predictive modeling of geomorphic systems include: (i) model imperfec...Sources of uncertainty or error that arise in attempting to scale up the results of laboratory-scale sediment transport studies for predictive modeling of geomorphic systems include: (i) model imperfection, (ii) omission of important processes, (iii) lack of knowledge of initial conditions, (iv) sensitivity to initial conditions, (v) unresolved heterogeneity, (vi) occurrence of external forcing, and (vii) inapplicability of the factor of safety concept. Sources of uncertainty that are unimportant or that can be controlled at small scales and over short time scales become important in large-scale applications and over long time scales. Control and repeatability, hallmarks of laboratory-scale experiments, are usually lacking at the large scales characteristic of geomorphology. Heterogeneity is an important concomitant of size, and tends to make large systems unique. Uniqueness implies that prediction cannot be based upon first-principles quantitative modeling alone, but must be a function of system history as well. Periodic data collection, feedback, and model updating are essential where site-specific prediction is required.展开更多
Oil wells on the North Slope of Alaska pass through deep deposits of permafrost. The heat transferred during their operation causes localized thawing, resulting in ground subsidence adjacent to the well casings. This ...Oil wells on the North Slope of Alaska pass through deep deposits of permafrost. The heat transferred during their operation causes localized thawing, resulting in ground subsidence adjacent to the well casings. This subsidence has a damaging effect, causing the casings to compress, deform, and potentially fail. This paper presents the results of a laboratory study of the thaw consolidation strain of deep permafrost and its predictive modeling. Tests were performed to determine strains due to thaw and post-thaw loading, as well as soil index properties. Results, together with data from an earlier testing program, were used to produce empirical models for predicting strains and ground subsidence. Four distinct strain cases were analyzed with three models by multiple regression analyses, and the best-fitting model was selected for each case. Models were further compared in a ground subsidence prediction using a shared subsurface profile. Laboratory results indicate that strains due to thaw and post-thaw testing in deep core permafrost are insensitive to depth and are more strongly influenced by stress redistributions and the presence of ice lenses and inclusions. Modeling results show that the most statistically valid and useful models were those constructed using moisture content, porosity, and degree of saturation. The applicability of these models was validated by comparison with results from Finite Element modeling.展开更多
Background:Accurate nestling age is valuable for studies on nesting strategies,productivity,and impacts on repro-ductive success.Most aging guides consist of descriptions and photographs that are time consuming to rea...Background:Accurate nestling age is valuable for studies on nesting strategies,productivity,and impacts on repro-ductive success.Most aging guides consist of descriptions and photographs that are time consuming to read and subjective to interpret.The Western Bluebird(Sialia mexicana)is a secondary cavity-nesting passerine that nests in coniferous and open deciduous forests.Nest box programs for cavity-nesting species have provided suitable nesting locations and opportunities for data collection on nestling growth and development.Methods:We developed models for predicting the age of Western Bluebird nestlings from morphometric meas-urements using model training and validation.These were developed for mass,tarsus,and two different culmen measurements.Results:Our models were accurate to within less than a day,and each model worked best for a specific age range.The mass and tarsus models can be used to estimate the ages of Western Bluebird nestlings 0-10 days old and were accurate to within 0.5 days for mass and 0.7 days for tarsus.The culmen models can be used to estimate ages of nest-lings 0-15 days old and were also accurate to within less than a day.The daily mean,minimum,and maximum values of each morphometric measurement are provided and can be used in the field for accurate nestling age estimations in real time.Conclusions:The model training and validation procedures used here demonstrate that this method can create aging models that are highly accurate.The methods can be applied to any passerine species provided sufficient nest-ling morphometric data are available.展开更多
