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The decision-making process for senior cancer patients: treatment allocation of older women with operable breast cancer in the UK

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Cancer Biology & Medicine 2015年第4期12卷 308-315页

作者： jenna l.morgan Paul Richards Osama Zaman Sue Ward Karen Collins Thompson Robinson Kwok-leung Cheung Riccardo A.Audisio Malcolm W.Reed lynda Wyld on behalf of the Bridging the Age Gap in Breast Cancer Trial Management Team Academic Unit of Surgical Oncology University of Sheffield Medical School Health Economics and Decision Science School for Health and Related Research University of Sheffield Center for Health and Social Care Research Sheffield Hallam University Collegiate Crescent Department of Cardiovascular Sciences University of Leicester School of Medicine University of Nottingham Royal Derby Hospital Center Department of Surgery University of Liverpool St Helens Teaching Hospital Brighton and Sussex Medical School University of Sussex

Objective: Up to 40% of women over 70 years with primary operable breast cancer in the UK are treated with primary endocrine therapy(PET) as an alternative to surgery. A variety of factors are important in determining treatment for older breast cancer patients. This study aimed to identify the patient and tumor factors associated with treatment allocation in this ***: Prospectively collected data on treatment received(surgery vs. PET) were analysed with multivariable logistic regression using the variables age, modified Charlson Comorbidity Index(CCI), activities of daily living(ADl) score, Mini-Mental State Examination(MMSE) score, HER2 status, tumour size, grade and nodal status. Results: Data were available for 1,122 cancers in 1,098 patients recruited between February 2013 and June 2015 from 51 UK hospitals. About 78% of the population were treated surgically, with the remainder being treated with PET. Increasing patient age at diagnosis, increasing CCI score, large tumor size(5 cm or more) and dependence in one or more ADl categories were all strongly associated with non-surgical treatment(Plusion: Increasing comorbidity, large tumor size and reduced functional ability are associated with reduced likelihood of surgical treatment of breast cancer in older patients. However, age itself remains a significant factor for non-surgical treatment; reinforcing the need for evidence-based guidelines.

关键词： Frail elderly breast neoplasms decision-making

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Automated Machine learning Algorithm Using Recurrent Neural Network to Perform long-Term Time Series Forecasting

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Computers, Materials & Continua 2024年第3期78卷 3529-3549页

作者： Ying Su morgan C.Wang Shuai liu Department of Statistics and Data Science University of Central FloridaOrlandoFL32816-2370USA School of Mathematics and Statistics Beijing Technology and Business UniversityBeijing100048China

long-term time series forecasting stands as a crucial research domain within the realm of automated machine learning(AutoMl).At present,forecasting,whether rooted in machine learning or statistical learning,typically relies on expert input and necessitates substantial manual *** manual effort spans model development,feature engineering,hyper-parameter tuning,and the intricate construction of time series *** complexity of these tasks renders complete automation unfeasible,as they inherently demand human intervention at multiple *** surmount these challenges,this article proposes leveraging long Short-Term Memory,which is the variant of Recurrent Neural Networks,harnessing memory cells and gating mechanisms to facilitate long-term time series ***,forecasting accuracy by particular neural network and traditional models can degrade significantly,when addressing long-term time-series ***,our research demonstrates that this innovative approach outperforms the traditional Autoregressive Integrated Moving Average(ARIMA)method in forecasting long-term univariate time *** is a high-quality and competitive model in time series prediction,and yet it requires significant preprocessing *** multiple accuracy metrics,we have evaluated both ARIMA and proposed method on the simulated time-series data and real data in both short and long ***,our findings indicate its superiority over alternative network architectures,including Fully Connected Neural Networks,Convolutional Neural Networks,and Nonpooling Convolutional Neural *** AutoMl approach enables non-professional to attain highly accurate and effective time series forecasting,and can be widely applied to various domains,particularly in business and finance.

