Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma

BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.

Case management does not decrease mortality of patients with myocardial infarction or unstable angina:Evidence from a systematic review

Objective:To objectively assess the impact of case management on patients with myocardial infarction or unstable angina.Methods:PubMed,EMBASE,Web of Science,Cochrane Library,China National Knowledge Infrastructure(CNKI),and Chinese Biomedical Literature Database were searched for relevant randomized controlled trials(RCTs)published through February 2015.The quality of eligible studies was independently assessed by two investigators.The primary outcome assessed from included studies was all-cause mortality,with total cholesterol,systolic and diastolic blood pressures,smoking cessation rates and cost-effectiveness as secondary outcomes.The pooled effect sizes were expressed as relative risk,odds risk,and standard mean difference with 95%confidence intervals.Heterogeneity among studies was assessed using Cochrane Q and determined with an I2 statistic.Results:After the initial search,a total of four studies divided into six RCTs that included 1293 participants met the inclusion criteria and were analyzed.The results of meta-and descriptive analyses failed to identify any significant differences in all-cause mortality during the follow-up period of up to 36 months.Furthermore,a definitive conclusion for remaining indicators could not be drawn due to limited evidence.Conclusion:Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care.Additional,prospective RCTs of high quality and large scale are warranted to verify these results.

Pain assessment and management in the newborn:A systematized review

BACKGROUND Neonatal pain has been underdiagnosed due to several false beliefs.AIM To determine the status of neonatal pain in newborns who are admitted to intensive care units.METHODS Different databases were searched.Literature reviews and research reports conducted in newborns that were written in English,Spanish,or Portuguese,published between 2010 and 2020,and having free access to the full text were selected.A total of 135 articles were found,and 18 articles were finally reviewed.RESULTS Newborns are exposed to numerous painful procedures.In order to assess their pain levels,several scales have been used,although they are sometimes not correctly interpreted.In terms of pain management,the nursing team plays a very important role based mainly on both pharmacological and non-pharmacological approaches.CONCLUSION Nursing staff members must be well trained in order to identify pain and to interpret the scales correctly.Besides,they have an important role in performing non-pharmacological procedures for pain management.

A Systematic Analysis of Systems Approach and Flood Risk Management Research:Trends,Gaps,and Opportunities

Flooding is a global threat,necessitating a comprehensive management approach.Due to the complexity of managing flood hazards and risks,researchers have advocated for holistic,comprehensive,and integrated approaches.This study,employing a systems thinking perspective,assessed global flood risk management research trends,gaps,and opportunities using132 published documents in BibTeX format.A systematic review of downloaded documents from the Scopus and Web of Science databases revealed slow progress of approximately 11.61% annual growth in applying systems thinking and its concomitant approaches to understanding global flood risk management over the past two decades compared to other fields like water resource management and business management systems.A significant gap exists in the application of systems thinking methodologies to flood risk management research between developed and developing countries,particularly in Africa,highlighting the urgency of reoriented research and policy efforts.The application gaps of the study methodology are linked to challenges outlined in existing literature,such as issues related to technical expertise and resource constraints.This study advocates a shift from linear to holistic approaches in flood risk management,aligned with the Sendai Framework for Disaster Risk Reduction 2015-2023 and the Sustainable Development Goals.Collaboration among researchers,institutions,and countries is essential to address this global challenge effectively.

Policy and Management of Carbon Peaking and Carbon Neutrality:A Literature Review

The vision of reaching a carbon peak and achieving carbon neutrality is guiding the low-carbon transition of China’s socioeconomic system.Currently,a research gap remains in the existing literature in terms of studies that systematically identify opportunities to achieve carbon neutrality.To address this gap,this study comprehensively collates and investigates 1105 published research studies regarding carbon peaking and carbon neutrality.In doing so,the principles of development in this area are quantitively analyzed from a space–time perspective.At the same time,this study traces shifts and alterations in research hotspots.This systematic review summarizes the priorities and standpoints of key industries on carbon peaking and carbon neutrality.Furthermore,with an emphasis on five key management science topics,the scientific concerns and strategic demands for these two carbon emission-reduction goals are clarified.The paper ends with theoretical insights on and practical countermeasures for actions,priority tasks,and policy measures that will enable China to achieve a carbon-neutral future.This study provides a complete picture of the research status on carbon peaking and carbon neutrality,as well as the research directions worth investigating in this field,which are crucial to the formulation of carbon peak and carbon neutrality policies.