This study focuses on empirical modeling of the strength characteristics of urban soils contaminated with heavy metals using machine learning tools and their subsequent stabilization with ordinary Portland cement(OPC)...This study focuses on empirical modeling of the strength characteristics of urban soils contaminated with heavy metals using machine learning tools and their subsequent stabilization with ordinary Portland cement(OPC).For dataset collection,an extensive experimental program was designed to estimate the unconfined compressive strength(Qu)of heavy metal-contaminated soils collected from awide range of land use pattern,i.e.residential,industrial and roadside soils.Accordingly,a robust comparison of predictive performances of four data-driven models including extreme learning machines(ELMs),gene expression programming(GEP),random forests(RFs),and multiple linear regression(MLR)has been presented.For completeness,a comprehensive experimental database has been established and partitioned into 80%for training and 20%for testing the developed models.Inputs included varying levels of heavy metals like Cd,Cu,Cr,Pb and Zn,along with OPC.The results revealed that the GEP model outperformed its counterparts:explaining approximately 96%of the variability in both training(R2=0.964)and testing phases(R^(2)=0.961),and thus achieving the lowest RMSE and MAE values.ELM performed commendably but was slightly less accurate than GEP whereas MLR had the lowest performance metrics.GEP also provided the benefit of traceable mathematical equation,enhancing its applicability not just as a predictive but also as an explanatory tool.Despite its insights,the study is limited by its focus on a specific set of heavy metals and urban soil samples of a particular region,which may affect the generalizability of the findings to different contamination profiles or environmental conditions.The study recommends GEP for predicting Qu in heavy metal-contaminated soils,and suggests further research to adapt these models to different environmental conditions.展开更多
A distributionally robust model predictive control(DRMPC)scheme is proposed based on neural network(NN)modeling to achieve the trajectory tracking control of robot manipulators with state and control torque constraint...A distributionally robust model predictive control(DRMPC)scheme is proposed based on neural network(NN)modeling to achieve the trajectory tracking control of robot manipulators with state and control torque constraints.First,an NN is used to fit the motion data of robot manipulators for data-driven dynamic modeling,converting it into a linear prediction model through gradients.Then,by statistically analyzing the stochastic characteristics of the NN modeling errors,a distributionally robust model predictive controller is designed based on the chance constraints,and the optimization problem is transformed into a tractable quadratic programming(QP)problem under the distributionally robust optimization(DRO)framework.The recursive feasibility and convergence of the proposed algorithm are proven.Finally,the effectiveness of the proposed algorithm is verified through numerical simulation.展开更多
Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential S...Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.展开更多
BACKGROUND An increasing number of studies to date have found preoperative magnetic resonance imaging(MRI)features valuable in predicting the prognosis of rectal cancer(RC).However,research is still lacking on the cor...BACKGROUND An increasing number of studies to date have found preoperative magnetic resonance imaging(MRI)features valuable in predicting the prognosis of rectal cancer(RC).However,research is still lacking on the correlation between preoperative MRI features and the risk of recurrence after radical resection of RC,urgently necessitating further in-depth exploration.AIM To investigate the correlation between preoperative MRI parameters and the risk of recurrence after radical resection of RC to provide an effective tool for predicting postoperative recurrence.METHODS The data of 90 patients who were diagnosed with RC by surgical pathology and underwent radical surgical resection at the Second Affiliated Hospital of Bengbu Medical University between May 2020 and December 2023 were collected through retrospective analysis.General demographic data,MRI data,and tumor markers levels were collected.According to the reviewed data of patients six months after surgery,the clinicians comprehensively assessed the recurrence risk and divided the patients into high recurrence risk(37 cases)and low recurrence risk(53 cases)groups.Independent sample t-test andχ2 test were used to analyze differences between the two groups.A logistic regression model was used to explore the risk factors of the high recurrence risk group,and a clinical prediction model was constructed.The clinical prediction model is presented in the form of a nomogram.The receiver operating characteristic curve,Hosmer-Lemeshow goodness of fit test,calibration curve,and decision curve analysis were used to evaluate the efficacy of the clinical prediction model.RESULTS The detection of positive extramural vascular invasion through preoperative MRI[odds ratio(OR)=4.29,P=0.045],along with elevated carcinoembryonic