关键词： Automated machine learning autoregressive integrated moving average neural networks time series analysis

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Prognosis of operated hepatocellular carcinoma developed on non-cirrhotic liver

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 736-738页

作者： morgan Vandermeulen Maxime Dewulf Olivier Detry Department of Visceral Surgery and Transplantation CHU LiegeLiegeBelgium Centre de Recherche et d’Enseignement du Département de Chirurgie(CREDEC) GIGA MetabolismUniversity of LiegeLiegeBelgium Department of Surgery Maastricht University Medical Center(MUMC+)MaastrichtThe Netherlands

The incidence of primary liver cancers,and particularly hepatocellular carcinoma(HCC),is increasing throughout the *** vast majority of HCCs develop on cirrhotic livers(Cls)(Cl HCC)or livers chronically infected by hepatotropic viruses,mainly hepatitis B virus(HBV)and hepatitis C virus(HCV)(1).As HCC occurring on non-HBV non-HCV non-Cl(NCl)HCC occurs much less frequently,its management is less established than for Cl ***,many clinicians might confuse the prognosis and management of NCl HCC with the one of Cl *** is however demonstrated that NCl HCCs behave differently than Cl *** prognostic factors and sensibility to systemic therapy are different,added to the fact that NCls can undergo major resections allowing curative surgical management or even systemic therapies that are not even possible in Cl HCCs due to the failing function of the *** established criteria for liver transplantation of Cl HCCs,including the famous Milan criteria,have no role in NCl HCC management(2-4).The Barcelona Clinic liver Cancer(BClC)strategy for prognosis prediction and treatment recommendation also concerns only Cl HCCs;and should not be used for NCl HCCs(5).

关键词： Cancer surgery transplantation recurrence

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Assessing bioactivity of environmental water samples filtered using nanomembrane technology and mammalian cell lines

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Eco-Environment & Health 2024年第3期3卷 347-354页

作者： Sarah E.morgan lisa A.Delouise Department of Environmental Medicine University of Rochester Medical CenterRochesterNY 14642USA Department of Biomedical Engineering University of RochesterRochesterNY 14627USA Department of Dermatology University of Rochester Medical CenterRochesterNY 14642USA lake Ontario Center for Microplastics and Human Health in a Changing Environment University of Rochester Medical CenterRochesterNY 14642USA

This project reports on the use of a novel nanomembrane filtering technology to isolate and analyze the bioactivity of microplastic(MP)-containing debris from lake Ontario water *** MPs are a complex mixture of polymers and sorbed chemicals that are persistent and can exhibit a wide range of toxic *** human exposure to MPs is unavoidable,it is necessary to characterize their bioactivity to assess potential health *** work seeks to quantify MP presence in the nearshore waters of lake Ontario and begin to characterize the bioactivity of the filtrate containing *** utilized silicon nitride(SiN)nanomembrane technology to isolate debris sized between 8 and 20μm from lake water samples collected at various times and *** were identified with Nile red ***-based assays were conducted directly on the filtered debris to test for cell viability,aryl hydrocarbon receptor(AhR)activity,and interleukin 6(Il-6)levels as a measure of proinflammatory *** samples contained *** of the isolated debris impacted cell ***,AhR activity and Il-6 levels varied over ***,no associations were observed between the amount of plastic and *** differences in activity are likely due to variations in the physiochemical properties of debris between *** results highlight the need for increased sampling to fully characterize the bioactivity of MPs in human cells and to elucidate the role that sample physiochemical and spatiotemporal properties play in this activity.

