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Chao Luo,1,&ast; Shuqi Li,1,&ast; Qin Zhao,1,&ast; Qiaowen Ou,2 Wenjie Huang,1 Guangying Ruan,1 Shaobo Liang,3 Lizhi Liu,1,4 Yu Zhang,5 Haojiang Li1 1Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong, People’s Republic of China; 2Department of Clinical Nutrition, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, People’s Republic of China; 3Department of Radiotherapy, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China; 4Department of Radiology, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 5Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Haojiang Li, Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, People’s Republic of China, Tel +86-20-87342135, Fax +86-20-87342125, Email lihaoj@sysucc.org.cn Yu Zhang, Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, People’s Republic of China, Email zhangyu@sysucc.org.cnPurpose: Traditional prognostic studies utilized different cut-off values, without evaluating potential information contained in inflammation-related hematological indicators. Using the interpretable machine-learning algorithm RuleFit, this study aimed to explore valuable inflammatory rules reflecting prognosis in nasopharyngeal carcinoma (NPC) patients.Patients and Methods: In total, 1706 biopsy-proven NPC patients treated in two independent hospitals (1320 and 386) between January 2010 and March 2014 were included. RuleFit was used to develop risk-predictive rules using hematological indicators with no distributive difference between the two centers. Time-event-dependent hematological rules were further selected by stepwise multivariate Cox analysis. Combining high-efficiency hematological rules and clinical predictors, a final model was established. Models based on other algorithms (AutoML, Lasso) and clinical predictors were built for comparison, as well as a reported nomogram. Area under the receiver operating characteristic curve (AUROC) and concordance index (C-index) were used to verify the predictive precision of different models. A site-based app was established for convenience.Results: RuleFit identified 22 combined baseline hematological rules, achieving AUROCs of 0.69 and 0.64 in the training and validation cohorts, respectively. By contrast, the AUROCs of the optimal contrast model based on AutoML were 1.00 and 0.58. For overall survival, the final model had a much higher C-index than the base model using TN staging in two cohorts (0.769 vs 0.717, P< 0.001; 0.752 vs 0.688, P< 0.001), and showing great generalizability in training and validation cohorts. The two models based on RuleFit rules performed best, compared with other models. As for other endpoints, the final model showed a similar trend. Kaplan–Meier curve exhibited 22.9% (390/1706) patients were “misclassified” by AJCC staging, but the final model could assess risk classification accurately.Conclusion: The proposed final models based on inflammation-related rules based on RuleFit showed significantly elevated predictive performance.Keywords: machine learning, nomograms, nasopharyngeal carcinoma, prognosis, survival analysis

Indepth research on the impact of energy endowment on provincial green development provides a new perspective for achieving high-quality provincial economic development. Based on 30 provinces’ panel data in China from 2009 to 2020, this study first constructs an index system to analyze energy endowment and provincial green development; then it explores the mechanism by which energy endowment affects provincial green development, including the moderating role of environmental regulation and the mediating role of energy efficiency. The results show that energy endowment can significantly curb provincial green development when environmental regulations are not taken into account. Moreover, environmental regulation has moderated the process of energy endowment affecting provincial green development. Energy efficiency has mediated the process of energy endowment affecting provincial green development. From a geographical viewpoint, the moderating effect of environmental regulation has regional heterogeneity but the mediating effect of energy efficiency does not. The conclusions of this research may supply applicable recommendations for provincial green development in China.

Background: Several primary fracture classification systems (FCSs) have been widely used for intra-articular calcaneal fractures. The purpose of this study was to measure the inter- and intra-observer variations as well as integrality of the Zwipp, Crosby-Fitzgibbons, Sanders, and Eastwood-Atkins classification systems based on more accurate CT scans. Methods: 549 patients with intra-articular calcaneal fractures taken from a database in our level-I trauma centre (3 affiliated hospitals) were included from January 2018 to December 2019. For each case, normative CT (1 mm slices) scans were available. Four different observers reviewed all CT scans two times according to these 4 most prevalent FCSs within a 2-month interval. For these four FCSs, the kappa [κ] coefficient was used to evaluate interobserver reliability and intraobserver reproducibility, and the percentage that can be classified was used to indicate integrality. Results: The κ values were measured for Zwipp (κ= 0.38 interobserver, κ= 0.61 intraobserver), Crosby-Fitzgibbons (κ= 0.48 interobserver, κ= 0.79 intraobserver), Sanders (κ= 0.40 interobserver, κ= 0.57 intraobserver), and Eastwood-Atkins (κ= 0.44 interobserver, κ= 0.72 intraobserver). Furthermore, the integrality were calculated for Zwipp (100 %), Crosby-Fitzgibbons (100 %), Sanders (92 %) as well as Eastwood-Atkins (89.6 %). Conclusion: Compared with previous literatures, CT scanning with higher accuracy can significantly improve intraobserver reproducibility of Zwipp and Eastwood-Atkins FCSs, but it has no positive effect on variability of Sanders FCS and interobserver reliability of Crosby-Fitzgibbons FCS. While in terms of integrality, Zwipp and Crosby-Fitzgibbons FCSs appear to be superior to the other two FCSs.

