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.

Factors affecting farmers'choice to adopt risk management strategies:The application of multivariate and multinomial probit models

This study investigates the factors that impact farmers'adoption of risk management strategies(RMS)in Pakistan during times of uncertainty.The study examines farmers'adoption of RMS using both multinomial probit(MNP)and multivariate probit(MVP).Data were collected from 382 farmers sampled from four districts in KhyberPakhtunkhwa(KP)province of Pakistan via a multistage sampling technique.This study utilizes the MNP model,considering the assumption of Independence of Irrelevant Alternatives(IIA)and incorporating correlated error terms.The objective is to understand farmers'behavior in risky situations and determine if there is heterogeneity.Results are compared with the MVP model to assess robustness and gain deeper understanding of farmers'decisionmaking processes.The research findings reveal that our results are robust,and farmers behave homogeneously in various RMS scenarios.Farmers adopt RMS individually or in combination to mitigate the adverse effects of natural calamities on their livelihood.The risk-averse farmers,who perceive weather-related risks as a threat,access credits and information,and have farms close to a river are more likely to adopt RMS,irrespective of the format of the strategies available.Moreover,the predicted probabilities and correlation of the RMS and RM categories have strengthened our model estimation.These findings provide insights into the behavior of farmers in adopting RMS which are helpful for policymakers and stakeholders in developing strategies to mitigate the impacts of natural calamities on farmers.

Survey and Prospect for Applying Knowledge Graph in Enterprise Risk Management

Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.

An Assessment of Procurement Risks Management Systems in the Public Sector

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.

Mapping Climate Services for Disaster Risk Management: A Systematic Review and Research Gaps from a Policy Process Perspective

Climate services (CS) are crucial for mitigating and managing the impacts and risks associated with climate-induced disasters. While evidence over the past decade underscores their effectiveness across various domains, particularly agriculture, to maximize their potential, it is crucial to identify emerging priority areas and existing research gaps for future research agendas. As a contribution to this effort, this paper employs the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to review the state-of-the-art in the field of climate services for disaster risk management. A comprehensive search across five literature databases combined with a snowball search method using ResearchRabbit was conducted and yielded 242 peer-reviewed articles, book sections, and reports over 2013-2023 after the screening process. The analysis revealed flood, drought, and food insecurity as major climate-related disasters addressed in the reviewed literature. Major climate services addressed included early warning systems, (sub)seasonal forecasts and impact-based warnings. Grounded in the policy processes’ theoretical perspective, the main focus identified and discussed three prevailing policy-oriented priority areas: 1) development of climate services, 2) use-adoption-uptake, and 3) evaluation of climate services. In response to the limitations of the prevalent supply-driven and top-down approach to climate services promotion, co-production emerges as a cross-cutting critical aspect of the identified priority areas. Despite the extensive research in the field, more attention is needed, particularly pronounced in the science-policy interface perspective, which in practice bridges scientific knowledge and policy decisions for effective policy processes. This perspective offers a valuable analytical lens as an entry point for further investigation. Hence, future research agendas would generate insightful evidence by scrutinizing this critical aspect given its importance to institutions and climate services capacity, to better understand intricate facets of the development and the integration of climate services into disaster risk management.

Outpatient management of obscure gastrointestinal bleeding:A new perspective in high-risk patients

Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.

Understanding Osteoporosis: Pathophysiology, Risk Factors, Diagnosis, and Management

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.

Nursing Risk Management in the Prevention of Post-ERCP Pancreatitis

Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.

Electronic Commerce Security and Risk Management: An Important Part of College Curriculum

With the rapid expansion of e-commerce,its security and risk management problems become increasingly prominent.In the current business environment,the ability to understand and apply e-commerce security and risk management has become an important criterion to measure a good person.Therefore,the importance of e-commerce security and risk management courses in college education is self-evident.This course can not only help students master the basic knowledge of e-commerce,but also enable them to understand how to deal with various risks in practical work and ensure the safe operation of e-commerce.At the same time,through the study of e-commerce security and risk management,students can better understand the operation mode and law of e-commerce,and lay a solid foundation for their future career.In general,e-commerce security and risk management occupy an important position in the curriculum of colleges and universities,and play a crucial role in cultivating e-commerce professionals with practical operation ability and innovative thinking.