antigen(OR=1.08,P=0.041),carbohydrate antigen 125(OR=1.19,P=0.034),and carbohydrate antigen 199(OR=1.27,P<0.001)levels,are independent risk factors for increased postoperative recurrence risk in patients with RC.Furthermore,there was a correlation between magnetic resonance based T staging,magnetic resonance based N staging,and circumferential resection margin results determined by MRI and the postoperative recurrence risk.Additionally,when extramural vascular invasion was integrated with tumor markers,the resulting clinical prediction model more effectively identified patients at high risk for postoperative recurrence,thereby providing robust support for clinical decision-making.CONCLUSION The results of this study indicate that preoperative MRI detection is of great importance for predicting the risk of postoperative recurrence in patients with RC.Monitoring these markers helps clinicians identify patients at high risk,allowing for more aggressive treatment and monitoring strategies to improve patient outcomes.展开更多
BACKGROUND Colorectal polyps are precancerous diseases of colorectal cancer.Early detection and resection of colorectal polyps can effectively reduce the mortality of colorectal cancer.Endoscopic mucosal resection(EMR...BACKGROUND Colorectal polyps are precancerous diseases of colorectal cancer.Early detection and resection of colorectal polyps can effectively reduce the mortality of colorectal cancer.Endoscopic mucosal resection(EMR)is a common polypectomy proce-dure in clinical practice,but it has a high postoperative recurrence rate.Currently,there is no predictive model for the recurrence of colorectal polyps after EMR.AIM To construct and validate a machine learning(ML)model for predicting the risk of colorectal polyp recurrence one year after EMR.METHODS This study retrospectively collected data from 1694 patients at three medical centers in Xuzhou.Additionally,a total of 166 patients were collected to form a prospective validation set.Feature variable screening was conducted using uni-variate and multivariate logistic regression analyses,and five ML algorithms were used to construct the predictive models.The optimal models were evaluated based on different performance metrics.Decision curve analysis(DCA)and SHapley Additive exPlanation(SHAP)analysis were performed to assess clinical applicability and predictor importance.RESULTS Multivariate logistic regression analysis identified 8 independent risk factors for colorectal polyp recurrence one year after EMR(P<0.05).Among the models,eXtreme Gradient Boosting(XGBoost)demonstrated the highest area under the curve(AUC)in the training set,internal validation set,and prospective validation set,with AUCs of 0.909(95%CI:0.89-0.92),0.921(95%CI:0.90-0.94),and 0.963(95%CI:0.94-0.99),respectively.DCA indicated favorable clinical utility for the XGBoost model.SHAP analysis identified smoking history,family history,and age as the top three most important predictors in the model.CONCLUSION The XGBoost model has the best predictive performance and can assist clinicians in providing individualized colonoscopy follow-up recommendations.展开更多
BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset D...BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.METHODS We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021.A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors.Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions.The Cox model was further employed to evaluate the impact of risk factors on DF.The area under the curve(AUC)was measured to evaluate the accuracy of the prediction model.RESULTS Seventy-five diabetic inpatients experienced DF.The incidence density of DF was 4.5/1000 person-years.A long duration of diabetes,lower extremity arterial disease,lower serum albumin,fasting plasma glucose(FPG),and diabetic nephropathy were independently associated with DF.Among these risk factors,the serum albumin concentration was inversely associated with DF,with a hazard ratio(HR)and 95%confidence interval(CI)of 0.91(0.88-0.95)(P<0.001).Additionally,a U-shaped nonlinear relationship was observed between the FPG level and DF.After adjusting for other variables,the HRs and 95%CI for FPG<4.4 mmol/L and≥7.0 mmol/L were 3.99(1.55-10.25)(P=0.004)and 3.12(1.66-5.87)(P<0.001),respectively,which was greater than the mid-range level(4.4-6.9 mmol/L).The AUC for predicting DF over 3 years was 0.797.CONCLUSION FPG demonstrated a U-shaped relationship with DF.Serum albumin levels were negatively associated with DF.The prediction nomogram model of DF showed good discrimination ability using diabetes duration,lower extremity arterial disease,serum albumin,FPG,and diabetic nephropathy(Clinicaltrial.gov NCT05519163).展开更多
BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety d...BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.展开更多
基金Supported by Discipline Advancement Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2020-2013.
文摘BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.
