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.

Impact of the carbon market on investment benefits of power-grid enterprises in China: a system dynamics analysis

The power grid,as the hub connecting the power supply and consumption sides,plays an important role in achieving carbon neutrality in China.In emerging carbon markets,assessing the investment benefits of power-grid enterprises is essential.Thus,studying the impact of the carbon market on the investment and operation of powergrid enterprises is key to ensuring their efficient operation.Notably,few studies have examined the interaction between the carbon and electricity markets using system dynamics models,highlighting a research gap in this area.This study investigates the impact of the carbon market on the investment of power-grid enterprises using a novel evaluation system based on a system dynamics model that considers carbon-emissions from an established carbon-emission accounting model.First,an index system for benefit evaluation was constructed from six aspects:financing ability,economic benefit,reliability,social responsibility,user satisfaction,and carbon-emissions.A system dynamics model was then developed to reflect the causal feedback relationship between the impact of the carbon market on the investment and operation of power-grid enterprises.The simulation results of a provincial power-grid enterprise analyze comprehensive investment evaluation benefits over a 10-year period and the impact of carbon emissions on the investment and operation of power-grid enterprises.This study provides guidelines for the benign development of power-grid enterprises within the context of the carbon market.

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.

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%.

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.

Research on Innovation Strategy of Supply Chain Management of Agricultural Enterprises Under the Background of Big Data

With the rapid development and widespread application of Big Data technology, the supply chain management of agricultural products enterprises is facing unprecedented reform and challenges. This study takes the perspective of Big Data technology and collects relevant information on the application of supply chain management in 100 agricultural product enterprises through a survey questionnaire. The study found that the use of Big Data can effectively improve the accuracy of demand forecasting, inventory management efficiency, optimize logistics costs, improve supplier management efficiency, enhance the overall level of supply chain management of enterprises, and propose innovative strategies for supply chain management of agricultural products enterprises based on this. Big Data technology brings a new solution for agricultural products enterprises to enhance their supply chain management level, making the supply chain smarter and more efficient.

Research and Analysis on the Application of Strategic Performance Management in Enterprises

In today’s competitive business environment,strategic performance management(SPM)is crucial for continuous growth and innovation.Therefore,it is important to realize the advantages of SPM in enterprise applications.This paper analyzes the theoretical basis,implementation framework,and application effects of SPM in enterprises by examining actual cases from different industries.It reveals the core elements of an effective performance management system,including clear goal setting,reasonable performance indicators,and periodic performance evaluations.Additionally,the paper examines the impact of China’s specific economic policy environment on the implementation of SPM and proposes strategies to optimize performance management practices,ultimately promoting the achievement of strategic goals.This paper provides specific and personalized practical guidance for enterprises.

Analysis of International Cooperation Management Strategies of Enterprises under the Background of the“Belt and Road”

With the deepening of the“Belt and Road”initiative,Chinese enterprises are facing unprecedented opportunities and challenges for international cooperation.This paper mainly analyzes the current situation,existing problems,and coping strategies of enterprise international cooperation management in the context of the“Belt and Road”.This article expounds on the importance of the“Belt and Road”initiative for international cooperation of enterprises and analyzes the key links of international cooperation management of enterprises from the aspects of internationalization strategy,cross-cultural management,risk prevention and control,and resource integration.Finally,combined with the case,this paper puts forward the management strategies and suggestions that enterprises should adopt in international cooperation,to provide a useful reference for Chinese enterprises in international cooperation in the construction of the“Belt and Road.”

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.

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.

Operation and Management of Electrical Equipment in Iron and Steel Enterprises

How to ensure the reliable operation of the complex and huge electrical system composed of a large number of electrical equipment in iron and steel enterprises?Combined with working experience,the author introduces four main factors affecting the normal operation of equipment,analyzes five main problems existing in the operation and management of electrical equipment,and puts forward corresponding improvement measures,so as to improve the management level of electrical equipment in iron and steel enterprises.

