Garg incontinence scores: New scoring system on the horizon to evaluate fecal incontinence. Will it make a difference?

The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.

Scoring and Consequential Validity Evidence of Computer-and Paper-Based Writing Tests in Times of Change

Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom writing assessments.The present mixed-methods study used Shaw and Weir’s(2007)sociocognitive writing test validation framework to examine the scoring and consequential validity evidence of CB and PB writing tests in EFL classroom assessment in higher education.Original handwritten and word-processed texts of 38 EFL university students were transcribed to their opposite format and assessed by three language lecturers(N=456 texts,152 per teacher)to examine the scoring validity of CB and PB tests.The teachers’perceptions of text quality and preferences for assessment modality accounted for the consequential validity evidence of both tests.Findings revealed that the assessment modality impacted teachers’scorings,perceptions,and preferences.The teachers awarded higher scores to original and transcribed handwritten texts,particularly text organization and language use.The teachers’perceptions of text quality differed from their ratings,and physical,psychological,and experiential characteristics influenced their preferences for assessment modality.The results have implications for the validity and fairness of CB and PB writing tests and teachers’assessment practices.

Effect of Application of One-Time Method and Multiple Root Canals on Cryptic Fracture with Endodontic Lesions and VAS Score

Objective:To evaluate the therapeutic efficacy of primary method root canal treatment(ORCT)and multiple root canal treatment(MRCT)for dental cryptocleidosis with endodontic lesions.Methods:88 patients with fissured teeth with endodontic lesions who were admitted to the hospital between November 2021 and November 2023 were selected,and after randomized numerical table grouping,44 cases in the experimental group were included in the ORCT treatment,and 44 cases in the reference group were included in the MRCT treatment,and the total effective rate,root canal filling rate,visual analog scale(VAS)score,periodontal indexes,and the complication rate were compared.Results:The total effective rate and root canal filling rate of the experimental group were higher than that of the reference group;after treatment,the VAS score of the experimental group was lower than that of the reference group,and the periodontal indexes were lower than that of the reference group;and the complication rate of the experimental group was lower than that of the reference group(P<0.05).Conclusion:ORCT can improve the overall efficacy of patients with fissured teeth with endodontic lesions,ensure the filling rate of root canals,significantly reduce pain symptoms,improve a number of periodontal indicators,have high endodontic safety,and have more therapeutic advantages than MRCT.

Impact of time between meniscal injury and isolated meniscus repair on post-operative outcomes:A systematic review

BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.

Storage time affects the level and diagnostic efficacy of plasma biomarkers for neurodegenerative diseases

Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is known about the long-term stability of these biomarker proteins in plasma samples stored at-80°C.We aimed to explore how storage time would affect the diagnostic accuracy of these biomarkers using a large cohort.Plasma samples from 229 cognitively unimpaired individuals,encompassing healthy controls and those experiencing subjective cognitive decline,as well as 99 patients with cognitive impairment,comprising those with mild cognitive impairment and dementia,were acquired from the Sino Longitudinal Study on Cognitive Decline project.These samples were stored at-80°C for up to 6 years before being used in this study.Our results showed that plasma levels of Aβ42,Aβ40,neurofilament light chain,and glial fibrillary acidic protein were not significantly correlated with sample storage time.However,the level of total tau showed a negative correlation with sample storage time.Notably,in individuals without cognitive impairment,plasma levels of total protein and tau phosphorylated protein threonine 181(p-tau181)also showed a negative correlation with sample storage time.This was not observed in individuals with cognitive impairment.Consequently,we speculate that the diagnostic accuracy of plasma p-tau181 and the p-tau181 to total tau ratio may be influenced by sample storage time.Therefore,caution is advised when using these plasma biomarkers for the identification of neurodegenerative diseases,such as Alzheimer's disease.Furthermore,in cohort studies,it is important to consider the impact of storage time on the overall results.