Clinical guidelines of non-alcoholic fatty liver disease: A systematic review

AIM To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease(NAFLD).METHODS A database search was conducted on Pub Med for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation(ARGEE) instrument Ⅱ was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. it was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.RESULTS Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia(3 in China, 1 in South Korea, and 1 in Japan), Europe(1 in italy),America(1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization(WGO)]. Using the ARGEE Ⅱ instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.CONCLUSION This is the first systematic review of NAFLD guidelines. it may yield insights for physicians and policy-makers in the development and application of guidelines.

Systematically Monitoring,Relational Database and Technology Roadmapping for Trends and Innovation Opportunities in Biopolymers

In recent years environmental and sustainability concerns have impacted the global chemical industry and instituted a rush to produce products from renewable raw materials.This dynamic,complex and turbulent organizational scenario,around themes touching on the issue of sustainable development model,was created involving a large number of different actors:chemical/petrochemical industries,agroindustry companies,oil/gas companies,brand owners and end users,biotechnology startups,governments,universities and society.This paper proposed the application of a structured and dynamic method of technological prediction for biopolymers in three levels:systematic monitoring process,relational database and the“alive”Technology Roadmapping visualization tool.The main objective is to identify strategic actions,business models,the latest´s technologies in development,as well as trends in the field of biopolymers in order to support companies on position themselves in this competitive scenario.Furthermore,companies,universities,government agencies and institutions could apply this dynamic and alive methodology to indeed access innovation opportunities,challenges and threats for different industrial segments and to provide dynamic knowledge management collaborating to their strategy including a database crossing for the all organization.

Exploring Students Engagement Towards the Learning Management System (LMS) Using Learning Analytics

Learning analytics is a rapidly evolving research discipline that uses theinsights generated from data analysis to support learners as well as optimize boththe learning process and environment. This paper studied students’ engagementlevel of the Learning Management System (LMS) via a learning analytics tool,student’s approach in managing their studies and possible learning analytic methods to analyze student data. Moreover, extensive systematic literature review(SLR) was employed for the selection, sorting and exclusion of articles fromdiverse renowned sources. The findings show that most of the engagement inLMS are driven by educators. Additionally, we have discussed the factors inLMS, causes of low engagement and ways of increasing engagement factorsvia the Learning Analytics approach. Nevertheless, apart from recognizing theLearning Analytics approach as being a successful method and technique for analyzing the LMS data, this research further highlighted the possibility of mergingthe learning analytics technique with the LMS engagement in every institution asbeing a direction for future research.

Enterprise Risk Management in Accounting Research:A Literature Review

This study aims to clarify the characteristics of studies on enterprise risk management(ERM)in accounting and present future research subjects through a literature review.There are few review studies in accounting,compared to adjacent fields such as management and finance.We selected 25 academic papers from the EBSCO database,and conducted a systematic review from three points of view:(1)ERM frameworks;(2)factors that promote or obstruct the introduction of ERM;and(3)the impact of ERM.We find that:(1)there are the conflicting results for ERM frameworks;(2)research on ERM frameworks is one of the features in accounting;and(3)accounting and finance journals follow different topics of interest related to ERM.In addition,this study contributes to the development of ERM research in accounting by clarifying and organizing the research on the introduction of ERM from the perspective of accounting,clarifying the characteristics of ERM research in accounting through a comparison with studies in adjacent fields,and identifying the conflicting findings on the impact of introducing ERM.

Investigain:A Productive Asset Management Web Application

The Investigain is a progressive web application to make mutual funds investments through a Systematic Investment Plan.The application utilizes the web’s modern capabilities,such as Asynchronous JavaScript and XML(AJAX),JavaScript,and Hypertext Marker Language(HTML5).The application also uses a powerful relational database management system,such as MySQL,to display asset management information.The application has two portals,one for investors and one for a particular asset manager or asset management company.Each investor has an account in the investor portal.The investor can view his/her profile,current balance,balance history,dividends,the units of mutual funds bought,unit price,the value of each mutual fund,and can pay installments using an embedded online payment gateway.Asset managers can monitor all investments,manage user accounts,and reimburse dividends using the admin portal.This paper also presents the experimental results of using the Investigain application,compares them with existing systems,and details the application’s prospect to improve its socio-economic conditions.The system’s frontend is designed with Bootstrap and jQuery frameworks.The backend is designed using Hypertext Preprocessor(PHP)server-side scripting language.The system demonstrated increased satisfaction from its clients.

