Development and Internal Validation of a Novel Nomogram for Predicting Lymph Node Invasion for Prostate Cancer Patients Undergoing Extended Pelvic Lymph Node Dissection

BACKGROUND: Few studies have focused on the performance of Briganti 2012, Briganti 2017 and MSKCC nomograms in the Chinese population in assessing the risk of lymph node invasion(LNI) in prostate cancer(PCa) patients and identifying patients suitable for extended pelvic lymph node dissection(ePLND). We aimed to develop and validate a novel nomogram based on Chinese PCa patients treated with radical prostatectomy(RP) and ePLND for predicting LNI. METHODS: We retrospectively retrieved clinical data of 631 patients with localized PCa receiving RP and ePLND at a Chinese single tertiary referral center. All patients had detailed biopsy information from experienced uropathologist. Multivariate logistic-regression analyses were performed to identify independent factors associated with LNI. The discrimination accuracy and net-benefit of models were quantified using the area under curve(AUC) and Decision curve analysis(DCA).The nonparametric bootstrapping were used to internal validation. RESULTS: A total of 194(30.7%) patients had LNI. The median number of removed lymph nodes was 13(range, 11-18). In univariable analysis, preoperative prostate-specific antigen(PSA), clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa, percentage of positive cores, percentage of positive cores with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy differed significantly. The multivariable model that included preoperative PSA, clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy represented the basis for the novel nomogram. Based on a 12% cutoff, our results showed that 189(30%) patients could have avoided ePLND while only 9(4.8%) had LNI missing ePLND. Our proposed model achieved the highest AUC (proposed model vs Briganti 2012 vs Briganti 2017 vs MSKCC model: 0.83 vs 0.8 vs 0.8 vs 0.8, respectively) and highest net-benefit CONCLUSION: We developed and validated a nomogram predicting the risk of LNI based on Chinese PCa patients, which demonstrated superior performance compared with previous nomograms

The role of LDH and ferritin levels as biomarkers for corticosteroid dosage in children with refractory Mycoplasma pneumoniae pneumonia

Abstract Background This study explored the relationship between inflammatory markers and glucocorticoid dosage upon admission. Methods We conducted a retrospective analysis of 206 patients with refractory Mycoplasma pneumoniae pneumonia (RMPP) admitted to a Children’s Hospital from November 2017 to January 2022. Patients were categorized into three groups based on their methylprednisolone dosage: low-dose (≤ 2 mg/kg/d), medium-dose (2–10 mg/kg/d), and high-dose (≥ 10 mg/kg/d). We compared demographic data, clinical manifestations, laboratory findings, and radiological outcomes. Spearman’s rank correlation coefficient was used to assess relationships between variables. Results The median age was highest in the low-dose group at 7 years, compared to 5.5 years in the medium-dose group and 6 years in the high-dose group (P < 0.001). The body mass index (BMI) was also highest in the low-dose group at 16.12, followed by 14.86 in the medium-dose group and 14.58 in the high-dose group (P < 0.001). More severe radiographic findings, longer hospital stays, and greater incidence of hypoxia were noted in the high-dose group (P < 0.05). Additionally, significant increases in white blood cells, C-reactive protein, procalcitonin, lactate dehydrogenase (LDH), alanine transaminase, aspartate transaminase, ferritin, erythrocyte sedimentation rate, and D-dimer levels were observed in the high-dose group (P < 0.05). Specifically, LDH and ferritin were markedly higher in the high-dose group, with levels at 660.5 U/L and 475.05 ng/mL, respectively, compared to 450 U/L and 151.4 ng/mL in the medium-dose group, and 316.5 U/L and 120.5 ng/mL in the low-dose group. Correlation analysis indicated that LDH and ferritin levels were significantly and positively correlated with glucocorticoid dose (Spearman ρ = 0.672 and ρ = 0.654, respectively; P < 0.001). Conclusions Serum LDH and ferritin levels may be useful biomarkers for determining the appropriate corticosteroid dosage in treating children with RMPP