PurposeExisting literature has elicited the external behaviors of cross-device search but not much is known about users' cognition of cross-device search. The study aims to explore how users perceive the cross-device search by combining with the mental models and how motivations affect the users' understanding of cross-device search.Design/methodology/approachThe research questions are addressed through semi-structured face-to-face interviews with 59 users. Prior to the interview, the user is asked to complete a cross-device search task designed with the simulation of controlled and autonomous motivations to gain a real experience. The concepts of mental models are coded according to the constructivist grounded theory method.FindingsThe study finds the users' mental models of cross-device search consist of four dimensions: Element, Quality, Function and Issue. The effect of motivation on the mental models is tested as significant in terms of the Quality and Function aspects. The controlled motivation affects the user's perception of how the device switch influence the search and the autonomous motivation influences the user's opinion of search system functions.Originality/valueThe contribution of this study is found to extend the existing knowledge of cross-device search and update the mental models of information search in the current multi-device environment. The findings inform the future study of cross-device search and practices of search system design.

PurposeAs voice search has progressively become a new way of information acquisition and human–computer interaction, this paper aims to explore the users' voice search behavior in human–vehicle interaction.Design/methodology/approachThis study employed mixed research methods, including questionnaires and interviews. A total of 151 Amazon MTurk volunteers were recruited to complete a questionnaire based on their most recent and impressive voice search experience. After the questionnaire, this paper conducted an online interview with the participants.FindingsThis paper studied users' voice search behavior characteristics in the context of the human–vehicle interaction and analyzed the voice search content, search need, search motivation and user satisfaction. In addition, this paper studied the barriers and suggestions for voice search in human–vehicle interaction through a content analysis of the interviews.Practical implicationsThis paper's analysis of users' barriers and suggestions has a specific reference value for optimizing the voice search interaction system and improving the service.Originality/valueThis study is exploratory research that seeks to identify users' voice search needs and tasks and investigate voice search satisfaction in human–vehicle interaction context.

PurposeThis paper aims to explore the users' cross-app behavior characteristics in mobile search and to predict users' cross-app behavior using multi-dimensional information.Design/methodology/approachThis paper presents a longitudinal user experiment in 15 days. This paper recruited 30 participants and collected their mobile phone log data in the whole experiment. The structured diary method was also used to collect contextual information in mobile search.FindingsThis study focused on the users' cross-app behavior in mobile search and described cross-app behavior's basic characteristics. Usage of communication app and tool apps could trigger more cross-app behavior in mobile search. The method of cross-app behavior prediction in the mobile search was proposed. Collecting users' more contextual information, such as search tasks, search motivation and other environmental information, can effectively improve the prediction accuracy of cross-app behavior in mobile search.Practical implicationsThe future research on cross-app behavior prediction should focus on context information in mobile search. Better prediction of cross-app behavior can reduce the users' interaction burden.Originality/valueThis paper contributes to research into cross-app behavior, especially in the mobile search research domain.

Mobile searches have become the main channel for people to search for information, and mobile searches have received attention in the field of information-seeking behavior. Especially as users use various apps to search network information, the app-switching behaviors in mobile searches have also attracted scholars’ attention in recent years. Research on app-switching behaviors in mobile searches can help to further understand users’ search motivations, evaluate search results, and improve users’ mobile search experiences. This study recruited participants (n = 30) and conducted a 15-day user experiment. This study collected all participants’ mobile phone log data during the experiment and identified the app-switching behaviors in mobile searches through a log collection tool. This study aimed to discover the app-switching behavior paths and patterns in mobile searches. Firstly, the basic characteristics of app-switching behaviors in mobile searches were analyzed, as were the app-switching paths in mobile searches from the perspective of switching probability between apps. Then, the different behaviors in mobile search sessions were identified and app-switching behavior patterns were put forward. These behavior patterns summarize user behavior changes in mobile search sessions. This paper focused on analyzing app-switching behavior paths under different patterns and found apparent differences in app-switching behavior paths. This study examined mobile search behavior from the perspective of app-switching. The research of this paper can help to better understand the relationship between users’ mobile search behaviors and app interactions and is an excellent supplement to the analysis of mobile search behaviors.