文摘Delirium,a complex neurocognitive syndrome,frequently emerges following surgery,presenting diverse manifestations and considerable obstacles,especially among the elderly.This editorial delves into the intricate phenomenon of postoperative delirium(POD),shedding light on a study that explores POD in elderly individuals undergoing abdominal malignancy surgery.The study examines pathophysiology and predictive determinants,offering valuable insights into this challenging clinical scenario.Employing the synthetic minority oversampling technique,a predictive model is developed,incorporating critical risk factors such as comorbidity index,anesthesia grade,and surgical duration.There is an urgent need for accurate risk factor identification to mitigate POD incidence.While specific to elderly patients with abdominal malignancies,the findings contribute significantly to understanding delirium pathophysiology and prediction.Further research is warranted to establish standardized predictive for enhanced generalizability.
基金Project supported by the National Natural Science Foundation ofChina (No. 40101014) and by the Science and technology Committee of Zhejiang Province (No. 001110445) China
文摘This article presents two approaches for automated building of knowledge bases of soil resources mapping. These methods used decision tree and Bayesian predictive modeling, respectively to generate knowledge from training data. With these methods, building a knowledge base for automated soil mapping is easier than using the conventional knowledge acquisition approach. The knowledge bases built by these two methods were used by the knowledge classifier for soil type classification of the Longyou area, Zhejiang Province, China using TM bi-temporal imageries and GIS data. To evaluate the performance of the resultant knowledge bases, the classification results were compared to existing soil map based on field survey. The accuracy assessment and analysis of the resultant soil maps suggested that the knowledge bases built by these two methods were of good quality for mapping distribution model of soil classes over the study area.
文摘There has been evidence of crime in the US since colonization. In this article, we analyze the crime statistics of San Francisco and its resolution of crime recorded from January to September of the year 2018. We define resolution of crime as a target variable and study its relationship with other variables. We make several classification models to predict resolution of crime using several data mining techniques and suggest the best model for predicting resolution.
基金Supported by the National Center for Advancing Translational Sciences,No.UL1 TR002377.
文摘Artificial intelligence(AI)and digital twin models of various systems have long been used in industry to test products quickly and efficiently.Use of digital twins in clinical medicine caught attention with the development of Archimedes,an AI model of diabetes,in 2003.More recently,AI models have been applied to the fields of cardiology,endocrinology,and undergraduate medical education.The use of digital twins and AI thus far has focused mainly on chronic disease management,their application in the field of critical care medicine remains much less explored.In neurocritical care,current AI technology focuses on interpreting electroencephalography,monitoring intracranial pressure,and prognosticating outcomes.AI models have been developed to interpret electroencephalograms by helping to annotate the tracings,detecting seizures,and identifying brain activation in unresponsive patients.In this mini-review we describe the challenges and opportunities in building an actionable AI model pertinent to neurocritical care that can be used to educate the newer generation of clinicians and augment clinical decision making.
文摘In a competitive digital age where data volumes are increasing with time, the ability to extract meaningful knowledge from high-dimensional data using machine learning (ML) and data mining (DM) techniques and making decisions based on the extracted knowledge is becoming increasingly important in all business domains. Nevertheless, high-dimensional data remains a major challenge for classification algorithms due to its high computational cost and storage requirements. The 2016 Demographic and Health Survey of Ethiopia (EDHS 2016) used as the data source for this study which is publicly available contains several features that may not be relevant to the prediction task. In this paper, we developed a hybrid multidimensional metrics framework for predictive modeling for both model performance evaluation and feature selection to overcome the feature selection challenges and select the best model among the available models in DM and ML. The proposed hybrid metrics were used to measure the efficiency of the predictive models. Experimental results show that the decision tree algorithm is the most efficient model. The higher score of HMM (m, r) = 0.47 illustrates the overall significant model that encompasses almost all the user’s requirements, unlike the classical metrics that use a criterion to select the most appropriate model. On the other hand, the ANNs were found to be the most computationally intensive for our prediction task. Moreover, the type of data and the class size of the dataset (unbalanced data) have a significant impact on the efficiency of the model, especially on the computational cost, and the interpretability of the parameters of the model would be hampered. And the efficiency of the predictive model could be improved with other feature selection algorithms (especially hybrid metrics) considering the experts of the knowledge domain, as the understanding of the business domain has a significant impact.
