The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evo...The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.展开更多
Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by in...Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.展开更多
This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverag...This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverage, stock and bond valuation, cost of capital, and managerial behavior. We also discuss how the effect of climate risk on real estate markets depends on individuals’ beliefs about climate change. Furthermore, we summarize papers on climate risk activism and how firms can employ financial devices and technology to mitigate their climate risk. Finally, we make some recommendations for further research areas.展开更多
Dongtan is set to be developed as a sustainable urban-rural integration,aiming to attract a wide range of commercial and leisure investments.The Shanghai Industrial Investment Corporation(SIIC),the largest internation...Dongtan is set to be developed as a sustainable urban-rural integration,aiming to attract a wide range of commercial and leisure investments.The Shanghai Industrial Investment Corporation(SIIC),the largest international investment group owned by the Shanghai municipal government,is leading the Dongtan project in partnership with Arup.The project’s risks are categorized into eight major groups:(1)Force majeure,(2)people-related risks,(3)financial and economic risks,(4)political and country risks,(5)environmental risks,(6)completion-related risks,(7)design-related risks,and(8)technology risks.Among these,political risk is particularly notable for its high probability and significant impact.Effective project risk management is essential to foresee and address uncertainties that could jeopardize the project’s objectives and timelines.Appropriate strategies must be implemented to manage and mitigate these risks.展开更多
Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a ...Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.展开更多
Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A c...Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.展开更多
Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall su...Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall survival time of patients.This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.Methods:This study included a derivation cohort and validation cohort.The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,2020.An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions.Based on the questionnaire,inpatient data were collected to form a model-derivation cohort.This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model reliability.The validation cohort included patients from August 1,2021 to December 31,2021 at the same hospital.Using the same imputation method,we organized the validation-queue data.We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue.We compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration curve.Results:The derivation cohort included 1377 patients,and the validation cohort included 131 patients.The independent predictors of AL after radical gastrectomy included age65 y,preoperative albumin<35 g/L,resection extent,operative time240 min,and intraoperative blood loss90 mL.The predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p<0.001)with a Brier score of 0.049.The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052.External validation showed an AUROC of 0.723(95%CI:0.564e0.882;p?0.006)and a Brier score of 0.055,confirming reliability in different clinical settings.Conclusions:We successfully developed a risk-prediction model for AL following radical gastrectomy.This tool will aid healthcare professionals in anticipating AL,potentially reducing unnecessary interventions.展开更多
A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct ...A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct or indirect potable reuse options. These options have garnered more interest as a result of water supply limitations in many urban areas. This risk assessment was developed from a risk assessment developed at the University of Miami in 2001 and Florida Atlantic University (FAU) in 2023. Direct potable reuse and injection wells were deemed to have the lowest risk in the most recent study by FAU. However, the injection well option may not be available everywhere. As a result, a more local means to assess exposure risk is needed. This paper outlines the process to evaluate the public health risks associated with available disposal alternatives which may be very limited in some areas. The development of exposure pathways can help local decision-makers define the challenges, and support later expert level analysis upon which public health decisions are based.展开更多
This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study const...This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study constructed a tail-risk spillover network(TRSN) of IEM and simulated the dynamic spillover tail-risk process through the cascading failure mechanism. The study found that renewable energy markets contributed more to systemic risk during the Paris Agreement and the COVID-19pandemic, while fossil energy markets played a larger role during the Russia-Ukraine conflict. This study identifies systemically important markets(SM) and critical tail-risk spillover paths as potential sources of systemic risk. The research confirms that cutting off the IEM risk spillover path can greatly reduce systemic risk and the influence of SM. This study offers insights into the management of systemic risk in IEM and provides policy recommendations to reduce the impact of shock events.展开更多
Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in...Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.展开更多
Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicato...Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.展开更多
Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation,providing advantages such as urban greening,reduced heat island effects,and decreased ...Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation,providing advantages such as urban greening,reduced heat island effects,and decreased air pollution.Moreover,it indirectly supports communities during weather events and natural disasters,ensuring food security and fostering community cohesion.However,concerns about planetary health risks persist in highly urbanized and climate-affected areas.Employing electronic databases such as Web of Science and PubMed and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,we identified 55 relevant papers to comprehend the planetary health risks associated with urban agriculture,The literature review identified five distinct health risks related to urban agriculture:(1)trace metal risks in urban farms;(2)health risks associated with wastewater irrigation;(3)zoonotic risks;(4)other health risks;and(5)social and economic risks.The study highlights that urban agriculture,while emphasizing environmental benefits,particularly raises concerns about trace metal bioaccumulation in soil and vegetables,posing health risks for populations.Other well studied risks included wastewater irrigation and backyard livestock farming.The main limitations in the available literature were in studying infectious diseases and antibiotic resistance associated with urban agriculture.展开更多
With the increasing urgency of the carbon emission reduction task,the generation expansion planning process needs to add carbon emission risk constraints,in addition to considering the level of power adequacy.However,...With the increasing urgency of the carbon emission reduction task,the generation expansion planning process needs to add carbon emission risk constraints,in addition to considering the level of power adequacy.However,methods for quantifying and assessing carbon emissions and operational risks are lacking.It results in excessive carbon emissions and frequent load-shedding on some days,although meeting annual carbon emission reduction targets.First,in response to the above problems,carbon emission and power balance risk assessment indicators and assessment methods,were proposed to quantify electricity abundance and carbon emission risk level of power planning scenarios,considering power supply regulation and renewable energy fluctuation characteristics.Secondly,building on traditional two-tier models for low-carbon power planning,including investment decisions and operational simulations,considering carbon emissions and power balance risks in lower-tier operational simulations,a two-tier rolling model for thermal power retrofit and generation expansion planning was established.The model includes an investment tier and operation assessment tier and makes year-by-year decisions on the number of thermal power units to be retrofitted and the type and capacity of units to be commissioned.Finally,the rationality and validity of the model were verified through an example analysis,a small-scale power supply system in a certain region is taken as an example.The model can significantly reduce the number of days of carbon emissions risk and ensure that the power balance risk is within the safe limit.展开更多
Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fra...Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.展开更多
BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages ...BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.展开更多
Objective To identify technical risks in the process of innovative drug development,and to provide reference for technical risk management so as to reduce the uncertainties and improve the efficiency of research and d...Objective To identify technical risks in the process of innovative drug development,and to provide reference for technical risk management so as to reduce the uncertainties and improve the efficiency of research and development.Methods The initial risk index was investigated by literature research.Then,the Likert scale was used to design a questionnaire,and the experts’opinion was used to analyze the risk factors affecting the different stages of the development of innovative drugs in China.Results and Conclusion Based on the analysis of questionnaire,31 risk indicators of five key stages in the development of innovative drugs from drug discovery to marketing authorization were established.The key risk indicators constructed in this study can provide reference for technology-related risk management in the process of innovative drug development.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-pres...Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.展开更多
The Nigerian oil sands represent the largest oil sand deposit in Africa, yet there is little published information on the distribution and potential health and ecological risks of trace elements in the oil resource. I...The Nigerian oil sands represent the largest oil sand deposit in Africa, yet there is little published information on the distribution and potential health and ecological risks of trace elements in the oil resource. In the present study, we investigated the distribution pattern of 18trace elements(including biophile and chalcophile elements) as well as the estimated risks associated with exposure to these elements. The results of the study indicated that Fe was the most abundant element, with a mean concentration of 22,131 mg/kg while Br had the lowest mean concentration of 48 mg/kg. The high occurrence of Fe and Ti suggested a possible occurrence of ilmenite(Fe TiO_(3)) in the oil sands. Source apportionment using positive matrix factorization showed that the possible sources of detected elements in the oil sands were geogenic, metal production, and crustal. The contamination factor, geo-accumulation index, modified degree of contamination, pollution load index, and Nemerow pollution index indicated that the oil sands are heavily polluted by the elements. Health risk assessment showed that children were relatively more susceptible to the potentially toxic elements in the oil sands principally via ingestion exposure route(HQ > 1E-04). Cancer risks from inhalation are unlikely due to CR < 1E-06 but ingestion and dermal contact pose severe risks(CR > 1E-04). The high concentrations of the elements pose serious threats due to the potential for atmospheric transport, bioaccessibility, and bioavailability.展开更多
