Automatic detection of small bowel lesions with different bleeding risks based on deep learning models

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.

Development of Localized Assessment of Municipal Wastewater Disposal Risks

A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct or indirect potable reuse options. These options have garnered more interest as a result of water supply limitations in many urban areas. This risk assessment was developed from a risk assessment developed at the University of Miami in 2001 and Florida Atlantic University (FAU) in 2023. Direct potable reuse and injection wells were deemed to have the lowest risk in the most recent study by FAU. However, the injection well option may not be available everywhere. As a result, a more local means to assess exposure risk is needed. This paper outlines the process to evaluate the public health risks associated with available disposal alternatives which may be very limited in some areas. The development of exposure pathways can help local decision-makers define the challenges, and support later expert level analysis upon which public health decisions are based.

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.

Conceptual Strategy for Mitigating the Risk of Hydrogen as an Internal Hazard in Case of Severe Accidents at Nuclear Power Plant Considering Existing Risks and Uncertainties Associated with the Use of Traditional Strategies

Hydrogen challenge mitigation stands as one of the main objectives in the management of severe accidents at Nuclear Power Plants (NPPs). Key strategies for hydrogen control include atmospheric inertization and hydrogen removal with Passive Autocatalytic Recombiners (PARs) being a commonly accepted approach. However, an examination of PAR operation specificity reveals potential inefficiencies and reliability issues in certain severe accident scenarios. Moreover, during the in-vessel stage of severe accident development, in some severe accident scenarios PARs can unexpectedly become a source of hydrogen detonation. The effectiveness of hydrogen removal systems depends on various factors, including the chosen strategies, severe accident scenarios, reactor building design, and other influencing factors. Consequently, a comprehensive hydrogen mitigation strategy must effectively incorporate a combination of strategies rather than be based on one strategy, taking into consideration the probabilistic risks and uncertainties associated with the implementation of PARs or other traditional methods. In response to these considerations, within the framework of this research it has been suggested a conceptual strategy to mitigate the hydrogen challenge during the in-vessel stage of severe accident development.

Cholinesterase Activity as an Indicator of Health Risks among Kou Valley Farmers

Introduction: Pesticides are currently an essential component of agricultural production techniques for controlling pests and weeds. In Burkina Faso, non-compliance with good practice in the use of pesticides poses a real health problem for the population. This study examines the health risks associated with pesticide management in rice-growing areas. Material and Methods: A field survey was conducted in Bama, involving farmers, focusing on their socio-demographic characteristics, pesticide usage, and health effects. Cholinesterase levels were measured in subsample of farmers using a portable device. Data were analysed using Microsoft Excel, calculating means and percentages for various practices. Health consultations, protection methods, and pesticide management were studied. Erythrocyte acetylcholinesterase activity was compared before and after treatment. Data were categorised into classes based on inhibition levels, and correlation analyses determined relationships between variables such as age, years of experience, and cholinesterase activity. Results: The results indicate that rice cultivation is mainly carried out by a fairly young population, with nearly 63% being under the age of 50. Common poor practices in pesticide use include improper storage and reuse of leftover pesticides. Seven types of pesticides were identified, including organophosphates such as glyphosate, which was used in 26.7% of cases. This organophosphate has resulted in class B poisoning, causing a 30% - 50% reduction in erythrocyte cholinesterase activity. The health effects of pesticide use are felt by agricultural farmers through various symptoms of poisoning. Conclusion: To reduce the occurrence of pesticide poisoning, it is essential to launch information and awareness campaigns among the population and farmers to promote safe practices in pesticide use in Bama, Burkina Faso.