文摘Laser surface hardening is a very promising hardening process for ferrous alloys where transformations occur during cooling after laser heating in the solid state. The characteristics of the hardened surface depend on the physicochemical properties of the material as well as the heating system parameters. To exploit the benefits presented by the laser hardening process, it is necessary to develop an integrated strategy to control the process parameters in order to produce desired hardened surface attributes without being forced to use the traditional and fastidious trial and error procedures. This study presents a comprehensive modelling approach for predicting the hardened surface physical and geometrical attributes. The laser surface transformation hardening of cylindrical AISI 4340 steel workpieces is modeled using the conventional regression equation method as well as artificial neural network method. The process parameters included in the study are laser power, beam scanning speed, and the workpiece rotational speed. The upper and the lower limits for each parameter are chosen considering the start of the transformation hardening and the maximum hardened zone without surface melting. The resulting models are able to predict the depths representing the maximum hardness zone, the hardness drop zone, and the overheated zone without martensite transformation. Because of its ability to model highly nonlinear problems, the ANN based model presents the best modelling results and can predict the hardness profile with good accuracy.
基金supported in part by the Key Research and Development Program for Guangdong Province(No.2019B010136001)in part by Hainan Major Science and Technology Projects(No.ZDKJ2019010)+3 种基金in part by the National Key Research and Development Program of China(No.2016YFB0800803 and No.2018YFB1004005)in part by National Natural Science Foundation of China(No.81960565,No.81260139,No.81060073,No.81560275,No.61562021,No.30560161 and No.61872110)in part by Hainan Special Projects of Social Development(No.ZDYF2018103 and No.2015SF 39)in part by Hainan Association for Academic Excellence Youth Science and Technology Innovation Program(No.201515)
文摘Objective:To determine the most influential data features and to develop machine learning approaches that best predict hospital readmissions among patients with diabetes.Methods:In this retrospective cohort study,we surveyed patient statistics and performed feature analysis to identify the most influential data features associated with readmissions.Classification of all-cause,30-day readmission outcomes were modeled using logistic regression,artificial neural network,and Easy Ensemble.F1 statistic,sensitivity,and positive predictive value were used to evaluate the model performance.Results:We identified 14 most influential data features(4 numeric features and 10 categorical features)and evaluated 3 machine learning models with numerous sampling methods(oversampling,undersampling,and hybrid techniques).The deep learning model offered no improvement over traditional models(logistic regression and Easy Ensemble)for predicting readmission,whereas the other two algorithms led to much smaller differences between the training and testing datasets.Conclusions:Machine learning approaches to record electronic health data offer a promising method for improving readmission prediction in patients with diabetes.But more work is needed to construct datasets with more clinical variables beyond the standard risk factors and to fine-tune and optimize machine learning models.
基金Supported by the National Natural Science Foundation of China(50975141)the Aviation Science Fund(20091652018,2010352005)the National Science and Technology Major Project of the Ministry of Science and Technology of China(2012ZX04003031-4)
文摘To optimize cutting control parameters and provide scientific evidence for controlling cutting forces,cutting force modeling and cutting control parameter optimization are researched with one tool adopted to orbital drill holes in aluminum alloy 6061.Firstly,four cutting control parameters(tool rotation speed,tool revolution speed,axial feeding pitch and tool revolution radius)and affecting cutting forces are identified after orbital drilling kinematics analysis.Secondly,hybrid level orthogonal experiment method is utilized in modeling experiment.By nonlinear regression analysis,two quadratic prediction models for axial and radial forces are established,where the above four control parameters are used as input variables.Then,model accuracy and cutting control parameters are analyzed.Upon axial and radial forces models,two optimal combinations of cutting control parameters are obtained for processing a13mm hole,corresponding to the minimum axial force and the radial force respectively.Finally,each optimal combination is applied in verification experiment.The verification experiment results of cutting force are in good agreement with prediction model,which confirms accracy of the research method in practical production.
