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.

The indispensable role of resilience in rational landslide risk management for social sustainability

Landslide disasters reflect the conflict between human society and the natural environment,posing challenges to the sustainable development of mountain regions.Identification of potential landslides,estimation of the degree of damage and potential losses of elements at risk,and control of the loss are the major tasks of landslide risk management.Resilience is defined as a social system’s comprehensive abilities to cope with disasters,including the abilities to prepare,anticipate,preserve,absorb,respond,resist,recover,mitigate,learn,and adapt.As an indispensable role,resilience enables more rational landslide risk management for social sustainability.However,quantitative landslide risk management does not pay sufficient attention to the role of resilience.Hence,in this paper,the role of resilience in a landslide risk management framework is systematically discussed.A quantita-tive landslide risk management framework consists of hazard analysis,exposure analysis,risk estimation,risk evaluation,and risk control.In hazard analysis,resilience assessment could help identify potential landslides that could cause significant damage due to the poor resilience of the elements at risk.Resilience assessment in exposure analysis might aid in identifying the most vulnerable elements or regions to certain landslides.Consid-eration of resilience in risk estimation aids in the calculation of indirect losses and improves the results of direct losses analysis.In risk evaluation,resilience as a disaster-coping ability will impact the social system’s landslide risk tolerance threshold.Enhancing resilience is an essential strategy to reduce the vulnerability of social sys-tems.We also proposed that the efficient use of risk information will increase the accuracy of landslide resilience assessments.

Ibrutinib and atrial fibrillation:An in-depth review of clinical implications and management strategies

Ibrutinib,a targeted therapy for B-cell malignancies,has shown remarkable efficacy in treating various hematologic cancers.However,its clinical use has raised concerns regarding cardiovascular complications,notably atrial fibrillation(AF).This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence,risk factors,mechanistic links,and management strategies.Through an extensive analysis of original research articles,this review elucidates the complex interplay between ibrutinib’s therapeutic benefits and cardiovascular risks.Moreover,it highlights the need for personalized treatment approaches,vigilant monitoring,and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy.The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib’s therapeutic landscape while prioritizing patient well-being.

Airway management of a patient with linear immunoglobulin A bullous dermatosis:A case report

BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable bullae.Careful clinical decision making is necessary when there is a risk of bleeding into the airway,and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios,especially when confronted with an unusual cause for bleeding.CASE SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis.The diagnosis of IgA dermatosis was recent,and the patient had been lost to follow-up.The severity of the disease and extent of airway involvement was unknown at the time of the surgery.Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room.The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case.The patient was extubated on postoperative day 4.CONCLUSION A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure.In our case,key communication between the surgery,anesthesia,and dermatology teams led to the quick and safe treatment of our patient’s disease.Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.

Enterprise Internal Control Based on Risk Management with Moutai Group as an Example

Focusing on the two themes of"internal control"and"risk management",this paper makes an in-depth analysis of the current situation of risk management and internal control of Moutai Group.It analyzes the current situation of risk management and internal control of Moutai Group.It is found that the risk management of Moutai Group is not perfect,the information exchange is not smooth,and the internal control assessment is not perfect.Finally,it puts forward some corresponding countermeasures,including establishing an effective information communication mechanism,perfecting the risk assessment system,and strengthening the construction of the professional talent team.

Identifying and Managing Technical Risks in the Process of Innovative Drugs Development in China

Objective To identify technical risks in the process of innovative drug development,and to provide reference for technical risk management so as to reduce the uncertainties and improve the efficiency of research and development.Methods The initial risk index was investigated by literature research.Then,the Likert scale was used to design a questionnaire,and the experts’opinion was used to analyze the risk factors affecting the different stages of the development of innovative drugs in China.Results and Conclusion Based on the analysis of questionnaire,31 risk indicators of five key stages in the development of innovative drugs from drug discovery to marketing authorization were established.The key risk indicators constructed in this study can provide reference for technology-related risk management in the process of innovative drug development.

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.”

Research on Enterprise Legal Service Strategy Based on Compliance Management Optimization

With the background of enterprise compliance management,this paper discusses how to improve the level of enterprise legal service and reduce enterprise legal risks by optimizing the compliance management system.It aims to analyze the current situation and existing problems of enterprise legal services through the analysis of the importance of compliance management.Furthermore,it delves into the case of enterprise legal service strategy based on compliance management optimization to verify the effectiveness and feasibility of enterprise legal service strategy.

Application of Hazard Vulnerability Analysis Based on Kaiser Model in Neonatal Breast Milk Management

Objective:To analyze the existing risks in breast milk management at the neonatal department and provide corresponding countermeasures.Methods:22 risk events were identified in 7 risk links in the process of bottle-feeding of breast milk.Hazard Vulnerability Analysis based on the Kaiser model was applied to investigate and evaluate the risk events.Results:High-risk events include breast milk quality inspection,hand hygiene during collection,disinfection of collectors,cold chain management,hand hygiene during the reception,breast milk closed-loop management,and post-collection disposal.Root cause analysis of high-risk events was conducted and breast milk management strategies outside the hospital and within the neonatal department were proposed.Conclusion:Hazard Vulnerability Analysis based on the Kaiser model can identify and assess neonatal breast milk management risks effectively,which helps improve the management of neonatal breast milk.It is conducive to the safe development and promotion of bottle feeding of breast milk for neonates,ensuring the quality of medical services and the safety of children.

Risk Assessment and Management of Alien Invasive Species Corythucha ciliata in Guangde City

Through two years of systematic investigation,it was found that Corythucha ciliata occurred in the main streets of Guangde City and spread rapidly to roads and streets of some villages and towns.The investigation found that C.ciliata could harm indigenous tree species such as Broussonetia papyrifera,and could also quickly occupy the living space of thrips,the original leaf pest of local Platanus acerifolia.Literature review also suggested that the pest would also be a potential threat to indigenous tree species,such as Rhododendron simsii Planch,Prunus cerasifera Ehrhar,etc.Guangde City,located in the middle and lower reaches of the Yangtze River,was sunny,hot and dry in summer from 2021 to 2022.However,C.ciliata had no obvious diapause habits in summer,with strong adaptability.It was easy to control C.ciliata,but was difficult to eradicate the pest.According to the risk analysis index system of dangerous forest pests,the risk value of C.ciliata was determined as R=1.80,belonging to moderately dangerous pest in Guangde.Through quarantine,publicity,winter and summer management measures,the occurrence of C.ciliata was controlled to a certain extent,and the harm and transmission risk of the pest were reduced.