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 publishe...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.展开更多
Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods ...Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods We analyzed two-sample of Mendelian randomization(2SMR)using genetic variant depression(n=113,154)and MDD(n=208,811)from Genome-Wide Association Studies(GWAS).Separate calculations were performed with modifiable risk factors from MR-Base for 1,001 genomes.The MR analysis was performed by screening drug targets with MDD in the DrugBank database to explore the therapeutic targets for MDD.Inverse variance weighted(IVW),fixed-effect inverse variance weighted(FE-IVW),MR-Egger,weighted median,and weighted mode were used for complementary calculation.Results The potential causal relationship between modifiable risk factors and depression contained 459 results for depression and 424 for MDD.Also,the associations between drug targets and MDD showed that SLC6A4,GRIN2A,GRIN2C,SCN10A,and IL1B expression are associated with an increased risk of depression.In contrast,ADRB1,CHRNA3,HTR3A,GSTP1,and GABRG2 genes are candidate protective factors against depression.Conclusion This study identified the risk factors causally associated with depression and MDD,and estimated 10 drug targets with significant impact on MDD,providing essential information for formulating strategies to prevent and treat depression.展开更多
This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study const...This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study constructed a tail-risk spillover network(TRSN) of IEM and simulated the dynamic spillover tail-risk process through the cascading failure mechanism. The study found that renewable energy markets contributed more to systemic risk during the Paris Agreement and the COVID-19pandemic, while fossil energy markets played a larger role during the Russia-Ukraine conflict. This study identifies systemically important markets(SM) and critical tail-risk spillover paths as potential sources of systemic risk. The research confirms that cutting off the IEM risk spillover path can greatly reduce systemic risk and the influence of SM. This study offers insights into the management of systemic risk in IEM and provides policy recommendations to reduce the impact of shock events.展开更多
Background:Soil acidifcationn caused by anthropogenic activities may aft soil biochemical cydling,bidiversity,productivity,and multiple eosystem-related functions in drylands.However,to date,such information is lackin...Background:Soil acidifcationn caused by anthropogenic activities may aft soil biochemical cydling,bidiversity,productivity,and multiple eosystem-related functions in drylands.However,to date,such information is lacking to support this hypothesis.Methods Based on a transect survey of 78 naturally assembled shrub communities,we caloulated acid deposition flux in Northwest China and evaluated its likely ecological ffets by testing three altemnative hypotheses,namely:.nidche complementarity,mass ratio,and vegetation quantity hypotheses Rao's quadratic entopy and community-weighted mean traits were employed to represent the complementary aspect of niche complementarity and mass ratio effects,respectively.Resulbs:We observed that in the past four decades,the concentrations of exchangeable base cations in soil in Northwest China have decreased significantly to the extent of having faced the risk of depletion,whereas changes in the calium carbonate content and pH of soil were not significant.Adid deposition primani ly increased the aboweground biomass and shrub density in shrublands but had no sigmificant effect on shrub richness and ecasystem multifunctionality(EMF),indicating that acid deposition had positive but weak ecological effects on dryland ecosystems.Community wd ghted mean of functional traits(representing the mass ratio hypothesis)correlated negatively with EMF,whereas both Rao's quadratic entropy(representing the niche complementarity hypothesis)and aboveground biomass(representing the vegetation quantity hypothesis)correlated positively but insignifcantly with EMF.These biodiversity-EMF relationships highlight the fragility and instability of drylands relative to forest ecasystems.Concuions:The findings from this study serve as important reference points to understand the ris of soil acidification in arid regions and its impacts on biodiversity-EMF relationships.展开更多
Energy storage batteries can smooth the volatility of renewable energy sources.The operating conditions during power grid integration of renewable energy can affect the performance and failure risk of battery energy s...Energy storage batteries can smooth the volatility of renewable energy sources.The operating conditions during power grid integration of renewable energy can affect the performance and failure risk of battery energy storage system(BESS).However,the current modeling of grid-connected BESS is overly simplistic,typically only considering state of charge(SOC)and power constraints.Detailed lithium(Li)-ion battery cell models are computationally intensive and impractical for real-time applications and may not be suitable for power grid operating conditions.Additionally,there is a lack of real-time batteries risk assessment frameworks.To address these issues,in this study,we establish a thermal-electric-performance(TEP)coupling model based on a multitime scale BESS model,incorporating the electrical and thermal characteristics of Li-ion batteries along with their performance degradation to achieve detailed simulation of grid-connected BESS.Additionally,considering the operating characteristics of energy storage batteries and electrical and thermal abuse factors,we developed a battery pack operational riskmodel,which takes into account SOCand charge-discharge rate(Cr),using amodified failure rate to represent the BESS risk.By integrating detailed simulation of energy storage with predictive failure risk analysis,we obtained a detailed model for BESS risk analysis.This model offers a multi-time scale integrated simulation that spans month-level energy storage simulation times,day-level performance degradation,minutescale failure rate,and second-level BESS characteristics.It offers a critical tool for the study of BESS.Finally,the performance and risk of energy storage batteries under three scenarios—microgrid energy storage,wind power smoothing,and power grid failure response—are simulated,achieving a real-time state-dependent operational risk analysis of the BESS.展开更多