关键词： Microplastics SiN nanomembranes lake Ontario Aryl hydrocarbon receptor(AhR)activity Il-6 levels Bioactivity

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Assessing the Impact of Catastrophic Electricity loss on the Food Supply Chain

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INTERNATIONAl JOURNAl OF DISASTER RISK SCIENCE 2024年第4期15卷 481-493页

作者： Blouin, Simon Herwix, Alexander Rivers, morgan Tieman, Ross J. Denkenberger, David C. Alliance Feed Earth Disasters AllFED Lafayette CO 80026 USA Univ Canterbury Dept Mech Engn Christchurch 8041 New Zealand Univ Cologne Cologne Inst Informat Syst D-50969 Cologne Germany

The food supply chain's heavy reliance on electricity poses significant vulnerabilities in the event of prolonged and widespread power disruptions. This study introduces a system-dynamics model that integrates five critical infrastructures-electric grid, liquid fossil fuels, Internet, transportation, and human workforce-to evaluate the resilience of food supply chains to major power outages. We validated the model using the 2019 Venezuelan blackouts as a case study, demonstrating its predictive validity. We then explored how more extreme electricity losses would disrupt the supply chain. More specifically, we modeled the impact of a large-scale cyberattack on the US electric grid and a high-altitude electromagnetic pulse (HEMP) event. A cyberattack severely damaging the US electric grid and allowing for recovery within a few weeks or months would lead to substantial drops in food consumption. However, it would likely still be possible to provide adequate calories to everyone, assuming that food is equitably distributed. In contrast, a year-long recovery from a HEMP event affecting most of the continental United States could precipitate a state of famine. Our analysis represents a first attempt at quantifying how food availability progressively worsens as power outages extend over time. Our open-source model is made publicly available, and we encourage its application to other catastrophic scenarios beyond those specifically considered in this work (for example, extreme solar storms, high-lethality pandemics).

关键词： Cyberattack Electricity Food supply chains Global catastrophic risk High-altitude electromagnetic pulse System dynamics

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The earliest evidence for a microblade adaptation in the remote,high altitude regions of the Tibetan Plateau

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Science China Earth Sciences 2024年第5期67卷 1561-1573页

作者： Yingshuai JIN Xiaoling ZHANG Shejiang WANG Junyi GE Wei HE Wa DA Yunyao TAN Ziyi YANG Christopher morgan Xing GAO Institute of Vertebrate Paleontology and Paleoanthropology Chinese Academy of SciencesBeijing 100044China University of the Chinese Academy of Sciences Beijing 100049China Cultural Relics Conservation Institute of the Xizang Autonomous Region Lhasa 850000China Nagqu Culture and Tourism Bureau Nagqu 852000China University of Nevada Reno 89557USA

Microblade assemblages are among the most common prehistoric archaeological materials found on the Tibetan Plateau(TP)and are thought to indicate large scale migration to and settlement of the *** microblade sites,however,have been systematically excavated,especially in the remotest,highest-elevation regions of the *** timing of the large-scale arrival,spread,and permanent settlement of people on the TP therefore remains *** this paper,we report on a recently excavated site,locality 3 of the Nwya Devu Site(ND3),located at 4600 meters above sea level(masl),near the shore of Ngoin lake,on the interior *** analyses reveal a fairly typical microblade technological orientation and two types of microblade cores:wedge-shaped and semi-conical,which are similar to those found throughout North *** Optically Stimulated luminescence(OSl)dating and AMS^(14)C dating,the age of ND3 ranges from 11 to 10 *** date range indicates ND3 is the oldest microblade site yet recorded in the remote,high-elevation regions of the TP and thus provides important information about when and how hunter-gatherers using microblades began exploiting the higher altitudes of the *** together,studies at ND3 and throughout the TP suggest that a microblade adaptation is associated with the first prolonged human occupation of the plateau and that microblades played a significant role in mediating the risks and facilitating the mobility necessary to permanently inhabit the TP.

