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At least 181 records · Page 10

Association of Serum Bile Acid and Unsaturated Fatty Acid Profiles with the Risk of Diabetic Retinopathy in Type 2 Diabetic Patients

Aim: We aimed to identify the ability of serum bile acids (BAs) and unsaturated fatty acids (UFAs) profiles to predict the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) patients. Methods: We first used univariate and multivariate analysis to compare 15 serum BA and 11 UFA levels in healthy control (HC) group (n = 82), T2DM patients with DR (n = 58) and T2DM patients without DR (n = 60). Forty T2DM patients were considered for validation. Then, the receiver operating characteristic curve (ROC) and decision curve analysis were used to assess the diagnostic value and clinical benefit of serum biomarkers alone, clinical variables alone or in combination, and the area under the curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were used to further assess whether the addition of biomarkers significantly improved the predictive ability of the model. Results: Orthogonal partial least squares-discriminant analysis (OPLS-DA) of serum BAs and UFAs separated the three cohorts including HC, T2DM patients with or without DR. The difference in serum BA and UFA profiles of T2DM patients with or without DR was mainly manifested in the three metabolites of taurolithocholic acid (TLCA), tauroursodeoxycholic acid (TUDCA) and arachidonic acid (AA). Together, they had an AUC of 0.785 (0.918 for validation cohort) for predicting DR in T2DM patients. After adjusting for numerous confounding factors, TLCA, TUDCA, and AA were independent predictors that differentiated T2DM with or without DR. The results of AUC, IDI, and NRI demonstrated that adding these three biomarkers to a model with clinical variables statistically increased their predictive value and were replicated in our independent validation cohort. Conclusion: These findings highlight the association of three metabolites, TLCA, TUDCA and AA, with DR and may indicate their potential value in the pathogenesis of DR.

60 APPLIED LIFE SCIENCES↗

Evaluation of Hands-On Cybersecurity Skills Development

Cybersecurity is a relatively new and quickly advancing industry, though there is a deficit in industry professionals throughout the world. This deficit is a result of the inability of education to keep up with the continuously changing cyber-threat landscape. A lack of effective, accessible, hands-on training platforms is a barrier for students and professionals who seek to gain the skills and abilities necessary to enter the workforce. Additionally, the lack of adequate training makes it difficult for industry experts to upskill or stay up to date on new advancements within the field of cybersecurity. The goal of this cohort is to discover what makes an effective or ineffective training platform, what platforms are currently available, and to determine the next steps for hands-on learning. Hands-on experience is necessary to create workforce ready professionals, yet it is underutilized by students and professionals of cybersecurity due to costs, availability, and ease of use. This cohort has uncovered hands-on training solutions, identified many effective training solutions, and explored potential improvement to cybersecurity training. These findings resulted in the cohort moving beyond research to test the resources that currently exist or are in development, and to apply that knowledge to discovering and developing engaging hands-on training.

