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.

Water and nitrogen footprint assessment of integrated agronomic practice management in a summer maize cropping system

The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.

Ecosystem service multifunctionality of mixed conifer-broad-leaved forests under climate change and forest management based on matrix growth modelling

Climate change and forest management are recognized as pivotal factors influencing forest ecosystem services and thus multifunctionality.However,the magnitude and the relative importance of climate change and forest management effects on the multifunctionality remain unclear,especially for natural mixed forests.In this study,our objective is to address this gap by utilizing simulations of climate-sensitive transition matrix growth models based on national forest inventory plot data.We evaluated the effects of seven management scenarios(combinations of various cutting methods and intensities)on the future provision of ecosystem services and multifunctionality in mixed conifer-broad-leaved forests in northeastern China,under four climate scenarios(SSP1-2.6,SSP2-4.5,SSP5-8.5,and constant climate).Provisioning,regulating,cultural,and supporting services were described by timber production,carbon storage,carbon sequestration,tree species diversity,deadwood volume,and the number of large living trees.Our findings indicated that timber production was significantly influenced by management scenarios,while tree species diversity,deadwood volume,and large living trees were impacted by both climate and management separately.Carbon storage and sequestration were notably influenced by both management and the interaction of climate and management.These findings emphasized the profound impact of forest management on ecosystem services,outweighing that of climate scenarios alone.We found no single management scenario maximized all six ecosystem service indicators.The upper story thinning by 5%intensity with 5-year interval(UST5)management strategy emerged with the highest multifunctionality,surpassing the lowest values by more than 20%across all climate scenarios.In conclusion,our results underlined the potential of climate-sensitive transition matrix growth models as a decision support tool and provided recommendations for long-term strategies for multifunctional forest management under future climate change context.Ecosystem services and multifunctionality of forests could be enhanced by implementing appropriate management measures amidst a changing climate.

Reinforcement Learning-Based Energy Management for Hybrid Power Systems:State-of-the-Art Survey,Review,and Perspectives

The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art survey and review of reinforcement learning-based energy management strategies for hybrid power systems.Additionally,it envisions the outlook for autonomous intelligent hybrid electric vehicles,with reinforcement learning as the foundational technology.First of all,to provide a macro view of historical development,the brief history of deep learning,reinforcement learning,and deep reinforcement learning is presented in the form of a timeline.Then,the comprehensive survey and review are conducted by collecting papers from mainstream academic databases.Enumerating most of the contributions based on three main directions—algorithm innovation,powertrain innovation,and environment innovation—provides an objective review of the research status.Finally,to advance the application of reinforcement learning in autonomous intelligent hybrid electric vehicles,future research plans positioned as“Alpha HEV”are envisioned,integrating Autopilot and energy-saving control.

Etiology and management of urethral calculi:A systematic review of contemporary series

Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.

AI-Driven Learning Management Systems:Modern Developments, Challenges and Future Trends during theAge of ChatGPT

COVID-19 pandemic restrictions limited all social activities to curtail the spread of the virus.The foremost and most prime sector among those affected were schools,colleges,and universities.The education system of entire nations had shifted to online education during this time.Many shortcomings of Learning Management Systems(LMSs)were detected to support education in an online mode that spawned the research in Artificial Intelligence(AI)based tools that are being developed by the research community to improve the effectiveness of LMSs.This paper presents a detailed survey of the different enhancements to LMSs,which are led by key advances in the area of AI to enhance the real-time and non-real-time user experience.The AI-based enhancements proposed to the LMSs start from the Application layer and Presentation layer in the form of flipped classroom models for the efficient learning environment and appropriately designed UI/UX for efficient utilization of LMS utilities and resources,including AI-based chatbots.Session layer enhancements are also required,such as AI-based online proctoring and user authentication using Biometrics.These extend to the Transport layer to support real-time and rate adaptive encrypted video transmission for user security/privacy and satisfactory working of AI-algorithms.It also needs the support of the Networking layer for IP-based geolocation features,the Virtual Private Network(VPN)feature,and the support of Software-Defined Networks(SDN)for optimum Quality of Service(QoS).Finally,in addition to these,non-real-time user experience is enhanced by other AI-based enhancements such as Plagiarism detection algorithms and Data Analytics.

Regenerative Braking Energy Recovery System of Metro Train Based on Dual-Mode Power Management

In order to fully utilize the regenerative braking energy of metro trains and stabilize the metro DC traction busbar voltage,a hybrid regenerative braking energy recovery system with a dual-mode power management strategy is proposed.Firstly,the construction of the hybrid regenerative braking energy recovery system is explained.Then,based on the power demand of low-voltage load in metro stations,a dual-mode power management strategy is proposed to allocate the reference power of each system according to the different working conditions,and the control methods of each system are set.Finally,the correctness and effectiveness of the dual-mode strategy are verified through simulation,and the proposed braking energy utilization scheme is compared with other singleform utilization schemes.The results illustrate that the hybrid system with the dual-mode strategy can effectively recycle the regenerative braking energy of metro train and inhibit the busbar voltage fluctuation;the proposed braking energy utilization scheme has certain advantages on energy recovery and DC bus voltage stabilization compared with other single-form schemes;the proposed power management strategy can correctly allocate the reference power of each system with a lower construction cost.

Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

Design and analysis of an advanced thermal management system for the solar close observations and proximity experiments spacecraft

In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

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.

