Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma

BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.

Survey and Prospect for Applying Knowledge Graph in Enterprise Risk Management

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.

Factors affecting farmers'choice to adopt risk management strategies:The application of multivariate and multinomial probit models

This study investigates the factors that impact farmers'adoption of risk management strategies(RMS)in Pakistan during times of uncertainty.The study examines farmers'adoption of RMS using both multinomial probit(MNP)and multivariate probit(MVP).Data were collected from 382 farmers sampled from four districts in KhyberPakhtunkhwa(KP)province of Pakistan via a multistage sampling technique.This study utilizes the MNP model,considering the assumption of Independence of Irrelevant Alternatives(IIA)and incorporating correlated error terms.The objective is to understand farmers'behavior in risky situations and determine if there is heterogeneity.Results are compared with the MVP model to assess robustness and gain deeper understanding of farmers'decisionmaking processes.The research findings reveal that our results are robust,and farmers behave homogeneously in various RMS scenarios.Farmers adopt RMS individually or in combination to mitigate the adverse effects of natural calamities on their livelihood.The risk-averse farmers,who perceive weather-related risks as a threat,access credits and information,and have farms close to a river are more likely to adopt RMS,irrespective of the format of the strategies available.Moreover,the predicted probabilities and correlation of the RMS and RM categories have strengthened our model estimation.These findings provide insights into the behavior of farmers in adopting RMS which are helpful for policymakers and stakeholders in developing strategies to mitigate the impacts of natural calamities on farmers.

Outpatient management of obscure gastrointestinal bleeding:A new perspective in high-risk patients

Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.

Understanding Osteoporosis: Pathophysiology, Risk Factors, Diagnosis, and Management

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.

Mapping Climate Services for Disaster Risk Management: A Systematic Review and Research Gaps from a Policy Process Perspective

Climate services (CS) are crucial for mitigating and managing the impacts and risks associated with climate-induced disasters. While evidence over the past decade underscores their effectiveness across various domains, particularly agriculture, to maximize their potential, it is crucial to identify emerging priority areas and existing research gaps for future research agendas. As a contribution to this effort, this paper employs the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to review the state-of-the-art in the field of climate services for disaster risk management. A comprehensive search across five literature databases combined with a snowball search method using ResearchRabbit was conducted and yielded 242 peer-reviewed articles, book sections, and reports over 2013-2023 after the screening process. The analysis revealed flood, drought, and food insecurity as major climate-related disasters addressed in the reviewed literature. Major climate services addressed included early warning systems, (sub)seasonal forecasts and impact-based warnings. Grounded in the policy processes’ theoretical perspective, the main focus identified and discussed three prevailing policy-oriented priority areas: 1) development of climate services, 2) use-adoption-uptake, and 3) evaluation of climate services. In response to the limitations of the prevalent supply-driven and top-down approach to climate services promotion, co-production emerges as a cross-cutting critical aspect of the identified priority areas. Despite the extensive research in the field, more attention is needed, particularly pronounced in the science-policy interface perspective, which in practice bridges scientific knowledge and policy decisions for effective policy processes. This perspective offers a valuable analytical lens as an entry point for further investigation. Hence, future research agendas would generate insightful evidence by scrutinizing this critical aspect given its importance to institutions and climate services capacity, to better understand intricate facets of the development and the integration of climate services into disaster risk management.

