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关键词： Surgical Oncology   Oncology   Surgery  

摘要： Background Nodal staging systems (NSS) for pancreatic ductal adenocarcinoma (PDAC) classify patients on the basis of number of metastatic lymph nodes (MLN), metastatic/retrieved lymph node ratio (LNR), and log odds of positive LN (LODDS). The relative prognostic performance of these NSS, however, remains unclear. Patients and Methods We identified 2584 patients who underwent surgery for PDAC between 2010 and 2019. Subgroups of each staging system were classified using K-adaptive partitioning method and assessed by comparing time-dependent areas under the curve (AUC) 5 years after surgery. Results Patients were subgrouped by MLN (0, 1-3, >= 4), LNR (0, 0-0.23, > 0.23), and LODDS (< - 3.5, - 3.5 to - 0.970, > - 0.97). All three NSS were independent prognostic factors for overall survival (OS) and recurrence-free survival (RFS). The AUCs for OS were comparable for the MLN (0.622), LNR (0.609), and LODDS (0.596) systems. Subgroup evaluation based on 12 retrieved lymph nodes (RLN), R1 resection, and extent of resection showed that the AUCs of the MLN and LNR NSS were comparable for OS and RFS regardless of the number of RLNs, R1 resection, and extent of resection. By contrast, the AUCs of the LODDS NSS were lower. Conclusion The NSS based on the number of MLN is the best prognostic indicator, with prognostic performance comparable to the other NSS and greater convenience for practical use. This NSS was applicable regardless of the numbers of RLN, R1 resection, and extent of resection.

关键词： Hepatocellular carcinoma   Liver neoplasms   Gadoxetic acid   Magnetic resonance imaging  

摘要： Objectives To determine the appropriate use of ancillary features (AFs) in upgrading LI-RADS category 3 (LR-3) to category 4 (LR-4) for hepatic nodules on gadoxetic acid-enhanced MRI. Methods We retrospectively analyzed MRI features of solid hepatic nodules (<= 30 mm) categorized as LR-3/4 on gadoxetic acid-enhanced MRI. In LI-RADS diagnostic table-based-LR-3 observations, logistic regression analyses were performed to identify AFs suggestive of hepatocellular carcinomas (HCCs) rather than non-malignant nodules. Using McNemar's test, the sensitivities and specificities of the final-LR-4 category for HCC diagnosis were compared according to the principles of AF application in category adjustment. Results A total of 336 hepatic nodules (191 HCCs;145 non-malignant) in 252 patients were evaluated. Based on major HCC features, 248 nodules (123 HCCs) were assigned as table-based-LR-3 and 88 nodules (68 HCCs) as table-based-LR-4. In table-based-LR-3 observations, mild-moderate T2 hyperintensity was identified as an independent predictor of HCC as opposed to non-malignant nodules (odds ratio = 3.01, p = 0.002). For HCC diagnosis, different criteria of final-LR-4: only table-based-LR-4, allowing category upgrade using only T2 hyperintensity, or using any AFs favoring malignancy resulted in sensitivities of 35.6% (68/191), 53.9% (103/191), and 88.5% (169/191), and specificities of 86.2% (125/145), 75.9% (110/145), and 21.4% (31/145), respectively, which differed from each other (all p < 0.001). Conclusions While the application of MRI AF in LI-RADS category adjustment increases the sensitivity of LR-4 category for HCC diagnosis, it is accompanied by a significant decrease in specificity. Mild-moderate T2 hyperintensity, a significant AF indicative of HCC, may be more appropriate for upgrading LR-3 to LR-4.

关键词： Direct mail   Retailer advertising   Product-mailer location   Type of product category  

摘要： This study examines the often-overlooked effect of product category type-high- vs. low-priced, high- vs. lowfrequency, and high- vs. low-perishability-when assessing the effectiveness of product advertisement locations in retailer direct mail flyers. Employing a quasi-experimental design, we analyze a national retail chain's various featured product weekly advertisements across the transaction records of 1817 products in 225 different product categories that cover a year of sales. All three-product types had a significant moderating effect on increasing the sales volume of the featured products when placed on the interior page feature location. For example, the interior pages are often ignored unless the recipient is sufficiently interested to flip through other parts of the flyer. Placing high-priced products, low-frequency products, and highly perishable products in the interior page feature location led to advertising effectiveness. In terms of frequency, the sales volume of highfrequency products were consistently higher than low-frequency products regardless of the location. On the other hand, the front and back page are the most visible pages of a flyer. In these two most visible locations, placing products that perish quickly maximized the effectiveness of using a flyer. These results highlight the importance of considering these three product types when making retail promotion decisions, including where retailers should position featured products within advertisements.