Comparison of German and American Higher Education Accreditation Systems and Implications for Quality Management of Higher Education in China

At the present stage,China’s higher education has experienced continuous reform and enhancement,the scale of education has jumped to the forefront,and the quality of education has been continuously improved,which has made gratifying achievements.The development of China’s higher education has entered the critical node of improving quality and efficiency,and the importance of quality management as the central link in improving the quality of higher education is self-evident.Accreditation as an effective means of quality assurance,in Germany and the United States has formed a mature and perfect system and procedures.Therefore,analysing and learning from the quality management system of higher education in Germany and the United States has an important reference value for promoting the further development of quality management of higher education in China.

Design and Implementation of Library Seating Management System

The library seating management system is an important part of the library’s modern services. The system is based on the Spring and Spring Boot framework, and the system realizes a series of functions such as real-time query, reservation, and cancellation of seat resources, providing users with great convenience. With a simple operation, users can know the availability of seats in the library in real time and reserve them according to their needs. At the same time, the system also provides rich management functions, enabling administrators to easily configure and manage seat resources. The addition, deletion, modification and review of users, the generation of seats, the viewing of user usage records, and the addition or deletion of points for users’ usage can also be carried out. This not only improves the management efficiency, but also provides more scientific and accurate data support for the management of the library. The system not only optimizes the user experience, but also promotes the scientific management and efficient utilization of library resources, and provides strong support for the modern services of the library.

Exploration of University English Teachers’Acceptance and Willingness to Use Learning Management System Data Analysis Tools

This study investigates university English teachers’acceptance and willingness to use learning management system(LMS)data analysis tools in their teaching practices.The research employs a mixed-method approach,combining quantitative surveys and qualitative interviews to understand teachers’perceptions and attitudes,and the factors influencing their adoption of LMS data analysis tools.The findings reveal that perceived usefulness,perceived ease of use,technical literacy,organizational support,and data privacy concerns significantly impact teachers’willingness to use these tools.Based on these insights,the study offers practical recommendations for educational institutions to enhance the effective adoption of LMS data analysis tools in English language teaching.

Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

Towards Automated Assessment of Learning Management Systems in Higher Education Institutions in Zambia

Zambia like any other country in most African regions is still grappling with the dynamics of harnessing technology for the betterment of Higher Education. The onset of the Covid 19 pandemic brought a test for the preparedness of the Zambian Higher Education Institutions (HEIs) in harnessing technology for pedagogical activities. As countries worldwide switched to electronic learning during the pandemic, the same could not be said for Zambian HEIs. Zambian HEIs struggled to conduct pedagogical activities on learning management platforms. This study investigated the factors affecting the implementation and assessment of learning Management systems in Zambia’s HEIs. With its focus on assessing: 1) system features, 2) compliance with regulatory standards, 3) quality of service and 4) technology acceptance as the four key assessment areas of an LMS, this article proposed a model for assessing learning management systems in Zambian HEIs. To test the proposed model, a software tool was also developed.

Exploring Efficient Salary Management Systems:A Case Study of Hefei Yusheng Hotel Management Co.,Ltd.

The issue of brain drain poses a significant obstacle to the development of the hotel and catering industry.Attracting and retaining skilled personnel to engage in management within this sector has emerged as a primary challenge.This paper examines the current landscape of China’s catering service industry and its salary management system,identifying key challenges encountered in salary management within the industry.Drawing upon salary management theory and insights into existing challenges,the paper proposes specific treatment measures and management strategies.

Development of an Information-Based Leadership Evaluation Index System for School Management Teams:A Comprehensive Approach

In the context of educational informatization reform,there are many uncertain factors in the process of education development.To optimize the educational environment so that it can be effectively combined with information technology,teachers need to change their teaching ideas,strengthen the school’s own adaptability to informatization,and promote the development of informatization construction in schools.As a branch of information leadership,the management team should establish an evaluation index system for information leadership in order to ensure the construction of school informatization,so as to provide a boost for the integration of school resources and information technology.Based on the overview and connotation of information-based leadership of the management team,this paper explores the construction of an evaluation index system of information-based leadership of the school management team,aiming to provide references for the research of relevant personnel in the future.

Construction of a Multi-Level Strategic System for Cultivating Cultural Industry Management Talents in Colleges and Universities

Through SWOT(strengths,weaknesses,opportunities,and threats)and PEST(political,economic,social,and technological)analysis,this study discusses the construction of a multi-level strategic system for the cultivation of cultural industry management talents in colleges and universities.First of all,based on SWOT analysis,it is found that colleges and universities have rich educational resources and policy support,but they face challenges such as insufficient practical teaching and intensified international competition.External opportunities come from the rapid development of the cultivation of cultural industry management talents and policy promotion,while threats come from global market competition and talent flow.Secondly,PEST analysis reveals the key factors in the macro-environment:at the political level,the state vigorously supports the cultivation of cultural industry management talents;at the economic level,the market demand for cultural industries is strong;at the social level,the public cultural consumption is upgraded;at the technological level,digital transformation promotes industry innovation.On this basis,this paper puts forward a multi-level strategic system covering theoretical education,practical skill improvement,interdisciplinary integration,and international vision training.The system aims to solve the problems existing in talent training in colleges and universities and cultivate high-quality cultural industry management talents with theoretical knowledge,practical skills,and global vision,so as to adapt to the increasingly complex and diversified cultural industry management talents market demand and promote the long-term development of the industry.

Application Strategy of Digital Comprehensive Management and Maintenance System for Bridges

Effective application of digital integrated management and maintenance systems is essential for successful operation and maintenance management of bridge projects.This article analyzes the application strategy of such systems.It provides an overview of comprehensive digital management and maintenance of bridges,an analysis of the basic components of the integrated management and maintenance system,and its application strategies.This study aims to offer guidance for the application of the system and to improve the quality of modern bridge engineering management and maintenance work.