Distribution, health and ecological risk assessments of trace elements in Nigerian oil sands

The Nigerian oil sands represent the largest oil sand deposit in Africa, yet there is little published information on the distribution and potential health and ecological risks of trace elements in the oil resource. In the present study, we investigated the distribution pattern of 18trace elements(including biophile and chalcophile elements) as well as the estimated risks associated with exposure to these elements. The results of the study indicated that Fe was the most abundant element, with a mean concentration of 22,131 mg/kg while Br had the lowest mean concentration of 48 mg/kg. The high occurrence of Fe and Ti suggested a possible occurrence of ilmenite(Fe TiO_(3)) in the oil sands. Source apportionment using positive matrix factorization showed that the possible sources of detected elements in the oil sands were geogenic, metal production, and crustal. The contamination factor, geo-accumulation index, modified degree of contamination, pollution load index, and Nemerow pollution index indicated that the oil sands are heavily polluted by the elements. Health risk assessment showed that children were relatively more susceptible to the potentially toxic elements in the oil sands principally via ingestion exposure route(HQ > 1E-04). Cancer risks from inhalation are unlikely due to CR < 1E-06 but ingestion and dermal contact pose severe risks(CR > 1E-04). The high concentrations of the elements pose serious threats due to the potential for atmospheric transport, bioaccessibility, and bioavailability.

Risk assessments of debris flow based on improved analytic hierarchy process and efficacy coefficient method

In order to evaluate the danger of debris flow properly, eight factors were selected as the risk assess- ment indexes of the debris flow, namely the vertical slope, valley relative difference, hillside slope, area of ba- sin, loose solid material reserves, the path length of sediment supply probability, silting and scouring derrieking and vegetation coverage. The improved Analytic Hierarchy Process （ AHP ） method was used to obtain the weights of the factors; and the efficacy coefficient method was adopted to evaluate the risks of six typical debris flow gullies. According to the research, the improved AHP method not only avoids the subjectivity in the indi- vidual factor valuation by comparing two factors of each layer, but also makes the subsequent consistency check unnecessary.

Surface water quality and potential health risk assessments in Changsha-Zhuzhou-Xiangtan section of Xiangjiang River, China

The Changsha-Xiangtan-Zhuzhou City Group is a heavy industrial district and accepted as the serious pollution area in the Xiangjiang River basin.In this study,7 metals(Pb,Hg,Cd,As,Zn,Cu and Se)and the river water quality parameters including pH,dissolved oxygen(DO),Escherichia coli(E.coli),potassium permanganate index(CODMn),dichromate oxidizability(CODCr),five-day biochemical oxygen demand(BOD5),ammonia nitrogen(NH4+-N),total nitrogen(TN),total phosphorus(TP)and fluoride(F)in 18 sampling sites of the Changsha-Xiangtan-Zhuzhou section are monthly monitored in 2016,which is the year to step into the second stage of the“Xiangjiang River Heavy Metal Pollution Control Implementation Plan”.It is found that E.coli,TN and TP are the main pollutants in the Changsha-Zhuzhou-Xiangtan section,and the pollution of heavy metal is not serious but As with potential risk to local people especially children should be concerned.In addition,Xiangtan city is mainly featured with heavy metal pollution,while Zhuzhou and Changsha city are both featured with other pollutants from municipal domestic sewage.

Multi-mycotoxin exposure and risk assessments for Chinese consumption of nuts and dried fruits

In this study, 15 mycotoxins were detected in 233 nut and dried fruit samples from China. The 15 mycotoxins included aflatoxins （AFs： AFB1, AFB2, AFG1 and AFG2）, trichothecene toxins （TCs： T-2, ZEA, ENA, ENA1, ENB, ENB1 and BEA）, Alternaria toxins （ATs： TEN, AOH and AME） and ochratoxin A （OTA）. The mycotoxins were detected in 47.6% of the samples and all 15 of the mycotoxins were found. Two samples were positive for AFB1 and exceeded the maximum tolerable levels allowed in China. The contamination levels of the mycotoxins found in nuts, dried jujubes, raisins, dried figs and dried Iongans were in the ranges of 0.1-462.7, 0.2-247.3, 0.8-10.1,0.2-384.1 and 0.1-89.2 μg kg^-1, respectively. Dried figs （80.0%） had the highest incidence of mycotoxins, followed by dried Iongans （60.0%）, dried jujubes （57.1%）, nuts （43.6%） and raisins （26.7%）. The estimated daily intake （EDI） values of each individual mycotoxin and all of the mycotoxins collectively were calculated by both the deterministic approach （DA） and the probability approach （PA）. For risk characterization, dietary exposure to TCs, ATs and OTA through consumption of nuts and dried fruits according to both approaches, showed no health risk to Chinese adults by exposure to either individual mycotoxins or in combination. To the best of our knowledge, this is the first work in which risk assessment of multimycotoxins is performed, specifically including the emerging ENNs and BEA, in nuts and dried fruits of China.