关键词： N2pc   Categorization   Visual search   Animals   Man-made objects  

摘要： Visual recognition occurs rapidly at multiple categorization levels, including the superordinate level (e.g., animal), basic level (e.g., cat), or exemplar level (e.g., my cat). Visual search for animals is faster than for man-made objects, even when the images from those categories have comparable gist statistics (i.e., low-or mid-level visual information), which suggests that higher-level, conceptual influences may support this search advantage for animals. However, it remains unclear whether the search advantage can be explained in part by early visual search processes via the N2pc ERP component, which emerges earlier than behavioral responses, across different categorization levels. Participants searched for 1) an exact image (e.g., a specific squirrel image, Exemplar-level Search), 2) any images of an item (e.g., any squirrels, Basic-level Search), or 3) any items in a category (e.g., any animals, Superordinate-level Search). In addition to Target Present trials, Foil trials measured involuntary attentional selection of task-irrelevant images related to the targets (e.g., other squirrel images when searching for a specific squirrel image, or other animals when searching for squirrels). ERP results revealed 1) a larger N2pc amplitude during Foil trials in Exemplar-level Search for animals than man-made objects, and 2) faster onset latencies for animal search than man-made object search across all categorization levels. These results suggest that the search advantage for animals over man-made objects emerges early, and that attentional selection is more biased toward the basic-level (e.g., squirrel) for animals than for man-made objects during visual search.

关键词： sweetener   consumer preference   frozen dairy foods  

摘要： The consumption of ice cream and frozen desserts in the "better-for-you" (BFY) category has grown rapidly over the past few years, even as traditional ice cream sales remain stagnant. To better understand consumer preferences within the BFY category, an online survey (n = 1,051) was conducted with ice cream and frozen dessert consumers, followed by consumer acceptance testing of commercial BFY frozen dairy desserts. Consumers of BFY frozen desserts (n = 578) completed an adaptive choice-based conjoint survey and MaxDiff exercise to identify the attributes that drive purchase of BFY frozen desserts. MaxDiff exercises were also used to determine which attributes all frozen dessert consumers (n = 1,051) perceived to make a frozen dessert BFY and which stabilizers or emulsifiers were most attractive on an ice cream or frozen dessert label. Subsequently, a consumer acceptance test (n = 186) was conducted using 4 commercial vanilla-flavored frozen dairy desserts made with different sweetening systems (sugar, sucralose + acesulfame K, monk fruit + allulose, and stevia + erythritol). Half of consumers were primed or informed with the sweeteners and basic nutritional information for the frozen desserts before tasting, and the other half of consumers evaluated samples blinded, where they were only informed that they were tasting a vanilla-flavored frozen dessert. Sweetener type and base (dairy vs. plant) were the most important attributes to BFY consumers when selecting a BFY frozen dessert (n = 578). For all ice cream and BFY dessert consumers (n = 1,051), sweetener-related claims (naturally sweetened, reduced sugar, no added sugar), along with "all natural" and a short ingredient list, were the top attributes that contributed to perception of a "healthier" frozen dessert. When BFY frozen desserts were tasted by consumers, purchase intent decreased after tasting, suggesting that frozen desserts made with natural non- nutritive sweeteners did not meet consumer expecta- tions.