97 MATHEMATICS AND COMPUTING↗

EMPOWERED Distributed Energy Resources Permit Accelerator Pilot

This report summarizes the EMPOWERED Distributed Energy Resources (DER) Permit Accelerator Pilot project. Its primary objective was to streamline the design, installation, permitting, and inspections of targeted Distributed Energy Resource (DER) solutions. Streamlining these processes is critical to strengthening and accelerating the adoption of DER solutions nationwide. Moreover, streamlined processes help expedite the clean energy transition and expand energy resilience by improving understanding and capability among key stakeholders like property owners, code officials, and the general workforce. The project team accomplished this by developing and deploying a set of design and permitting guides for simple DER solutions, which they rolled out via a permitting pilot program. The project team developed nine permitting and inspection guides for simple DER solutions, as follows: 1. Single-Family and Duplex: Electric Vehicle Service Equipment (EVSE), and Storage, Solar + Storage (each in two code cycles) 2. Multi-family and Office: EVSE, Storage, Solar + Storage (each in two code cycles) 3. A permitting process guide to support the implementation of the permitting guides. The guides cover key code requirements via plan review and field inspection checklists for code officials and building owners to follow to streamline the permitting and inspections process for DER solutions. Following the development of the initial set of guides, the project team formed two cohorts, each made up of four jurisdictions, to participate in the Permit Accelerator Pilot. Each cohort received training and technical assistance to support them in incorporating the guides into use. The project successfully engaged jurisdictions in two disparate US regions: Chelsea, Somerville, Natick, and Norwood in metro Boston; and Pima County, Town of Gilbert, Flagstaff, and Sedona in Arizona. Feedback gathered from the project was valuable in refining the guides to better address jurisdictional needs. After the pilot period, the project team developed final versions of the guides based on extensive feedback from the cohorts and from external technical peer review. Feedback included needs and barriers related to implementation, as well as detailed technical improvements from external peer review. The final guides were presented in a series of webinars with a national reach, with 192 attendees from 35 states in the live session of the final webinar, and the final guides are posted online and available for use nationwide. Key findings: • The most receptive jurisdictions were those adjacent to other jurisdictions that had already adopted similar initiatives. The least receptive jurisdictions were those in the midst of adopting new code cycles. • The most common barrier to jurisdictional adoption of new guidelines were internal administrative and process delays, more so than technical barriers. • The main technical barrier to adoption proved to be the concern of fire hazard risks posed by energy storage systems. There is some apprehension in the code enforcement community about the safety of the batteries. Education coordinated with fire and safety services will help alleviate concerns and increase confidence in the acceptance of innovative technologies. • Opportunities to further leverage and advance the guides and related resources include outreach, education, and jurisdictional support; updates to the resources to align with code cycle changes and local requirements; and advancements supporting emerging technologies.

14 SOLAR ENERGY↗

Regional Training Program: Promoting Undergraduate Minority Persistence in Nuclear Physics (RTP: PUMP-NP)

A total of two cohorts of research experience were conducted under this grant. The first year of the program in which a cohort of six students were recruited from three Historically Black Colleges and Universities (HBCUs). These students travelled to Durham, NC in summer to participate in this program. Prior to their arrival, the students participated in an orientation in which they selected from a choice of topics for summer research and were paired up with mentors from Triangle Universities Nuclear Laboratory (TUNL). The participants of the program were integrated with the larger cohort of summer students who had arrived at TUNL as part of other programs, such as the Research Experience for Undergraduates (REU).

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

U.S. Research Impact Alliance IMPACT Accelerator

The U.S. Research Impact Alliance (USRIA) was created with a vision to leverage successful models that accelerate technology development and commercialization, and support startup businesses based upon federal research investments. Building upon lessons learned and feedback from cohort teams, the USRIA programs have morphed into customized solutions that offer services which provide the most impact to startup businesses. Based upon discussions with small and startup businesses, entrepreneurs, and technology developers, a variety of resources have been developed to support each of these target audiences. USRIA created program differentiators to offer one-on-one engagement and direct communication with cohort teams, highly relevant conversations with targeted introductions, and minimal “class” time (only used when an issue is applicable to all cohort members).

43 PARTICLE ACCELERATORS↗

Intermediate Molecular Phenotypes to Identify Genetic Markers of Anthracycline-Induced Cardiotoxicity Risk

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.