An Assessment of Procurement Risks Management Systems in the Public Sector

Risk management in public procurement is a critical aspect that needs to be addressed in the public sector.Several studies have been conducted to understand the challenges and factors influencing risk management in public procurement.These studies have explored the importance of risk management principles,the role of political influence,and the need for effective risk assessment and anticipation.The research has also highlighted the need for specific risk management mechanisms and tools to be implemented in public procurement processes.Risk management reforms in the public sector are essential but often circumvented due to assorted reasons,such as political influence and the emergence of new risks.The research investigation employs a quantitative research design.A total of 380 questionnaires were recovered from respondents.The study showed that the public sector has a procurement risk management system that is effective,but there may be some areas for improvement in the prequalification process,onboarding process,and support provided to newly onboarded suppliers.Additionally,the public sector used some strategies to mitigate and control contract risks during the procurement process,but there were some areas for improvement in the review and lessons learned process,risk mitigation measures,contract monitoring and performance evaluation mechanisms,and communication and documentation process.Finally,the results suggest that there were constraints placed on the risk management strategies currently utilized by professionals working in the public sector.These constraints include insufficient support and buy-in from senior management and stakeholders,bureaucratic or administrative hurdles,inadequate policies and regulations,insufficient training and skill development opportunities,and insufficient resources.The study highlights the significance of tackling risk management in the realm of public procurement and offers valuable perspectives on avenues for enhancement,obstacles encountered by practitioners,and the necessity of thorough evaluation and revisions.Through the adoption of the suggestions originating from this study,governmental entities can improve their procurement risk management frameworks and guarantee improved adherence to risk management principles.

Nursing Risk Management in the Prevention of Post-ERCP Pancreatitis

Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.

Electronic Commerce Security and Risk Management: An Important Part of College Curriculum

With the rapid expansion of e-commerce,its security and risk management problems become increasingly prominent.In the current business environment,the ability to understand and apply e-commerce security and risk management has become an important criterion to measure a good person.Therefore,the importance of e-commerce security and risk management courses in college education is self-evident.This course can not only help students master the basic knowledge of e-commerce,but also enable them to understand how to deal with various risks in practical work and ensure the safe operation of e-commerce.At the same time,through the study of e-commerce security and risk management,students can better understand the operation mode and law of e-commerce,and lay a solid foundation for their future career.In general,e-commerce security and risk management occupy an important position in the curriculum of colleges and universities,and play a crucial role in cultivating e-commerce professionals with practical operation ability and innovative thinking.

Research on Tax Risk Regulation and Strategic Management in the Context of Big Data

With the rapid development of big data,big data has been more and more applied in all walks of life.Under the big data environment,massive big data provides convenience for regional tax risk control and strategic decision-making but also increases the difficulty of data supervision and management.By analyzing the status quo of big data and tax risk management,this paper finds many problems and puts forward effective countermeasures for tax risk supervision and strategic management by using big data.

Internal Control Management and Risk Prevention Measures of State-Owned Enterprises

As an important pillar of national economic development,state-owned enterprises,their operational efficiency,and risk management ability are directly related to the stability and security of the national economy.As an important part of enterprise management,internal control management plays an irreplaceable role.Especially in the current domestic and international economic situation is complex and changeable,market competition is increasingly fierce environment,to strengthen the internal control management of state-owned enterprises and risk prevention measures is particularly important.This paper starts with the importance of internal control management and risk prevention for state-owned enterprises,and analyzes the problems and strategies in the internal control management and risk prevention of state-owned enterprises,in order to build a more comprehensive and efficient risk management system for state-owned enterprises to adapt to the ever-changing market environment and realize sustainable development.

Colonoscopic perforation:Incidence,risk factors,management and outcome

This review discusses the incidence,risk factors,management and outcome of colonoscopic perforation(CP).The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic interventions.The perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple comorbidities.Management of CP is mainly based on patients' clinical grounds and their underlying colorectal diseases.Current therapeutic approaches include conservative management(bowel rest plus the administration of broadspectrum antibiotics),endoscopic management,and operative management(open or laparoscopic approach).The applications of each treatment are discussed.Overall outcomes of patients with CP are also addressed.

Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management

The global burden of breast cancer continues to increase largely because of the aging and growth of the world population. More than 1.38 million women worldwide were estimated to be diagnosed with breast cancer in 2008, accounting for 23% of all diagnosed cancers in women. Given that the 5-year survival rate for breast cancer is now 90%, experiencing breast cancer is ultimately about quality of life. Women treated for breast cancer are facing a life-time risk of developing lymphedema, a chronic condition that occurs in up to 40% of this population and negatively affects breast cancer survivors' quality of life. This review offers an insightful understanding of the condition by providing clinically relevant and evidence based knowledge regarding lymphedema symptoms, diagnosis, risk reduction, and management with the intent to inform health care professionals so that they might be better equipped to care for patients.

