Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

Application Analysis of Nursing Students'Grades in Course Relevance Based on Association Rule Mining Algorithm Apriori

By analyzing the correlation between courses in students’grades,we can provide a decision-making basis for the revision of courses and syllabi,rationally optimize courses,and further improve teaching effects.With the help of IBM SPSS Modeler data mining software,this paper uses Apriori algorithm for association rule mining to conduct an in-depth analysis of the grades of nursing students in Shandong College of Traditional Chinese Medicine,and to explore the correlation between professional basic courses and professional core courses.Lastly,according to the detailed analysis of the mining results,valuable curriculum information will be found from the actual teaching data.

Characterization and comparison of the aroma-active compounds on different grades of sesame-flavor Baijiu by headspace solid-phase microextraction and gas chromatography-olfactometry-mass spectrometry

This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfactometry-mass spectrometry(GC-O-MS).A total of 54 aroma-active compounds were detected.Principal component analysis showed that JZ1,JZ2,and JZ3 were well separated from each other.JZ1 as the premium-grade Baijiu had the highest aroma intensities,concentrations.According to aroma intensities and concentrations,dimethyl trisulfide,butanoic acid,phenylacetaldehyde,2-furylmethanethiol,ethyl hexanoate,2,6-dimethylpyrazine,etc.could be potentially applied as volatile makers to distinguish the three different grades of sesame-flavor Baijiu as their significant difference(P<0.05)in three Baijiu samples.Roasted aroma had the significant difference(P<0.05)in three sample base on aroma profiles.Meanwhile,2-furylmethanethiol,2,6-dimethylpyrazine were related to the roasted aroma,they may be had a significant contribution to the differences of three different grades of sesame-flavor Baijiu.This study has provided a comprehensive understanding of the differences of three different grades of sesame-flavor Baijiu.

Spatial and Temporal Distribution of Different Grades of Short-time Precipitation in Xining City

Based on the hourly precipitation data from 4 observation stations of Xining City from June to September during 2005-2011,the temporal and spatial distribution characteristics of short-time precipitation were analyzed.The results show that the precipitation distribution in Xining region exhibited the less-more-less trend from southwest to northeast,while the torrential rain gradually increased from the northwest and southwest to the middle.The hourly general precipitation in Xining region had obviously seasonal characteristics,and its annual distribution showed wavy changes,but the annual variation of short-time heavy precipitation and rainstorm was very obvious.Furthermore,short-time heavy precipitation was concentrated from 18:00 to 24:00,followed by 03:00-07:00 on the following day.The occurrence time of short-time rainstorm accorded with short-time heavy precipitation.It offers a useful reference for the accurate and timely short-term forecast.

A Preliminary Study on Strategies to Improve Writing Skills in Lower Grades of Primary School

Teaching writing is an essential component of Chinese education in primary schools and an important foundation for students’reading,writing,and core literacy development.However,due to various reasons,children in the lower grades always face multiple difficulties in the learning task of writing.Based on this educational status quo,this article puts forward strategic suggestions for improving writing skills in the lower grades of primary school.Teachers should analyze students and attend to each student individually,optimize teaching methods,and implement hierarchical teaching.They should also strengthen the training of students’fine motor skills to solidify the physiological foundation for writing.Emphasis should be placed on cultivating the core quality of aesthetic creation.Employing multiple process evaluations can inspire children’s long-term interest in learning.

Influence of Online Learning Attitude in the Blended Teaching Model on the Final Grades

The combination of online teaching and traditional offline teaching can maximize the advantages of both.Based on the blended teaching of English Reading course,39 students were selected as the research subjects to study the relationship between their online learning attitudes and their grades in the final examination.Judged from the number of times for each student to download teaching resources,the number of assignments submitted online,and the quality of the submitted assignments,each student’s attitude toward online learning was examined comprehensively,and a correlation analysis was conducted through SPSS Statistics 21.0 to explore the influence of online learning attitude on English reading performance.Through data collection and analysis of the online learning attitudes over a 16-week period,a significant positive correlation was found between the online learning attitudes and the English reading grades,indicating that the online learning attitude in the blended learning model plays a crucial role in improving the English reading skill,and students should maintain a positive attitude toward online teaching in blended learning.