关键词： The interior of Tibetan Plateau Nwya Devu locality 3 Microblade Early Holocene High altitude adaption

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Modelling land Use/land Cover Change of River Rwizi Catchment, South-Western Uganda Using GIS and Markov Chain Model

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Journal of Water Resource and Protection 2024年第2期16卷 181-206页

作者： lauben Muhangane morgan Andama Faculty of Agriculture Uganda Martyrs University Nkozi Uganda Faculty of Science Muni University Arua Uganda

Analysis of catchment land use/land cover (lUlC) change is a vital tool in ensuring sustainable catchment management. The study analyzed land use/land cover changes in the Rwizi catchment, south western Uganda from 1989-2019 and projected the trend by 2040. landsat images, field observations, key informant interviews and focus group discussions were used to collect data. Changes in cropland, forestland, built up area, grazing land, wetland and open water bodies were analyzed in ArcGIS version 10.2.2 and ERDAS IMAGINE 14 software and a Markov chain model. All the lUlC classes increased in area except grazing land. Forest land and builtup area between 2009-2019 increased by 370.03% and 229.53% respectively. Projections revealed an increase in forest land and builtup area by 2030 and only built up area by 2040. lUlCC in the catchment results from population pressure, reduced soil fertility and high value of agricultural products.

关键词： land Cover River Catchment Geographic Information System Markov Model Sustainable land Management

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Impact on Soil Organic C and Total Soil N from Cool- and Warm-Season legumes Used in a Green Manure-Forage Cropping System

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Agricultural Sciences 2024年第3期15卷 333-357页

作者： Clark B. Neely Francis M. Rouquette Jr. Cristine l.S. morgan Frank M. Hons William l. Rooney Gerald R. Smith Department of Soil and Crop Science Washington State University Pullman WA USA Texas A&M Agrilife Research Overton TX USA Chief Scientific Officer Soil Health Institute Morrisville NC USA Department of Soil and Crop Science Texas A&M University College Station TX USA

Annual forage legumes are important components of livestock production systems in East Texas and the southeastern US. Forage legumes contribute nitrogen (N) to cropping systems through biological N fixation, and their seasonal biomass production can be managed to complement forage grasses. Our research objectives were to evaluate both warm- and cool-season annual forage legumes as green manure for biomass, N content, ability to enhance soil organic carbon (SOC) and soil N, and impact on post season forage grass crops. Nine warm-season forage legumes (WSl) were spring planted and incorporated as green manure in the fall. Forage rye (Secale cereale l.) was planted following the incorporation of WSl treatments. Eight cool-season forage legumes (CSl) were fall planted in previously fallow plots and incorporated as green manure in late spring. Sorghum-sudangrass (Sorghum bicolor x Sorghum bicolor var. sudanense) was planted over all treatments in early summer after forage rye harvest and incorporation of CSl treatments. Sorghum-sudangrass was harvested in June, August and September, and treatments were evaluated for dry matter and N concentration. Soil cores were taken from each plot, split into depths of 0 to 15, 15 to 30 and 30 to 60 cm, and soil C and N were measured using combustion analysis. Nylon mesh bags containing plant samples were buried at 15 cm and used to evaluate decomposition rate of above ground legume biomass, including change in C and N concentrations. Mungbean (Vigna radiata l. [Wilczek]) had the highest shoot biomass yield (6.24 t DM ha-1) and contributed the most total N (167 kg∙ha-1) and total C (3043 kg∙ha-1) of the WSl tested. Decomposition rate of WSl biomass was rapid in the first 10 weeks and very slow afterward. Winter pea (Pisum sativum l. spp. sativum), arrow leaf clover (Trifolium vesiculosum Savi.), and crimson clover (Trifolium incarnatum l.) were the most productive CSl in this trial. Austrian winter pea

关键词： Annual legumes Soil N Soil Organic C Green Manure Deer Browse Forage Cropping Systems

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Hepatic angiotensin-converting enzyme 2 expression in metabolic dysfunction-associated steatotic liver disease and in patients with fatal COVID-19

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World Journal of Gastroenterology 2024年第31期30卷 3705-3716页