Engineering complex systems applied to risk management in the mining industry

Related to complexity, there is a wide diversity of concepts, ranging from ‘‘systemic" to ‘‘complex", implying a need for a unified terminology. Per different authors, the main drivers of complexity can be found in human behaviour and uncertainty. This complexity, structural or dynamic can be organizational, technological, or nested in their relationship. ISO international standard 31000:2009 definition of risk management ‘‘coordinated activities to direct and control an organization with regard to risk", when applied to economic sectors, industry, services, project, or activity, it requires the use of models or theories as guidelines. Therefore, as its basic elements comprehend human behaviour and/or uncertainty, risk management to be effective and adapted as much as possible to reality, must be operational within complex systems, as already demonstrated in different R&D environments. Risk management faces demanding challenges when approaching specific and endogenous needs, such as the mining sector. This paper presents a multivariable function analysis methodology approach based on complex system modelling and through real data corresponding to a risk management tool in the mining sector.

Safety risk management of underground engineering in China：Progress, challenges and strategies

Underground construction in China is featured by large scale, high speed, long construction period,complex operation and frustrating situations regarding project safety. Various accidents have been reported from time to time, resulting in serious social impact and huge economic loss. This paper presents the main progress in the safety risk management of underground engineering in China over the last decade, i.e.（1） establishment of laws and regulations for safety risk management of underground engineering,（2） implementation of the safety risk management plan,（3） establishment of decision support system for risk management and early-warning based on information technology, and（4） strengthening the study on safety risk management, prediction and prevention. Based on the analysis of the typical accidents in China in the last decade, the new challenges in the safety risk management for underground engineering are identified as follows：（1） control of unsafe human behaviors;（2） technological innovation in safety risk management; and（3） design of safety risk management regulations. Finally, the strategies for safety risk management of underground engineering in China are proposed in six aspects, i.e. the safety risk management system and policy, law, administration, economy, education and technology.

Landslide susceptibility zonation method based on C5.0 decision tree and K-means cluster algorithms to improve the efficiency of risk management

Machine learning algorithms are an important measure with which to perform landslide susceptibility assessments, but most studies use GIS-based classification methods to conduct susceptibility zonation.This study presents a machine learning approach based on the C5.0 decision tree(DT) model and the K-means cluster algorithm to produce a regional landslide susceptibility map. Yanchang County, a typical landslide-prone area located in northwestern China, was taken as the area of interest to introduce the proposed application procedure. A landslide inventory containing 82 landslides was prepared and subsequently randomly partitioned into two subsets: training data(70% landslide pixels) and validation data(30% landslide pixels). Fourteen landslide influencing factors were considered in the input dataset and were used to calculate the landslide occurrence probability based on the C5.0 decision tree model.Susceptibility zonation was implemented according to the cut-off values calculated by the K-means cluster algorithm. The validation results of the model performance analysis showed that the AUC(area under the receiver operating characteristic(ROC) curve) of the proposed model was the highest, reaching 0.88,compared with traditional models(support vector machine(SVM) = 0.85, Bayesian network(BN) = 0.81,frequency ratio(FR) = 0.75, weight of evidence(WOE) = 0.76). The landslide frequency ratio and frequency density of the high susceptibility zones were 6.76/km^(2) and 0.88/km^(2), respectively, which were much higher than those of the low susceptibility zones. The top 20% interval of landslide occurrence probability contained 89% of the historical landslides but only accounted for 10.3% of the total area.Our results indicate that the distribution of high susceptibility zones was more focused without containing more " stable" pixels. Therefore, the obtained susceptibility map is suitable for application to landslide risk management practices.

The use of UAVs for landslide disaster risk research and disaster risk management: a literature review

On a global scale,from 2005 to 2019,there were 275 high-magnitude,low-frequency disasters that involved 14,172 fatalities and four million affected people.Similar patterns have taken place during longer periods of time in recent decades.This paper aims to analyse the contribution of the international landslide research community to disaster risk reduction and disaster risk management in reference to the use of Unmanned Aerial Vehicles(UAVs)in a literature review.The first section notes the relevance of disaster risk research contributions for the implementation of initiatives and strategies concerning disaster risk management.The second section highlights background information and current applications of drones in the field of hazards and risk.The methodology,which included a systematic peer review of journals in the ISI Web of Science and SCOPUS,was presented in the third section,where the results include analyses of the considered data.This study concludes that most current scholarly efforts remain rooted in hazards and post-disaster evaluation and response.Future landslide disaster risk research should be transdisciplinary in order to strengthen participation of the various relevant stakeholders in contributing to integrated disaster risk management at local,subnational,national,regional and global levels.