Fluopyram is an succinate dehydrogenase inhibitors(SDHI)fungicide that has been registered in China to control gummy stem blight(GSB)in watermelons for many years.However,whether the field pathogens of GSB are still s...Fluopyram is an succinate dehydrogenase inhibitors(SDHI)fungicide that has been registered in China to control gummy stem blight(GSB)in watermelons for many years.However,whether the field pathogens of GSB are still sensitive to fluopyram or not is unknown.Therefore,we collected 69 Didymella bryoniae isolates from the fields that usually use fluopyram to control GSB to determine the sensitivity change.The EC50(50%inhibition effect)values of fluopyram against D.bryoniae ranged from 0.0691 to 0.3503μg mL–1 and the variation factor was 5.07.The mean EC50 value was(0.1579±0.0669)μg mL–1 and the curve of sensitivity was unimodal.No resistant strains were found in the isolates,which means that the pathogens were still sensitive to fluopyram.The minimal inhibition concentration(MIC)of fluopyram against D.bryoniae was 3μg mL–1.Four low-resistant mutants and two mediumresistant mutants were obtained using fungicide taming and the resistance of mutants could be inherited stably.The growth rate of mutants decreased significantly compared with that of wild-type strains while the biomass of most mutants was similar to that of wild-type strains.The sensitivity of most resistant mutants to various stresses was increased compared with that of wild-type strains.The virulence of mutants receded except for low-resistant mutant XN51FR-1,which had the same lesion area as XN51 on the watermelon leaves.The results indicated that the fitness of resistant mutants was decreased compared with that of wild-type strains.The cross-resistance assay indicated that fluopyram-resistant mutants were positive cross-resistant to all six SDHI fungicides in this test but were still sensitive to fluazinam and tebuconazole.So the resistance risk of D.bryoniae to fluopyram was moderate.In addition,we found that the SdhB gene of low-resistant mutant XN30FR-1 had three new point mutations at positions K258N,A259P,and H277N.Medium-resistant mutant XN52FR-1 showed a mutation at position H277N and other mutants did not have any point mutation.展开更多
基金key technology project for the prevention and control of major workplace safety accidents in 2017 from the State Administration of Work Safety of China-the research on the identification and assessment technology and control system of major risks of enterprises for the prevention and control of severe accidents(Hubei-0002-2017AQ)supported by the Department of Emergency Management of Hubei Province,Wuhan 430064,China.
文摘The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.
基金supported by the Shandong Province Science and Technology Project(2023TSGC0509,2022TSGC2234)Qingdao Science and Technology Plan Project(23-1-5-yqpy-2-qy).
文摘Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.
文摘This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverage, stock and bond valuation, cost of capital, and managerial behavior. We also discuss how the effect of climate risk on real estate markets depends on individuals’ beliefs about climate change. Furthermore, we summarize papers on climate risk activism and how firms can employ financial devices and technology to mitigate their climate risk. Finally, we make some recommendations for further research areas.
文摘Dongtan is set to be developed as a sustainable urban-rural integration,aiming to attract a wide range of commercial and leisure investments.The Shanghai Industrial Investment Corporation(SIIC),the largest international investment group owned by the Shanghai municipal government,is leading the Dongtan project in partnership with Arup.The project’s risks are categorized into eight major groups:(1)Force majeure,(2)people-related risks,(3)financial and economic risks,(4)political and country risks,(5)environmental risks,(6)completion-related risks,(7)design-related risks,and(8)technology risks.Among these,political risk is particularly notable for its high probability and significant impact.Effective project risk management is essential to foresee and address uncertainties that could jeopardize the project’s objectives and timelines.Appropriate strategies must be implemented to manage and mitigate these risks.
基金financially supported by the National Ministry of Industry and Information Technology Innovation Special Project-Engineering Demonstration Application of Subsea Production System,Topic 4:Research on Subsea X-Tree and Wellhead Offshore Testing Technology(Grant No.MC-201901-S01-04)the Key Research and Development Program of Shandong Province(Major Innovation Project)(Grant Nos.2022CXGC020405,2023CXGC010415)。
文摘Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.
基金This work was supported by the Ministry of Higher Education(MOHE),Malaysia,through Fundamental Research Grant Scheme(FRGS/1/2022/SKK10/UTAR/02/1)Universiti Tunku Abdul Rahman,Malaysia,through UTAR-Research Grant(IPSR/RMC/UTARRF/2021-C2/L08)MBBS Community Health Project(2022/2023),UTAR.
文摘Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.
基金This workwas supported by the Medical and Health Science and Technology Project of Zhejiang Province(No.2021KY180).