Cyber-physical power system(CPPS)has significantly improved the operational efficiency of power systems.However,cross-space cascading failures may occur due to the coupling characteristics,which poses a great threat t...Cyber-physical power system(CPPS)has significantly improved the operational efficiency of power systems.However,cross-space cascading failures may occur due to the coupling characteristics,which poses a great threat to the safety and reliability of CPPS,and there is an acute need to reduce the probability of these failures.Towards this end,this paper first proposes a cascading failure index to identify and quantify the importance of different information in the same class of communication services.On this basis,a joint improved risk-balanced service function chain routing strategy(SFC-RS)is proposed,which is modeled as a robust optimization problem and solved by column-and-constraint generation(C-CG)algorithm.Compared with the traditional shortest-path routing algorithm,the superiority of SFC-RS is verified in the IEEE 30-bus system.The results demonstrate that SFC-RS effectively mitigates the risk associated with information transmission in the network,enhances information transmission accessibility,and effectively limits communication disruption from becoming the cause of cross-space cascading failures.展开更多
This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the ...This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.展开更多
Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable c...Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable centralized traffic control(CTC)system risk assessment method.Design/methodologylapproach-First,system-theoretic process analysis(STPA)is used to conduct risk analysis on the CTC system and constructs risk assessment indexes based on this analysis.Then,to enhance the accuracy of weight calculation,the fuzzy analytical hierarchy process(FAHP),fuzzy decision-making trial and evaluation laboratory(FDEMATEL)and entropy weight method are employed to calculate the subjective weight,relative weight and objective weight of each index.These three types of weights are combined using game theory to obtain the combined weight for each index.To reduce subjectivity and uncertainty in the assessment process,the backward cloud generator method is utilized to obtain the numerical character(NC)of the cloud model for each index.The NCs of the indexes are then weighted to derive the comprehensive cloud for risk assessment of the CTC system.This cloud model is used to obtain the CTC system's comprehensive risk assessment.The model's similarity measurement method gauges the likeness between the comprehensive risk assessment cloud and the risk standard cloud.Finally,this process yields the risk assessment results for the CTC system.Findings-The cloud model can handle the subjectivity and fuzziness in the risk assessment process well.The cloud model-based risk assessment method was applied to the CTC system risk assessment of a railway group and achieved good results.Originality/value-This study provides a cloud model-based method for risk assessment of CTC systems,which accurately calculates the weight of risk indexes and uses cloud models to reduce uncertainty and subjectivity in the assessment,achieving effective risk assessment of CTC systems.It can provide a reference and theoretical basis for risk management of the CTC system.展开更多
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 pu...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.展开更多
Based on the complex network theory,this paper studies the systemic financial risks in China’s financial market.According to the industry classification of the China Securities Regulatory Commission in 2012,the daily...Based on the complex network theory,this paper studies the systemic financial risks in China’s financial market.According to the industry classification of the China Securities Regulatory Commission in 2012,the daily closing prices of 45 listed financial institutions are collected and the daily return rates of each financial institution are measured according to the logarithmic return rate calculation formula.In this paper,the risk spillover value ΔCoVaR is used to measure the contribution degree of each financial institution to systemic risk.Finally,the relationship between the risk spillover valueΔCoVaR and the node topology index of the risk transmission network is investigated by using a regression model,and some policy suggestions are put forward based on the regression results.展开更多
