Bayesian network structure for predicting local tumor recurrence in rectal cancer patients treated with neoadjuvant chemoradiation followed by surgery

Background and Purpose Tumor recurrence, a characteristic of malignant tumors, is the biggest concern for rectal cancer survivors. The epidemiology of the disease calls for a pressing need to improve healthcare quality and patient outcomes. Prediction models such as Bayesian networks, which can probabilistically reason under uncertainty, could assist caregivers with patient management. However, some concerns are associated with the standard approaches to developing these structures in medicine. Therefore, this study aims to compare Bayesian network structures that stem from these two techniques. Materials and Methods A retrospective analysis was performed on 6754 locally advanced rectal cancer (LARC) patients enrolled in 14 international clinical trials. Local tumor recurrence at 2, 3, and 5-years was defined as the endpoints of interest. Five rectal cancer treating physicians from three countries elicited the expert structure. The algorithmic structure was inferred from the data with the hill-climbing algorithm. Structural performance was assessed with calibration plots and area under the curve values. Results The area under the curve for the expert structure on the training and validation data was above 0.9 and 0.8, respectively, for all the time points. However, the algorithmic structure had superior predictive performance over the expert structure for all time points of interest. Conclusion We have developed and internally validated a Bayesian networks structure from experts’ opinions, which can predict the risk of a LARC patient developing a tumor recurrence at 2, 3, and 5 years. Our result shows that the algorithmic-based structures are more performant and less interpretable than expert-based structures

One-step twin-screw extrusion process of cellulose fibers and hydroxyethyl cellulose to produce fibrillated cellulose biocomposite

Abstract In this work, the defibrillation of cellulose fibers (CF) in the presence of hydroxyethyl cellulose (HEC) within the one-step twin-screw extrusion (TSE) process was examined. The effect of the TSE on cellulose fiber size reduction as well as CF-HEC biocomposites properties were investigated. The results showed that the TSE of cellulose fiber-hydroxyethyl cellulose (CF-HEC) with different cellulose fiber contents (50, 65, and 80 wt%) resulted in partial defibrillation of the cellulose fibers. The fractionation test of the cellulose fibers confirmed that their size was reduced and some fibrillation was observed in microscopy studies. The maximum width reduction of 46% occurred with 80 wt% cellulose content. However, the partial width reduction was also observed with 50% and 65 wt% of cellulose contents. Based on rheological measurements, the shear-viscosity trend of CF-HEC dispersion abruptly dropped when higher fiber content (80 wt%) was extruded, which was related to the fibrillation of the cellulose fibers as well as the reduction of the length. The extruded CF-HEC materials (powder form) were compression molded to prepare the biocomposites with different cellulose fiber contents (50, 65, and 80 wt%). The extruded CF-HEC powders were diluted with addition extra HEC to make biocomposites with lower fiber content (20%, 30%, and 40 wt%) and compression molded to study how the size reduction of the cellulose fibers affected the mechanical properties of biocomposites. The results showed that the E-modulus improved from 0.4 GPa of the neat HEC to 1.6 GPa for the composite with 40 wt% CF. Interestingly, the tensile strength of CF-HEC biocomposite with 40 wt% confirmed a clear improvement from 9.8 to 26.6 MPa, confirming good interaction between HEC and CF

Mechanical and chemical dispersion of nanocelluloses to improve their reinforcing effect on recycled paper

The use of nanocelluloses as strength-enhancing additives in papermaking is widely known since both cellulose nanofibers (CNF) and nanocrystals (CNC) present similar composition than paper but their exceptional properties in the nanometer scale confers a paper quality enhancement. However, some agglomeration problems in CNF and CNC through hydrogen bonding cause a lower improvement of mechanical properties of paper. Therefore, a better dispersion of both nanocelluloses can maximize their effect on paper properties, thus reducing the needed dose to get the same increment in tensile strength and then reducing material costs. To ease the implementation of these nanocelluloses in the production process of recycled paper, typically used operations of these industries have been used. Among them, those devoted to improve the homogeneous mixture of nanocellulose in the pulp suspension have been assessed. Firstly, pulping conditions were studied, including pulping time, temperature and need for soaking as variables. Secondly, some dispersing agents used in papermaking were considered, studying the effect of different types and doses. The highest tensile strength of paper was achieved by applying long pulping times (60 min), getting increments up to 30% with the use of soaking and polyacrylamide as retention system. However, with the use of a low dose of a dispersing agent (0.003%), tensile index can be still increased up to 20.6% avoiding these long times. This study can be of great interest of those researchers trying to implement the use of nanocelluloses as strength additive in papermaking.Economy and Competitiveness Ministry of Spain (MINECO)Depto. de Ingeniería Química y de MaterialesFac. de Ciencias QuímicasTRUEpu