基金Supported by"Academic Backbone"Project of Northeast Agricultural University(15XG26)the National High-level Talents Special Support Program of China
文摘Predictive microbiology was utilized to model Staphylococcus aureus （S. aureus） growth and staphylococcal enterotoxin A （SEA） production in milk in this study. The modifed logistic model, modifed Gompertz model and Baranyi model were applied to model growth data of S. aureus between 15℃ and 37℃. Model comparisons indicated that Baranyi model described the growth data more accurately than two others with a mean square error of 0.0129. Growth rates generated from Baranyi model matched the observed ones with a bias factor of 0.999 and an accuracy factor of 1.01, and ft a square root model with respect to temperature; other two modifed models both overestimated the observed ones. SEA amount began to be detected when the cell number reached106.4 cfu ？ mL-1, and showed the linear correlation with time. Besides, the rate of SEA production ftted an exponential relationship as a function of temperature. Predictions based on the study could be applied to indicate possible growth of S. aureus and prevent the occurrence of staphylococcal food poisoning.
基金Knowledge Innovation Project of CAS No.KZCX1-10-04
文摘Sources of uncertainty or error that arise in attempting to scale up the results of laboratory-scale sediment transport studies for predictive modeling of geomorphic systems include: (i) model imperfection, (ii) omission of important processes, (iii) lack of knowledge of initial conditions, (iv) sensitivity to initial conditions, (v) unresolved heterogeneity, (vi) occurrence of external forcing, and (vii) inapplicability of the factor of safety concept. Sources of uncertainty that are unimportant or that can be controlled at small scales and over short time scales become important in large-scale applications and over long time scales. Control and repeatability, hallmarks of laboratory-scale experiments, are usually lacking at the large scales characteristic of geomorphology. Heterogeneity is an important concomitant of size, and tends to make large systems unique. Uniqueness implies that prediction cannot be based upon first-principles quantitative modeling alone, but must be a function of system history as well. Periodic data collection, feedback, and model updating are essential where site-specific prediction is required.
文摘Oil wells on the North Slope of Alaska pass through deep deposits of permafrost. The heat transferred during their operation causes localized thawing, resulting in ground subsidence adjacent to the well casings. This subsidence has a damaging effect, causing the casings to compress, deform, and potentially fail. This paper presents the results of a laboratory study of the thaw consolidation strain of deep permafrost and its predictive modeling. Tests were performed to determine strains due to thaw and post-thaw loading, as well as soil index properties. Results, together with data from an earlier testing program, were used to produce empirical models for predicting strains and ground subsidence. Four distinct strain cases were analyzed with three models by multiple regression analyses, and the best-fitting model was selected for each case. Models were further compared in a ground subsidence prediction using a shared subsurface profile. Laboratory results indicate that strains due to thaw and post-thaw testing in deep core permafrost are insensitive to depth and are more strongly influenced by stress redistributions and the presence of ice lenses and inclusions. Modeling results show that the most statistically valid and useful models were those constructed using moisture content, porosity, and degree of saturation. The applicability of these models was validated by comparison with results from Finite Element modeling.
文摘Background:Accurate nestling age is valuable for studies on nesting strategies,productivity,and impacts on repro-ductive success.Most aging guides consist of descriptions and photographs that are time consuming to read and subjective to interpret.The Western Bluebird(Sialia mexicana)is a secondary cavity-nesting passerine that nests in coniferous and open deciduous forests.Nest box programs for cavity-nesting species have provided suitable nesting locations and opportunities for data collection on nestling growth and development.Methods:We developed models for predicting the age of Western Bluebird nestlings from morphometric meas-urements using model training and validation.These were developed for mass,tarsus,and two different culmen measurements.Results:Our models were accurate to within less than a day,and each model worked best for a specific age range.The mass and tarsus models can be used to estimate the ages of Western Bluebird nestlings 0-10 days old and were accurate to within 0.5 days for mass and 0.7 days for tarsus.The culmen models can be used to estimate ages of nest-lings 0-15 days old and were also accurate to within less than a day.The daily mean,minimum,and maximum values of each morphometric measurement are provided and can be used in the field for accurate nestling age estimations in real time.Conclusions:The model training and validation procedures used here demonstrate that this method can create aging models that are highly accurate.The methods can be applied to any passerine species provided sufficient nest-ling morphometric data are available.