Study was carried out to analyze the distribution and migration patterns,soil-to-plant transfer and potential health risks of chromium in soil-vegetable system in areas near a ferro-alloy manufactory in Hunan province...Study was carried out to analyze the distribution and migration patterns,soil-to-plant transfer and potential health risks of chromium in soil-vegetable system in areas near a ferro-alloy manufactory in Hunan province.The results show that soils near sewer outlet,sewer channel and in control area are averaged 2 239.5,995.33 and 104.9 mg/kg,respectively.The total Cr has a relative accumulation in soil depth of 200-400 mm near the sewer outlet,mainly enriches in the surface layer(0-200 mm) near the sewer channel and decreases gradually in unpolluted soils.The differential concentration level of enrichment between layers is little.The results also indicate that the three vegetables of celery,lettuce and Chinese cabbage are able to convert the potentially toxic Cr(Ⅵ) species into the non-toxic Cr(Ⅲ) species,and the chromium contents in the edible parts of the vegetables are averaged 11.95 mg/kg.The transfer factors of the three vegetables follow the order:Chinese cabbage lettuce celery.The estimated total daily intake of chromium substantially exceeds the dietary allowable value,which may pose health risks to local population.展开更多
The impact of risk correlation on firm's investments in information system security is studied by using quantification models combining the ideas of the risk management theory and the game theory. The equilibrium lev...The impact of risk correlation on firm's investments in information system security is studied by using quantification models combining the ideas of the risk management theory and the game theory. The equilibrium levels of self-protection and insurance coverage under the non- cooperative condition are compared with socially optimal solutions, and the associated coordination mechanisms are proposed. The results show that self-protection investment increases in response to an increase in potential loss when the interdependent risk is small; the interdependent risk of security investments often induce firms to underinvest in security relative to the socially efficient level by ignoring marginal external costs or benefits conferred on others. A subsidy on self-protection investment from the government can help coordinate a firm's risk management decision and, thereby, improve individual security level and overall social welfare.展开更多
[Objective] The study was to explore the major factors affecting diary cattle brucellosis risk assessment,as well as their strong-to-weak sequence,so as to provide theoretical basis for assessing diary cattle brucello...[Objective] The study was to explore the major factors affecting diary cattle brucellosis risk assessment,as well as their strong-to-weak sequence,so as to provide theoretical basis for assessing diary cattle brucellosis risk level in different regions.[Method] From 4 dimensions of feeding and importing,breeding,housing and polyculture situation,an evaluation index system was set up,and diary cattle brucellosis risk survey was conducted in 3 typical regions.Finally,systematic multilevel grey relation entropy method was applied to perform data analysis.[Result] The strong-to-weak sequence of Level 1 impact factor of diary cattle brucellosis was as follows:feeding and importinghousingpolyculture situationbreeding;the sequence of Level 2 impact factor was U32〉U12〉U11〉U31〉U21〉U42〉U43〉U23〉U22〉U41;the risk level sequence of 3 typical regions was Province A(County A1,A2,A3)Province B(County B1,B2,B3)Province C(County C1,C2,C3).[Conclusion] According to the weight of Level 1 index strata,administrative departments at all levels and dairy cattle farmers should lay emphasis on the aspects of feeding,importing and housing;viewed from the perspective of Level 2 index strata,dairy cattle farmers should value the siting of cattle field,the brucellosis surveillance before importing and milking modes most.According to the diary cattle brucellosis risk level of 3 typical regions,if administrative departments at all levels strengthen peoples' awareness of their personal health and increase investment in this area,with new healthy cultured atmosphere built,the risk level of diary cattle brucellosis will surly decline.展开更多
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 ...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.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of sui...Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.展开更多
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 thi...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.展开更多
Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien...Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.展开更多
BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some ...BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.展开更多
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 inv...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.展开更多
文摘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.
基金supported by Natural Science Foundation of Shandong ProvinceChina[ZR2022MH115]the National Natural Science Foundation of China[81301479,82202593]。
文摘Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods We analyzed two-sample of Mendelian randomization(2SMR)using genetic variant depression(n=113,154)and MDD(n=208,811)from Genome-Wide Association Studies(GWAS).Separate calculations were performed with modifiable risk factors from MR-Base for 1,001 genomes.The MR analysis was performed by screening drug targets with MDD in the DrugBank database to explore the therapeutic targets for MDD.Inverse variance weighted(IVW),fixed-effect inverse variance weighted(FE-IVW),MR-Egger,weighted median,and weighted mode were used for complementary calculation.Results The potential causal relationship between modifiable risk factors and depression contained 459 results for depression and 424 for MDD.Also,the associations between drug targets and MDD showed that SLC6A4,GRIN2A,GRIN2C,SCN10A,and IL1B expression are associated with an increased risk of depression.In contrast,ADRB1,CHRNA3,HTR3A,GSTP1,and GABRG2 genes are candidate protective factors against depression.Conclusion This study identified the risk factors causally associated with depression and MDD,and estimated 10 drug targets with significant impact on MDD,providing essential information for formulating strategies to prevent and treat depression.