In this study, we developed a real-time quantitative polymerase chain reaction (qPCR) assay based on a dual-labeled hydrolysis probe to simultaneously detect both duck circovirus (DuCV) 1 and DuCV-2. The reproducibility, sensitivity and specificity of the primer set and probe were evaluated using other duck pathogens. The detection limit was 20 copies per µL. The intra-assay coefficients of variation (CVs) were ≤ 0.73% and the inter-assay CVs were ≤ 1.89%. No cross-reaction occurred with other duck pathogens. In addition, the qPCR assay was successfully applied to the simultaneous detection of DuCV-1 and DuCV-2 in clinical field samples. Therefore, this assay will be useful for laboratory diagnosis and epidemiological field studies of DuCV. Supplementary Information The online version contains supplementary material available at 10.1007/s11262-021-01862-9.

Summary Background & aim Several studies explored the association of vitamin B6 intake with the risk of cancers. However, it is unclear whether different doses of vitamin B6 have distinct effects on the prognosis of nasopharyngeal carcinoma (NPC) patients. This study investigated the relationship between different doses of B6 intake and the prognosis of NPC patients. Methods This retrospective cohort analysis included 792 newly diagnosed NPC patients with a median follow-up of 62.05 months. Restricted cubic spline and maximally selected rank statistics were performed to determine the cut-off value of vitamin B6 during treatment (VB6DT). Kaplan–Meier method and log-rank tests were performed to analyze survival outcomes. A multivariable Cox proportional hazard model was performed to determine the independent prognostic factors. Results NPC patients were divided into three groups according to the cut-off value of VB6DT: non-users (0 mg/d), VB6DT > 8.6 mg/d, and VB6DT ≤ 8.6 mg/d. Patients with VB6DT > 8.6 mg/d had significantly lower 5-year overall survival (OS) (83.5% vs. 90.8%, p = 0.006), distant metastasis-free survival (DMFS) (83.5% vs. 91.0%, p = 0.004), and progression-free survival (PFS) (73.7% vs. 81.7%, p = 0.011) and slightly but not significantly lower 5-year local recurrence-free survival (LRFS) (87.7% vs. 90.7%, p = 0.214) than the non-users. Patients with VB6DT ≤ 8.6 mg/d had slightly but not significantly better 5-year OS (93.3% vs. 90.8%, p = 0.283) than the non-users, while all other primary endpoints were similar (p > 0.50). Multivariable analyses confirmed that VB6DT > 8.6 mg/d was an independent negative prognostic factor of OS (p = 0.010), DMFS (p = 0.017), and PFS (p = 0.030) but not of LRFS (p = 0.428). Conclusions Excessive VB6DT higher than the cut-off value is an independent negative prognostic factor for NPC patients. Additionally, low dose intake improved OS only slightly but not significantly.

To evaluate how prevertebral space involvement (PSI) and degree of tumor extension within the space affects prognosis in nasopharyngeal carcinoma (NPC).Data of patients with newly-diagnosed nonmetastatic NPC (n = 757) were retrospectively analyzed. Patients were separated into groups according to presence or absence of PSI and degree of tumor spread. Overall survival (OS), failure-free survival (FFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between the groups.Prevalence of PSI, simple prevertebral muscle involvement (PMI), and behind prevertebral muscle involvement (BPMI) were 44.9% (340/757), 22.5% (170/757), and 22.5% (170/757), respectively. OS, FFS, LRFS, and DMFS for patients with and without PSI were 64% vs. 84.8%, 68% vs. 85.6%, 85.8% vs. 94.4%, and 78.5% vs. 92.8%, respectively (all P 0.001). PSI was an independent predictor of OS, FFS, LRFS, and DMFS. OS, FFS, and DMFS for patients with simple PMI and with BPMI were 72.7% vs. 54.8% (P = 0.002), 75.8% vs. 59.8% (P = 0.003), and 85.5% vs. 71.2% (P = 0.002), respectively. Degree of PSI extension was related to OS, FFS, and DMFS. OS, FFS, LRFS, and DMFS were significantly poorer in patients with PSI in T2-3 stage than in patients without PSI in T3 stage (P 0.05), but comparable to those in patients with T4 stage (P 0.05).PSI predicts poor prognosis in NPC. Survival is poorer in patients with BPMI than in those with simple PMI. NPC with PSI should be classified as T4 stage.