关键词： CA125   NT-proBNP   Acute heart failure   Cardiorenal syndrome  

摘要： Background: This study aimed to evaluate whether glomerular filtration rate (eGFR) during admission modifies the predictive value of plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) and carbohydrate antigen 125 (CA125) in patients hospitalized for acute heart failure (AHF). Methods: We retrospectively evaluated 4595 patients consecutively discharged after admission for AHF at three tertiary-care hospitals from January 2008 through October 2019. To investigate the effect of kidney function on the association of NT-proBNP and CA125 with 1-year mortality (all-cause and cardiovascular mortality), we stratified patients according to four eGFR categories: <30 ***(-1).1.73 m(-2), 30-44 ***-1.1.73 m(-2), 44-59 ***(-1) .1.73 m(-2), and >= 60 ***(-1) .1.73 m(-2). Biomarkers were assessed within the first 24 hours following admission. Results: At 1-year follow-up, 748 of 4595 (16.3%) patients died after discharge (of all deaths, 575 [12.5%] were cardiovascular). After multivariate adjustment, both NT-proBNP and CA125 remained independently associated with a higher risk of death when modeled as main effects (P<0.001). However, we found a differential prognostic effect of NT-proBNP across eGFR categories for both endpoints (all-cause mortality, P-value for interaction=0.002;CV mortality, P-value for interaction=0.001). Whereas NT-proBNP was positively and linearly associated with mortality in the subset of patients with normal or mildly reduced eGFR, its predictive ability progressively decreased at the lower extreme of eGFR (<45 ***(-1).1.73 m(-2)). In contrast, the association between CA125 and survival remained consistent across all eGFR categories (all-cause mortality, P-value for interaction=0.559;CV mortality, P-value for interaction=0.855). Conclusions: In patients with AHF and severely reduced eGFR, CA125 outperforms NT-proBNP in predicting 1year mortality.

关键词： Deep learning   Radiography   Lung neoplasms   Image interpretation   computer-assisted  

摘要： Objective To explore the value of a deep learning-based algorithm in detecting Lung CT Screening Reporting and Data System category 4 nodules on chest radiographs from an asymptomatic health checkup population. Methods Data from an annual retrospective cohort of individuals who underwent chest radiographs for health checkup purposes and chest CT scanning within 3 months were collected. Among 3073 individuals, 118 with category 4 nodules on CT were selected. A reader performance test was performed using those 118 radiographs and randomly selected 51 individuals without any nodules. Four radiologists independently evaluated the radiographs without and with the results of the algorithm;and sensitivities/specificities were compared. The sample size needed to confirm the difference in detection rates was calculated, i.e., the number of true-positive radiographs divided by the total number of radiographs. Results The sensitivity of the radiologists substantially increased aided by the algorithm (38.8% [183/472] to 45.1% [213/472];p < .001) without significant change in specificity (94.1% [192/204] vs. 92.2% [188/204];p = .22). Pooled radiologists detected more nodules with the algorithm (32.0% [156/488] vs. 38.9% [190/488];p < .001), without alteration of false-positive rates (0.09 [62/676], both). Pooled detection rates for the annual cohort were 1.49% (183/12,292) and 1.73% (213/12,292) without and with the algorithm, respectively. A sample size of 41,776 in each arm would be required to demonstrate significant detection rate difference with < 5% type I error and > 80% power. Conclusion Although readers substantially increased sensitivity in detecting nodules on chest radiographs from a health checkup population aided by the algorithm, detection rate difference was only 0.24%, requiring a sample size >80,000 for a randomized controlled trial.

关键词： 程度前缀   网络建构   认知识解  

摘要： 在语言学研究中,人们普遍认为派生是构词的重要方式,其通过在原词的基础上添加词缀产生新的词汇。在认知语言学的形态学研究中,人们通常将派生法分为三种:添加前缀、中缀和后缀。语义连续统由时间、空间和程度组成。三者作为连续统的一部分,也可以划分为三个范畴。在认知理论的指导下,本研究主要聚焦于跨域的程度前缀语义整合和图式表征语义网络的建构。传统的构词法研究中,主要集中于讨论前缀或后缀的原型意义和添加规则。本文通过构词研究的基础,将概念整合理论融合进研究中来,基于此,对英语程度前缀语义整合机制、意义建构进行了多维度研究。并就相应程度词缀表征程度“高”、“中”和“低”的语义分布网络,探究程度前缀的语义特征、分布和用法,为未来研究提供一定的参考。本文指出,英语程度前缀在调节派生语义的同时,也会对于个别词类产生词类偏转。从域、范畴和识解这三个认知维度探究英语程度前缀的语义整合过程,挖掘程度前缀在派生过程中产生的语义能产性和表征特点。同时,文章还对位于同一程度范畴的不同前缀进行比较,区分每一个前缀的典型性概念化过程和语义侧重并得出理论依据。主要成果:1.论文拓展了英语程度类前缀的起源研究角度。很多英语前缀是从拉丁语和希腊语中借鉴和演变而来的。它们的语义和使用都有差异,并且不同派生前缀在现代英语中的能产性不同。2.论文以域、范畴和识解为研究视角,在认知领域中对程度前缀进行了相对全面的研究。每一个语言单位都有所属语域,每一个域中有多个范畴,范畴之下就是概念和属性。识解用来解释前缀的概念合成和用法。用这三个维度对程度前缀进行研究比较科学和全面。3.论文研究发现概念整合理论是研究词汇语义生成机制的强有力科学理论。英语程度类前缀的语义整合过程实际上是人们认知外部世界的方式。论文论证了派生的不同语义来源于概念化的过程。语义表征差异可以用识解理论中的图形-背景理论进行阐释。4.论文建构了程度前缀语义分布和整合网路,并对其进行了识解。心智空间中抽象的语义加工过程具体化和可视化,为研究词汇的语义整合提供了参考。学习者可以更加全面地通过语义网络建构和识解的过程了解一个程度前缀的不同义项。5.论文建构了跨域的程度前缀的图式表征连续统,以厘清程度前缀在不同语域的表征特点,为英语词缀的习得提供一定的参考。探究英语词汇的一般性认知规律,可以有效提高程度词汇习得能力。以上研究成果的核心在于程度前缀语义表征网络建构与识解,并启示英语词汇教学可与语义表征网络结合。