基金supported by National Natural Science Foundation of China(71974001,72374001)National Social Science Foundation of China(22ZDA112,19BTJ014)+3 种基金the Social Science Foundation of the Ministry of Education of China(21YJAZH081)Anhui Provincial Natural Science Foundation(2108085Y24)the University Social Science Research Project of Anhui Province(2022AH020048,SK2020A0051)the Anhui University of Finance and Economics Graduate Research Innovation Funds(ACYC2021390)。
文摘This study examines the systemic risk caused by major events in the international energy market(IEM)and proposes a management strategy to mitigate it. Using the tail-event driven network(TENET)method, this study constructed a tail-risk spillover network(TRSN) of IEM and simulated the dynamic spillover tail-risk process through the cascading failure mechanism. The study found that renewable energy markets contributed more to systemic risk during the Paris Agreement and the COVID-19pandemic, while fossil energy markets played a larger role during the Russia-Ukraine conflict. This study identifies systemically important markets(SM) and critical tail-risk spillover paths as potential sources of systemic risk. The research confirms that cutting off the IEM risk spillover path can greatly reduce systemic risk and the influence of SM. This study offers insights into the management of systemic risk in IEM and provides policy recommendations to reduce the impact of shock events.
基金financially supported by the third xinjiang scientific expedition program (grant no.2022xjkk0901)the Strategic Priority Research Program of Chinese Academy of Sciences (No.XDA2006030102)the National Natural Sciences Foundation of China(No.42171068 and No.42330503)。
文摘Background:Soil acidifcationn caused by anthropogenic activities may aft soil biochemical cydling,bidiversity,productivity,and multiple eosystem-related functions in drylands.However,to date,such information is lacking to support this hypothesis.Methods Based on a transect survey of 78 naturally assembled shrub communities,we caloulated acid deposition flux in Northwest China and evaluated its likely ecological ffets by testing three altemnative hypotheses,namely:.nidche complementarity,mass ratio,and vegetation quantity hypotheses Rao's quadratic entopy and community-weighted mean traits were employed to represent the complementary aspect of niche complementarity and mass ratio effects,respectively.Resulbs:We observed that in the past four decades,the concentrations of exchangeable base cations in soil in Northwest China have decreased significantly to the extent of having faced the risk of depletion,whereas changes in the calium carbonate content and pH of soil were not significant.Adid deposition primani ly increased the aboweground biomass and shrub density in shrublands but had no sigmificant effect on shrub richness and ecasystem multifunctionality(EMF),indicating that acid deposition had positive but weak ecological effects on dryland ecosystems.Community wd ghted mean of functional traits(representing the mass ratio hypothesis)correlated negatively with EMF,whereas both Rao's quadratic entropy(representing the niche complementarity hypothesis)and aboveground biomass(representing the vegetation quantity hypothesis)correlated positively but insignifcantly with EMF.These biodiversity-EMF relationships highlight the fragility and instability of drylands relative to forest ecasystems.Concuions:The findings from this study serve as important reference points to understand the ris of soil acidification in arid regions and its impacts on biodiversity-EMF relationships.
基金Supported by Open Fund of National Key Laboratory of Power Grid Safety(No.XTB51202301386).
文摘Energy storage batteries can smooth the volatility of renewable energy sources.The operating conditions during power grid integration of renewable energy can affect the performance and failure risk of battery energy storage system(BESS).However,the current modeling of grid-connected BESS is overly simplistic,typically only considering state of charge(SOC)and power constraints.Detailed lithium(Li)-ion battery cell models are computationally intensive and impractical for real-time applications and may not be suitable for power grid operating conditions.Additionally,there is a lack of real-time batteries risk assessment frameworks.To address these issues,in this study,we establish a thermal-electric-performance(TEP)coupling model based on a multitime scale BESS model,incorporating the electrical and thermal characteristics of Li-ion batteries along with their performance degradation to achieve detailed simulation of grid-connected BESS.Additionally,considering the operating characteristics of energy storage batteries and electrical and thermal abuse factors,we developed a battery pack operational riskmodel,which takes into account SOCand charge-discharge rate(Cr),using amodified failure rate to represent the BESS risk.By integrating detailed simulation of energy storage with predictive failure risk analysis,we obtained a detailed model for BESS risk analysis.This model offers a multi-time scale integrated simulation that spans month-level energy storage simulation times,day-level performance degradation,minutescale failure rate,and second-level BESS characteristics.It offers a critical tool for the study of BESS.Finally,the performance and risk of energy storage batteries under three scenarios—microgrid energy storage,wind power smoothing,and power grid failure response—are simulated,achieving a real-time state-dependent operational risk analysis of the BESS.