An Analysis of Formal Risk Assessments for Safety and Security in Ports： Empirical Evidence from Container Terminals in Greece

Nowadays, the most prominent risk assessment techniques are founded on the values of measuring and controlling the frequency and the consequences of risks in order to assure an ＂acceptable level＂ of ＂safeness＂ mainly in the lines of environmental, health and hygiene and port product issues. This paper initially introduces risk assessment approaches within the emerging role of ports Thereafter, it qualitatively assesses their potential for ports by discussing issues challenging every safety and security approach within the maritime industry such as proactiveness, organization, transparency, cost-effectiveness and, when possible, calibration to specific experiences. Moreover, an empirical study was conducted in order to provide evidence for formal risk assessment for safety and security in the main Greek port container terminals of Piraeus and Thessaloniki. The empirical research is based on in-depth semi-structured interviews with the administrations of container terminals. The results include important findings, regarding the likelihood of appearance of certain risks and their perceived severity in Greek container terminals. The collected answers and their analysis are also important for confirming the suggested theoretical formal risk assessment framework for ports.

Comprehensive insight into the occurrence characteristics,influencing factors and risk assessments of antibiotics in the Chaohu Basin

The pollution of antibiotics in aquatic environments has received extensive attention.Yet,research on antibiotic contamination in river-lake systems,a significant form of modern aquatic environments,still needs to be explored.This study focuses on the Chaohu Basin(China)investigating the occurrence characteristics,influencing factors,and risk assessments of antibiotics in the river-lake system.The total antibiotic concentrations in the water phase and sediment phase were 3.14–1887.49 ng/L and 0.92–1553.75 ng/g,respectively.Clindamycin was the predominant antibiotic in the water phase,whereas tetracycline prevailed in the sediment phase.Notable differences in concentration and structural composition of antibiotics between the tributaries(river system)and Chaohu Lake were observed,indicating the involvement of various geochemical processes in the attenuation of antibiotics during transport to the receiving lake.Spatial analysis suggested that the western river is the primary source of antibiotics in Chaohu Lake.Controlling nutrient influx in heavily polluted areas is crucial to addressing the escalating issue of antibiotic pollution in the river-lake system.The widespread occurrence of clindamycin in the waters is likely due to wastewater treatment plant discharges,and high-intensity human activities continue to exacerbate antibiotic contamination.Risk assessment indicated that sulfamethoxazole,tetracycline,lincomycin,and clindamycin ranked in the top four with the highest risks to the most sensitive aquatic organisms.Nonetheless,the antibiotics presented no risk to consumer health.This study provides valuable insights for controlling antibiotic pollution in riverlake systems.

Distribution, Mobility, and Health Risks Assessment of Trace Metals in River Sediments from Intense Agricultural Activity Areas in West Africa

The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected from the Bandama, Comoé, and Bia Rivers in south and south eastern Côte d’Ivoire (West Africa), were analyzed for total metal concentrations and chemical speciation. The results showed that the river sediments were considerably contaminated by Cd and moderately contaminated by As, Cu, Pb, and Zn. Significant spatial variations were observed among the stations but not between the rivers. Metals Cd and Cu were likely to cause more ecological risks. The speciation analysis unravelled that the metal(loid)s partitioned mainly in the residual fraction, with the potential mobile fraction varying from 14% to 28%. The study calls for establishment of strict policies relative to the application of fertilizers and agrochemicals and mining activities to protect the environment and human health risks.