Cybersecurity Risk Management through Behavior-Based Contextual Analysis of Online Logs

This paper studies cyber risk management by integrating contextual log analysis with User and Entity Behavior Analytics (UEBA). Leveraging Python scripting and PostgreSQL database management, the solution enriches log data with contextual and behavioral information from Linux system logs and semantic datasets. By incorporating Common Vulnerability Scoring System (CVSS) metrics and customized risk scoring algorithms, the system calculates Insider Threat scores to identify potential security breaches. The integration of contextual log analysis and UEBA [1] offers a proactive defense against insider threats, reducing false positives and prioritizing high-risk alerts.

Importance of risk assessment,endoscopic hemostasis,and recent advancements in the management of acute non-variceal upper gastrointestinal bleeding

Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.

Research on Tax Risk Regulation and Strategic Management in the Context of Big Data

With the rapid development of big data,big data has been more and more applied in all walks of life.Under the big data environment,massive big data provides convenience for regional tax risk control and strategic decision-making but also increases the difficulty of data supervision and management.By analyzing the status quo of big data and tax risk management,this paper finds many problems and puts forward effective countermeasures for tax risk supervision and strategic management by using big data.

Internal Control Management and Risk Prevention Measures of State-Owned Enterprises

As an important pillar of national economic development,state-owned enterprises,their operational efficiency,and risk management ability are directly related to the stability and security of the national economy.As an important part of enterprise management,internal control management plays an irreplaceable role.Especially in the current domestic and international economic situation is complex and changeable,market competition is increasingly fierce environment,to strengthen the internal control management of state-owned enterprises and risk prevention measures is particularly important.This paper starts with the importance of internal control management and risk prevention for state-owned enterprises,and analyzes the problems and strategies in the internal control management and risk prevention of state-owned enterprises,in order to build a more comprehensive and efficient risk management system for state-owned enterprises to adapt to the ever-changing market environment and realize sustainable development.

Risk factors and management countermeasures for obstructive sleep apnea hypoventilation syndrome in children

BACKGROUND Obstructive sleep apnea hypoventilation syndrome(OSAHS)in children is a sleep respiratory disorder characterized by a series of pathophysiologic changes.Statistics in recent years have demonstrated an increasing yearly incidence.AIM To investigate the risk factors for OSAHS in children and propose appropriate management measures.METHODS This study had a case–control study design.Altogether,85 children with OSAHS comprised the case group,and healthy children of the same age and sex were matched at 1:1 as the control group.Basic information,including age,sex,height,weight and family history,and medical history data of all study participants were collected.Polysomnography was used to detect at least 8 h of nocturnal sleep.All participants were clinically examined for the presence of adenoids,enlarged tonsils,sinusitis,and rhinitis.RESULTS The analysis of variance revealed that the case group had a higher proportion of factors such as adenoid grading,tonsil indexing,sinusitis,and rhinitis than the control group.CONCLUSION A regression model was established,and glandular pattern grading,tonsil indexing,sinusitis,and pharyngitis were identified as independent risk factors affecting OSAHS development.

A novel framework of ecological risk management for urban development in ecologically fragile regions: A case study of Turpan City, China

Assessing and managing ecological risks in ecologically fragile areas remain challenging at present.To get to know the ecological risk situation in Turpan City,China,this study constructed an ecological risk evaluation system to obtain the ecological risk level(ERL)and ecological risk index(ERI)based on the multi-objective linear programming-patch generation land use simulation(MOP-PLUS)model,analyzed the changes in land use and ecological risk in Turpan City from 2000 to 2020,and predicted the land use and ecological risk in 2030 under four different scenarios(business as usual(BAU),rapid economic development(RED),ecological protection priority(EPP),and eco-economic equilibrium,(EEB)).The results showed that the conversion of land use from 2000 to 2030 was mainly between unused land and the other land use types.The ERL of unused land was the highest among all the land use types.The ecological risk increased sharply from 2000 to 2010 and then decreased from 2010 to 2020.According to the value of ERI,we divided the ecological risk into seven levels by natural breakpoint method;the higher the level,the higher the ecological risk.For the four scenarios in 2030,under the EPP scenario,the area at VII level was zero,while the area at VII level reached the largest under the RED scenario.Comparing with 2020,the areas at I and II levels increased under the BAU,EPP,and EEB scenarios,while decreased under the RED scenario.The spatial distributions of ecological risk of BAU and EEB scenarios were similar,but the areas at I and II levels were larger and the areas at V and VI levels were smaller under the EEB scenario than under the BAU scenario.Therefore,the EEB scenario was the optimal development route for Turpan City.In addition,the results of spatial autocorrelation showed that the large area of unused land was the main reason affecting the spatial pattern of ecological risk under different scenarios.According to Geodetector,the dominant driving factors of ecological risk were gross domestic product rating(GDPR),soil type,population,temperature,and distance from riverbed(DFRD).The interaction between driving factor pairs amplified their influence on ecological risk.This research would help explore the low ecological risk development path for urban construction in the future.