An Integrated Real-Time FMCW Radar Baseband Processor in 40-nm CMOS

In this paper, a pipelined frequency-modulated continuous-wave (FMCW) radar baseband processor applied to real-time applications is proposed and implemented in 40-nm CMOS technology. The FMCW radar signal processing time is analyzed according to the system specifications. On the basis of the theoretical analysis and systematic considerations, a pipelined baseband architecture with internal single-port static random access memory (SRAM) is employed. The baseband processor is mainly composed of two-dimensional fast Fourier transform (2D-FFT), two-dimensional constant false alarm rate (2D-CFAR), digital beam-forming (DBF), and memory control modules. The 2D-FFT module is structured with a pipelined scheme and avoids the waste of data transferring time between modules. The 2D-CFAR module is programmable for different applications. The designed address control is proposed to depose the edge cells. The processor occupies a core chip area of 3.353 mm $\times 3.353$ mm and has been tested on the personal computer (PC) and field programmable gate array (FPGA) platform. The power consumption and processing time are also analyzed and compared with other works. The processor consumes 55.65 mW, including SRAMs. The processing time is 12.67 ms with the maximum window size and 256 targets when operating at 125 MHz. This time is estimated based on the assumption that each chirp lasts for 0.04096 ms, and data input takes 10.48 ms. Within this period, the range FFT is completed. The Doppler FFT, 2D-CFAR with the maximum window size, and DBF with 256 targets require 0.80 ms, 1.16 ms, and 0.23 ms respectively

Coherent and tunable terahertz radiation from graphene surface plasmon polarirons excited by cyclotron electron beam

Terahertz (THz) radiation can revolutionize modern science and technology. To this date, it remains big challenges to develop intense, coherent and tunable THz radiation sources that can cover the whole THz frequency region either by means of only electronics (both vacuum electronics and semiconductor electronics) or of only photonics (lasers, for example, quantum cascade laser). Here we present a mechanism which can overcome these difficulties in THz radiation generation. Due to the natural periodicity of 2π of both the circular cylindrical graphene structure and cyclotron electron beam (CEB), the surface plasmon polaritions (SPPs) dispersion can cross the light line of dielectric, making transformation of SPPs into radiation immediately possible. The dual natural periodicity also brings significant excellences to the excitation and the transformation. The fundamental and hybrid SPPs modes can be excited and transformed into radiation. The excited SPPs propagate along the cyclotron trajectory together with the beam and gain energy from the beam continuously. The radiation density is enhanced over 300 times, up to 105 W/cm2. The radiation frequency can be widely tuned by adjusting the beam energy or chemical potential. This mechanism opens a way for developing desired THz radiation sources to cover the whole THz frequency regime

Study of compact terahertz source with parallel multi-beam

In this paper, a compact terahertz (THz) radiation source with a slow wave structure (SWS) consisting of multi-pin rectangular waveguide based on parallel multiple beams is proposed. The dispersion and coupling impedance of the SWS are studied in detail. For this type of parallel multi-beam, a model of electron gun and hybrid structure of a periodic permanent magnet is designed and optimized by analyzing the electron trajectory. Furthermore, a backward wave oscillator (BWO) with the SWS and multi-beam operating above 320 GHz is simulated by a PIC code. Simulation results show that the THz source can operate with a high power, low voltage, low current, compact size and light weight

Fraction-degree reference dependent stochastic dominance

For addressing the Allis-type anomalies, a fractional degree reference dependent stochastic dominance rule is developed which is a generalization of the integer degree reference dependent stochastic dominance rules. This new rule can effectively explain why the risk comparison does not satisfy translational invariance and scaling invariance in some cases. The rule also has a good property that it is compatible with the endowment effect of risk. This rule can help risk-averse but not absolute risk-averse decision makers to compare risks relative to reference points. We present some tractable equivalent integral conditions for the fractional degree reference dependent stochastic dominance rule, as well as some practical applications for the rule in economics and finance