Annual Monitoring and Evaluation of the Grades of Arable Land Quality——Taking Lingchuan County as an Example

With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and development trends of arable land quality. It is also an important measure for protecting the quality of arable land. in the present study, the distribution and changes of arable lands of different gradient types and grades in Lingchuan County, Guangxi Zhuang Autonomous Region in 2015 were monitored and evaluated, to analyze the trends and reasons for the changes in the quality and productivity of arable lands, and to provide references for dynamic monitoring of the quality of arable land.

Trends in the Different Grades of Precipitation over South China during 1960–2010 and the Possible Link with Anthropogenic Aerosols

Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades of precipitation during the period 1960-2010 was analyzed and the possible link with anthropogenic aerosols examined.Statistical analysis showed that drizzle and small precipitation has significantly decreased,whereas medium to heavy precipitation has increased slightly over the past 50 years （although not statistically significant）.Further data analysis suggested that the decline in drizzle and small precipitation probably has a strong link to increased concentrations of anthropogenic aerosols produced by large-scale human activities related to the rapid socioeconomic development of the PRD region.These aerosols may also have led to the obvious decreasing trend in horizontal visibility and sunshine duration in SC,which is statistically significant according to the t-test.

Effects of PM2.5 Exposure in Different Air Quality Grades on Daily Outpatient Visits for Childhood Asthma in Shijiazhuang, China

Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,

Effect of copper slag recovery on hydrometallurgical cut-off grades considering environmental aspects

Determining the hydrometallurgical cut-off grades specifies the destination of low grade materials and this is subjected to more benefits in mining. Copper production rate is considered as one of the fundamental issues in hydrometallurgical cut-off grades determination. Slags are remarked as one of the main sources of copper. It is not only regarded as a waste but also identified as another resource extracting base metals. Slags are characterized by copper high grade. Thus, slag copper recovery can be led to different cut-off grades and net present value(NPV). The current research scrutinizes the effect of slag recovery by both flotation and hydrometallurgical methods on the hydrometallurgical cut-off grades. For this purpose, the optimum cut-off grade algorithms of hydrometallurgical methods are developed by considering associated environmental parameters, incomes and also the costs. Then, their optimum amounts are calculated with NPV maximization as an objective function. The results indicate that considering slag copper recovery in the hydrometallurgical cut-off grade algorithms reduces the environmental costs caused by slag dumping and leads to more NPV by 9%.

Optimization of Shanghai Marine Environmental Monitoring Sites in the Identification of Boundaries of Different Water Quality Grades

Water quality is critical to ensure that marine resources and the environment are utilized in a sustainable manner. The objective of this study is therefore to investigate the optimum placement of marine environmental monitoring sites to monitor water quality in Shanghai, China. To improve the mapping or estimation accuracy of the areas with different water quality grades, the monitoring sites were fixed in transition bands between areas of different grades rather than in other positions. Following bidirectional optimization method, first, 18 candidate sites were selected by filtering out specific site categories. Second, three of these were, in turn, eliminated because of the rule defined by the changes in the areas of water quality grades and by the standard deviation of the interpolation errors of dissolved inorganic nitrogen(DIN) and phosphate(PO_4-P). Furthermore, indicator kriging was employed to depict the transition bands between different water quality grades whenever new sampling sites were added. The four optimization projects of the newly added sites reveal that, all optimized sites were distributed in the transition bands of different water grades, and at the same time in the areas where the historical sites were sparsely distributed. New sites were also found in the overlap region of different transition bands. Additional sites were especially required in these regions to discriminate the boundaries of different water quality grades. Using the bidirectional optimization method of the monitoring sites, the boundaries of different water quality grades could be determined with a higher precision. As a result, the interpolation errors of DIN and PO_4-P could theoretically decrease.

Research on Relationship Between Humic Substance Grades and Their Dispersion Ability as CWM Additives

Four humic coal samples are extracted to obtain humic substances (HS), and then subdivided(or purified) to obtain sixteen grades of HS, four from each coal. The effectiveness of these sixteen HS samples as additives for producing coal water mixture (CWM) is tested (w (additive) = 1 % and the the coal used is from the Baiyi coal preparation plant). A linear regression analysis of viscosity versus the additive’s components shows: (1)humic acids(HA) and humin (HM) are much better than fulvic acids (HF) with HA being tbe best, and (2) tke effects of grades of HS on coal dispersion as measured by viscosity are quite different. CWM additive effectiveness correlates positively with the increase of E4/E6,ash content, acid groups, and carboxyl groups, and negatively with the increase of molecular weight, HS content and phenolic alcohol content.