Research on the Status Quo and Countermeasures of Human Resource Management Outsourcing in China’s Pharmaceutical Enterprises

Objective To explore the current situation of human resource management outsourcing in China’s pharmaceutical enterprises,and to put forward some suggestions for enterprises and the government.Methods The current situation of human resource management outsourcing in China’s pharmaceutical enterprises was analyzed through the method of literature research.Results and Conclusion At present,the status of human resource management outsourcing in China’s pharmaceutical companies is that the level of human resource outsourcing companies is not high,and there are no relevant industry norms and laws.The information asymmetry between pharmaceutical enterprises and outsourcing companies results in adverse selection and moral hazard.Besides,the different culture of pharmaceutical enterprises and outsourcing companies leads to inefficient communication between enterprises and employee.To solve these problems,the government should promote and improve industry norms and laws to regulate the market.In addition,enterprises should clarify the motivation for outsourcing and make good decision on the outsourcing content.Meanwhile,enterprises should strengthen communication with employees to eliminate employees’concerns.

Exploring the Digital Path of Human Resource Management in Innovation and Entrepreneurship Enterprises

The digitization of human resource management functions can enhance the adaptability of human resource management and promote the comprehensive digital development of innovative and entrepreneurial enterprises.This article first summarizes and evaluates the connotation and research status of the digitalization of enterprise human resource management.Secondly,it analyzes the influencing factors of digitalization of human resource management in innovative and entrepreneurial enterprises from three aspects:employee factors,organizational factors,and technological factors.Finally,it designs a digitalization plan for human resource management in innovative and entrepreneurial enterprises from four aspects:analyzing the current situation,preparing thoroughly,designing plans,and building systems.It emphasizes the value of digitalization of enterprise human resource management for innovative and entrepreneurial enterprises.

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.

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.

The Application of Knowledge Management(KM)by Small and Medium-Sized Enterprises(SME)in Manufacturing Industry

To accelerate the digital transformation of small and medium-sized manufacturing enterprises(SMEs),this study delves into the primary challenges encountered in adopting knowledge management(KM)within these organizations and identifies the essential methods for successful implementation.The objective is to provide practical recommendations for the effective adoption of KM.This research suggests that enterprises should promote knowledge management through three key approaches:enhancing employees’cognitive understanding,standardizing knowledge systems,and tailoring business scenarios to meet diverse needs.These findings offer valuable insights into the digital transformation of SMEs in the manufacturing sector,ultimately helping these businesses to remain competitive and innovative in a rapidly changing market.By addressing the specific needs and challenges faced by SMEs,this study aims to contribute to a more comprehensive understanding of how knowledge management can be leveraged to drive digital transformation and improve overall business performance.

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.

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.

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.

Variable and Invariable,Explore the Value-Creation Techniques of Management Accounting by Benchmarking the Financial Management of Large Enterprises

With the development of information technology such as ChatGPT,artificial intelligence,5G,and so on,technological innovation brings about a qualitative change in the economic business.This change is embodied in breakthroughs in the field of science and technology and the iterative upgrading process of products.The traditional business model undoubtedly fails to adapt to the management needs of modern enterprises,while traditional financial practices and knowledge reserves cannot meet these needs.Faced with sudden technological changes and the emergence of financial sharing,financial robots,etc.,there is an urgent need for financial practitioners to transform from traditional financial accounting to value-creating management accounting.In the future,financial professionals with the ability to embrace uncertainty,adapt to environmental changes,and find breakthroughs in uncertain environments will be the most sought-after by enterprises.This paper aims to benchmark the excellent financial management models of large enterprises and conduct thematic research on financial management in large enterprises.It seeks to explore,in the era of big data management accounting,the road and art of creating value in enterprises.The objective is to provide references for colleagues in the financial field and to explore effective ways to generate value for enterprise management ideas,thus serving as a reference point in the financial transformation journey.