60 APPLIED LIFE SCIENCES↗

Impact of Solid State Roadway Lighting on Melatonin in Humans

Introduction: In 2009, the World Health Organization identified vehicle crashes, both injury-related and fatal, as a public health hazard. Roadway lighting has long been used to reduce crashes and improve the safety of all road users. Ocular light exposure at night can suppress melatonin levels in humans. At sufficient light levels, all visible light wavelengths can elicit this response, but melatonin suppression is maximally sensitive to visible short wavelength light. With the conversion of roadway lighting to solid state sources that have a greater short wavelength spectrum than traditional sources, there is a potential negative health impact through suppressed melatonin levels to roadway users and those living close to the roadway. This paper presents data on the impact of outdoor roadway lighting on salivary melatonin in three cohorts of participants: drivers, pedestrians, and those experiencing light trespass in their homes. Methods: In an outdoor naturalistic roadway environment, healthy participants (N = 29) each being assigned to a cohort of either pedestrian, driver, or light trespass experiment, were exposed to five different solid state light sources with differing spectral emissions and one no lighting condition. Salivary melatonin measurements were made under an average roadway luminance of 1.0 cd/m2 (IES RP-18 Roadway Lighting Requirements for expressway roads) with a corneal melanopic Equivalent Daylight Illuminances (EDI) ranging from 0.22 to 0.86 lux. Results: The results indicate that compared to the no roadway lighting condition, the roadway light source spectral content did not significantly impact salivary melatonin levels in the participants in any of the cohorts. Conclusions: These data show that recommended levels of street lighting for expressway roads do not elicit an acute suppression of salivary melatonin and suggest that the health benefit of roadway lighting for traffic safety is not compromised by an acute effect on salivary melatonin.

60 APPLIED LIFE SCIENCES↗

Comparative Uptake Patterns of Radioactive Iodine and [18F]-Fluorodeoxyglucose (FDG) in Metastatic Differentiated Thyroid Cancers

Background: Metastatic differentiated thyroid cancer (DTC) represents a molecularly heterogeneous group of cancers with varying radioactive iodine (RAI) and [ 18 F]-fluorodeoxyglucose (FDG) uptake patterns potentially correlated with the degree of de-differentiation through the so-called “flip-flop” phenomenon. However, it is unknown if RAI and FDG uptake patterns correlate with molecular status or metastatic site. Materials and Methods: A retrospective analysis of metastatic DTC patients (n = 46) with radioactive 131-iodine whole body scan (WBS) and FDG-PET imaging between 2008 and 2022 was performed. The inclusion criteria included accessible FDG-PET and WBS studies within 1 year of each other. Studies were interpreted by two blinded radiologists for iodine or FDG uptake in extrathyroidal sites including lungs, lymph nodes, and bone. Cases were stratified by BRAF V600E mutation status, histology, and a combination of tumor genotype and histology. The data were analyzed by McNemar’s Chi-square test. Results: Lung metastasis FDG uptake was significantly more common than iodine uptake (WBS: 52%, FDG: 84%, p = 0.04), but no significant differences were found for lymph or bone metastases. Lung metastasis FDG uptake was significantly more prevalent in the papillary pattern sub-cohort (WBS: 37%, FDG: 89%, p = 0.02) than the follicular pattern sub-cohort (WBS: 75%, FDG: 75%, p = 1.00). Similarly, BRAF V600E+ tumors with lung metastases also demonstrated a preponderance of FDG uptake (WBS: 29%, FDG: 93%, p = 0.02) than BRAF V600E- tumors (WBS: 83%, FDG: 83%, p = 1.00) with lung metastases. Papillary histology featured higher FDG uptake in lung metastasis (WBS: 39%, FDG: 89%, p = 0.03) compared with follicular histology (WBS: 69%, FDG: 77%, p = 1.00). Patients with papillary pattern disease, BRAF V600E+ mutation, or papillary histology had reduced agreement between both modalities in uptake at all metastatic sites compared with those with follicular pattern disease, BRAF V600E- mutation, or follicular histology. Low agreement in lymph node uptake was observed in all patients irrespective of molecular status or histology. Conclusions: The pattern of FDG-PET and radioiodine uptake is dependent on molecular status and metastatic site, with those with papillary histology or BRAF V600E+ mutation featuring increased FDG uptake in distant metastasis. Further study with an expanded cohort may identify which patients may benefit from specific imaging modalities to recognize and surveil metastases.