Cyclotron electron beam excited surface plasmon polaritons coherent radiation

A physical mechanism of electron beam excitation of surface plasmon polaritons (SPPs) on the circular cylindrical structure and transformation into coherent radiation is proposed. Here SPPs on the circular cylindrical structures are excited by a cyclotron electron beam (CEB) rather than by the linearly moving electron beam (LEB). This change leads to an essential consequence due to the natural periodicity of 2π in structure and CEB, and this dual natural periodicity makes the SPPs transformation possible and brings significant excellences. HEM hybrid modes and TM0n modes SPPs can be excited and propagate along a cyclotron trajectory together with the CEB to attract energy from CEB continuously to compensate the energy loss; the phase velocity of SPPs synchronizes the CEB; the process of the excitation and transformation is longer. Therefore, the transformed power density is enhanced and reaches up to 1010W/cm2. The cyclotron frequency of the electron beam is 1THz, but the frequency regime of the SPPs and the radiation are much higher, up to hundreds of terahertz. The mechanism presented in this letter opens the way for developing the desired room temperature, powerful and coherent light radiation sources from the infrared to the ultraviolet frequency regime

Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection

BackgroundFew studies have focused on the performance of Briganti 2012, Briganti 2017 and MSKCC nomograms in the Chinese population in assessing the risk of lymph node invasion(LNI) in prostate cancer(PCa) patients and identifying patients suitable for extended pelvic lymph node dissection(ePLND). We aimed to develop and validate a novel nomogram based on Chinese PCa patients treated with radical prostatectomy(RP) and ePLND for predicting LNI.MethodsWe retrospectively retrieved clinical data of 631 patients with localized PCa receiving RP and ePLND at a Chinese single tertiary referral center. All patients had detailed biopsy information from experienced uropathologist. Multivariate logistic-regression analyses were performed to identify independent factors associated with LNI. The discrimination accuracy and net-benefit of models were quantified using the area under curve(AUC) and Decision curve analysis(DCA).The nonparametric bootstrapping were used to internal validation.ResultsA total of 194(30.7%) patients had LNI. The median number of removed lymph nodes was 13(range, 11-18). In univariable analysis, preoperative prostate-specific antigen(PSA), clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa, percentage of positive cores, percentage of positive cores with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy differed significantly. The multivariable model that included preoperative PSA, clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy represented the basis for the novel nomogram. Based on a 12% cutoff, our results showed that 189(30%) patients could have avoided ePLND while only 9(4.8%) had LNI missing ePLND. Our proposed model achieved the highest AUC (proposed model vs Briganti 2012 vs Briganti 2017 vs MSKCC model: 0.83 vs 0.8 vs 0.8 vs 0.8, respectively) and highest net-benefit via DCA in the Chinese cohort compared with previous nomograms. In internal validation of proposed nomogram, all variables had a percent inclusion greater than 50%.ConclusionWe developed and validated a nomogram predicting the risk of LNI based on Chinese PCa patients, which demonstrated superior performance compared with previous nomograms

Theoretical analysis and spatial–temporal dynamic simulation of radiation from graphene

In this paper, the terahertz (THz) radiation based on the graphene is studied by theoretical analysis and particle-in-cell (PIC) simulation. We present the transition radiation (TR) of the charged particle traversing a monoatomic graphene layer under arbitrary incidence. By theoretical analysis, we find strongly tunable effects of the radiation field distribution related to the electron’s incident angle, substrate permittivity and graphene conductivity. In the case of the normal incidence, the transition radiation exhibits strong symmetry and considerably more intensive than that at oblique incidence. Furthermore, the plasmon and radiation are simulated by a PIC code with the method of equivalent permittivity to deal graphene. With the PIC code, we observe the spatial–temporal dynamics of plasmon and transition radiation from graphene. Meanwhile, the PIC simulation results of radiation are in good agreement with those by theoretical analysis