Predictive factors for percutaneous nephrolithotomy bleeding risks

Objective:This study aimed to identify predictive factors for percutaneous nephrolithotomy(PCNL)bleeding risks.With better risk stratification,bleeding in high-risk patient can be anticipated and facilitates early identification.Methods:A prospective observational study of PCNL performed at our institution was done.All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy,planned for additional procedures.Factors including gender,co-morbidities,body mass index,stone burden,puncture site,tract dilatation size,operative position,surgeon's seniority,and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin(Hb)deficiency.Results:Overall,4.86%patients(n=7)received packed cells transfusion.The mean estimated Hb deficiency was 1.3(range 0-6.5)g/dL and the median was 1.0 g/dL.Stepwise multivariate regression analysis revealed that absence of hypertension(p=0.024),puncture site(p=0.027),and operative duration(p=0.023)were significantly associated with higher estimated Hb deficiency.However,the effect sizes are rather small with partial eta-squared of 0.037,0.066,and 0.038,respectively.Observed power obtained was 0.621,0.722,and 0.625,respectively.Other factors studied did not correlate with Hb difference.Conclusion:Hypertension,puncture site,and operative duration have significant impact on estimated Hb deficiency during PCNL.However,the effect size is rather small despite adequate study power obtained.Nonetheless,operative position(supine or prone),puncture number,or tract dilatation size did not correlate with Hb difference.The mainstay of reducing bleeding in PCNL is still meticulous operative technique.Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient,without increasing risk of bleeding.

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.

Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment

Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.

Planetary health risks in urban agriculture

Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation,providing advantages such as urban greening,reduced heat island effects,and decreased air pollution.Moreover,it indirectly supports communities during weather events and natural disasters,ensuring food security and fostering community cohesion.However,concerns about planetary health risks persist in highly urbanized and climate-affected areas.Employing electronic databases such as Web of Science and PubMed and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,we identified 55 relevant papers to comprehend the planetary health risks associated with urban agriculture,The literature review identified five distinct health risks related to urban agriculture:(1)trace metal risks in urban farms;(2)health risks associated with wastewater irrigation;(3)zoonotic risks;(4)other health risks;and(5)social and economic risks.The study highlights that urban agriculture,while emphasizing environmental benefits,particularly raises concerns about trace metal bioaccumulation in soil and vegetables,posing health risks for populations.Other well studied risks included wastewater irrigation and backyard livestock farming.The main limitations in the available literature were in studying infectious diseases and antibiotic resistance associated with urban agriculture.

Contamination assessment,source apportionment and associated health risks of PTEs in agricultural soil under five land-use patterns in Sanya,China

To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.

Predicting potential invasion risks of Leucaena leucocephala(Lam.)de Wit in the arid area of Saudi Arabia

The presence of invasive plant species poses a substantial ecological impact,thus comprehensive evaluation of their potential range and risk under the influence of climate change is necessary.This study uses maximum entropy(MaxEnt)modeling to forecast the likelihood of Leucaena leucocephala(Lam.)de Wit invasion in Saudi Arabia under present and future climate change scenarios.Utilizing the MaxEnt modeling,we integrated climatic and soil data to predict habitat suitability for the invasive species.We conducted a detailed analysis of the distribution patterns of the species,using climate variables and ecological factors.We focused on the important influence of temperature seasonality,temperature annual range,and precipitation seasonality.The distribution modeling used robust measures of area under the curve(AUC)and receiver-operator characteristic(ROC)curves,to map the invasion extent,which has a high level of accuracy in identifying appropriate habitats.The complex interaction that influenced the invasion of L.leucocephala was highlighted by the environmental parameters using Jackknife test.Presently,the actual geographic area where L.leucocephala was found in Saudi Arabia was considerably smaller than the theoretical maximum range,suggesting that it had the capacity to expand further.The MaxEnt model exhibited excellent prediction accuracy and produced reliable results based on the data from the ROC curve.Precipitation and temperature were the primary factors influencing the potential distribution of L.leucocephala.Currently,an estimated area of 216,342 km^(2)in Saudi Arabia was at a high probability of invasion by L.leucocephala.We investigated the potential for increased invasion hazards in the future due to climate change scenarios(Shared Socioeconomic Pathways(SSPs)245 and 585).The analysis of key climatic variables,including temperature seasonality and annual range,along with soil properties such as clay composition and nitrogen content,unveiled their substantial influence on the distribution dynamic of L.leucocephala.Our findings indicated a significant expansion of high risk zones.High-risk zones for L.leucocephala invasion in the current climate conditions had notable expansions projected under future climate scenarios,particularly evident in southern Makkah,Al Bahah,Madina,and Asir areas.The results,backed by thorough spatial studies,emphasize the need to reduce the possible ecological impacts of climate change on the spread of L.leucocephala.Moreover,the study provides valuable strategic insights for the management of invasion,highlighting the intricate relationship between climate change,habitat appropriateness,and the risks associated with invasive species.Proactive techniques are suggested to avoid and manage the spread of L.leucocephala,considering its high potential for future spread.This study enhances the overall comprehension of the dynamics of invasive species by combining modeling techniques with ecological knowledge.It also provides valuable information for decision-making to implement efficient conservation and management strategies in response to changing environmental conditions.