“Culture time”板块教学中跨文化意识培养的策略

在新课程改革的大环境中,文化意识成为英语学科核心素养的重要组成部分。语言是文化的载体,语言与文化是相互依赖、相互影响、相互制约的。学习语言的过程也是学习文化的过程。文章主要结合译林版英语五、六年级教材中的Culture time板块的教学案例,探讨如何在英语课堂教学实践中丰富文化素材、发掘其中的文化元素和领略中西方文化异同,以帮助学生有效学习文化知识,拓宽文化视野,培养文化意识。

Radiomics-based predictive risk score: A scoring system for preoperatively predicting risk of lymph node metastasis in patients with resectable non-small cell lung cancer

Objective: To develop and validate a radiomics-based predictive risk score(RPRS) for preoperative prediction of lymph node(LN) metastasis in patients with resectable non-small cell lung cancer(NSCLC).Methods: We retrospectively analyzed 717 who underwent surgical resection for primary NSCLC with systematic mediastinal lymphadenectomy from October 2007 to July 2016. By using the method of radiomics analysis, 591 computed tomography(CT)-based radiomics features were extracted, and the radiomics-based classifier was constructed. Then, using multivariable logistic regression analysis, a weighted score RPRS was derived to identify LN metastasis. Apparent prediction performance of RPRS was assessed with its calibration,discrimination, and clinical usefulness.Results: The radiomics-based classifier was constructed, which consisted of 13 selected radiomics features.Multivariate models demonstrated that radiomics-based classifier, age group, tumor diameter, tumor location, and CT-based LN status were independent predictors. When we assigned the corresponding score to each variable,patients with RPRSs of 0-3, 4-5, 6, 7-8, and 9 had distinctly very low(0%-20%), low(21%-40%), intermediate(41%-60%), high(61%-80%), and very high(81%-100%) risks of LN involvement, respectively. The developed RPRS showed good discrimination and satisfactory calibration (C-index: 0.785, 95% confidence interval(95% CI):0.780-0.790)Additionally, RPRS outperformed the clinicopathologic-based characteristics model with net reclassification index(NRI) of 0.711(95% CI: 0.555-0.867).Conclusions: The novel clinical scoring system developed as RPRS can serve as an easy-to-use tool to facilitate the preoperatively individualized prediction of LN metastasis in patients with resectable NSCLC. This stratification of patients according to their LN status may provide a basis for individualized treatment.

Validation of a new scoring system: Rapid assessment faecal incontinence score

AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between "state" and "leaks" was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r " for the different subscales of the questionnaire were: "lifestyle" r =-0.87, "coping/behaviour" r =-0.91, "depression" r =-0.36 and "embarrassment" r =-0.90,(P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high.CONCLUSION: RAFIS is a valid and reliable tool to assess Faecal Incontinence.

4种植物源性成分多重real-time PCR检测方法的建立及其在食用淀粉中的应用

建立一种可同时快速检测红薯、木薯、马铃薯、玉米源性成分的多重实时聚合酶链式反应(real-time polymerase chain reaction,real-time PCR)方法。分别以红薯g3pdh基因、木薯g3pdh基因、马铃薯UGPase基因、玉米zSSIIb基因为靶基因设计特异性引物和TaqMan探针,以18S rRNA基因为内参基因,建立多重real-time PCR方法,开展方法学验证,并对不同掺入比例模拟样品和实际淀粉样品进行检测。结果显示,该方法具有高通量、特异性强、灵敏度高等优点。与15种非目标源性均无交叉反应;对目标DNA的检测灵敏度可达到3×10^(-3) ng/μL,且具有良好的线性关系和扩增效率;对淀粉样品的检出限可达0.1%,对50份实际样品进行检测,结果与参比方法一致,说明建立的多重real-time PCR法可用于食用淀粉种类掺假鉴别检测。

Impact of time from diagnosis to chemotherapy in advanced gastric cancer: A Propensity Score Matching Study to Balance Prognostic Factors