基金funded by the National Natural Science Foundation of China under Grant 52177074.
文摘Cyber-physical power system(CPPS)has significantly improved the operational efficiency of power systems.However,cross-space cascading failures may occur due to the coupling characteristics,which poses a great threat to the safety and reliability of CPPS,and there is an acute need to reduce the probability of these failures.Towards this end,this paper first proposes a cascading failure index to identify and quantify the importance of different information in the same class of communication services.On this basis,a joint improved risk-balanced service function chain routing strategy(SFC-RS)is proposed,which is modeled as a robust optimization problem and solved by column-and-constraint generation(C-CG)algorithm.Compared with the traditional shortest-path routing algorithm,the superiority of SFC-RS is verified in the IEEE 30-bus system.The results demonstrate that SFC-RS effectively mitigates the risk associated with information transmission in the network,enhances information transmission accessibility,and effectively limits communication disruption from becoming the cause of cross-space cascading failures.
文摘This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.
基金National Natural Science Foundation of China under Grant 62203468Technological Research and Development Program of China State Railway Group Co.,Ltd.under Grant J2023G007+2 种基金Young Elite Scientist Sponsorship Program by China Association for Science and Technology(CAST)under Grant 2022QNRC001Youth Talent Program Supported by China Railway SocietyResearch Program of Beijing Hua-Tie Information Technology Corporation Limited under Grant 2023HT02.
文摘Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable centralized traffic control(CTC)system risk assessment method.Design/methodologylapproach-First,system-theoretic process analysis(STPA)is used to conduct risk analysis on the CTC system and constructs risk assessment indexes based on this analysis.Then,to enhance the accuracy of weight calculation,the fuzzy analytical hierarchy process(FAHP),fuzzy decision-making trial and evaluation laboratory(FDEMATEL)and entropy weight method are employed to calculate the subjective weight,relative weight and objective weight of each index.These three types of weights are combined using game theory to obtain the combined weight for each index.To reduce subjectivity and uncertainty in the assessment process,the backward cloud generator method is utilized to obtain the numerical character(NC)of the cloud model for each index.The NCs of the indexes are then weighted to derive the comprehensive cloud for risk assessment of the CTC system.This cloud model is used to obtain the CTC system's comprehensive risk assessment.The model's similarity measurement method gauges the likeness between the comprehensive risk assessment cloud and the risk standard cloud.Finally,this process yields the risk assessment results for the CTC system.Findings-The cloud model can handle the subjectivity and fuzziness in the risk assessment process well.The cloud model-based risk assessment method was applied to the CTC system risk assessment of a railway group and achieved good results.Originality/value-This study provides a cloud model-based method for risk assessment of CTC systems,which accurately calculates the weight of risk indexes and uses cloud models to reduce uncertainty and subjectivity in the assessment,achieving effective risk assessment of CTC systems.It can provide a reference and theoretical basis for risk management of the CTC system.
文摘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.
文摘Based on the complex network theory,this paper studies the systemic financial risks in China’s financial market.According to the industry classification of the China Securities Regulatory Commission in 2012,the daily closing prices of 45 listed financial institutions are collected and the daily return rates of each financial institution are measured according to the logarithmic return rate calculation formula.In this paper,the risk spillover value ΔCoVaR is used to measure the contribution degree of each financial institution to systemic risk.Finally,the relationship between the risk spillover valueΔCoVaR and the node topology index of the risk transmission network is investigated by using a regression model,and some policy suggestions are put forward based on the regression results.