Machine Learning-Based Decision-Making Mechanism for Risk Assessment of Cardiovascular Disease

Cardiovascular disease(CVD)has gradually become one of the main causes of harm to the life and health of residents.Exploring the influencing factors and risk assessment methods of CVD has become a general trend.In this paper,a machine learning-based decision-making mechanism for risk assessment of CVD is designed.In this mechanism,the logistics regression analysismethod and factor analysismodel are used to select age,obesity degree,blood pressure,blood fat,blood sugar,smoking status,drinking status,and exercise status as the main pathogenic factors of CVD,and an index systemof risk assessment for CVD is established.Then,a two-stage model combining K-means cluster analysis and random forest(RF)is proposed to evaluate and predict the risk of CVD,and the predicted results are compared with the methods of Bayesian discrimination,K-means cluster analysis and RF.The results show that thepredictioneffect of theproposedtwo-stagemodel is better than that of the comparedmethods.Moreover,several suggestions for the government,the medical industry and the public are provided based on the research results.

Spatial distribution and risk assessments of mercury in topsoils of Central Asia

Central Asia is one of the largest arid areas on earth,yet little is known about the concentration levels and risks of mercury(Hg)in the soils of this region.In this study,extensive sampling of topsoils(0-10 cm)from representative landscapes was carried out over Central Asia(i.e.,Tajikistan,Uzbekistan,and Kyrgyzstan).The total mercury(THg)concentrations in topsoils varied widely from 1.6 to 908.0 ng/g,with high values observed in samples collected in the capital cities and urban areas.Topsoil THg concentrations among different landscapes showed a decreasing order of urban(79.8±184.0 ng/g)>woodland(27.3±28.9 ng/g)>grassland(20.6±15.9 ng/g)>farmland(18.3±9.5 ng/g)>desert(12.3±8.0 ng/g).High THg concentrations were found in the capital cities/urban clusters,followed by a gradual decrease towards the peripheries.THg concentrations were found to be negatively correlated with the distance from the sampling sites to their nearest cities,indicating that anthropogenic emissions significantly influenced the spatial distribution of topsoil Hg.A significant correlation between THg concentrations and topsoil total organic carbon(TOC)contents was also observed,suggesting that TOC played an essential role in the spatial distribution of topsoil Hg.The assessments of pollution and potential ecological risk suggested that topsoils in highly densely-populated areas were contaminated by Hg and had higher degrees of potential ecological risks.The health risk assessment results showed that the exposure risk of topsoil Hg to children was higher than that to adults.Fortunately,there was no unacceptable human health risk of topsoil Hg.This study clarified the spatial distribution and risks of Hg in the Central Asian topsoils,offering new insight into the risk prevention and control of soil Hg.

Risk Assessment of Deep-Water Horizontal X-Tree Installation

Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.

Risk assessment of oil and gas investment environment in countries along the Belt and Road Initiative

With the implementation of the Belt and Road Initiative, China is deepening its cooperation in oil and gas resources with countries along the Initiative. In order to better mitigate risks and enhance the safety of investments, it is of significant importance to research the oil and gas investment environment in these countries for China's overseas investment macro-layout. This paper proposes an indicator system including 27 indicators from 6 dimensions. On this basis, game theory models combined with global entropy method and analytic hierarchy process are applied to determine the combined weights, and the TOPSIS-GRA model is utilized to assess the risks of oil and gas investment in 76 countries along the Initiative from 2014 to 2021. Finally, the GM(1,1) model is employed to predict risk values for 2022-2025. In conclusion, oil and gas resources and political factors have the greatest impact on investment environment risk, and 12 countries with greater investment potential are selected through cluster analysis in conjunction with the predicted results. The research findings may provide scientific decisionmaking recommendations for the Chinese government and oil enterprises to strengthen oil and gas investment cooperation with countries along the Belt and Road Initiative.