作者： Angus K Jacobs Steven D Morley Kay Samuel Katie morgan lyndsey Boswell Timothy J Kendall David A Dorward Jonathan A Fallowfield Peter C Hayes John N Plevris Hepatology laboratory University of EdinburghEdinburgh EH164SBUnited Kingdom Scottish National Blood Transfusion Service Jack Copland CentreEdinburgh EH144BEUnited Kingdom Institute for Regeneration and Repair University of EdinburghEdinburgh EH164UUUnited Kingdom Edinburgh Pathology University of EdinburghEdinburgh EH164SBUnited Kingdom

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASlD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and *** injury(lI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASlD increases the risk of lI and the development of COVID-19-associated *** of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell *** To determine if hepatic ACE2 levels are altered during progression of MASlD and in patients who died with severe *** ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASlD were determined in formalin-fixed liver tissue sections across the MASlD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel *** ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct ***,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in ***2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASlD *** A

关键词： Metabolic dysfunction-associated steatotic liver disease Angiotensin-converting enzyme 2 Immunohistochemistry COVID-19 COVID-19-associated cholangiopathy

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Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children:results from the French pediatric national registry

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World Journal of Pediatrics 2024年第6期20卷 611-620页

作者： Marguerite lockhart-Bouron Noemie Vanel Michael levy Anais R.Briant Etienne Javouhey Sophie Breinig Julia Dina Marion Caseris Francois Angoulvant Stephane leteurtre morgan Recher David W.Brossier Univ.lille CHU LilleULR 2694-METRICS:Evaluation Des Technologies de Sante Et Des Pratiques Medicales59000LilleFrance Pediatric Intensive Care Unit CHU de MarseilleMarseilleFrance Pediatric Intensive Care Unit CHU Robert-DebreAssistance Publique Hopitaux de ParisParisFrance UniversitéParis-Cite ParisFrance Biostatistics and Clinical Research Unit CHU de Caen Normandie14000CaenFrance Pediatric Intensive Care Hospices Civils de LyonLyonFrance Neonatal andPediatric IntensiveCare Unit Children's HospitalToulouseFrance Virology Department INSERM U1311 DynamicureUniv CAEN NormandieCHU de Caen14000 CaenFrance Medical School Universite Caen Normandie14000 CaenFrance Department of Pediatrics CHU Robert-DebréAssistance Publique Hopitaux de ParisParisFrance Department Women-Mother-Child Service of PediatricsLausanne University Hospital(CHUV)LausanneSwitzerland Pediatric Intensive Care Unit Réanimation Et Soins Intensifs PéediatriquesCHU de CAENAvenue de La Cote de Nacre14000 CaenFrance CHU Sainte Justine Research Center MontréalCanada

Background Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is responsible for an important mortality rate *** aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit(PICU).Secondary objectives were to identify risk factors for *** This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions(PCRs)[acute corona virus disease 2019(COVID-19)or incidental SARS-CoV-2 infection]and/or pediatric inflammatory multisystem syndrome(PIMS)recorded in the French PICU registry(PICURe)between September 1,2021,and August 31,*** patients were classified and compared according to their living status at the end of their PICU *** patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive *** imputability of SARS-CoV-2 as the cause of death was classified into four categories:certain,very probable,possible,or unlikely,and was defined by any of the first three *** There were 948 patients included of which 43 died(4.5%).From this,26 deaths(67%)could be attributed to SARS-CoV-2 infection,with an overall mortality rate of 2.8%.The imputability of death to SARS-CoV-2 was considered certain in only one case(O.1%).Deceased patients suffered more often from comorbidities,especially heart disease,neurological disorders,hematological disease,cancer,and *** of the deceased patients were admitted for pediatric inflam-matory multisystem syndrome(PIMS).Mortality risk factors were male gender,cardiac comorbidities,cancer,and acute respiratorydistress *** SARS-CoV-2 mortality in the French pediatric population was *** though the imputability of SARS-Cov-2 on mortality was considered in almost two-thirds of cases,this imputability was considered certain in only one case.

关键词： Death Pediatric intensive care unit SARS-CoV-2

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