BACKGROUND Soft tissue involvement (STI) indicates poor prognosis in nasopharyngeal carcinoma (NPC). However, only a few studies have systematically assessed this extension using network analysis. PURPOSE To investigate the prognostic value of STI and to propose an improved STI grading system for NPC therapy. STUDY TYPE Retrospective study. POPULATION A total of 1225 consecutive patients with pathologically confirmed NPC treated with intensive-modulated radiotherapy from January 2010 to March 2014 were enrolled from two centers. FIELD STRENGTH/SEQUENCE T1- and T2-weighted imaging and enhanced T1-weighted imaging with fast spin echo sequence at 1.5 or 3.0 T. ASSESSMENT The levator veli palatini and tensor veli palatini involvement were graded "mild," prevertebral muscle involvement, "moderate," medial pterygoid, lateral pterygoid, and the infratemporal fossa involvement, "severe" STI. The above STI sites were evaluated separately by three radiologists using MRI images and graded using network analysis. Overall survival (OS) and progression-free survival (PFS) were assessed. STATISTICAL TESTS Kaplan-Meier method, Cox's proportional hazards model, and concordance index (C-index) were used. RESULTS Five-year OS and PFS rates between mild and moderate groups (90.5% vs. 81.7%, P

Mass timber building materials such as cross-laminated timber (CLT) have captured attention in mid- to high-rise building designs because of their potential environmental benefits. The recently updated multistory building code also enables greater utilization of these wood building materials. The cost-effectiveness of mass timber buildings is also undergoing substantial analysis. Given the relatively new presence of CLT in United States, high front-end construction costs are expected. This study presents the life-cycle cost (LCC) for a 12-story, 8,360-m2 mass timber building to be built in Portland, Oregon. The goal was to assess its total life-cycle cost (TLCC) relative to a functionally equivalent reinforced-concrete building design using our in-house-developed LCC tool. Based on commercial construction cost data from the RSMeans database, a mass timber building design is estimated to have 26 percent higher front-end costs than its concrete alternative. Front-end construction costs dominated the TLCC for both buildings. However, a decrease of 2.4 percent TLCC relative to concrete building was observed because of the estimated longer lifespan and higher end-of-life salvage value for the mass timber building. The end-of-life savings from demolition cost or salvage values in mass timber building could offset some initial construction costs. There are minimal historical construction cost data and lack of operational cost data for mass timber buildings; therefore, more studies and data are needed to make the generalization of these results. However, a solid methodology for mass timber building LCC was developed and applied to demonstrate several cost scenarios for mass timber building benefits or disadvantages.

Objectives We aimed to reconstitute T2 and T3 stage classification in nasopharyngeal carcinoma (NPC) cases and verify its utility in clinical settings. Materials and Methods We enrolled 792 NPC patients. Cox proportional hazards model was used to compare the effect sizes (hazard ratio [HR]) of the cranial structure invasion on survival and select the structures for up‐staging or downstaging T2 and T3 NPC. The samples were reclassified and the survival curves for T2 and T3 stages were analyzed. The proposed new staging system was validated on an external sample (n = 433). Results Thirteen cranial structures were examined. American Joint Committee on Cancer (AJCC) T3 stage patients with the invasion of the base of the sphenoid (HR = 2.58, 95% CI = 1.16‐5.77) or base of the pterygoid (HR = 2.00, 95% CI = 0.84‐4.77) had significantly lower hazard ratios than T2 stage patients with the invasion of soft tissues in the bilateral parapharyngeal space (HR = 5.26, 95% CI = 2.02‐13.68) and single/bilateral carotid sheath (HR = 7.78, 95% CI = 3.06‐19.76). T3 stage with the invasion of the above‐mentioned bones was reclassified as T2, and T2 stage with the invasion of the above‐mentioned soft‐tissue structures was reclassified as T3. Survival analysis showed a significant difference between the reclassified T2 and T3 stages (P, Hazard ratio was lower for AJCC T3 with bone than AJCC T2 with soft tissue invasion ·The 5‐year OS and PFS were higher for re‐classified T2 than T3 stage NPC patients·Modified staging system for T2 and T3 NPC may result in better management.

Programmed death ligand 1 (PD-L1) immune checkpoint inhibitors are promising therapeutic agents for treating cancers but the response rate is