60 APPLIED LIFE SCIENCES↗

Spatial and temporal patterns in age structure of Golden Eagles wintering in eastern North America

The behavior of wildlife varies seasonally, and that variation can have substantial demographic consequences. This is especially true for long-distance migrants where the use of landscapes varies by season and, sometimes, age cohort. In this study, we tested the hypothesis that distributional patterns of Golden Eagles (Aquila chrysaetos) wintering in eastern North America are age-structured (i.e., birds of similar ages winter together) through the analysis of 370,307 images collected by motion-sensitive trail cameras set over bait during the winters of 2012–2013 and 2013–2014. At nine sites with sufficient data for analysis, we documented 145 eagle visits in 2012–2013 and 146 in 2013–2014. We found significant between-year variation in age structure of wintering eastern Golden Eagles, driven largely by annual differences in the proportion of first-winter birds. However, although many other species show spatial structure in wintering behavior, our analysis revealed no latitudinal organization among age cohorts of wintering eastern Golden Eagles. The lack of age-related latitudinal segregation in wintering behavior does not exclude the possibility that these eagles have sex-based or other types of dominance hierarchies that could result in spatial or temporal segregation. Alternatively, other mechanisms such as food availability or habitat structure may determine the distribution and abundance of Golden Eagles in winter.

59 BASIC BIOLOGICAL SCIENCES↗

Bayesian estimation of HIV acquisition dates for prevention trials

Accurate timing estimates of when participants acquire HIV in HIV prevention trials are necessary for determining antibody levels at acquisition. The Antibody-Mediated Prevention (AMP) Studies showed that a passively administered broadly neutralizing antibody can prevent the acquisition of HIV from a neutralization-sensitive virus. We developed a pipeline for estimating the date of detectable HIV acquisition (DDA) in AMP Study participants using diagnostic and viral sequence data. Using a Bayesian strategy that combines three streams of data (REN [rev/vpu/env/Δnef] sequence, GP [gag/Δpol] sequence, and diagnostic) where their 95% credible intervals overlap based on pre-specified criteria and decision rules. We evaluated the performance of our AMP pipeline using PacBio viral sequence data from 41 participants across two prospective acute HIV acquisition cohort studies, FRESH and RV217, with twice-weekly sampling. These cohort studies enrolled young women in South Africa and men and women in Kenya and Thailand, respectively, with a high likelihood of HIV acquisition. In evaluating performance, “true DDA” was the center of bounds between last-negative and first-positive RNA diagnostic tests (median time 4 days, range 2–7 days); bias was the mean difference between estimated and true DDA. Using diagnostic data alone yielded timing estimates with a bias of 2.4 days and root mean square error (RMSE) of 7.9 days. These results were improved using sequence + diagnostic data (bias 1.5 days, RMSE 6.9 days), as well as by restricting sequence-based estimation to samples from ≤5 weeks post-DDA (bias 0.2 days, RMSE 7.8 days).

59 BASIC BIOLOGICAL SCIENCES↗

Stochastic parametric skeletal dosimetry model for humans: General approach and application to active marrow exposure from bone-seeking beta-particle emitters

The objective of this study is to develop a skeleton model for assessing active marrow dose from bone-seeking beta-emitting radionuclides. This article explains the modeling methodology which accounts for individual variability of the macro- and microstructure of bone tissue. Bone sites with active hematopoiesis are assessed by dividing them into small segments described by simple geometric shapes. Spongiosa, which fills the segments, is modeled as an isotropic three-dimensional grid (framework) of rod-like trabeculae that “run through” the bone marrow. Randomized multiple framework deformations are simulated by changing the positions of the grid nodes and the thickness of the rods. Model grid parameters are selected in accordance with the parameters of spongiosa microstructures taken from the published papers. Stochastic modeling of radiation transport in heterogeneous media simulating the distribution of bone tissue and marrow in each of the segments is performed by Monte Carlo methods. Model output for the human femur at different ages is provided as an example. The uncertainty of dosimetric characteristics associated with individual variability of bone structure was evaluated. An advantage of this methodology for the calculation of doses absorbed in the marrow from bone-seeking radionuclides is that it does not require additional studies of autopsy material. The biokinetic model results will be used in the future to calculate individual doses to members of a cohort exposed to 89,90 Sr from liquid radioactive waste discharged to the Techa River by the Mayak Production Association in 1949–1956. Further study of these unique cohorts provides an opportunity to gain more in-depth knowledge about the effects of chronic radiation on the hematopoietic system. In addition, the proposed model can be used to assess the doses to active marrow under any other scenarios of 90 Sr and 89 Sr intake to humans.