文摘Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall survival time of patients.This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.Methods:This study included a derivation cohort and validation cohort.The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,2020.An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions.Based on the questionnaire,inpatient data were collected to form a model-derivation cohort.This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model reliability.The validation cohort included patients from August 1,2021 to December 31,2021 at the same hospital.Using the same imputation method,we organized the validation-queue data.We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue.We compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration curve.Results:The derivation cohort included 1377 patients,and the validation cohort included 131 patients.The independent predictors of AL after radical gastrectomy included age65 y,preoperative albumin<35 g/L,resection extent,operative time240 min,and intraoperative blood loss90 mL.The predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p<0.001)with a Brier score of 0.049.The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052.External validation showed an AUROC of 0.723(95%CI:0.564e0.882;p?0.006)and a Brier score of 0.055,confirming reliability in different clinical settings.Conclusions:We successfully developed a risk-prediction model for AL following radical gastrectomy.This tool will aid healthcare professionals in anticipating AL,potentially reducing unnecessary interventions.
文摘A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct or indirect potable reuse options. These options have garnered more interest as a result of water supply limitations in many urban areas. This risk assessment was developed from a risk assessment developed at the University of Miami in 2001 and Florida Atlantic University (FAU) in 2023. Direct potable reuse and injection wells were deemed to have the lowest risk in the most recent study by FAU. However, the injection well option may not be available everywhere. As a result, a more local means to assess exposure risk is needed. This paper outlines the process to evaluate the public health risks associated with available disposal alternatives which may be very limited in some areas. The development of exposure pathways can help local decision-makers define the challenges, and support later expert level analysis upon which public health decisions are based.
基金supported by National Natural Science Foundation of China(71974001,72374001)National Social Science Foundation of China(22ZDA112,19BTJ014)+3 种基金the Social Science Foundation of the Ministry of Education of China(21YJAZH081)Anhui Provincial Natural Science Foundation(2108085Y24)the University Social Science Research Project of Anhui Province(2022AH020048,SK2020A0051)the Anhui University of Finance and Economics Graduate Research Innovation Funds(ACYC2021390)。
文摘This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study constructed a tail-risk spillover network(TRSN) of IEM and simulated the dynamic spillover tail-risk process through the cascading failure mechanism. The study found that renewable energy markets contributed more to systemic risk during the Paris Agreement and the COVID-19pandemic, while fossil energy markets played a larger role during the Russia-Ukraine conflict. This study identifies systemically important markets(SM) and critical tail-risk spillover paths as potential sources of systemic risk. The research confirms that cutting off the IEM risk spillover path can greatly reduce systemic risk and the influence of SM. This study offers insights into the management of systemic risk in IEM and provides policy recommendations to reduce the impact of shock events.
文摘Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.
基金National Natural Science Foundation of China(Nos.42171444,42301516)Beijing Natural Science Foundation Project-Municipal Education Commission Joint Fund Project(No.KZ202110016021)Beijing Municipal Education Commission Scientific Research Project-Science and Technology Plan General Project(No.KM202110016005).
文摘Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.
文摘Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation,providing advantages such as urban greening,reduced heat island effects,and decreased air pollution.Moreover,it indirectly supports communities during weather events and natural disasters,ensuring food security and fostering community cohesion.However,concerns about planetary health risks persist in highly urbanized and climate-affected areas.Employing electronic databases such as Web of Science and PubMed and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,we identified 55 relevant papers to comprehend the planetary health risks associated with urban agriculture,The literature review identified five distinct health risks related to urban agriculture:(1)trace metal risks in urban farms;(2)health risks associated with wastewater irrigation;(3)zoonotic risks;(4)other health risks;and(5)social and economic risks.The study highlights that urban agriculture,while emphasizing environmental benefits,particularly raises concerns about trace metal bioaccumulation in soil and vegetables,posing health risks for populations.Other well studied risks included wastewater irrigation and backyard livestock farming.The main limitations in the available literature were in studying infectious diseases and antibiotic resistance associated with urban agriculture.
基金supported by Science and Technology Project of State Grid Anhui Electric Power Co.,Ltd. (No.B6120922000A).
文摘With the increasing urgency of the carbon emission reduction task,the generation expansion planning process needs to add carbon emission risk constraints,in addition to considering the level of power adequacy.However,methods for quantifying and assessing carbon emissions and operational risks are lacking.It results in excessive carbon emissions and frequent load-shedding on some days,although meeting annual carbon emission reduction targets.First,in response to the above problems,carbon emission and power balance risk assessment indicators and assessment methods,were proposed to quantify electricity abundance and carbon emission risk level of power planning scenarios,considering power supply regulation and renewable energy fluctuation characteristics.Secondly,building on traditional two-tier models for low-carbon power planning,including investment decisions and operational simulations,considering carbon emissions and power balance risks in lower-tier operational simulations,a two-tier rolling model for thermal power retrofit and generation expansion planning was established.The model includes an investment tier and operation assessment tier and makes year-by-year decisions on the number of thermal power units to be retrofitted and the type and capacity of units to be commissioned.Finally,the rationality and validity of the model were verified through an example analysis,a small-scale power supply system in a certain region is taken as an example.The model can significantly reduce the number of days of carbon emissions risk and ensure that the power balance risk is within the safe limit.