基金funded by the Natural Science Foundation of China(Grant No.52090084)was partially supported by the Sand Hazards and Opportunities for Resilience,Energy,and Sustainability(SHORES)Center,funded by Tamkeen under the NYUAD Research Institute Award CG013.
文摘This study focuses on empirical modeling of the strength characteristics of urban soils contaminated with heavy metals using machine learning tools and their subsequent stabilization with ordinary Portland cement(OPC).For dataset collection,an extensive experimental program was designed to estimate the unconfined compressive strength(Qu)of heavy metal-contaminated soils collected from awide range of land use pattern,i.e.residential,industrial and roadside soils.Accordingly,a robust comparison of predictive performances of four data-driven models including extreme learning machines(ELMs),gene expression programming(GEP),random forests(RFs),and multiple linear regression(MLR)has been presented.For completeness,a comprehensive experimental database has been established and partitioned into 80%for training and 20%for testing the developed models.Inputs included varying levels of heavy metals like Cd,Cu,Cr,Pb and Zn,along with OPC.The results revealed that the GEP model outperformed its counterparts:explaining approximately 96%of the variability in both training(R2=0.964)and testing phases(R^(2)=0.961),and thus achieving the lowest RMSE and MAE values.ELM performed commendably but was slightly less accurate than GEP whereas MLR had the lowest performance metrics.GEP also provided the benefit of traceable mathematical equation,enhancing its applicability not just as a predictive but also as an explanatory tool.Despite its insights,the study is limited by its focus on a specific set of heavy metals and urban soil samples of a particular region,which may affect the generalizability of the findings to different contamination profiles or environmental conditions.The study recommends GEP for predicting Qu in heavy metal-contaminated soils,and suggests further research to adapt these models to different environmental conditions.
基金Project supported by the National Natural Science Foundation of China(Nos.62273245 and 62173033)the Sichuan Science and Technology Program of China(No.2024NSFSC1486)the Opening Project of Robotic Satellite Key Laboratory of Sichuan Province of China。
文摘A distributionally robust model predictive control(DRMPC)scheme is proposed based on neural network(NN)modeling to achieve the trajectory tracking control of robot manipulators with state and control torque constraints.First,an NN is used to fit the motion data of robot manipulators for data-driven dynamic modeling,converting it into a linear prediction model through gradients.Then,by statistically analyzing the stochastic characteristics of the NN modeling errors,a distributionally robust model predictive controller is designed based on the chance constraints,and the optimization problem is transformed into a tractable quadratic programming(QP)problem under the distributionally robust optimization(DRO)framework.The recursive feasibility and convergence of the proposed algorithm are proven.Finally,the effectiveness of the proposed algorithm is verified through numerical simulation.
文摘Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.
文摘BACKGROUND An increasing number of studies to date have found preoperative magnetic resonance imaging(MRI)features valuable in predicting the prognosis of rectal cancer(RC).However,research is still lacking on the correlation between preoperative MRI features and the risk of recurrence after radical resection of RC,urgently necessitating further in-depth exploration.AIM To investigate the correlation between preoperative MRI parameters and the risk of recurrence after radical resection of RC to provide an effective tool for predicting postoperative recurrence.METHODS The data of 90 patients who were diagnosed with RC by surgical pathology and underwent radical surgical resection at the Second Affiliated Hospital of Bengbu Medical University between May 2020 and December 2023 were collected through retrospective analysis.General demographic data,MRI data,and tumor markers levels were collected.According to the reviewed data of patients six months after surgery,the clinicians comprehensively assessed the recurrence risk and divided the patients into high recurrence risk(37 cases)and low recurrence risk(53 cases)groups.Independent sample t-test andχ2 test were used to analyze differences between the two groups.A logistic regression model was used to explore the risk factors of the high recurrence risk group,and a clinical prediction model was constructed.The clinical prediction model is presented in the form of a nomogram.The receiver operating characteristic curve,Hosmer-Lemeshow goodness of fit test,calibration curve,and decision curve analysis were used to evaluate the efficacy of the clinical prediction model.RESULTS The detection of positive extramural vascular invasion through preoperative MRI[odds ratio(OR)=4.29,P=0.045],along with elevated carcinoembryonic antigen(OR=1.08,P=0.041),carbohydrate antigen 125(OR=1.19,P=0.034),and carbohydrate antigen 199(OR=1.27,P<0.001)levels,are independent risk factors for increased postoperative recurrence risk in patients with RC.Furthermore,there was a correlation between magnetic resonance based T staging,magnetic resonance based N staging,and circumferential resection margin results determined by MRI and the postoperative recurrence risk.Additionally,when extramural vascular invasion was integrated with tumor markers,the resulting clinical prediction model more effectively identified patients at high risk for postoperative recurrence,thereby providing robust support for clinical decision-making.CONCLUSION The results of this study indicate that preoperative MRI detection is of great importance for predicting the risk of postoperative recurrence in patients with RC.Monitoring these markers helps clinicians identify patients at high risk,allowing for more aggressive treatment and monitoring strategies to improve patient outcomes.