59 BASIC BIOLOGICAL SCIENCES↗

Strategies for Successful Energy Project Financing [Slides]

The Energy to Communities (E2C) peer-learning cohort program provides technical assistance to groups of 15 community entities around a common energy topic over the course of 6 months. Every month, participants join a virtual meeting where they hear from experts and exchange strategies and best practices with their peers.This cohort, "Successful Energy Project Implementation" will explore common challenges in implementing energy projects and learn strategies to turn project plans into reality. Each participant will focus on a local energy project or priority as a cornerstone for their learning throughout the series. This presentation focuses on strategies for successful project financing. This workshop is on April 29, 2026.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Energy Project Siting, Permitting, and Community Impacts [Slides]

The Energy to Communities (E2C) peer-learning cohort program provides technical assistance to groups of 15 community entities around a common energy topic over the course of 6 months. Every month, participants join a virtual meeting where they hear from experts and exchange strategies and best practices with their peers.This cohort, "Successful Energy Project Implementation" will explore common challenges in implementing energy projects and learn strategies to turn project plans into reality. Each participant will focus on a local energy project or priority as a cornerstone for their learning throughout the series. This presentation focuses on strategies for successful project financing. This workshop is on April 29, 2026.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Advanced Transmission Technologies – GETs and HPCs Session 1: ATT Foundations and Dynamic Line Ratings (DLRs)

The INL TADA GETs Cohort Session 1, held on November 4, 2025, convened experts to address the integration of advanced transmission technologies, including Grid-Enhancing Technologies (GETs) and High Performance Conductors (HPCs), with a focus on digital assurance challenges. The session highlighted the growing importance of cybersecurity, supply chain transparency, reliability, and business risk management in deploying GETs, especially Dynamic Line Ratings (DLRs). Participants examined how expanded attack surfaces, limited vendor pools, and new regulatory requirements—such as FERC Orders 881, 2023, and 1920—are influencing utilities and technology providers. The workshop underscored the need for cyber-informed engineering, secure-by-design principles, and practical risk management strategies, while fostering collaboration and knowledge sharing among industry peers. Technical discussions covered the evolution from static to dynamic line ratings, complexities of cloud-based architectures, and NERC CIP compliance challenges. The session concluded with a collaborative risk exercise and a preview of future workshops on advanced power flow control and transmission topology optimization, reinforcing the cohort’s commitment to advancing digital assurance in the energy sector.

24 - POWER TRANSMISSION AND DISTRIBUTION↗

Evaluation of Plasma Phosphorylated Tau217 for Differentiation Between Alzheimer Disease and Frontotemporal Lobar Degeneration Subtypes Among Patients With Corticobasal Syndrome