Impact of Exercise on Depression in Older Adults:Potential Benefits,Risks,and Appropriate Application Strategies

As the global elderly population increases,depression within this group has become a significant public health concern.Although exercise has been recognized for its potential to improve depression in the elderly,the benefits,risks,and implementation strategies remain contentious.This review attempts to examine the impact of exercise on depression in older adults,including potential benefits,risks,and suggestions for application.Our analysis highlights the benefits of aerobic and resistance training,which can significantly alleviate depressive symptoms and enhance overall quality of life.Despite these benefits,the review acknowledges the complexity of the exercise-depression interaction in the elderly,necessitating personalized exercise regimens.Potential risks,such as muscle and joint pain,are pointed out,emphasizing the importance of tailored,supervised exercise programs.The review calls for future research to focus on identifying the most effective types of exercise and regimens for this population,considering factors such as age,gender,and existing health conditions.Lastly,it advocates for the inclusion of exercise in comprehensive treatment plans for depression in older adults,viewing it as a promising step toward achieving holistic mental health care in a growing demographic.

Gross Alpha and Beta Activities and Related Lifetime Risks Assessment Due to Ingestion of Drinking Water from Different Sources in the District of Abidjan, Cote d’Ivoire

Drinking good quality water is essential for better health. It is therefore essential to assess the radiological quality of all water consumed in the District of Abidjan in order to prevent related hazards. Thus, the objective of this study was to assess the risk of cancer due to the ingestion of alpha and beta emitting radionuclides in the different types of water consumed in the region. A total of 63 water samples with 43 tap water samples, 5 bottled mineral water and 15 sachet water samples was collected and taken to GAEC laboratory for analysis. The low background Gas-less Automatic Alpha/Beta counting system (Canberra iMaticTM) was used to determine alpha and beta activity concentrations. Activity concentrations of both gross alpha and gross beta obtained in water sample were respectively lower than the WHO recommended limits of 0.1 Bq/l and 1 Bq/l. Also, the annual effective dose and total equivalent effective dose found in mineral bottled water samples were higher than in other types of water. The assessment of radiological lifetime risk has shown values of cancer risk due to ingestion alpha and beta emitters lower than recommended limit. These results indicate that there is no health hazard associated to consumption of water in the District of Abidjan.