Comprehensive Risk Assessment of Sea Level Rise and Tropical Cyclones in Dongzhaigang Mangroves,China

Mangroves play a pivotal role in tropical and subtropical coastal ecosystem,yet they are highly vulnerable to the effects of climate change,particularly the accelerated global sea level rise(SLR)and stronger tropical cyclones(TCs).However,there is a lack of research addressing future simultaneous combined impacts of the slow-onset of SLR and rapid-onset of TCs on China's mangroves.In order to develop a comprehensive risk assessment method considering the superimposed effects of these two factors and analyze risk for mangroves in Dongzhaigang,Hainan Island,China,we used observational and climate model data to assess the risks to mangroves under low,intermediate,and very high greenhouse gas(GHG)emission scenarios(such as SSP1-2.6,SSP2-4.5,and SSP5-8.5)in 2030,2050,and 2100,and compiled a risk assessment scheme for mangroves in Dongzhaigang,China.The results showed that the combined risks from SLR and TCs will continue to rise;however,SLRs will increase in intensity,and TCs will decrease.The comprehensive risk of the Dongzhaigang mangroves posed by climate change will remain low under SSP1-2.6 and SSP2-4.5 scenarios by 2030,but it will increase substantially by 2100.While under SSP5-8.5 scenario,the risks to mangroves in Dongzhaigang are projected to increase considerably by 2050,and approximately 68.8%of mangroves will be at very high risk by 2100.The risk to the Dongzhaigang mangroves is not only influenced by the hazards but also closely linked to their exposure and vulnerability.We therefore propose climate resilience developmental responses for mangroves to address the effects of climate change.This study for the combined impact of TCs and SLR on mangroves in Dongzhaigang,China can enrich the method system of mangrove risk assessment and provide references for scientific management.

Identifying the Hydrochemical Characteristics,Genetic Mechanisms and Potential Human Health Risks of Fluoride and Nitrate Enriched Groundwater in the Tongzhou District,Beijing,North China

Fluoride and nitrate enriched groundwater are potential threats to the safety of the groundwater supply that may cause significant effects on human health and public safety,especially in aggregated population areas and economic hubs.This study focuses on the high F^(−)and NO_(3)^(−)concentration groundwater in Tongzhou District,Beijing,North China.A total of 36 groundwater samples were collected to analyze the hydrochemical characteristics,elucidate genetic mechanisms and evaluate the potential human health risks.The results of the analysis indicate:Firstly,most of the groundwater samples are characterized by Mg-HCO_(3) and Na-HCO_(3) with the pH ranging from 7.19 to 8.28 and TDS with a large variation across the range 471-2337 mg/L.The NO_(3)^(−)concentration in 38.89%groundwater samples and the F^(−)concentration in 66.67%groundwater samples exceed the permissible limited value.Secondly,F^(−)in groundwater originates predominantly from water-rock interactions and the fluorite dissolution,which is also regulated by cation exchange,competitive adsorption of HCO_(3)−and an alkaline environment.Thirdly,the effect of sewage disposal and agricultural activities have a significant effect on high NO3-concentration,while the high F^(−)concentration is less influenced by anthropogenic activity.The alkaline environment favors nitrification,thus being conducive to the production of NO_(3)^(−).Finally,the health risk assessment is evaluated for different population groups.The results indicate that high NO_(3)^(−)and F^(−)concentration in groundwater would have the largest threat to children’s health.The findings of this study could contribute to the provision of a scientific basis for groundwater supply policy formulation relating to public health in Tongzhou District.

Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

Arsenic and fluoride co-enrichment of groundwater in the loess areas and associated human health risks:A case study of Dali County in the Guanzhong Basin

This study aims to reveal the occurrence and origin of typical groundwater with high arsenic and fluoride concentrations in the loess area of the Guanzhong Basin—a Neogene faulted basin.Key findings are as follows:(1)Groundwater samples with high arsenic and fluoride concentrations collected from the loess area and the terraces of the Weihe River accounted for 26%and 30%,respectively,of the total samples,with primary hydrochemical type identified as HCO_(3)-Na.The karst and sand areas exhibit relatively high groundwater quality,serving as preferred sources for water supply.It is recommended that local governments fully harness groundwater in these areas;(2)groundwater with high arsenic and fluoride concentrations in the loess area and the alluvial plain of rivers in Dali County is primarily distributed within the Guanzhong Basin,which represents the drainage zone of groundwater;(3)arsenic and fluoride in groundwater originate principally from natural and anthropogenic sources;(4)the human health risk assessments reveal that long-term intake of groundwater with high arsenic and fluoride concentrations pose cancer or non-cancer risks,which are more serious to kids compared to adults.This study provides a theoretical basis for the prevention and treatment of groundwater with high arsenic and fluoride concentrations in loess areas.