文摘BACKGROUND Colorectal polyps are precancerous diseases of colorectal cancer.Early detection and resection of colorectal polyps can effectively reduce the mortality of colorectal cancer.Endoscopic mucosal resection(EMR)is a common polypectomy proce-dure in clinical practice,but it has a high postoperative recurrence rate.Currently,there is no predictive model for the recurrence of colorectal polyps after EMR.AIM To construct and validate a machine learning(ML)model for predicting the risk of colorectal polyp recurrence one year after EMR.METHODS This study retrospectively collected data from 1694 patients at three medical centers in Xuzhou.Additionally,a total of 166 patients were collected to form a prospective validation set.Feature variable screening was conducted using uni-variate and multivariate logistic regression analyses,and five ML algorithms were used to construct the predictive models.The optimal models were evaluated based on different performance metrics.Decision curve analysis(DCA)and SHapley Additive exPlanation(SHAP)analysis were performed to assess clinical applicability and predictor importance.RESULTS Multivariate logistic regression analysis identified 8 independent risk factors for colorectal polyp recurrence one year after EMR(P<0.05).Among the models,eXtreme Gradient Boosting(XGBoost)demonstrated the highest area under the curve(AUC)in the training set,internal validation set,and prospective validation set,with AUCs of 0.909(95%CI:0.89-0.92),0.921(95%CI:0.90-0.94),and 0.963(95%CI:0.94-0.99),respectively.DCA indicated favorable clinical utility for the XGBoost model.SHAP analysis identified smoking history,family history,and age as the top three most important predictors in the model.CONCLUSION The XGBoost model has the best predictive performance and can assist clinicians in providing individualized colonoscopy follow-up recommendations.
基金Supported by National Natural Science Foundation of China,No.81972947Academic Promotion Programme of Shandong First Medical University,No.2019LJ005.
文摘BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.METHODS We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021.A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors.Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions.The Cox model was further employed to evaluate the impact of risk factors on DF.The area under the curve(AUC)was measured to evaluate the accuracy of the prediction model.RESULTS Seventy-five diabetic inpatients experienced DF.The incidence density of DF was 4.5/1000 person-years.A long duration of diabetes,lower extremity arterial disease,lower serum albumin,fasting plasma glucose(FPG),and diabetic nephropathy were independently associated with DF.Among these risk factors,the serum albumin concentration was inversely associated with DF,with a hazard ratio(HR)and 95%confidence interval(CI)of 0.91(0.88-0.95)(P<0.001).Additionally,a U-shaped nonlinear relationship was observed between the FPG level and DF.After adjusting for other variables,the HRs and 95%CI for FPG<4.4 mmol/L and≥7.0 mmol/L were 3.99(1.55-10.25)(P=0.004)and 3.12(1.66-5.87)(P<0.001),respectively,which was greater than the mid-range level(4.4-6.9 mmol/L).The AUC for predicting DF over 3 years was 0.797.CONCLUSION FPG demonstrated a U-shaped relationship with DF.Serum albumin levels were negatively associated with DF.The prediction nomogram model of DF showed good discrimination ability using diabetes duration,lower extremity arterial disease,serum albumin,FPG,and diabetic nephropathy(Clinicaltrial.gov NCT05519163).
基金Supported by the Henan Provincial Health Commission,No.232102310145.
文摘BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.