关键词： 娄底   小碧话   体貌范畴   语法化  

摘要： 娄底市位于湖南省中部,小碧位于娄底市北郊,境内方言属于湘语娄邵片。目前汉语方言体貌范畴研究是方言语法研究的热点问题,娄底小碧话的体貌范畴较为清晰,表现形式较为丰富,但现有关于娄底小碧话的体貌范畴研究较为薄弱,因此具体描写分析娄底小碧话的体貌范畴很有必要。本研究以娄底小碧话体貌范畴为对象,在田野调查的基础上,立足于大量语料事实与已有研究成果,对娄底小碧话的体貌范畴作深入、细致研究,分析当前娄底小碧话体貌范畴研究现状、问题、背景及意义,并阐述语料来源和体例说明。我们主要采用描写法、共时比较和历时考察,把娄底小碧话中指动作、事件在一定时间进程中的状态称为“体”标记,把体现说话人主观臆想、情绪,并且与动作、事件的时间进程没有关系或关系较少的称为“貌”标记,从而研究小碧话的“体”“貌”标记及表达式,其中重点描写比较完成体、进行体、起始体、持续体、反复体、短时貌、尝试貌。通过调查,我们发现娄底小碧话完成体标记主要有“咖”“哩1”“哩2”“起1”“咖哩2”“咖...哩2”。“哩1”“哩2”应用最广,其次是“咖”,最后是“起1”,复合完成体标记“咖...哩2”出现在宾语后,若无宾语则用“咖哩2”。进行体标记主要有“在N”和“在N...倒1”,前者使用频率高于后者且比后者更强调进行;起始体标记主要有“起2”“起来”,两者主要区别在于后者应用范围比前者更广。持续体标记主要有“倒2”“起3”,前者动作持续时间或状态比后者短,但应用范围却比后者广,后者只表动作结束后状态的持续。反复体主要有“倒3...倒3”“住3...住3”,前者语义关联更紧密,后者通常接反预期或无预期信息。短时貌标记主要有“V（一）下唧”“V（一）下”,尝试貌标记主要有“V+下”“V+下看”,两种貌标记多有重叠之处,主要区别在于只有前者可与完成体标记同现。此外,我们在对娄底小碧话体貌范畴描写比较的基础上对特殊“体”标记进行语法化考察,如“在N”“起”。“在N”主要通过隐喻机制从处所词虚化为进行体标记。“起”主要通过隐喻和凸显机制从动词虚化为体标记,“起”的虚化路径分别为“趋向补语>完成体标记‘起1’”>持续体标记‘起3’”“趋向补语>起始体标记‘起2’>持续体标记‘起3’”。最后概括娄底小碧话体貌范畴特色,并对研究中存在的不足和对后续研究的展望等方面进行总结。我们希望通过对娄底小碧话体貌范畴的深入研究能展现更多的方言体貌标记形式,为娄底方言的语法研究提供一定的素材,除此之外也可以更完整地记录、传承娄底小碧话,对加强地方文化建设起到一定积极作用。