Causes of death in persons with haematological cancers include the index cancer, a new cancer or a seemingly unrelated cause such as cardio-vascular disease. These causes are complex and sometimes confounded. We analyzed trends in cause of death in 683,333 persons with an index haematological cancer diagnosed in 1975–2016 reported in the Surveillance, Epidemiology and End Results dataset. Non-cancer deaths were described using standardized mortality ratios. The index cancer was the predominant cause of death amongst persons with plasma cell myeloma, acute lymphoblastic leukaemia and acute myeloid leukaemia. Non-cancer death was the major cause of death in persons with chronic lymphocytic leukaemia, Hodgkin lymphoma and chronic myeloid leukaemia, mostly from cardio-vascular diseases. The greatest relative decrease in index-cancer deaths was amongst persons with Hodgkin lymphoma, chronic myeloid leukaemia and chronic lymphocytic leukaemia, where the proportion of non-cancer deaths increased substantially. Changing distribution of causes of death across haematological cancers reflects substantial progress in some cancers and suggests strategies to improve the survival of persons with haematological cancers in the future.
In semi-arid climate regions of China, vegetation restoration on open pit mining lands is limited by soil moisture. However, multi-layered soil profiles can impede water infiltration into deeper underground, leaving more water stored in the root zone. Here, three types of soils with contrasting texture, sandy loam (SL), sand (S), and silt loam (SiL), were used to construct four multilayer profiles: SL-SiL, SL-S, SL-S-SiL, and SL-SiL-S. Silt loam was taken from the humus layer, which is more conducive to plant growth than other layers, and it was allocated to the first layer in the four profiles, while sand and silt loam underlay the silt loam layer. Column experiments and Hydrus-1D simulation of the vertical infiltration and drainage process were performed: (1) The simulated results showed that when the sand layer underlay the sandy loam layer (SL-SiL and SL-S-SiL), the sandy loam layer could hold more water than the silt loam layer underlaying the sandy loam layer (SL-SiL and SL-SiL-S). The water content of the sandy loam layer in SL-SiL (95 cm) and SL-S-SiL (95 cm) was 28.3% higher than SL-SiL (74 cm) and 10.5% higher than SL-SiL-S (86 cm). (2) Both the measured and simulated cumulative infiltration and wetting front penetration time were positively related to the thickness of the silt loam layer and negatively related to the thickness of the sand layer. (3) The simulated infiltration rate, accumulation infiltration, and wetting front of the first layer were unaffected by the texture of the underlying layer. According to multi-criteria decision analysis, SL-S-SiL had the best water holding capacity and was suggested for land reclamation in the open pit mine in our research.
We aimed to assess the prognostic value of pretreatment inflammatory and nutritional parameters for predicting overall survival (OS) in patients with newly diagnosed multiple myeloma (NDMM), and to build a new scoring system using the most important variables. Methods: We retrospectively analyzed baseline clinical and laboratory data for patients with NDMM, who were randomly grouped into training and validation cohorts at a ratio of 8:2. The Inflammatory Nutritional Score (INS) was developed based on the least absolute shrinkage and selection operator (LASSO) Cox regression. The INS and other independent prognostic factors were entered into a multivariate Cox model and merged to generate a nomogram model for predictive optimization. Performance and predictive accuracy were assessed using the concordance index (C-index), calibration plots, and time-dependent receiver operating characteristic (ROC) curves. Results: In total, 442 eligible patients were enrolled. Six inflammatory/nutritional variables, including the Nutritional Risk Index (NRI), body mass index (BMI), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and albumin-alkaline phosphatase ratio (AAPR), were integrated to construct the INS using the LASSO Cox model. The predictive nomogram constructed following the multivariate Cox analysis included INS, performance status, lactate dehydrogenase, age, and C-reactive protein. The model exhibited good predictive performance, with a C-index of 0.708 in the training cohort and 0.749 in the validation cohort. Moreover, the calibration curves also demonstrated excellent consistency between predicted and observed survival in both cohorts. In the time-dependent ROC analysis, our nomogram model exhibited better performance than other staging systems for multiple myeloma.
Conclusion:The INS represents an independent prognostic signature in patients with NDMM. Our novel nomogram based on INS may aid in predicting survival probability and stratifying risk.
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