BACKGROUND It is unclear whether treatment delay affects the clinical outcomes of chemotherapy in advanced gastric cancer(A-GC).AIM To assess whether treatment delay affects the clinical outcomes of chemotherapy in A-GC.METHODS This single-center retrospective study examined consecutive patients with A-GC between April 2012 and July 2018. In total, 110 patients with stage Ⅳ A-GC who underwent chemotherapy were enrolled. We defined the wait time(WT) as the interval between diagnosis and chemotherapy initiation. We evaluated the influence of WT on overall survival(OS).RESULTS The mean OS was 303 d. The median WT was 17 d. We divided the patients into early and elective WT groups, with a 2-wk cutoff point. There were 46 and 64 patients in the early and elective WT groups, respectively. Compared with the elective WT group, the early WT group had significantly lower albumin(Alb)levels and higher neutrophil/lymphocyte ratios and C-reactive protein(CRP)levels but not a lower performance status. The elective WT group underwent more combination chemotherapy than did the early WT group. OS was different between the two groups(230 d vs 340 d, respectively). Multivariate analysis revealed that higher CRP levels, lower Alb levels and monotherapy were significantly related to a poor prognosis. To minimize potential selection bias,patients in the elective WT group were 1:1 propensity score matched with patients in the early WT group; no significant difference in OS was found(303 d vs 311 d, respectively, log-rank P = 0.9832).CONCLUSION A longer WT in patients with A-GC does not appear to be associated with a worse prognosis.

基于Z-Score动态压缩的高效联邦学习算法

联邦学习作为一种具有隐私保护的新兴分布式计算范式,在一定程度上保护了用户隐私和数据安全。然而,由于联邦学习系统中客户端与服务器需要频繁地交换模型参数,造成了较大的通信开销。在带宽有限的无线通信场景中,这成为了限制联邦学习发展的主要瓶颈。针对这一问题,提出了一种基于Z-Score的动态稀疏压缩算法。通过引入Z-Score,对局部模型更新进行离群点检测,将重要的更新值视为离群点,从而将其挑选出来。在不需要复杂的排序算法以及原始模型更新的先验知识的情况下,实现模型更新的稀疏化。同时随着通信轮次的增加,根据全局模型的损失值动态地调整稀疏率,从而在保证模型精度的前提下最大程度地减少总通信量。通过实验证明,在I.I.D.数据场景下,该算法与联邦平均(FedAvg)算法相比可以降低95%的通信量,精度损失仅仅为1.6%,与FTTQ算法相比可以降低40%~50%的通信量,精度损失仅为1.29%,证明了该方法在保证模型性能的同时显著降低了通信成本。

Real-time Monitoring of Subsea Gas Pipelines,Offshore Platforms,and Ship Inspection Scores Using an Automatic Identification System

The aim of this research is to develop an algorithm and application that can perform real-time monitoring of the safety operation of offshore platforms and subsea gas pipelines as well as determine the need for ship inspection using data obtained from automatic identification system(AIS).The research also focuses on the integration of shipping database,AIS data,and others to develop a prototype for designing a real-time monitoring system of offshore platforms and pipelines.A simple concept is used in the development of this prototype,which is achieved by using an overlaying map that outlines the coordinates of the offshore platform and subsea gas pipeline with the ship’s coordinates(longitude/latitude)as detected by AIS.Using such information,we can then build an early warning system(EWS)relayed through short message service(SMS),email,or other means when the ship enters the restricted and exclusion zone of platforms and pipelines.The ship inspection system is developed by combining several attributes.Then,decision analysis software is employed to prioritize the vessel’s four attributes,including ship age,ship type,classification,and flag state.Results show that the EWS can increase the safety level of offshore platforms and pipelines,as well as the efficient use of patrol boats in monitoring the safety of the facilities.Meanwhile,ship inspection enables the port to prioritize the ship to be inspected in accordance with the priority ranking inspection score.