Reconstruction of the Rainfall in Rainy Season Based on Historical Drought/Flood Grades

On the basis of historical yearly drought and flood grades from A.D.1470 to A.D.1949, the ten-year mean precipitation in the rainy season in Wuhan district was reconstructed by means of statistical method. The reconstructing method was testified to be simple and effective.

RELATION BETWEEN MORPHOMETRIC GRADES OF BLADDER TUMOR AND PROGNOSIS

The relation between morphometric grades (M grading) of 84 cases of bladder tumor and prognoses was evaluated. The results shown that the higher the M grading, the lower the survival rate and the higher the recurrence rate. As the M grade increases, the tumor has partial of total absence of ABO(H) antigens of tumor cell surface and could be accompanied with muscular invasion. When recurring, the tumor has a poor prognosis if M grading increases from lower to higher grades. The morphometric grading system is able to make a quantitative pathologic diagnosis and can predict the biological behavior of bladder tumors.

Non Alcoholic Fatty Liver Disease: Assessment of Lipid Profile Estimation in Different Grades of Fatty Liver on Ultrasound

Background: Non Alcoholic Fatty Liver Disease (NAFLD) is common hepatic disorder which is recognized as a great health problem causing different diseases worldwide. To determine non-alcoholic fatty liver and assess the relation of fasting total lipids with different grades of fatty liver (NAFLD) subjects diagnosed through ultrasound. By identifying the risk factors of Lipid Profile and NAFLD, the health care provider can properly manage it, even awareness specific for patients and community as general being launched to diminish the morbidity and mortality by this study. Methods: This cross-sectional research carried out at Medicine Department of PMCH, Shaheed Benazirabad. This study comprises 300 subjects of NAFLD. Patients who attended the medicine department with abdominal complains after examination consultant advised ultrasound. The ultrasound performed in Radiology department, patients with findings of fatty liver selected, and history taken from all the patients with special regard to alcoholism. Fasting lipid profile done in all patients included in present study. The blood samples collected from a vein and immediately sent to the laboratory. Results: This present study enlisted total 300 patients out of them 203 (67.7%) belonged to male gender and 97 (32.3%) were females. A ratio of 2.1:1 observed in male and female subjects. There were 176 (58.7%) patients in grade I, while 82 (27.3%) patients in grade II and 42 (14%) patients in grade III. The cholesterol value was abnormal in 186 (62%), while normal in remaining 114 (38%) patients. Triglycerides were abnormal in 152 (50.7%) while in 148 (49.3%) patients were normal. HDL in 155 (51.7%) patients was abnormal while 145 (48.3%) patients had normal values. Low density lipoprotein value in 117 (39%) patient was abnormal and 183 (61%) patient normal. Very low-density lipoprotein in 117 (39%) patients was abnormal and 183 (61%) patient normal. The mean age and SD of patients in present study was 46.83 ± 8.82, with minimum 30 years and maximum age 65 years respectively (p value 0.000). The mean and SD of total cholesterol value was 154.66 ± 58.88 mg/dl (p value 1.000), TG 180.98 ± 96.46 mg/dl (p value 0.974), HDL-C 32.13 ± 5.88 mg/dl (p value 0.000), LDL-C 116.41 ± 41.002 mg/dl (p value 0.000), and VLDL-C was 43.47 ± 34.34 mg/dl (p value 0.000). Conclusions: In current study, variable changes in lipid profile observed amongst NAFLD (non-alcoholic fatty liver disease) patients who diagnosed on ultrasound. Early diagnosis and treatment of non alcoholic fatty liver with abnormal lipids can prevent from long-term complication of fatty liver.