Imperative for long-term management and surveillance in Kawasaki disease

Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.

Enhancing perianal disease management with integrated physical and psychological approaches

This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

Advancing gastrointestinal stromal tumor management: The role of imagomics features in precision risk assessment

BACKGROUND Gastrointestinal stromal tumors(GISTs)vary widely in prognosis,and traditional pathological assessments often lack precision in risk stratification.Advanced imaging techniques,especially magnetic resonance imaging(MRI),offer potential improvements.This study investigates how MRI imagomics can enhance risk assessment and support personalized treatment for GIST patients.AIM To assess the effectiveness of MRI imagomics in improving GIST risk stratification,addressing the limitations of traditional pathological assessments.METHODS Analyzed clinical and MRI data from 132 GIST patients,categorizing them by tumor specifics and dividing into risk groups.Employed dimension reduction for optimal imagomics feature selection from diffusion-weighted imaging(DWI),T1-weighted imaging(T1WI),and contrast enhanced T1WI with fat saturation(CET1WI)fat suppress(fs)sequences.RESULTS Age,lesion diameter,and mitotic figures significantly correlated with GIST risk,with DWI sequence features like sphericity and regional entropy showing high predictive accuracy.The combined T1WI and CE-T1WI fs model had the best predictive efficacy.In the test group,the DWI sequence model demonstrated an area under the curve(AUC)value of 0.960 with a sensitivity of 80.0%and a specificity of 100.0%.On the other hand,the combined performance of the T1WI and CE-T1WI fs models in the test group was the most robust,exhibiting an AUC value of 0.834,a sensitivity of 70.4%,and a specificity of 85.2%.CONCLUSION MRI imagomics,particularly DWI and combined T1WI/CE-T1WI fs models,significantly enhance GIST risk stratification,supporting precise preoperative patient assessment and personalized treatment plans.The clinical implications are profound,enabling more accurate surgical strategy formulation and optimized treatment selection,thereby improving patient outcomes.Future research should focus on multicenter studies to validate these findings,integrate advanced imaging technologies like PET/MRI,and incorporate genetic factors to achieve a more comprehensive risk assessment.

Risk Assessment and Management of Hazardous Hydrological and Geological Processes in Ukraine

Due to long and irrational land-utilization, Ukraine deals with one of the most strained ecological situations in Europe. This work is devoted to the study of land resources transformation that was caused by human activity. The subject of study is to assess and forecast physical land and soil degradation, associated with the technical intensification of hazardous exogenous processes. The research is based on the use of methods of ecologic-geomorphological analysis, mathematical-statistical modeling and forecasting. This project gives characteristics to the main anthropogenic factors of threats and risks to land and soil, which take place in the territory of Ukraine. The estimation was conducted relatively dangerous hydrological and geological processes that are key factors of physical degradation of resources. These processes include erosion, flooding, secondary waterlogging, landslides and other collapsed phenomena. Graphic models reflect specific factors and environmental consequences of the most dangerous exogenous processes. Predicted is the development of dangerous hydrological and geological processes, influenced by technogenic factors. Different scenarios of physical land degradation are developed by the example of a specific technonatural geosystem. A measurement system of the sustainable usage and management of soil condition in Ukraine is improved.

On the Application of IPRA Tool in Risk Assessment and Management of International Construction Projects

Construction companies face threats from competition and must be able to adjust to modem technology and changes in customer expectations. These issues require efficient risk management techniques. The success of construction companies running projects in international markets depends on how the risks arise from the host country conditions as well as the project specific risk factors. Successful management of risks requires identification of risks, construction of a risk model which can be used to assess the magnitude of risks, and implementation of response strategies so that an acceptable risk-return balance can be achieved. The project success usually depends on the combination of all risks, response strategies used to mitigate risks, and a company＇s ability to manage them. There exists a need to develop risk models containing the risks of doing business in international markets and factors that affect manageability of these risks. One of the market＇s critical challenges is scheduled management and the understanding and application of program management. This paper uses systematic risk identification, classification and analysis, and measurement and response methodologies to help international contractors quantify the risks of project development and accomplishment.