Spatial distribution and potential ecological and health risks associated with heavy metals in the Ijero-Ekiti mining site,Nigeria

Artisanal gold mining,a labor-intensive and antiquated technique,is a growing industry and the source of income for rural communities all over the world.However,artisanal gold mining has potential negative and long-term effects on economy,environment,and society.This study collected soil samples from 16 sample points including a control point to examine the pollution degrees and spatial distribution of heavy metals,as well as ecological and health risks associated with heavy metal pollution in the Ijero-Ekiti mining site,Nigeria.Geographical Information System(GIS)and remote sensing technologies were used to identify regions with high concentrations of heavy metals and assess the environmental impact of gold mining activities.The results show that the mean heavy metal concentrations of 16 soil pointa are 8.94(±5.97)mg/kg for As,0.18(±0.54)mg/kg for Cd,0.11(±1.06)mg/kg for Co,14.32(±3.43)mg/kg for Cr,6.89(±0.64)mg/kg for Cu,48.92(±11.77)mg/kg for Fe,135.81(±30.75)mg/kg for Mn,5.92(±0.96)mg/kg for Ni,5.72(±1.66)mg/kg for Pb,and 13.94(±1.38)mg/kg for Zn.The study reveals that heavy metal concentration in soils follows the order of Mn>Fe>Cr>Zn>As>Cu>Ni>Pb>Co>Cd.An analysis of soil samples indicates that 3 principal components(PCs)account for 70.008%of the total variance and there are strong positive correlations between various pairs of heavy metals.The total potential ecological risk index(309.599)in the study area is high.Non-carcinogenic risk suggests that there may be long-term health impacts on people who work in the mining areas due to chronic exposure to the environment.Based on the study,the hazard index of carcinogenic health risks associated with heavy metals through ingestion is 520.00×10^(–4).Dermal contact from As and Cr also increases the risk of cancer,with the highest hazard index value of 18.40×10^(–4).The lowest exposure pathway,with the hazard index value of 0.68×10^(–4),indicates that the inhalation of heavy metals has a comparatively low risk of cancer.This study recommends the formulation of policies to monitor the Ijero-Ekiti mining site and other regions in Nigeria where indiscriminate artisanal gold mining activities exist.

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

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

Analytic Hierarchy Process for Technological Risks in the Process of Innovative Drug Development in China

Objective To identify the critical risks in the process of innovative drug research and development,and to provide reference for improving the efficiency of innovative drug development and risk control in China.Methods Expert investigation and analytic hierarchy process were used to determine the weights of different risks.Results and Conclusion The research and analysis results showed that the risks at different stages of development had different effects on the success rate of drug development,among which the risk at the drug discovery stage influenced the most.In the drug discovery stage,inappropriate target selection had the greatest impact on the success rate of drug development.The lack of appropriate cell tissue or animal models had the greatest impact on the success rate of drug development from the discovery of a compound to the application for clinical trials.The difference in changes between nonclinical and clinical studies had the greatest impact on the success rate of drug development from early clinical studies to pivotal clinical studies.Incorrect dose selection had the greatest impact on the success rate of drug development from pivotal clinical studies to marketing authorization applications.The biggest impact from the marketing authorization application to the approval stage was inadequate communication with regulators.After investigating the weight of risk factors in the process of innovative drug development based on scientific methods,a new perspective for the risk control of new drug development and improving the research and development efficiency is provided.

Corporate Social Responsibility and Shipping Supply Chain Risks

This study aims to investigate whether Corporate Social Responsibility(CSR)activities reduce supply chain disruptions by examining the impact of the Suez Canal obstruction on the Ever Given container ship in March 2021.This study conclude that the more responsible companies have higher returns and are less affected by this event than the less responsible companies;the less responsible companies have lower returns.The companies with better CSR have a lower impact on their supply chains when faced with disruptions in the supply chain.

RiskSystem系统在化工园区风险管控中的应用

化工园区历来是环境风险管控的重点区域,RiskSystem系统在化工园区规划环评中也得到较为广泛的利用,系统严格按《建设项目环境风险评价技术导则》要求进行构建,在参数充分的情况下,其界面友好,模拟结果可信,结合卫星定位系统,可对主要风险源实施精细化管理。本文结合化工园区规划环评实际工作,采用RiskSystem系统对园区风险源进行预测评价,并提出园区环境风险管控重点,能够为化工园区规划环评及风险管理工作提供参考。

Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

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.