Adaptive System for Assigning Reliable Students’ Letter Grades—A Computer Code

The availability of automated evaluation methodologies that may reliably be used for determining students’ scholastic performance through assigning letter grades are of utmost practical importance to educators, students, and do invariably have pivotal values to all stakeholders of the academic process. In particular, educators use letter grades as quantification metrics to monitor students’ intellectual progress within a framework of clearly specified learning objectives of a course. To students grades may be used as predictive measures and motivating drives for success in a study field. However due to numerous objective and subjective variables that may by be accounted for in a methodological process of assigning students’ grades, and since such a process is often tainted with personal philosophy and human psychology factors, it is essential that educators exercise extra care in maximizing positive account of all objective factors and minimizing negative ramifications of subjectively fuzzy factors. To this end, and in an attempt to make assigning students’ grades more reliable for assessing true-level of mastering specified learning outcomes, this paper will: i) provide a literature review on previous works on the most common methods that have traditionally been in use for assigning students’ grades, and a short account of the virtues and/or vices of such methods, and ii) present a user-friendly computer code that may be easily adapted for the purpose of assigning students’ grades. This would relieve educators from the overwhelming concerns associated with mechanistic aspects of determining educational metrics, and it would allow them to have more time and focus to obtain reliable assessments of true-level of students’ mastery of learning outcomes by accounting for all possible evaluation components.

Correlation Between Playing an Instrument and Grades in Middle and High School Students in the U.S.

The purpose of this study is to determine if there is a correlation between grades and playing an instrument.Furthermore,it will be determined if the number of hours one spends practicing their instrument and how long one has played their instrument affects one’s grade in a class.The data for this study were obtained through a Google Form and were targeted towards middle and high school students in the United States.Results of this study concluded that there is a correlation between playing an instrument and one’s grades in certain subjects.It was also determined that the amount of time spent practicing or how long one has played an instrument also had an impact on one’s grades in certain subjects.

On the Modern English Picture Book in the Teaching of English Reading in Lower Grades of Elementary School

Nowadays, more and more educators have affirmed that picture book plays an important significance in the development of children and thought that reading picture book is indispensable to the education of lower grades of elementary school.However, the teaching of reading in English, most teachers have not realized the satisfactory teaching effect, it is necessary to analyze the theoretical basis of English picture book and its application in the teaching of English reading in lower grades of elementary school and dig its value.

The clinical study of preoperative external lumbar drainage in patients with aneurysmal subarachnoid hemorrhage in Hunt and Hess grades Ⅰ～Ⅲ undergoing early surgery

Objective To explore the therapeutic effect of preoperative external lumbar drainage in Hunt and Hess grade Ⅰ～Ⅲ patients with subarachnoid hemorrhage (SAH) undergoing early surgery for intracranial aneurysms. Methods 101 cases of gradeⅠ～Ⅲ patients according to the classification of Hunt and Hess

Tumor regression grades:Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy

AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were studied.All patients underwent radical surgery(between 2004 and 2010)after 30-Gy/10-fraction preoperative radiotherapy(preRT).All 190 patients received a short course of preRT and were reassessed for disease recurrence and survival;the slides of surgical specimens were reviewed and classified according to Mandard TRG.We compared patients with good response(Mandard TRG1 or TRG2)vs patients with bad/poor response(Mandard TRG3-5).Outcomes evaluated were 5-year overall survival(OS),5-year disease-free survival(DFS),and local,distant and mixed recurrence.Fisher’s exact test orχ2 test,logrank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.RESULTS:One hundred and sixty-six of 190 patients(87.4%)were identified as Mandard bad responders(TRG3-5).High Mandard grade was correlated with tumor height(41.7%<6 cm vs 58.3%≥6 cm,P=0.050),yp T stage(75%yp T0-2 vs 25%yp T3-4,P=0.000),and yp N stage(75%yp N0 vs 25%yp N1,P=0.031).In univariate survival analysis,Mandard grade bad responders had significantly worse OS and DFSthan good responders(TRG1/2)(OS,83.1%vs 96.4%,P=0.000;DFS,72.3%vs 92.0%,P=0.002).In multivariate survival analysis,Mandard bad responders had significantly worse DFS than Mandard good responders(DFS 3.8 years(95%CI:1.2-12.2 years,P=0.026).CONCLUSION:Mandard grade good responders had a favorable prognosis.TRG may be a potential predictor for DFS in LARA after pre-RT.