Plasma phosphorylated tau217 (p-tau217), a biomarker of Alzheimer disease (AD), is of special interest in corticobasal syndrome (CBS) because autopsy studies have revealed AD is the driving neuropathology in up to 40% of cases. This differentiates CBS from other 4-repeat tauopathy (4RT)–associated syndromes, such as progressive supranuclear palsy Richardson syndrome (PSP-RS) and nonfluent primary progressive aphasia (nfvPPA), where underlying frontotemporal lobar degeneration (FTLD) is typically the primary neuropathology. To validate plasma p-tau217 against positron emission tomography (PET) in 4RT-associated syndromes, especially CBS. This multicohort study with 6, 12, and 24-month follow-up recruited adult participants between January 2011 and September 2020 from 8 tertiary care centers in the 4RT Neuroimaging Initiative (4RTNI). All participants with CBS (n = 113), PSP-RS (n = 121), and nfvPPA (n = 39) were included; other diagnoses were excluded due to rarity (n = 29). Individuals with PET-confirmed AD (n = 54) and PET-negative cognitively normal control individuals (n = 59) were evaluated at University of California San Francisco. Operators were blinded to the cohort. Plasma p-tau217, measured by Meso Scale Discovery electrochemiluminescence, was validated against amyloid-β (Aβ) and flortaucipir (FTP) PET. Imaging analyses used voxel-based morphometry and bayesian linear mixed-effects modeling. Clinical biomarker associations were evaluated using longitudinal mixed-effect modeling. Of 386 participants, 199 (52%) were female, and the mean (SD) age was 68 (8) years. Plasma p-tau217 was elevated in patients with CBS with positive Aβ PET results (mean [SD], 0.57 [0.43] pg/mL) or FTP PET (mean [SD], 0.75 [0.30] pg/mL) to concentrations comparable to control individuals with AD (mean [SD], 0.72 [0.37]), whereas PSP-RS and nfvPPA showed no increase relative to control. Within CBS, p-tau217 had excellent diagnostic performance with area under the receiver operating characteristic curve (AUC) for Aβ PET of 0.87 (95% CI, 0.76-0.98; P < .001) and FTP PET of 0.93 (95% CI, 0.83-1.00; P < .001). At baseline, individuals with CBS-AD (n = 12), defined by a PET-validated plasma p-tau217 cutoff 0.25 pg/mL or greater, had increased temporoparietal atrophy at baseline compared to individuals with CBS-FTLD (n = 39), whereas longitudinally, individuals with CBS-FTLD had faster brainstem atrophy rates. Individuals with CBS-FTLD also progressed more rapidly on a modified version of the PSP Rating Scale than those with CBS-AD (mean [SD], 3.5 [0.5] vs 0.8 [0.8] points/year; P = .005). In this cohort study, plasma p-tau217 had excellent diagnostic performance for identifying Aβ or FTP PET positivity within CBS with likely underlying AD pathology. Plasma P-tau217 may be a useful and inexpensive biomarker to select patients for CBS clinical trials.

59 BASIC BIOLOGICAL SCIENCES↗

Harmonizing tau positron emission tomography in Alzheimer's disease: The CenTauR scale and the joint propagation model

Abstract INTRODUCTION Tau‐positron emission tomography (PET) outcome data of patients with Alzheimer's disease (AD) cannot currently be meaningfully compared or combined when different tracers are used due to differences in tracer properties, instrumentation, and methods of analysis. METHODS Using head‐to‐head data from five cohorts with tau PET radiotracers designed to target tau deposition in AD, we tested a joint propagation model (JPM) to harmonize quantification (units termed “CenTauR” [CTR]). JPM is a statistical model that simultaneously models the relationships between head‐to‐head and anchor point data. JPM was compared to a linear regression approach analogous to the one used in the amyloid PET Centiloid scale. RESULTS A strong linear relationship was observed between CTR values across brain regions. Using the JPM approach, CTR estimates were similar to, but more accurate than, those derived using the linear regression approach. DISCUSSION Preliminary findings using the JPM support the development and adoption of a universal scale for tau‐PET quantification. Highlights Tested a novel joint propagation model (JPM) to harmonize quantification of tau PET. Units of common scale are termed “CenTauRs”. Tested a Centiloid‐like linear regression approach. Using five cohorts with head‐to‐head tau PET, JPM outperformed linearregressionbased approach. Strong linear relationship was observed between CenTauRs values across brain regions.

Neurosciences & Neurology↗

Prognostic importance of the preoperative New‐Naples prognostic score for patients with gastric cancer

Abstract Background The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New‐NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis. Methods This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t‐ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan–Meier method and log‐rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C‐index), and decision curve. Results A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New‐NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA ( P = 0.026), Borrmann type ( P = 0.001), pTNM ( P < 0.001), New‐NPS ( P < 0.001), and nerve infiltration ( P = 0.035) were independent risk factors for prognosis. Conclusion The New‐NPS based on the cutoff values of NLR, LMR, Alb, and TC is not only suitable for predicting prognosis but can also be combined with clinicopathological characteristics to construct a nomogram model for GC patients.

Wang, Hao↗