Real-Time Timing Channel Detection in a Software-Defined Networking Virtual Environment

Despite extensive research, timing channels (TCs) are still known as a principal category of threats that aim to leak and transmit information by perturbing the timing or ordering of events. Existing TC detection approaches use either signature-based approaches to detect known TCs or anomaly-based approach by modeling the legitimate network traffic in order to detect unknown TCs. Un-fortunately, in a software-defined networking (SDN) environment, most existing TC detection approaches would fail due to factors such as volatile network traffic, imprecise timekeeping mechanisms, and dynamic network topology. Furthermore, stealthy TCs can be designed to mimic the legitimate traffic pattern and thus evade anomalous TC detection. In this paper, we overcome the above challenges by presenting a novel framework that harnesses the advantages of elastic re-sources in the cloud. In particular, our framework dynamically configures SDN to enable/disable differential analysis against outbound network flows of different virtual machines (VMs). Our framework is tightly coupled with a new metric that first decomposes the timing data of network flows into a number of using the discrete wavelet-based multi-resolution transform (DWMT). It then applies the Kullback-Leibler divergence (KLD) to measure the variance among flow pairs. The appealing feature of our approach is that, compared with the existing anomaly detection approaches, it can detect most existing and some new stealthy TCs without legitimate traffic for modeling, even with the presence of noise and imprecise timekeeping mechanism in an SDN virtual environment. We implement our framework as a prototype system, OBSERVER, which can be dynamically deployed in an SDN environment. Empirical evaluation shows that our approach can efficiently detect TCs with a higher detection rate, lower latency, and negligible performance overhead compared to existing approaches.

A Timing Skew Calibration Scheme in Time-Interleaved ADC

This paper proposes a digital background calibration scheme for timing skew in time-interleaved analog-to-digital converters (TIADCs). It detects the relevant timing error by subtracting the output difference with the sum of the first derivative of the digital output. The least-mean-square (LMS) loop is exploited to compensate the timing skew. Since the calibration scheme depends on the digital output, all timing skew sources can be calibrated and the main ADC is maintained. The proposed scheme is effective within the entire frequency range of 0 ? fs/2. Compared with traditional calibration schemes, the proposed approach is more feasible and consumes significantly lesser power and smaller area.

Extended time improves reading comprehension test scores for adolescents with ADHD

Objective: To test the hypotheses that reading comprehension difficulties of adolescent students with ADHD: 1) are related not so much to weak verbal abilities or weak basic reading skills, as to impairments of working memory and processing speed characteristic of ADHD;and 2) that extended time on a test of reading comprehension would yield significantly higher reading comprehension scores than would standard time. Method: Charts of 145 adolescents 13-18 years diagnosed with DSM-IV ADHD and no specific reading disorder after a comprehensive clinical and psycho-educational evaluation, were reviewed to extract 1) word reading and word attack subtest scores from the Woodcock-Johnson Achievement Test or the Wechsler Individual Achievement Test;2) Index scores from WISC-IV or WAIS-III IQ tests;3) scores from the Nelson-Denny Reading Test. Results: Mean index scores for verbal comprehension abilities not including reading were in the high average range, but working memory and processing speed index scores were significantly weaker. Under standard time limits 53% were unable to complete the reading comprehension test and only 42.8% were able to score within 1 SD of their IQ verbal comprehension index (VCI). When allowed extended time, 77.9% were able to score within 1 SD of their VCI. T-test comparisons between standard time and extended time were significant at < 0.001. Conclusions: Allowing extended time for adolescents with ADHD to complete tests involving reading may help to compensate for their impairments of working memory and processing speed, allowing them to score closer to their actual verbal abilities.