基金Project (2009ZX07212-001-01) supported by the Key Project of National Natural Science Foundation for Water Pollution Control and RemediationProject (50925417) supported by the National Funds for Distinguished Young Scientists+1 种基金Project (50830301) supported by the National Natural Science Foundation of ChinaProject (51074191) supported by the National Natural Science Foundation of China
文摘Study was carried out to analyze the distribution and migration patterns,soil-to-plant transfer and potential health risks of chromium in soil-vegetable system in areas near a ferro-alloy manufactory in Hunan province.The results show that soils near sewer outlet,sewer channel and in control area are averaged 2 239.5,995.33 and 104.9 mg/kg,respectively.The total Cr has a relative accumulation in soil depth of 200-400 mm near the sewer outlet,mainly enriches in the surface layer(0-200 mm) near the sewer channel and decreases gradually in unpolluted soils.The differential concentration level of enrichment between layers is little.The results also indicate that the three vegetables of celery,lettuce and Chinese cabbage are able to convert the potentially toxic Cr(Ⅵ) species into the non-toxic Cr(Ⅲ) species,and the chromium contents in the edible parts of the vegetables are averaged 11.95 mg/kg.The transfer factors of the three vegetables follow the order:Chinese cabbage lettuce celery.The estimated total daily intake of chromium substantially exceeds the dietary allowable value,which may pose health risks to local population.
基金The National Natural Science Foundation of China(No.71071033)
文摘The impact of risk correlation on firm's investments in information system security is studied by using quantification models combining the ideas of the risk management theory and the game theory. The equilibrium levels of self-protection and insurance coverage under the non- cooperative condition are compared with socially optimal solutions, and the associated coordination mechanisms are proposed. The results show that self-protection investment increases in response to an increase in potential loss when the interdependent risk is small; the interdependent risk of security investments often induce firms to underinvest in security relative to the socially efficient level by ignoring marginal external costs or benefits conferred on others. A subsidy on self-protection investment from the government can help coordinate a firm's risk management decision and, thereby, improve individual security level and overall social welfare.
基金Supported by Special Research Fund for Public Sector(Agriculture)(200903055)~~
文摘[Objective] The study was to explore the major factors affecting diary cattle brucellosis risk assessment,as well as their strong-to-weak sequence,so as to provide theoretical basis for assessing diary cattle brucellosis risk level in different regions.[Method] From 4 dimensions of feeding and importing,breeding,housing and polyculture situation,an evaluation index system was set up,and diary cattle brucellosis risk survey was conducted in 3 typical regions.Finally,systematic multilevel grey relation entropy method was applied to perform data analysis.[Result] The strong-to-weak sequence of Level 1 impact factor of diary cattle brucellosis was as follows:feeding and importinghousingpolyculture situationbreeding;the sequence of Level 2 impact factor was U32〉U12〉U11〉U31〉U21〉U42〉U43〉U23〉U22〉U41;the risk level sequence of 3 typical regions was Province A(County A1,A2,A3)Province B(County B1,B2,B3)Province C(County C1,C2,C3).[Conclusion] According to the weight of Level 1 index strata,administrative departments at all levels and dairy cattle farmers should lay emphasis on the aspects of feeding,importing and housing;viewed from the perspective of Level 2 index strata,dairy cattle farmers should value the siting of cattle field,the brucellosis surveillance before importing and milking modes most.According to the diary cattle brucellosis risk level of 3 typical regions,if administrative departments at all levels strengthen peoples' awareness of their personal health and increase investment in this area,with new healthy cultured atmosphere built,the risk level of diary cattle brucellosis will surly decline.
基金financially supported by the National Ministry of Industry and Information Technology Innovation Special Project-Engineering Demonstration Application of Subsea Production System,Topic 4:Research on Subsea X-Tree and Wellhead Offshore Testing Technology(Grant No.MC-201901-S01-04)the Key Research and Development Program of Shandong Province(Major Innovation Project)(Grant Nos.2022CXGC020405,2023CXGC010415)。
文摘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.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
文摘Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.
基金This work is supported by the National Natural Science Foundation of China(Nos.72071150,71871174).
文摘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.
基金supported by grants from the National Nat-ural Science Foundation of China (81570587 and 81700557)the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007 and 2017B030314018)+3 种基金Guangdong Provincial Natural Science Funds for Major Basic Science Culture Project (2015A030308010)Science and Technology Program of Guangzhou (201704020150)the Natural Science Foundations of Guangdong province (2016A030310141 and 2020A1515010091)Young Teachers Training Project of Sun Yat-sen University (K0401068) and the Guangdong Science and Technology Innovation Strategy (pdjh2022b0010 and pdjh2023a0002)。
文摘Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.
基金The Shanxi Provincial Administration of Traditional Chinese Medicine,No.2023ZYYDA2005.
文摘BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.
基金the financial support from the National Natural Science Foundation of China(71934004)Key Projects of the National Social Science Foundation(23AZD065)the Project of the CNOOC Energy Economics Institute(EEI-2022-IESA0009)。
文摘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.