Organizational Psychology Revisited.Goal Setting Theory in Recent Years:A Systematic Literature Review

Recently,setting goals has received a lot of attention.Studies show that not all goals are the same,not all goals are suitable for every situation.Interesting findings have emerged over the past 20 years regarding demanding versus realistic goals,generic versus more precise goals,assigned versus participative goals,and finally learning versus performance-based goals.This systematic literature review aims to highlight the importance of goal setting theory in business and explore its fundamental concepts,by reviewing and evaluating the most recent studies,finally,to discuss potential applications and offer suggestions for further research.

Diuretic combinations in critically ill patients with respiratory failure:A systematic review and meta-analysis

BACKGROUND In patients with respiratory failure,loop diuretics remain the cornerstone of the treatment to maintain fluid balance,but resistance is common.AIM To determine the efficacy and safety of common diuretic combinations in critically ill patients with respiratory failure.METHODS We searched MEDLINE,Embase,Cochrane Library and PROSPERO for studies reporting the effects of a combination of a loop diuretic with another class of diuretic.A meta-analysis using mean differences(MD)with 95%confidence interval(CI)was performed for the 24-h fluid balance(primary outcome)and the 24-h urine output,while descriptive statistics were used for safety events.RESULTS Nine studies totalling 440 patients from a total of 6510 citations were included.When compared to loop diuretics alone,the addition of a second diuretic is associated with an improved negative fluid balance at 24 h[MD:-1.06 L(95%CI:-1.46;-0.65)],driven by the combination of a thiazide plus furosemide[MD:-1.25 L(95%CI:-1.68;-0.82)],while no difference was observed with the combination of a loop-diuretic plus acetazolamide[MD:-0.40 L(95%CI:-0.96;0.16)]or spironolactone[MD:-0.65 L(95%CI:-1.66;0.36)].Heterogeneity was high and the report of clinical and safety endpoints varied across studies.CONCLUSION Based on limited evidence,the addition of a second diuretic to a loop diuretic may promote diuresis and negative fluid balance in patients with respiratory failure,but only when using a thiazide.Further larger trials to evaluate the safety and efficacy of such interventions in patients with respiratory failure are required.

The preferences and values of patients treated with acupuncture for cancer pain:a qualitative systematic review

Background:Understanding values and preferences in the context of personal,physical,emotional,relational,and social factors is important in optimizing cancer patient counselling,facilitating treatment decision-making,and improving guideline recommendations in treating cancer pain patients.Objective:To systematically review the available evidence regarding the values,preferences,and expectations of acupuncture for patients with cancer pain.Methods:A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)statement was conducted.Eight databases were searched without time limits for eligible studies up to April 26,2021.Reference lists of included articles were also searched manually and authors were contacted to inquire about other relevant papers.The quality of the studies was appraised using the Critical Appraisal Skill Program Qualitative Appraisal Checklist(CASP)for studies.This research was registered on PROSPERO with number CRD42020213396.Results:A total of eight studies published in period from 2002 to 2020 were identified from 8 studies involving 2,835 patients.The number of participants in each study ranged from 76 to 706.The quality of the eight included studies was considered high as judged by the CASP tool.Safety is the main factor influencing patients'willingness and preference to accept acupuncture treatment.Human race,education,gender,and knowledge of acupuncture were potentially correlated with patients'preferences.Patients with moderate to severe pain were more likely to use acupuncture than those with mild pain.Conclusion:The preferences and values of patients with cancer pain to receive acupuncture treatment are mainly related to the safety of acupuncture,the degree of cancer pain and demographic characteristics.It is hoped that future high-quality studies could further confirm our conclusions.