基于F-score和二进制灰狼优化的肿瘤基因选择方法

针对肿瘤基因数据维度高、噪声多、冗余性高的现状,结合Spearman相关系数改进F-score算法,在此基础上优化二进制灰狼算法,提出了一种基于改进F-score和二进制灰狼算法的肿瘤基因选择算法.首先,考虑特征之间的相关性,计算每个特征的F-score值和特征之间的Spearman相关系数的绝对值;然后,计算权重系数得出各个特征的权重值,依据重要性进行排序,选出初选特征子集;最后,通过收敛因子的衰减曲线和初始化方法优化二进制灰狼算法,调整全局搜索和局部搜索所占比例,增强全局搜索能力并提高局部搜索速度,有效节省时间开销,提升特征选择的分类性能和效率,得到最优特征子集.在9个肿瘤基因数据集上测试所提算法,在分类准确率和筛选特征数目两个指标上进行仿真实验,并与4种其他算法进行对比,实验结果证明所提算法表现良好,可有效降低基因数据维度,并具有较好的分类精度.

Application of Geodetic Receivers to Timing and Time Transfer

Two methods for smoothing pseudorange observable by Carrier and Doppler are discussed. Then the procedure based on the RINEX observation files is tested using the Ashtech Z-XII3T geodetic receivers driven by a stable external frequency at UNSO. This paper proposes to adapt this procedure for the links between geodetic receivers, in order to take advantage of the P codes available on L 1 and L 2. This new procedure uses the 30-second RINEX observations files, the standard of the International GPS Service (IGS), and processes the ionosphere-free combination of the codes P 1 and P 2; the satellite positions are deduced from the IGS rapid orbits, available after two days.

ICON/MIGHTI与TIMED/SABER探测温度数据的对比

ICON卫星为临近空间环境特性研究、建模和预报提供了新数据.通过对ICON/MIGHTI与TIMED/SABER在90~105 km高度探测温度数据的比较,计算两者的年平均温度偏差和均方根误差,同时分析月平均温度偏差在不同月份中随高度和纬度的分布情况,为MIGHTI和SABER温度探测数据在临近空间大气建模和预报应用提供参考依据.结果表明,MIGHTI和SABER的温度垂直廓线变化趋势基本吻合,数值上有所差异.在12°S-42°N范围内,MIGHTI探测温度与SABER相比,在90~93 km时偏低,偏差最大值约2.5 K,在93~105 km偏高,偏差的绝对值最大约10 K.在不同季节,白天的温度偏差通常高于夜晚.SABER和MIGHTI的月平均温度偏差随季节和纬度的变化显著,夏季时的月平均温度偏差最大,且温度的均方根误差最大.

引入ESG框架的Z-Score业绩评价模式研究

本文结合当前企业可持续高质量发展的目标导向,构建了引入ESG框架的Z-Score业绩评价模式,以弥补EVA评价中过于关注经济利润以及BSC评价中过于关注企业内部治理的视角局限性。通过主成分分析法测度的关键综合业绩指标,在案例分析中证明了引入ESG框架后的业绩评价模式在实际应用中具有必要性和合理性。在传统业绩指标评价模式的基础上引入ESG框架来进一步优化企业业绩评价体系,有助于企业培育或强化适应高质量发展的业绩观。

Partition-Time Masking:一种唇语识别数据增强方法

提出了一种唇语识别数据增强方法Partition-Time Masking。该方法直接作用于输入数据,通过将输入划分为多个子序列再分别进行Mask操作最后再将各子序列按序拼接,使得模型能对部分帧缺失的输入具有更强的鲁棒性,从而增强泛化能力。实验前根据划分的子序列数目与掩码值来源不同而设计了5种增强策略,并与唇语识别研究中最重要的数据增强方法Time Masking进行了对比实验。实验在LRW数据集和LRW1000数据集上进行,实验结果表明Partition-Time Masking方法对模型性能提升的效果要优于Time Masking方法,其中子序列数目为3、掩码值选择各子序列平均帧时为最优策略,该策略使得目前最佳的唇语识别模型DC-TCN的性能从89.6%提高到90.0%。