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Background & Aims: Hepatocellular carcinoma (HCC) is the leading cause of death in patients with chronic hepatitis. In this international collaboration, we sought to develop a global universal HCC risk score to predict the HCC development for patients with chronic hepatitis. Methods: A total of 17,374 patients, comprising 10,578 treated Asian patients with chronic hepatitis B (CHB), 2,510 treated Caucasian patients with CHB, 3,566 treated patients with hepatitis C virus (including 2,489 patients with cirrhosis achieving a sustained virological response) and 720 patients with non-viral hepatitis (NVH) from 11 international prospective observational cohorts or randomised controlled trials, were divided into a training cohort (3,688 Asian patients with CHB) and 9 validation cohorts with different aetiologies and ethnicities (n = 13,686). Results: We developed an HCC risk score, called the aMAP score (ranging from 0 to 100), that involves only age, male, albuminbilirubin and platelets. This metric performed excellently in assessing HCC risk not only in patients with hepatitis of different aetiologies, but also in those with different ethnicities (C-index: 0.82-0.87). Cutoff values of 50 and 60 were best for discriminating HCC risk. The 3-or 5-year cumulative incidences of HCC were 0-0.8%, 1.5-4.8%, and 8.1-19.9% in the low-(n = 7,413,

Over the last decade or so, there has been increasing interest in 'zero inflated' (ZI) regression models to account for 'excess' zeros in data. Examples include ZI poisson (ZIP), ZI binomial (ZIB), ZI negative binomial and ZI tobit models. Recently, extensions of these models to the clustered data case have begun to appear. For example, Hall considered ZIP and ZIB models with cluster specific random effects. In this paper, we consider an alternative expectation maximization approach on the basis of marginal models and generalized estimating equation (GEE) methodology. In the usual EM algorithm for fitting ZI models, the M step is replaced by the solution of a GEE to take into account within cluster correlation. The details of this approach, including formulas for an asymptotic variance-covariance matrix of parameter estimates, are given for several of the most important ZI regression model classes. Alternatively, GEEs can be applied directly by computing the first two marginal moments of the observed response. We illustrate these two marginal modeling approaches with examples, and compare them via a small simulation study.

In this multicenter study, TAVR achieved favorable outcomes in patients with pre-procedural CT, with the exception of high permanent pacemaker rates for all devices and shapes.

PurposeThe authors seek to understand the process of digital servitization as a shift of manufacturing companies from the provision of standard products and services to smart solutions. Specifically, the authors focus on changes in the business model (i.e. the value proposition, the value delivery system and the value capture mechanism) for digital servitization.Design/methodology/approachThe authors examine a Chinese air conditioner manufacturer, Gree, who became the global leader with their smart solutions. These solutions included performance-based contracts underpinned by artificial intelligence (AI)-powered air conditioners that automatically adjust to environmental changes and are capable of remote monitoring and servicing thanks to its Internet of things (IoT) technology.FindingsTo successfully offer smart solution value propositions, a manufacturer needs an ecosystem value delivery system composed of suppliers, distributors, partners and customers. Once the ecosystem relationships are well aligned, the manufacturer gains value with multiple value capture mechanisms (i.e. efficiency, accountability, shared customer value and novelty). To arrive at this point, a manufacturer has to pass through different stages that are characterized by both discontinuous and continuous interplay between business models and digital technologies. At the beginning of each stage, new value propositions and value delivery systems are first discontinuously created and then enabled with digital technology. As a result, new value capture mechanisms are activated. Meanwhile, the elements of the existing business model are continuously improved.Research limitations/implicationsBy combining process-perspective and business-model lenses, the authors offer nuanced insights into how digital servitization unfolds.Practical implicationsExecutives can obtain insights into the business model elements, they need to change over the course of digital servitization and how to manage the process.Originality/valueA longitudinal case study of a traditional manufacturer that has achieved stellar success through digital servitization business models development.

The nature of liquid structures with their changing behaviors remains an unsolved fundamental problem in many fields of science and technology. It has been widely accepted that liquid structures change gradually with temperature and/or pressure. With x-ray diffraction in the melt In-Sn80, however, we have confirmed that a temperature-dependent discontinuous structural change could occur in some binary liquids, which does not fall into any other up-to-date recognized liquid-liquid changes. This finding, together with the recently recognized pressure-induced liquid change, suggests that the conventional view on liquids should be revised.

Study of intraflagellar transport protein IFT20 in male germ cell development shows that it is essential for male fertility and spermiogenesis in mice, playing a role in the building of sperm flagella and the disposal of cytoplasmic components.

The shear mechanical compliance of the glass−rubber transition or softening zone of high molecular weight amorphous polymers typically increases from the glassy compliance of ∼10−10 cm2/dyn up to the rubbery plateau of ∼10−6 cm2/dyn. The contributions from the local segmental relaxation and the Rouse modes cannot account for the entire range of compliance, leaving three decades of compliance in between their contributions unaccounted for. Although new viscoelastic mechanism called sub-Rouse modes with length scales intermediate between the local segmental relaxation and the Rouse modes have been found to fill the void, so far they have not been found in archetypal polymers including polystyrene (PS) and poly(methyl methacrylate) (PMMA). This calls the generality of the existence of sub-Rouse modes into question. Using high precision shear mechanical spectroscopic tool, we report the observation of the sub-Rouse modes in PS and PMMA. From the various properties of the sub-Rouse modes determined, we find that the sub-Rouse modes are intermolecularly coupled like the local segmental relaxation, albeit to a less degree. The results are isomorphic to those found in poly(vinyl acetate) (PVAc) and PVAc−poly(ethylene oxide) (PVAc−PEO) blends. Thus, the sub-Rouse modes and its properties seem general in amorphous polymers.