Social Prescribing through Primary Care: A Systematic Review of the Evidence

Background: In primary care, social prescribing (SP) is where a patient is referred to a “link worker”, who considers their needs and then “prescribes” or connects them to appropriate community-based resources and services. Recent policy and guidance in the UK has significantly expanded the provision of SP to improve patient health and wellbeing. Methods: This study conducted a systematic review of evidence for SP effectiveness and to report needs addressed, interventions provided, and behaviour change techniques employed. Inclusion criterion was patient referral from primary care to a SP link worker. Online databases were searched for studies published from February 2016 to July 2021. Searches were restricted to English language only. Risk of bias assessment and a narrative analysis were undertaken. Results: Eight studies were included. All studies reported some positive outcomes. There were weaknesses and limitations in study design and in reporting of results: a lack of comparative controls, short duration and single point follow-up, a lack of standardised assessments, missing data, and a failure to consider potential confounding factors. All studies had features which indicated a high risk of bias. Conclusion: Evidence for the value and positive impact of SP is accumulating, but evaluation design remains relatively weak. There is a need to improve evaluation through robust methodological design and the adoption of universal outcome measures and evaluation/analytical framework. SP should seek to assess patient wellbeing, self-management, and quality of lifeoutcomes systematically, and adopt behaviour change techniques to enable healthier lifestyles in the short and long term.

基层治理新趋势:以系统化改革破解基层治理的难题

随着我国走向现代化发展新阶段,基层治理也面临着现代化的转型。在此过程中,要突破基层治理在认知性、结构性和功能性方面的困境,全面深化改革“必须坚持系统观念”。为此,基层治理改革要加强党政统筹的顶层设计,通过优化治理系统结构、明确系统主体职责和推进数字化治理等改革措施,实现由“要素管理”向“系统治理”转变,以求增强基层治理的系统性、整体性和协同性,从而全面推进基层治理体系和治理能力现代化。

危机管理渗透式风险预控在脑膜瘤手术专科护理中的应用

目的:探讨危机管理渗透式风险预控联合系统化专科护理在脑膜瘤术后患者的应用价值。方法:选择在某院接受脑膜瘤切除术103例患者,根据随机数表法分成对照组(52例)和观察组(51例),对照组患者选用常规护理干预措施,观察组患者选用危机管理渗透式风险预控协同专业化专科护理对策。比较两组患者脑膜瘤术后初期并发症发生率与发生时间情况,以及患者手术后的意识恢复情况。结果:相较于对照组,观察组患者术后早期24 h内并发症的发生率明显降低(P=0.001),术后2 h以上手术并发症的发现率明显提高(P<0.05),患者意识恢复情况较好。结论:危机管理渗透式风险预控联合系统化专科护理在脑膜瘤术后患者中应用效果较好,对降低脑膜瘤患者术后早期并发症的发生,提高术后2 h内并发症的发现率及促进患者意识恢复方面有较高的价值。

长江中下游崩岸险情智能感知预警与防治关键技术研究构想及成果展望

崩岸是长江中下游河道自然演变的常见形式,严重威胁防洪安全、航道畅通及沿江经济基础设施正常运行甚至是人民生命财产安全。三峡工程等水利水电工程建成运行引起长江中下游水沙情势显著改变,近年来,中下游河道持续冲刷、局部河势调整、崩岸频发,造成多方面不利影响。尽管以往已开展了相关研究并进行了治理,但由于影响因素众多,崩岸机理复杂,隐蔽性、突发性和随机性强,预警及治理难度依然很大。本文以“崩岸机理揭示—大范围筛查—介入式监测—多尺度预警—系统化防治”为总体思路开展研究,围绕流-固耦合作用下的崩岸机理与险情智能筛查、河道岸坡土体全要素实时感知及崩岸模拟预警技术、耦合河势控制措施的崩岸系统防治技术等关键科学技术问题,重点研究持续冲刷下河势变化与崩岸动态响应关系,研发多源信息融合的崩岸险情智能筛查技术、河道岸坡全要素一体化智能感知技术、多尺度河道崩岸预测与预警技术,以及耦合河势控制措施的崩岸系统防治技术,旨在揭示持续冲刷条件下长江中下游崩岸发生的驱动因素及内在机理,研发崩岸险情智能感知预警及防治关键技术,实现崩岸险情智能筛查、多要素监测、动态预警与系统防治。研究有望显著提高长江中下游河道崩岸发生的预见性和治理技术水平,促进崩岸从灾后抢护向灾前预防转变,为河道系统治理和水安全保障能力提升提供科技支撑。