文摘Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.
文摘BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.
文摘Objective To identify technical risks in the process of innovative drug development,and to provide reference for technical risk management so as to reduce the uncertainties and improve the efficiency of research and development.Methods The initial risk index was investigated by literature research.Then,the Likert scale was used to design a questionnaire,and the experts’opinion was used to analyze the risk factors affecting the different stages of the development of innovative drugs in China.Results and Conclusion Based on the analysis of questionnaire,31 risk indicators of five key stages in the development of innovative drugs from drug discovery to marketing authorization were established.The key risk indicators constructed in this study can provide reference for technology-related risk management in the process of innovative drug development.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
文摘Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
文摘The Nigerian oil sands represent the largest oil sand deposit in Africa, yet there is little published information on the distribution and potential health and ecological risks of trace elements in the oil resource. In the present study, we investigated the distribution pattern of 18trace elements(including biophile and chalcophile elements) as well as the estimated risks associated with exposure to these elements. The results of the study indicated that Fe was the most abundant element, with a mean concentration of 22,131 mg/kg while Br had the lowest mean concentration of 48 mg/kg. The high occurrence of Fe and Ti suggested a possible occurrence of ilmenite(Fe TiO_(3)) in the oil sands. Source apportionment using positive matrix factorization showed that the possible sources of detected elements in the oil sands were geogenic, metal production, and crustal. The contamination factor, geo-accumulation index, modified degree of contamination, pollution load index, and Nemerow pollution index indicated that the oil sands are heavily polluted by the elements. Health risk assessment showed that children were relatively more susceptible to the potentially toxic elements in the oil sands principally via ingestion exposure route(HQ > 1E-04). Cancer risks from inhalation are unlikely due to CR < 1E-06 but ingestion and dermal contact pose severe risks(CR > 1E-04). The high concentrations of the elements pose serious threats due to the potential for atmospheric transport, bioaccessibility, and bioavailability.
基金sponsored by the National Key R&D Program of China(2022YFD1400900)the National Natural Science Foundation of China(32272585)the Fundamental Research Funds for the Central Universities,China(KYCXJC2023003)。
文摘Fluopyram is an succinate dehydrogenase inhibitors(SDHI)fungicide that has been registered in China to control gummy stem blight(GSB)in watermelons for many years.However,whether the field pathogens of GSB are still sensitive to fluopyram or not is unknown.Therefore,we collected 69 Didymella bryoniae isolates from the fields that usually use fluopyram to control GSB to determine the sensitivity change.The EC50(50%inhibition effect)values of fluopyram against D.bryoniae ranged from 0.0691 to 0.3503μg mL–1 and the variation factor was 5.07.The mean EC50 value was(0.1579±0.0669)μg mL–1 and the curve of sensitivity was unimodal.No resistant strains were found in the isolates,which means that the pathogens were still sensitive to fluopyram.The minimal inhibition concentration(MIC)of fluopyram against D.bryoniae was 3μg mL–1.Four low-resistant mutants and two mediumresistant mutants were obtained using fungicide taming and the resistance of mutants could be inherited stably.The growth rate of mutants decreased significantly compared with that of wild-type strains while the biomass of most mutants was similar to that of wild-type strains.The sensitivity of most resistant mutants to various stresses was increased compared with that of wild-type strains.The virulence of mutants receded except for low-resistant mutant XN51FR-1,which had the same lesion area as XN51 on the watermelon leaves.The results indicated that the fitness of resistant mutants was decreased compared with that of wild-type strains.The cross-resistance assay indicated that fluopyram-resistant mutants were positive cross-resistant to all six SDHI fungicides in this test but were still sensitive to fluazinam and tebuconazole.So the resistance risk of D.bryoniae to fluopyram was moderate.In addition,we found that the SdhB gene of low-resistant mutant XN30FR-1 had three new point mutations at positions K258N,A259P,and H277N.Medium-resistant mutant XN52FR-1 showed a mutation at position H277N and other mutants did not have any point mutation.