Post-pancreaticoduodenectomy hemorrhage:risk factors, managements and outcomes

BACKGROUND： Post-pancreaticoduodenectomy（PD） hemorrhage（PPH） is an uncommon but serious complication. This retrospective study analyzed the risk factors, managements and outcomes of the patients with PPH.METHODS： A total of 840 patients with PD between 2000 and2010 were retrospectively analyzed. Among them, 73 patients had PPH： 19 patients had early PPH and 54 had late PPH.The assessment included the preoperative history of disease,pancreatic status and surgical techniques. Other postoperative complications were also evaluated.RESULTS： The incidence of PPH was 8.7%（73/840）. There were no independent risk factors for early PPH. Male gender（OR=4.40, P0.02）, diameter of pancreatic duct（OR=0.64,P0.01）, end-to-side invagination pancreaticojejunostomy（OR=5.65, P0.01）, pancreatic fistula（OR=2.33, P0.04）and intra-abdominal abscess（OR=12.19, P0.01） were the independent risk factors for late PPH. Four patients with early PPH received conservative treatment and 12 were treated surgically. As for patients with late PPH, the success rate of medical therapy was 27.8%（15/54）. Initial endoscopy was operated in 12 patients（22.2%）, initial angiography in 19（35.2%）,and relaparotomy in 15（27.8%）. Eventually, PPH resulted in 19 deaths. The main causes of death were multiple organ failure,hemorrhagic shock, sepsis and uncontrolled rebleeding.CONCLUSIONS： Careful and ongoing observation of hemorrhagic signs, especially within the first 24 hours after PD or within the course of pancreatic fistula or intra-abdominal abscess, is recommended for patients with PD and a prompt management is necessary. Although endoscopy and angiography are the standard procedures for the management of PPH,surgical approach is still irreplaceable. Aggressive prevention of hemorrhagic shock and re-hemorrhage is the key to treat PPH.

Critical role of risk management in ground engineering and opportunities for improvement

Green mining is concerned with mining in a sustainable manner, such that the needs of the present are met without compromising future generations. The achievement of this objective depends on balancing social, environmental and economic objectives and has to have regard to both active mining operations and legacy issues associated with mine closure. Ground engineering has a critical role in achieving green mining objectives but its contribution is characterised by pervasive uncertainty. Uncertainty equates to risk. This means that ground engineering should be practiced within a risk management framework that aims to both prevent unwanted outcomes and to mitigate their consequences to an acceptable level. This keynote address presents the fundamentals of risk management and demonstrates its effectiveness by reference to improvements in the safety performance of the NSW coal sector over the past three decades.Nevertheless, ground control remains a mix of art and science, relying heavily on judgements which should be premised on knowledge, skill and experience(that is, competence). Risk management has now been enshrined in mining legislation and operating practice in Australia for over two decades.Notwithstanding this, near-hit and accident and incident investigations, commissions of inquiry and legal proceedings almost invariably identify deficiencies and opportunities for improvements necessary to achieve the objectives of sustainable mining. Three of the more important opportunities which have global application in relation to ground engineering are discussed. These relate to the vexing issue of defining competency in ground engineering; the criteria for undertaking rigorous risk assessment; and the need for ground engineers to become involved in mine rehabilitation and closure planning over the full life cycle of a mine, commencing at the prefeasibility stage.

Managing Climate Change Risk in China's Agricultural Sector: The Potential for an Integrated Risk Management Framework

Climate change poses a serious threat to the future food security of China, which is among the most disaster-prone countries in the world. This paper discusses the implications of climate change for China＇s agricultural sector. Its main objectives are to identify the agricultural risks associated with climate change, to introduce a conceptual framework for agricultural climate risk management and to enumerate key adaptation strategies, challenges, and recommendations.