Occurrence,Spatial Distribution,Sources and Risk Assessment of Per-and Polyfluoroalkyl Substances in Surface Sediments of the Yellow River Delta Wetland

Per-and polyfluoroalkyl substances(PFASs)are emerging persistent organic pollutants(POPs).In this study,47 surface sediment samples were collected from the Yellow River Delta wetland(YRDW)to investigate the occurrence,spatial distribution,potential sources,and ecological risks of PFASs.Twenty-three out of 26 targeted PFASs were detected in surface sediment samples from the YRDW,with totalΣ23PFASs concentrations ranging from 0.23 to 16.30 ng g^(-1) dw and a median value of 2.27 ng g^(-1) dw.Perfluorooctanoic acid(PFOA),perfluorobutanoic acid(PFBA)and perfluorooctanesulfonic acid(PFOS)were the main contaminants.The detection frequency and concentration of perfluoroalkyl carboxylic acids(PFCAs)were higher than those of perfluoroal-kanesulfonic acids(PFSAs),while those of long-chain PFASs were higher than those of short-chain PFASs.The emerging PFASs substitutes were dominated by 6:2 chlorinated polyfluoroalkyl ether sulfonic acid(6:2 Cl-PFESA).The distribution of PFASs is significantly influenced by the total organic carbon content in the sediments.The concentration of PFASs seems to be related to human activities,with high concentration levels of PFASs near locations such as beaches and villages.By using a positive matrix factorization model,the potential sources of PFASs in the region were identified as metal plating mist inhibitor and fluoropolymer manufacturing sources,metal plating industry and firefighting foam and textile treatment sources,and food packaging material sources.The risk assessment indicated that PFASs in YRDW sediments do not pose a significant ecological risk to benthic organisms in the region overall,but PFOA and PFOS exert a low to moderate risk at individual stations.

Stroke Risk Assessment Decision-Making Using a Machine Learning Model:Logistic-AdaBoost

Stroke is a chronic cerebrovascular disease that carries a high risk.Stroke risk assessment is of great significance in preventing,reversing and reducing the spread and the health hazards caused by stroke.Aiming to objectively predict and identify strokes,this paper proposes a new stroke risk assessment decision-making model named Logistic-AdaBoost(Logistic-AB)based on machine learning.First,the categorical boosting(CatBoost)method is used to perform feature selection for all features of stroke,and 8 main features are selected to form a new index evaluation system to predict the risk of stroke.Second,the borderline synthetic minority oversampling technique(SMOTE)algorithm is applied to transform the unbalanced stroke dataset into a balanced dataset.Finally,the stroke risk assessment decision-makingmodel Logistic-AB is constructed,and the overall prediction performance of this new model is evaluated by comparing it with ten other similar models.The comparison results show that the new model proposed in this paper performs better than the two single algorithms(logistic regression and AdaBoost)on the four indicators of recall,precision,F1 score,and accuracy,and the overall performance of the proposed model is better than that of common machine learning algorithms.The Logistic-AB model presented in this paper can more accurately predict patients’stroke risk.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

A risk assessment method considering risk attributes and work safety informational needs and its application

The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.

Construction and validation of a risk-prediction model for anastomotic leakage after radical gastrectomy: A cohort study in China

Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall survival time of patients.This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.Methods:This study included a derivation cohort and validation cohort.The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,2020.An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions.Based on the questionnaire,inpatient data were collected to form a model-derivation cohort.This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model reliability.The validation cohort included patients from August 1,2021 to December 31,2021 at the same hospital.Using the same imputation method,we organized the validation-queue data.We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue.We compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration curve.Results:The derivation cohort included 1377 patients,and the validation cohort included 131 patients.The independent predictors of AL after radical gastrectomy included age65 y,preoperative albumin<35 g/L,resection extent,operative time240 min,and intraoperative blood loss90 mL.The predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p<0.001)with a Brier score of 0.049.The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052.External validation showed an AUROC of 0.723(95%CI:0.564e0.882;p?0.006)and a Brier score of 0.055,confirming reliability in different clinical settings.Conclusions:We successfully developed a risk-prediction model for AL following radical gastrectomy.This tool will aid healthcare professionals in anticipating AL,potentially reducing unnecessary interventions.