山水林田湖草沙系统治理与水土保持高质量发展

[目的]中国水土流失治理已由“全面治理,重点治理”迈向“系统治理,攻坚克难”的新阶段。分析山水林田湖草沙系统治理的内涵、准则及其与水土保持的关系,旨在丰富新时代水土保持理论体系,引领水土保持高质量发展。[方法]在长期理论探索和实践验证的基础上,梳理山水林田湖草沙系统治理理念的发展过程,阐明其内涵、目标与实践准则。[结果]水土流失长期治理实践总结提升形成的以小流域为单元的综合治理技术路线是山水林田湖草沙生命共同体系统思想最朴素的实践体现。小流域综合治理的系统性主要体现为治理对象的系统协调,总体布局的系统统筹,治理措施的系统考量,治理成效的多效益兼顾,实施和管理的多部门协同和多主体参与的共治共享6个方面。水土保持高质量发展实践需要遵循的基于系统治理理念的具体举措包括:利用系统思维理解水土保持高质量发展的内涵和要求,精准诊断山水林田湖草沙系统短板及其控制性要素,构建山水林田湖草沙多层次全方位立体化防控体系,构筑完备的水土保持管理与技术保障体系。[结论]在新的历史时期,应该完整准确理解并全面贯彻落实山水林田湖草沙系统治理的理念,探索整体提升水土保持学术研究水平和治理效能的新路径、新模式、新机制。同时应结合区域或流域实际,对农田、水利、牧业、林业及生产建设活动进行全面综合系统的规划和治理,推动水土保持高质量发展。

基于系统理论的校企协同育人项目管理——以湖北水职院实施的教育部供需对接就业育人项目为例

教育部供需对接育人项目涉及到学校、企业、学生、行业及教育主管部门等多方的不同需求,涉及教育部发布项目指南、企业和学校的项目申请,校企供需对接,以及协议签订,项目实施、结题等多个环节,还涉及到安全、资金、管理、法律、教学等多种影响因素,呈现出项目的系统化特征。基于系统思维的供需对接育人项目管理是项目有效实施的根本保证。特别在新冠疫情背景下,实施供需对接育人项目需要加大项目管理力度,有效满足各方需求,从全过程全环节全因素方面实施管控,保障项目可持续发展。以某职业技术学院实施供需对接育人项目为例,分析了项目实施的环节、影响因素,以及采取的举措。

采供血机构采购管理体系化建设的探索

目的为进一步有效保障采购资金使用的合规性与安全性,开展采供血机构采购管理体系化建设并分析应用效果。方法以国家政策为基础,根据行业的采购特性,通过试点、多阶段推行的方式建立并实施符合规范的采购管理体系,并从提升工作效率、采购方式选择及信息公开、采购文件优化完善情况3个方面分析了体系应用效果。结果通过设立“实施-审核-控制”权力分层分级的组织架构、建立全过程采购内控制度(采购过程内控机制、绩效评价及改进机制、风险控制机制),形成持续改进、不断自我完善的采购管理体系。采购管理体系化实施后(2019—2023年),与实施前(2015—2017年)比较,年度采购环节项目处理效率提高了23.64%,采购工作效率显著提升。采用外送招标方式采购的项目占比由(23.18±6.10)%上升到(62.79±2.31)%,采用采购审核小组审议方式采购的项目占比由(76.82±6.10)%下降到(16.39±3.39)%,采购方式的占比差异具有统计学意义(P<0.05),采购评审越来越专业化。发布公告的项目占比由(23.18±6.10)%上升到(99.3±1.56)%,差异具有统计学意义(P<0.05),信息公开越来越透明化。采购管理体系化建立后,采购文件修改率达(36.31±12.19)%,采购工作越来越规范。结论采购管理体系的建立有效控制了采购权利的使用,提高了工作效率,进一步保障采供血机构的资金使用的合规性和安全性,采购过程的系统化、标准化、程序化,构建廉洁、合规、风清气正的采购环境,值得推广应用。